Objective To compare the efficacy of three different methods in the prevention of adhesion after the HEOS system for different degrees of intrauterine adhesions.Methods 284 patients with mild,moderate and severe intrauterine adhesions,who were treated with the HEOS system,were divided into three groups,the intrauterine device with sodium hyaluronate gel was placed in Group A,Foley water capsule tube with sodium hyaluronate gel was placed in Group B,and sodium hyaluronate gel was placed in Group C only.The recovery of uterine adhesion,improvement of menstruation,endometrial thickness,and adverse reactions were compared among the three groups.Results The mild intrauterine adhesions group showed statistical differences among the three groups(P<0.05).Group A had a higher menstrual improvement rate than Group C(P<0.017),and there was no significant difference in other therapeutic indicators(P>0.017).However,the adverse reaction rate in Group A was also higher than that in Group C(P<0.017).In the moderate intrauterine group,there was a significant difference in the improvement rate of intrauterine adhesions between Group B and the other two groups(P<0.017).Group A and B were higher than Group C in terms of menstrual status,endometrial thickness,and adverse reactions(P<0.017).In severe intrauterine adhesions,Group A had higher efficacy indicators than other groups(P<0.017).Conclusions The curative effect index and adverse reaction rate were analyzed,after operation.For the light,moderate,and severe intrauterine adhesions,sodium hyaluronate gel,Foley water capsule tube with sodium hyaluronate gel,and intrauterine device with sodium hyaluronate gel were the best choice for adhesion.Individual and hierarchical management can achieve good clinical effects,which is worth popularizing.

Objective To study the effect of silica in soil on the extraction of biological evidence DNA at the crime scene using the silica bead method.Methods Mud suspension and diluted blood were mixed to prepare biological samples mixed with dust and soil,which is to simulate biological evidence at the crime scene.Cell lysis was performed using heating lysis and guanidine salt chemical lysis,respectively.DNA was extracted using the silica bead method,amplified by PCR using Identifiler Plus kit and detected by capillary electrophoresis.The electrophoresis results were compared.Using mud suspension instead of silica beads to extract diluted blood DNA to validate the effect of silica in soil on the extraction of biological evidence DNA at crime scene using silica beads method.Results The complete STR loci were obtained after the extraction and amplification of 4 μL,20 μL dilute blood mixed with mud and lysed with heating cracking,whoes average peak heights arel 969.7±376.9 RFU and 9 706.7±349.8 RFU.For the 4 μL dilute blood mixed with mud guanidine salt chemical lysis,it cannot obtain complete STR loci after extraction and amplification.20 μL dilute blood mixed with mud guanidine salt was chemically cleaved and amplified to obtain complete STR loci with an average peak height of 1 899.8±801.3 RFU.After extraction and amplification by mud suspension instead of silica beads to extract 20 μL diluted blood DNA,complete STR loci were obtained.Conclusion Silicon dioxide in soil can bind to DNA in the presence of guanidine salts,leading to a decrease in the efficiency of recovering on-site biological evidence DNA using the silicon bead method.

Inflammation is a key player in various pathophysiological processes and diseases, especially throughout the gestational cycle, and inflammation plays an important role in ovulation, embryo implantation, placental formation, and all stages of pregnancy maintenance. However, excessive inflammatory activity can impair endometrial receptivity, which can lead to clinical problems such as infertility, recurrent implantation failure, and recurrent miscarriage, which in turn can negatively impact women's reproductive health and pregnancy outcomes. Studies have shown that about two-thirds of embryo implantation failures are associated with inadequate endometrial receptivity. Therefore, the precise regulation of inflammatory states is of great significance for increasing pregnancy rates and improving pregnancy outcomes.

Based on the Delphi method, combined with the results of the previous literature study and expert interviews, 3 rounds of expert consultation were conducted to evaluate the degree of concentration of expert opinions and their importance from 3 aspects: arithmetic mean, full score ratio ( Ki), and rank sum ( Si), to construct a diagnostic scale for rheumatoid arthritis (RA) cold-dampness syndrome. In this study, 30 expert questionnaires were distributed in the 1st round, 30 questionnaires were recovered, and the expert coordination coefficient was 0.309; 30 expert questionnaires were distributed in the 2nd round, 30 questionnaires were recovered, and the expert coordination coefficient was 0.320; and 30 expert questionnaires were distributed in the 3rd round, 29 questionnaires were recovered, and the expert coordination coefficient was 0.387. The maximum value of the coefficient of variation of the experts of the 3 rounds was 0.27, and the minimum value was 0.09, suggesting that the consistency and credibility of the experts' evaluation of the importance of the entries of cold-dampness syndrome were high. In this study, the mean values and weights of 17 entries were finally obtained, of which the top 5 entries were cold pain in joints (4.793, 0.066 6); aggravated by cold (4.586, 0.063 7); white tongue coating (4.552, 0.063 2); aggravated in cloudy and rainy days (4.448, 0.061 8); and painful joints that are not warm to the touch (4.379, 0.060 8). This study completed the screening of relevant entries and conducted preliminary discussions, laying the foundation for constructing a diagnostic scale for RA cold-dampness syndrome and forming the final diagnostic criteria. The research method is scientific and reliable, which can provide reference for the diagnostic standard of RA cold-dampness syndrome, but further clinical practice research is still needed.

