ObjectiveTo understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District， Shanghai， and to provide references for promoting the utilization of preconception healthcare services under the new population policy. MethodsA questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District， Shanghai. The results were statistically analyzed. ResultsThe average age of the women was （31.7±4.5） years， 30.2% of whom were ≥35 years old. The proportion of women having their third or subsequent children was low， at 16.4%. A significant majority， 92.4%， were found to have various risk factors during initial pregnancy screening. The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%. Awareness of the free preconception check-up program in Jiading District was also low at 28.6%， and the utilization rate for these services was even lower at 7.69%. Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services， accounting for 63.6%. The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged ≤29 years old （OR=1.789， 95%CI： 1.033‒3.099）. Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy （OR=4.164， 95%CI： 2.627‒6.602）. Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy （OR=7.534， 95%CI： 4.954‒11.456）. Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services （OR=1.903， 95%CI： 1.083‒3.345）. ConclusionUnder the context of three-child policy， the proportion of women seeking three or more children in Jiading District is low. Most of these women have risk factors identified during initial pregnancy screenings. The utilization rate of preconception healthcare services and the awareness of the free preconception screening program in Jiading District are both low. Unplanned pregnancies remain the primary reason for failing to receive timely preconception healthcare services. Age， whether the pregnancy was planned， whether the women had received preconception healthcare services before their first baby and family history of chronic diseases are the main factors affecting the utilization of preconception healthcare services. Relevant departments should enhance the promotion of preconception healthcare service programs， especially for women of childbearing age who have not yet given birth， so as to improve the utilization rate of preconception health care services.

ObjectiveTo understand the acceptance of sex-related behaviors， sexual safety awareness， and refusal skills among junior high school students and conduct association analysis， and to provide a reference for the implementation of sex and reproductive health education for adolescents. MethodsA questionnaire survey related to knowledge of sexual and reproductive health was conducted among 478 students from two junior high schools in Jiading District， Shanghai. ResultsThe pass rate for sex and reproductive health knowledge among junior high school students was only 36.6%， with acceptance rates for dating， watching pornography， engaging in sexual behavior， pregnancy， and artificial abortion at 24.5%， 11.1%， 5.6%， 4.8%， and 5.9%， respectively. Binary logistic regression analysis showed that students who passed the sexual and reproductive health assessment had a significantly lower acceptance rate of sex-related behaviors than those who did not （aOR=1.666， 95%CI： 1.124‒2.470， P=0.011）. Adolescents with a passing knowledge of sexual and reproductive health （aOR=1.607， 95%CI： 1.060‒2.438， P=0.026） or a lower acceptance of sex-related behaviors （aOR=4.199， 95%CI： 2.804‒6.289， P<0.001） had higher awareness of sexual safety. Adolescents with a passing knowledge of sexual and reproductive health （aOR=1.691， 95%CI： 1.066‒2.684， P=0.026）， a lower acceptance of sex-related behaviors （aOR=1.756， 95%CI： 1.130‒2.729， P=0.012）， or higher awareness of sexual safety （aOR=2.872， 95%CI： 1.826‒4.516， P<0.001） had stronger skills to refuse sex-related behaviors. ConclusionSexual and reproductive attitudes， sexual safety awareness， and refusal skills for sex-related behaviors among junior high school students in Jiading District need to be improved. Schools should focus on cultivating adolescents’ sexual and reproductive knowledge and related skills， and advocate for relevant institutions to provide appropriate sexual healthcare services to meet their needs for reproductive healthcare.

Objective     To investigate the safety and feasibility of day surgery for patients with palmar hyperhidrosis based on the principles of enhanced recovery after surgery (ERAS). Methods     We retrospectively reviewed the medical records of consecutive patients who underwent endoscopic thoracic sympathicotomy (ETS) in the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to December 2021. Patients were divided into a day surgery group and a conventional group according to their perioperative management methods. The patients in the day surgery group underwent an optimized perioperative procedure under the guidance of ERAS, and were ventilated with a laryngeal or face mask during the operation. The patients in the conventional group completed the preoperative examination, operation and postoperative observation according to the conventional procedures, and were intubated with a single-lumen endotracheal tube. The demographic characteristics, operation time, hospital stay, postoperative complications, and hospitalization cost were compared between the two groups. Results     Finally 172 patients were collected, including 90 males and 82 females, with an average age of 25.97±7.43 years. There were 86 patients in each group. All patients ceased suffering from palmar sweating after surgery. No patient experienced massive bleeding or conversion to thoracotomy. There was no statistical difference in operation time between the two groups (P=0.534). Patients in the day surgery group were discharged within 24 hours. The average hospital stay in the conventional group was 2.09±0.41 days. Incidence of postoperative respiratory complications, and the hospitalization cost of the day surgery group were significantly lower than those of the conventional group (P<0.001). The satisfaction rate in both groups was greater than 95%. Conclusion     Day surgery for patients with palmar hyperhidrosis based on the principles of ERAS is safe and feasible, which can reduce postoperative complications, shorten the length of hospital stay and save the cost of hospitalization.

