OBJECTIVE To observe the efficacy of cetrorelix combined with aspirin in preventing early-onset ovarian hyperstimulation syndrome （OHSS）. METHODS A retrospective analysis was conducted on clinical data from 38 early-onset OHSS patients， who received treatment in our hospital from January 1st to July 1st， 2022. These patients were divided into intervention group （19 cases） and control group （19 cases） according to the therapy regimen. On the first day after oocyte retrieval surgery， the control group was given aspirin enteric-coated tablets 100 mg orally until menstruation began. The intervention group was given cetrorelix for injection 0.25 mg subcutaneously， for consecutive 3 days+aspirin enteric-coated tablets （same usage and dosage as the control group）. The first luteal phase， the degree of OHSS， and the ovarian volume， ascites volume， serum estradiol （E2）， white blood cell count （WBC）， hematocrit （HCT）， neutrophil ratio （NEUT%）， D-dimer （DD）， prothrombin time （PT）， fibrinogen （Fib） after oocyte retrieval surgery were observed and measured in 2 groups. RESULTS The first luteal phase was significantly shorter， and the proportions of median and severe OHSS cases were significantly lower in the intervention group compared to the control group （P＜0.05 or P＜0.01）. After oocyte retrieval surgery， the intervention group showed significantly lower ovarian volume， ascites volume， serum E2， WBC， NEUT%， HCT， DD and Fib compared to the control group， but PT of intervention group was signiticantly higher than that of control group （P＜0.05）. CONCLUSIONS Cetrorelix combined with aspirin is more effective in preventing early-onset OHSS than aspirin alone.

Objective To investigate the effects of nicorandil combined with rosuvastatin calcium on monocyte-to-high density lipoprotein cholesterol ratio (MHR), systemic immune-inflammation index (SII), and cardiac function in patients with coronary slow flow (CSF). Methods A group case-control study was used to select 240 patients with CSF confirmed by coronary angiography, and they were randomly divided into observation group and control group, with 120 patients in each group. On the basis of conventional drug treatment, the control group was treated with rosuvastatin calcium, while the observation group was treated with nicorandil combined with rosuvastatin calcium for 6 months. Clinical efficacy, inflammatory markers[high-sensitivity C-reactive protein (hs-CRP), MHR, SII], corrected TIMI frame count (CTFC) of major coronary branches [left anterior descending branch (LAD), left circumflex branch (LCX), right coronary artery (RCA)], cardiac function indicators[left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), global longitudinal strain (GLS)], and the occurrence of major adverse cardiovascular events (MACE) were compared between the two groups. Results The total effective rate in the observation groupwas significantly higher than that in the control group (95.00% versus 80.00%, P < 0.05). After treatment, the duration, severity, andfrequency of angina pectoris attacks were reduced or shortened in both groups, with more changes observed in the observation group (P < 0.05). Serum levels of hs-CRP, MHR, and SII were lower in both groups after 6 months of treatment, and the observation group with significantly was lower compared to the control group (P < 0.05). CTFC values of LAD, LCX, and RCA were also lower in both groups after 6 months, with the observation group showing significantly lower values (P < 0.05). The absolute values of LVEF and GLS increased in both groups after 6 months of treatment, and the observation group was higher than the control group (P < 0.05). However, no significant difference was observed in LVEDD and occurrence of MACE between the two groups (P>0.05). Conclusion The application of nicorandil combined with rosuvastatin calcium in the treatment of CSF patients can significantly improve the overall treatment efficacy, reduce hs-CRP, MHR, and SII levels, enhance cardiac function indicators such as LVEF, LVEDD, and GLS, and effectively alleviate the severity of angina pectoris attacks.