Acute hematogenous pulmonary tuberculosis (AHPTB) during pregnancy, combined with acute respiratory distress syndrome (ARDS) and septic shock, is a rare and fatal condition. The two reported patients both underwent in vitro fertilization and embryo transfer (IVF-ET) to assist in pregnancy due to tubal factors. They developed critical AHPTB after pregnancy and subsequently developed respiratory failure. After assisted breathing, early anti tuberculosis treatment, and symptomatic treatment, both patients improved their condition. For women who are pregnant after IVF-ET due to tubal infertility in areas with high incidence of tuberculosis, if they have persistent fever, cough, expectoration and vaginal bleeding during pregnancy, they should be alert to the possibility of tuberculosis and be screened as soon as possible. For patients with pregnancy complicated with AHPTB, active treatment and vigilance against worsening of the condition should be taken.

The pharmacy department of medical institutions assumes important responsibilities in the emergency response work.The standard of pharmacy administration in emergencies is formulated based on the principles of scientificity,versatility,instructiveness,and operability,through sorting out problems,collecting opinions and expert argumentation.This standard has 49 standards of 9 key elements from three aspects:emergency mechanism,emergency support,and emergency services.This article aims to introduce the construction method and formulation process of the pharmacy administration in emergency standards,and analyzes the content,to guide for improving emergency response ability of the medical institutions'pharmacy department in emergency events.

Sepsis is a systemic inflammatory syndrome induced by infection and other factors， with the number of patients worldwide exceeding 10 million each year. The pathophysiological mechanism is of this disease complex. Sepsis is often accompanied by endotoxin translocation， gastrointestinal dysfunction， inflammatory cytokine activation， immune dysregulation， coagulation disorder， multiple organ function impairment and many other body imbalances， as well as systemic inflammation， apoptosis， oxidative stress injury and other cell damage mechanisms. This disease causes a heavy medical burden due to the difficult diagnosis and treatment and the poor prognosis. Great progress has been achieved in the diagnosis and treatment of sepsis with traditional Chinese medicine （TCM） and western medicine. The value of western medicine in the diagnosis and treatment of sepsis is limited due to antibiotic resistance， hormone abuse， and high medical costs. Sepsis is classified as a warm disease or typhoid fever in TCM. Da Chengqitang is a classical formula in the Treatise on Typhoid Fever to deal with the excess syndrome of Yang brightness Fu-organ. Modern medicine has proved that Da Chengqitang has the effect of inhibiting oxidative stress， reducing inflammation， and delaying apoptosis by improving gastrointestinal dynamics and regulating intestinal microecology. On the basis of the previous theoretical basis and the rich experience in the medication， medical practitioners have proposed a new therapeutic concept of using Da Chengqitang in combination with western drugs from a holistic view involving both bacteria and toxicity for treating both the symptoms and the root cause， which has a wide range of application. The article reviews the classical research and latest findings of Da Chengqitang in the treatment of sepsis， with a view to clarifying the mechanism and advantages of this formula in the adjuvant treatment of sepsis， exploring its potential efficacy， and providing timely， adequate， and scientific theoretical support for the promotion of this formula in the clinical practice.