Objective:To explore the relationship between family cumulative risk, non-adaptive cognitive emotion regulation, school climate and depression of junior high school students.Methods:From June to September 2022, a total of 1 136 junior high school students were surveyed by the family cumulative risk questionnaire, the cognitive emotion regulation strategy questionnaire, the self-rating depression scale for children and school climate scale.The mediating effect of non-adaptive cognitive emotion regulation and the moderating effect of school climate were tested by the Macro program PROCESS of SPSS 25.0 software.Results:Family cumulative risk score was 1.00(2.00), non-adaptive cognitive emotion regulation score was 21.00(8.00) and depression score was 7.00(9.00). (2) Family cumulative risk was significantly positively correlated with non-adaptive cognitive emotion regulation( r=0.28, P<0.01) and depression( r=0.43, P<0.01). There was a significantly positive correlation between non-adaptive cognitive emotion regulation and depression( r=0.41, P<0.01), and a significantly negative correlation between school climate and depression( r=-0.56, P<0.01). (3) Non-adaptive cognitive emotion regulation played a partial mediating role between family cumulative risk and depression, and the direct effect and mediating effect accounted for 80.49%(0.33/0.41) and 19.51%(0.08/0.41)of the total effect respectively.(4) School climate played a moderating role in the influence of family cumulative risk on non-adaptive cognitive emotion regulation. Under the condition of the level of school climate was high, the positive predicting effect of family cumulative risk on non-adaptive cognitive emotion regulation was significantly enhanced( Bsimple=0.34, P<0.001). Conclusion:Family cumulative risk plays a certain role in depression through the mediation of non-adaptive cognitive emotion regulation strategies and the regulation of school climate in junior high school students.

Objective : To investigate the effect of hypoxia/cold exposure on white fat browning in an obese rat model . Methods : Obese rat model was constructed by high⁃fat feeding and randomly divided into control group , of body weight and body fat were observed , and the morphological changes of rat adipose tissue cells were observed using HE staining and compared with the area of adipocytes . The expression of peroxisome proliferator⁃activated receptor γ2 (PPAR⁃γ2) , PR structural domain binding factor 16 ( PRDM16) and uncoupling protein 1 ( UCP⁃1) gene and the expression of UCP⁃1 protein in the adipose tissue of rats were examined by immunofluorescence , realtime fluorescence quantitative PCR and Western blot . Results : Compared with the control group , the body weight and body fat of rats in the hypoxic , hypothermic and cryogenic hypoxic groups were reduced , and the body weight and body fat of rats in the hypothermic hypoxic group were lower than those in the hypoxic and cryogenic groups (P< 0. 05) . Compared with the control group , the adipocyte area of rats in the hypoxia , hypothermia and low⁃temperature hypoxia groups was reduced , and the adipocyte area of rats in the low⁃temperature hypoxia group was lower than that in the hypoxia and low⁃temperature groups (P < 0. 05) . Compared with the control group , the expression of PPAR⁃γ2 , PRDM16 and UCP⁃1 genes all increased in the scapular brown adipose tissue ( F = 378. 495 , 102. 061 , 322. 443 , P < 0. 05) and decreased in the perirenal white adipose tissue (F = 4. 555 , P < 0. 05) in the hypoxic , hypothermic and low⁃temperature hypoxic groups of rats , PRDM16 and UCP⁃1 gene expression all increased (F = 24. 387 , 163 . 660 , P < 0. 05) . Compared with the control group , the expression of UCP⁃1 protein in scapular brown adipose tissue and perirenal white adipose tissue of rats in the hypoxic , hypothermic and low⁃temperature hypoxic groups increased (P < 0. 05) ; UCP⁃1 protein expression was lower in scapular brown adipose tissue and perirenal white adipose tissue of rats in the hypoxic and hypothermic groups compared to the hypothermic hypoxic group (P < 0. 05) . Conclusion Hypoxia/cold exposure can induce white adipose browning and affect the body weight of rats by modulating the intra⁃adipose PPAR⁃γ2 and PRDM16 pathways which lead to high UCP⁃1 expression .