Objective To investigate the mechanism of Yes-associated protein 1(YAP1)ameliorating aristolochic acid 1(AAI)-induced liver injury in mice based on untargeted metabolomics techniques.Methods There were 83-week-old male hepatocyte-specific Yap1 gene knockout mice(genotyped as Yap1Flox/Flox,Albumin-Cre,aka.Yap1LKO)were randomly selected as the Yap1LKO+AAI group,and 8 Yap1Flox control mice as the Yap1Flox+AAI group.Both groups were injected intraperitoneally with AAI at a dose of 2.5 mg·kg-1·d-1 for 14 consecutive days.Genotypes were identified by tail PCR;serum alanine transaminase(ALT)and aspartate transaminase(AST)activities were determined by microplate assay;histopathological changes of liver tissue were observed by HE staining;and the protein expression of YAP1 in liver tissue was determined by immunohistochemistry.The untargeted metabolomics approach was used to analyze the liver tissue differential metabolites,and the samples were analyzed by ultra performance liquid chromatography-quadrupole-electrostatic field orbit trap high-resolution mass spectrometry,and the differential metabolites were screened by principal component analysis(PCA),Partial least square-discriminant analysis(PLS-DA),and orthogonal partial least squares-discriminant analysis(OPLS-DA);using HMDB database and METLIN database to identify metabolites,and the pathway enrichment of differential metabolites was analyzed by KEGG database.Results(1)After 14 days of AAI induction,the increase of body mass in Yap1LKO mice was lower than that in Yap1Flox mice,but there was no statistical significance(P＞0.05).On day 14,compared with the Yap1Flox+AAI group,the serum ALT and AST enzyme activities in the Yap1LKO+AAI group of mice were significantly increased(P＜0.05),and the histopathological damage of the liver was significantly aggravated.The livers of the Yap1Flox mice had a positive protein expression of YAP1,whereas the Yap1LKO mice did not have a positive protein expression of YAP1.(2)A total of 139 differential metabolites with significant changes(VIP＞1 and P＜0.05)were screened by metabonomic analysis;compared with Yap1LKO+ AAI group,62 liver metabolites in Yap1Flox+AAI group were up-regulated,including choline,taurine,hypotaurine,α-linolenic acid,eleostearic acid,chenodeoxycholic acid and so on.Seventy-seven metabolites were down-regulated including glycerophosphocholine,L-phosphatidylcholine,L-glutamine,L-serine,L-glutathione,5-methionine,phenylalanine,glucose 6-phosphate,lactic acid,uric acid glycosides,etc..KEGG-enriched pathways were mainly choline metabolism,glycerophospholipid metabolism,insulin resistance,glutathione metabolism,etc..Conclusion Hepatocyte-specific Yap1 gene knockout exacerbated AAI-induced liver injury in mice,and YAP1 was involved in the regulation of choline metabolism and glycerophospholipid metabolism through the up-regulation of unsaturated fatty acids,such as choline and taurine,which ameliorated AAI-induced liver injury in mice.

【Objective】 To investigate the status quo of disease perception and partner support of erectile dysfunction (ED) patients, and to analyze their correlation. 【Methods】 With convenient sampling method, 220 ED patients in a first-class hospital in Taiyuan were surveyed with the short version of disease perception questionnaire (BIPQ) and partner support coping questionnaire (DCI). 【Results】 The BIPQ score was (41.90±7.33), and the DCI score was (116.79±20.37). Pearson correlation analysis showed that except life influence, treatment control and emotional influence, the mutual support dimension of partner support of ED patients was correlated with all dimensions of disease perception (r=-0.173, 0.151, -0.182, 0.163, 0.188,P<0.05).Except cognitive comprehension, the negative support dimension of partner support of ED patients was correlated with the dimensions and total score of disease perception (r=0.399, 0.185, -0.167, -0.306, 0.269, 0.445, 0.320, 0.357,P<0.05). 【Conclusion】 ED patients have negative disease perception, and their partners have better coping strategies. Medical staff may pay more attention to partner support so as to reduce patients’ negative perception of disease and promote recovery.