Objective: To evaluate the effectiveness of family interventions among children with allergic rhinitis receiving immunotherapy, so as to provide insights into improvements of allergic rhinitis treatment. Methods: A total of 80 children with allergic rhinitis admitted to The First People's Hospital of Linping District from July 2018 to July 2021 were enrolled and randomly assigned into the control and intervention groups, of 40 participants in each group, and all children underwent immunotherapy. Children in the control group received routine interventions, while participants in the intervention group were given family interventions for 3 months, including health education, psychological counseling, and periodical follow-up. Parental awareness of allergic rhinitis was investigated using self-designed questionnaires, and the compliance to immunotherapy was evaluated. The clinical symptoms were evaluated using the symptom scores and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and the prognosis was evaluated using the Sino-Nasal Outcome Test-20 (SNOT-20). Results: There were no significant differences between the intervention and control groups in terms of gender, age, course of disease or disease severity (P>0.05). The scores for parental awareness of etiology [(9.56±0.25) vs. (7.45±0.85)], inducement factor [(8.84±0.62) vs. (6.76±1.36)], medication management [(9.56±0.25) vs. (7.97±0.85)] and daily life management of allergic rhinitis [(9.14±0.55) vs. (8.14±0.46)] were significantly higher in the intervention group than in the control group (P<0.05). The proportion of participants' compliance to immunotherapy was significantly higher in the intervention group than in the control group (92.50% vs. 75.00%, P<0.05). The scores for clinical symptoms [(3.12±0.94) vs. (3.96±1.23)], RQLQ score [(3.31±0.87) vs. (3.87±1.02)] and the SNOT-20 scores for nasal symptoms [(6.54±2.14) vs. (8.22±2.45)], sleep disorders [(4.11±0.58) vs. (5.24±1.03)], associated symptoms [(5.29±1.52) vs. (6.34±2.01)] and emotional consequences [(7.52±1.85) vs. (9.19±2.69)] were significantly lower in the intervention group than in the control group post-interventions (P<0.05). Conclusion Family interventions are effective to improve the compliance to immunotherapy, clinical symptoms, prognosis and quality of life among children with allergic rhinitis

Objective:To investigate the predictive value of mucosal vascular pattern (MVP) under narrow-band imaging (NBI) enteroscopy in patients with ulcerative colitis (UC) in clinical remission for histological healing and clinical recurrence.Methods:A total of 142 patients with UC in clinical remission who visited the First Affiliated Hospital of Weifang Medical University from January 2018 to January 2021 were included in the study and underwent colonoscopy. The white light and NBI endoscopic images were collected and biopsies were obtained. The Mayo endoscopic score (MES) was calculated based on white light images, and MVP staging was evaluated based on mucosal vascular patterns under NBI. Nancy index (NI) was used to evaluate histological healing and patients were followed up for 1 year. The Spearman correlation coefficients of MES and MVP with histological healing and recurrence were calculated. The receiver operator characteristic (ROC) curve was plotted and the area under curve (AUC) was applied to evaluate the accuracy of white light and NBI endoscopy for predicting histological healing of UC in clinical remission.Results:According to the MVP criteria, 47 were defined as clear, 63 blurred, and 32 invisible. Spearman correlation analysis showed a significant correlation between MVP under NBI and histological healing ( r=0.549, P<0.001) and a moderate correlation between MES under white light and histological healing ( r=0.462, P<0.001). Spearman correlation analysis showed a moderate correlation between MVP under NBI and clinical recurrence ( r=0.451, P<0.001) and a moderate correlation between MES under white light and clinical recurrence ( r=0.352, P<0.001). AUC of NBI for diagnosing histological healing of UC in clinical remission was 0.809 (95% CI: 0.738-0.879), with a sensitivity of 84.6% (77/91) and specificity of 64.7% (33/51), superior to the white light endoscopy, of which AUC, sensitivity and specificity were 0.763 (95% CI: 0.678-0.848), 81.3% (74/91) and 66.7% (34/51). Conclusion:MVP staging under NBI could predict histological healing of UC patients in clinical remission and is superior to white light endoscopy.

Objective:To analyze the use of policy tools for rural-oriented tuition-waived medical student training policy and to provide relevant suggestions for the continuous promotion of the policy.Methods:With "rural-oriented tuition-waived medical students" as the key word, the policy texts were collected and screened from government portals. Using ROTHWELL disaggregated method to build the rural order directional medical students training policy analysis framework, applying Excel 2019 software for classification and coding of policy texts.Results:A total of 13 rural-oriented medical student training policy texts were screened and obtained. The X dimension of the policy analysis framework for rural order-oriented medical student training included three policy tools, namely, supply, environment and demand, and the Y dimension included three policy objectives, namely, available, usable, and retained. In X dimension, environmental policy tools were most frequently used. In Y dimension, the "retained" target had the highest frequency of use.Conclusion:There were differences in the frequency of using policy tools for targeted medical student cultivation in different policies. The frequency of using environmental tools is higher, which highlighted the attention of the state to medical and health services. The internal structure of policy tools is unbalanced, so the configuration of supply-oriented policy tools should be optimized, and the construction of demand-oriented policy tools should be emphasized. It is suggested to continuously optimize the combination of policy tools, improve the compatibility between policy tools and rural order-oriented medical student training, and pay attention to the sustainability of policy tools.