ObjectiveTo understand the influencing factors of women’s intention to utilize preconception health care services， so as to promote the utilization of preconception care among women with future pregnancy plan. MethodsThe study was conducted at 8 outpatient health clinics of medical institutions providing perinatal health care in Jiading District of Shanghai. Women who had fertility intention for another child were invited to complete an electronic questionnaire from November 2020 to February 2021. ResultsWomen with better pregnancy and birth care behaviors during the last periconception were more likely to utilize preconception care service before the next conception than those with previous poorer behaviors （OR=1.980， 95%CI= 1.061‒3.694， P=0.032）. Women with higher preconception care knowledge scores had better pregnancy and birth care behaviors during the last periconception than those with lower knowledge scores （OR=1.362， 95%C1= 1.004‒1.846， P=0.047）. ConclusionsIn order to improve the utilization of preconception care among the population with future pregnancy plan， it is necessary to further strengthen health education and social mobilization to promote the preconception eugenic knowledge， planned pregnancy and pregnancy and birth care behaviors.

Objective:To investigate the relationship between life events, cognitive emotional regulation strategies, neuroticism and depression in pregnant women and the internal mechanism of action.Methods:Short-term longitudinal follow-up design were used in this study.A total of 327 pregnant women in the third trimester of pregnancy were investigated with pregnant women's life events scale, cognitive emotion regulation strategy questionnaire, neuroticism subscale of Chinese big five personality questionaire-short form at T1 time point, and patient health questionnaire 9 were measured after 6 weeks(T2).SPSS 20.0 macro program PROCESS was used to examine the mediating effect of cognitive emotion and the moderating effect of neuroticism.Results:(1) The incidence of depression in the third trimester pregnant women was 12.23%.(2)There was significant positive correlation between the total score of life events in pregnant women(T1) and the total score of non-adaptive cognitive emotional regulation strategies(T1) ( r=0.25, P<0.01).Total neurotic personality(T1) and total depressive mood(T2) were significantly positively correlated ( r=0.46, P<0.01).The total scores of life events(T1) of pregnant women were significantly positively correlated with the total scores of depression(T2) ( r=0.36, P<0.01).(3) The non-adaptive cognitive emotion regulation strategy (T1) played a partial mediating role between life events (T1) and depression (T2).The direct effect (effect size=0.29) and the mediating effect (effect size=0.07) accounted for 80.55% and 19.44% of the total effect (effect size=0.36).(4) Neuroticism regulates the second part of the mediating effect of the mediating model.Specifically, the higher the level of individual neuroticism, the stronger the positive predictive effect of non-adaptive cognitive emotion regulation strategies on maternal depression. Conclusion:Pregnant life events play a role in maternal depression through the mediating role of non-adaptive cognitive emotional regulation strategies and the moderating role of neuroticism.

Objective:The extensive development of anatomical pulnonary segmentectomy requires thoracic surgeons to be familiar with the anatomical variations of the lung segment. The purpose of this study is to analyze the anatomical patterns of the right upper lobe lung segment using three-dimensional reconstruction, and to count rare variant types.Methods:From October 2017 to March 2020, 101 patients with small pulmonary nodules who were undergo segmental resection in our center were subjected to preoperative three-dimensional reconstruction of the lung structure, and the reconstruction data was retained for the statistics and analysis of the anatomical structure in the right upper lung lobe.Results:The right upper lobe bronchus is the most common with three branches(77/101), followed by two branches(16/101) and four branches(7/101). The two branches(70/101) of the right upper lobe pulmonary artery are the most common, followed by single branch(19/101) and three branches(11/101). In rare cases, four branches(1/101 cases) can be seen. The two branches(63/101) of the right upper pulmonary vein were the most common, followed by three branches(32/101) and single branch(6/101). In addition, a total of 12 rare mutations were counted. There were 2 variants in the bronchus, totaling 2 cases; 4 rare variants in the pulmonary artery, 13 cases total; 6 rare variants in the pulmonary vein, 10 cases total.Conclusion:The lung anatomy is complex and has many variations. The surgeon should fully grasp the anatomical structure of the lung segment of the patient's operating area before surgery, the data in this article will be a valuable reference for thoracic surgeons to carry out the upper right lobe segmentectomy.