The aim of this study is to investigate the immune effect of H9 subtype avian influenza virus(AIV)NP protein on mice and lay the foundation for the development of avian influenza vi-rus(AIV)vaccine.The H9N2 virus NP gene amplification product was cloned into the pET-32a expression vector,and the protein expression was verified by SDS-PAGE and Western blot,and the immune effect was evaluated by measuring the secretion of supernatant multicytokines in mouse splenocytes culture.The results showed that the total length of the coding region sequence of NP gene was 1 497 bp,NP recombinant proteins exist in both soluble and insoluble protein forms,and the specific bands were visible in Western blot.After immunizing mice,serum produces IgG-bind-ing antibodies with antibody titers of 1∶40 000.Compared with the control group,IL-2,IL-5 and IL-13 were significantly increased(P＜0.001),and the secretion of IL-6 was significantly increased compared with the control group.IL-4 and IL-12 p70 secretions were elevated compared with con-trols,but there was no significant difference.Compared with the control group,the secretions of IL-1β,IL-18,GM-CMF,TNF-α and IFN-γ were inhibited,but the difference was not significant(P＞0.05).The results showed that NP recombinant protein is a good immunogen,laying a foundation for in-depth research on influenza vaccine.

Objective To verify the diagnostic efficiency and application value of fecal syndecan 2(SDC2)gene methylation detection in intestinal tumor screening.Methods The clinical data of 1 456 patients with fecal SDC2 gene methylation detection in this hospital from November 2021 to December 2023 were ana-lyze retrospectively.The detection positive rate,colonoscopic compliance,sensitivity,specificity,positive pre-dictive rate and negative predictive rate were analyzed.The pathological diagnosis served as the gold standard.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to judge the diagnostic effect.Results In the results in 1 456 cases of fecal SDC2 gene methylation detection,90 cases were positive with a positive rate of 6.2％.The positive rate had no statistical difference between different sexes(P＞0.05).The positive rate in the patients ≥50 years old was higher than that in the patients＜50 year old(P＜0.05).Among 90 cases of detection results positive,67 cases completed the enteroscopic examination and the enteroscopic compliance rate was 74.4％.The enteroscopic compliance rate had no statistical difference be-tween the different sexes and among different ages of patients(P＞0.05).Among 67 cases of enteroscopic ex-amination completion,there were 6 cases(9.0％)of colorectal cancer,17 cases(25.4％)of progressive stage adenoma,15 cases(22.4％)of non-progressive stage adenoma,6 cases(9.0％)of non-adenomatous polyp and the lesion detection rate was 65.7％.Among 112 cases of fecal SDC2 gene methylation detection negative,there were 2 cases(1.8％)of progressive stage adenoma and 22 cases(19.6％)of non-progressive stage ade-noma.The sensitivity and specificity of this detection for colorectal cancer and progressive stage adenoma were 92.0％and 71.4％,respectively,which had obvious diagnostic significance for colorectal tumor(AUC=0.721,P＜0.001).Conclusion The fecal SDC2 gene methylation detection has an important clinical value in the preliminary screening of colorectal cancer.

Objective:To explore the multidisciplinary management that centred on gastroenterology department, and follow-up study of children with Alagille syndrome(ALGS).Methods:The clinical data of 19 children diagnosed with ALGS in Pediatric Gastroenterology Department, Shengjing Hospital of China Medical University since June 2013 to December 2022 was retrospectively analyzed, and the clinical manifestations of various systems of the body were followed up and evaluated, and then developed the personalised management strategies.Results:Among the 19 confirmed patients, 18 cases were confirmed by genetic testing.Eighteen cases(94.7%) had characteristic facial features.To follow-up node, 8 cases(42.1%) had cholestasis, with alanine aminotransferase(210.20±110.50)U/L, aspartate aminotransferase(187.86±96.70)U/L, and direct bilirubin(110.93±108.15)μmol/L.Eighteen cases(94.7%) had pruritus.Eighteen cases(94.7%) of the patients had a high risk of malnutrition, and the level of total bilirubin[(76.17±107.34)μmol/L] and total bile acid[(100.18±83.78)μmol/L] were significantly increased in the children with obvious growth retardation.Thirteen cases(68.42%) had diffuse liver injury.The clinical opinions on genetic counseling, application of new drugs, liver transplantation, cardiac medicine and surgery follow-up, spine and oral surgery orthodontics were given by multiple disciplines.Conclusion:ALGS children have a high risk of long-term malnutrition and are associated with the severity of liver injury, and pruritus and jaundice are the main clinical manifestations.The management of ALGS patients should be centered around liver disease doctors, combined with multiple disciplines, paying attention to changes in various related organs of ALGS patients, and improving their quality of life.