OBJECTIVE： To study the vasodilatory effect of oxysophocarpine （OSC） on isolated thoracic aortic rings of rats and its possible mechanism. METHODS： Thoracic aortic rings of rats were collected （called “vascular ring” for short）. Using K-H nutrient solution as blank control and the diastolic rate as index， the effects of different concentrations （0.2-1.0 mg/mL） of OSC on normal vascular rings in basal state， normal or endothelium-free vascular rings pre-contracted by norepinephrine （PE， 1×10－6 mol/L） were investigated. After pre-culturing normal thoracic aortic rings by nitric oxide synthase inhibitor L-nitro-arginine methyl ester（L-NAME）and cyclooxygenase inhibitor indomethacin（INDO），as well as pre-culturing endothelium-free vascular rings by potassium ion channel blocker BaCl2，tetraethylammonium（TEA）and 4-aminopyridine（4-AP）， the diastolic effects of OSC of different concentrations （0.2-1.0 mg/mL） on the above vascular rings were investigated by using the same method. RESULTS： Compared with blank control， there was no significant effects of different concentrations of OSC on the diastolic rate of normal vascular rings in basal state （P＞0.05）， but 0.4-1.0 mg/mL OSC could significantly improve the diastolic rate of normal or endothelium-free vascular rings pre-contracted by PE （P＜0.01）， in concentration-dependent manner. After preculturing with L-NAME， INDO， 4-AP and BaCl2， different concentrations of OSC had no significant effect on the diastolic rate of normal or endothelium-free vascular rings pre-contracted by PE （P＞0.05）. After pre-culturing with TEA and Gli， 0.4-1.0 mg/mL OSC could significantly reduce the diastolic rate of endothelium-free vas- cular rings pre-contracted by PE （P＜0.01）. CONCLUSIONS： OSC did not significantly dilate the thoracic aortic rings of rats in the basal state within the dose range （0.2-1.0 mg/mL）， but OSC of 0.4-1.0 mg/mL have significant diastolic effects on the normal or endothelium-free thoracic aortic rings of rats pre-contracted with PE. The mechanism of thoracic aortic rings dilation is endothelium-independent， which may be associated with receptor operational calcium channel，Ca2+-activated potassium channels and ATP-sensitive potassium channels.

Four hundred and twenty two patients with ureteral calculi undergoing surgical treatment from January 2016 to December 2016 were enrolled in the study.Urine samples were taken from upper and lower ureter of stone obstruction,pathogen examination and drug susceptibility tests were performed.Twenty nine strains of pathogens were isolated from the upper segment of ureter with a detection rate of 6.9%;22 strains were gram-negative bacteria(75.9%)and 3 strains were gram-positive bacteria(10.3%)and 4 strains were fungi(13.8%).Forty eight strains of pathogenic bacteria were isolated from the lower segment with a detection rate of 11.4%;37 strains were gram-negative bacteria(77.1%),11 strains were gram-positive bacteria(22.9%),no fungi was isolated.In 20 cases the positive results were obtained only from upper ureter urine samples, and in 39 cases the positive results were obtained only from lower segment samples.The same pathogens were detected from both upper and lower ureter of stone obstruction in 7 cases, and different pathogens were identified in 2 cases.The most common pathogens were Escherichia coli, followed by Proteus mirabilis, Klebsiella pneumoniae, Enterococcus faecalis and Enterococcus faecium.The resistance to quinolones in gram-negative bacteria was higher than that to cephalosporins.The resistance rate of Escherichia coli to cephalosporin was 36.7%-63.3%,that to ciprofloxacin and levofloxacin was 86.7%-100.0%; the resistance rate of Enterococcus to erythromycin was 100.0%.It is suggested that ureteral calculi obstruction may lead to negative culture results of conventional mid-stream urine samples.It is of clinical value to investigate the distribution and antibiotic resistance of pathogens both from upper and lower segments of ureter in patients with ureteral calculi.