The effect of anti-programmed cell death 1 (anti-PD-1) immunotherapy is limited in patients with hepatocellular carcinoma (HCC). Yes-associated protein 1 (YAP1) expression increased in liver tumor cells in early HCC, and Akkermansia muciniphila abundance decreased in the colon. The response to anti-PD-1 treatment is associated with A. muciniphila abundance in many tumors. However, the interaction between A. muciniphila abundance and YAP1 expression remains unclear in HCC. Here, anti-PD-1 treatment decreased A. muciniphila abundance in the colon, but increased YAP1 expression in the tumor cells by mice with liver tumors in situ. Mechanistically, hepatocyte-specific Yap1 knockout (Yap1^LKO) maintained bile acid homeostasis in the liver, resulting in an increased abundance of A. muciniphila in the colon. Yap1 knockout enhanced anti-PD-1 efficacy. Therefore, YAP1 inhibition is a potential target for increasing A. muciniphila abundance to promote anti-PD-1 efficacy in liver tumors. Dihydroartemisinin (DHA), acting as YAP1 inhibitor, increased A. muciniphila abundance to sensitize anti-PD-1 therapy. A. muciniphila by gavage increased the number and activation of CD8⁺ T cells in liver tumor niches during DHA treatment or combination with anti-PD-1. Our findings suggested that the combination anti-PD-1 with DHA is an effective strategy for liver tumor treatment.

Objective:To combine sexology with nursing teaching organically, and construct the content index of the elective course Introduction to Sexology for nursing master, so as to provide reference for promoting the construction of new medical education in China.Methods:This study was a cross-sectional survey. The elective course content of Introduction to Sexual Science for Master of Nursing was preliminarily drawn up through literature analysis,by consulting the literature and materials. From June to October in 2021, by using Delphi method, 20 sexual science experts from 9 provinces and municipalities with relevant experience in master′s teaching were interviewed for two rounds. After statistical processing, the course content indicators were selected according to the importance assignment, coefficient of variation, full score rate and recognition rate of the indicators, and the course content indicators were determined.Results:The positive coefficients of experts in two rounds of correspondence were 83.33% and 100.00% respectively, the authoritative coefficients of experts were 0.818 and 0.815 respectively, and Kendall's harmonious coefficients were 0.137 and 0.403 respectively. The course content of "Introduction to Sexual Science" was composed of 11 first-level indicators and 46 second-level indicators. Its importance value was 4.15-5.00, the coefficient of variation was 0.000-0.136, the full score rate was 20.00%-100.00%, and the recognition rate was 95.00%-100.00%.Conclusion:The course content of "Introduction to Sexual Science" for nursing postgraduates constructed in this study takes the knowledge of sexual psychology and sociology as the core, pays attention to the cultivation of sexual values, combines theoretical knowledge of sexual medicine with clinical practice ability, and has high enthusiasm and authority of experts and good coordination of opinions. It is of positive significance to supplement the lack of sexual health courses for nursing postgraduates and cultivate nursing postgraduates with certain sexual health care literacy.

Objective:To construct a death education intervention program for advanced cancer caregivers to improve the reference for death education for advanced cancer caregivers.Methods:Content analysis, semi-structured interview, Delphi expert consultation method were used to develop a preliminary death education program based on the theory of knowledge, belief, and behavior. From April to May 2022, fifteen experts from palliative care, life and death education, oncology nursing, psychological nursing and other related fields were selected for two rounds of expert consultation, and the contents of the program were revised and improved through preliminary experiments.Results:After two rounds of expert consultation, the results showed that the expert opinions tend to be unanimous. The authoritative coefficient of experts was 0.87, and the Kendall coordination coefficients of feasibility, validity and scientificity of the two rounds of consultation were 0.181, 0.303, 0.363 and 0.249, 0.355, 0.366, respectively (both P<0.05). The preliminary experiments revised and improved the intervention frequency and content, and finally formed a death education intervention program for advanced cancer caregivers which included four-stage progressive death themes: made an appointment with death, made a discussion on death, made an embrace with death and made friends with death. Conclusions:The process of constructing a death education program for advanced cancer caregivers is scientific, and the content is feasible, valid, and scientific. In addition, it is of great significance to promote death education in palliative care.