BACKGROUND:Oxidative modification of high-density lipoprotein occurs in patients with polycystic ovary syndrome.However,the relationship between oxidized high-density lipoprotein and ovulation dysfunction and its mechanism are unknown. OBJECTIVE:To investigate the effect and potential mechanism of oxidized high-density lipoprotein on ovarian granulosa cell apoptosis. METHODS:Polycystic ovary syndrome rat model was established,then the high-density lipoprotein was harvested from the rat serum of heart blood.The degree of oxidation of the high-density lipoprotein was detected by high-density lipoprotein inflammation index assay,malondialdehyde assay and lipoprotein agarose gel electrophoresis assay.The normal rat ovarian granulosa cells were isolated and treated with high-density lipoprotein and oxidized high-density lipoprotein isolated from the model rat serum.Cell viability was detected by CCK-8 assay.Cell apoptosis was detected by flow cytometry.The generation of reactive oxygen species was detected by H2DCF-DA staining.The p38 signaling activity was detected by western blot assay.Ovarian granulosa cells were pretreated with reactive oxygen species inhibitors N-acetylcysteine,tetramethylpiperidine(Tempol)and p38 inhibitor SB203580,and then treated with oxidized high-density lipoprotein.Finally,cell apoptosis,reactive oxygen species production and p38 signaling activity were detected. RESULTS AND CONCLUSION:A portion of the high-density lipoprotein from the serum of polycystic ovary syndrome model rats affected oxidative modification.High-density lipoprotein and oxidized high-density lipoprotein isolated from the model rat serum inhibited granulosa cell viability and promoted apoptosis(all P<0.05).They promoted rat granulosa cell reactive oxygen species production and p38 activation(all P<0.05).N-acetylcysteine,Tempol and SB203580 reversed oxidized high-density lipoprotein induced granulosa cell apoptosis(all P<0.05).N-acetylcysteine and Tempol suppressed oxidized high-density lipoprotein-induced p38 activation(all P<0.05).SB203580 did not have a regulatory effect on reactive oxygen species production(P>0.05).In summary,polycystic ovary syndrome can promote partial oxidative modification of high-density lipoprotein.The oxidized high-density lipoprotein promotes rat granulosa cell apoptosis by the activation of the reactive oxygen species-initiated p38 signaling pathway.

Objective To investigate the correlation of neutrophil to high-density lipoprotein cho-lesterol ratio(NHR)and lipoprotein(a)[Lp(a)]with occurrence of acute ischemic stroke(AIS)in elderly patients with non-valvular atrial fibrillation(NVAF).Methods A total of 301 elderly NVAF patients admitted to Hefei First People's Hospital from May 2020 to May 2023 were en-rolled,and according to whether they were combined with AIS or not,they were divided into stroke group(143 cases)and non-stroke group(158 cases).Binary logistic regression analysis was used to screen risk factors,and ROC curve was plotted to assess their predictive values for AIS.Results Lp(a)and NHR in stroke group were significantly higher than those in non-stroke group,the difference was statistically significant(P＜0.01).Multivariate binary logistic regression analysis showed that NHR and Lp(a)were independent risk factors for death with NVAF com-bined AIS(OR=1.728,95％CI:1.367-2.186,P=0.000;OR=1.005,95％CI:1.002-1.007,P=0.000);ROC curve analysis indicated that the AUC value of NHR and Lp(a)in diagnosing AIS in NVAF patients was 0.668 and 0.735,respectively,and that of their combination was 0.789,which was significantly higher than that of NHR and Lp(a)alone(P＜0.01).Conclusion NHR and Lp(a)are independently related to AIS in NVAF patients,and their combination has certain diagnos-tic efficacy.

Objective To analyze the effects of low-level laser therapy(LLLT)combined with elec-tromyogram-triggered neuromuscular electrical stimulation(ETNS)on upper limb function and quality of life in patients with subacute ischemic stroke.Methods A total of 52 patients with sub-acute ischemic stroke admitted to our hospital from January 2020 to October 2023 were recruited,and then randomly divided into control group(26 cases)and observation group(26 cases).Fugl-Meyer Motor Function Score-Upper Limb(FMA-UE),Trunk Injury Scale(TIS),Wolf Motor Function Test Scale(WMFT)-Time(TS)and Functional Ability(FS),Chinese version of Stroke Quality of Life Scale(SS-QOL)were used before treatment(day of enrollment)and after treat-ment(5 months after enrollment)to evaluate these patients.Results After treatment,the obser-vation group had obviously higher FMA-UE score,TIS score,WMFT-FS score and SS-QOL score than those before treatment(P＜0.05),and these scores were also notably higher than those in control group after treatment(P＜0.01).The WMFT-TS score in the observation group after treatment was statistically lower than that before treatment(P＜0.05),and also reduced than that of the control group after treatment(39.42±11.65 vs 46.12±11.89,P=0.045).Conclusion LLLT combined with ETNS shows good efficacy in improvement of upper limb function and quality of life in subacute ischemic stroke patients.

【Objective】 To discuss the prevention and control strategies of physical examination and health consultation for apheresis donation during the COVID-19 outbreak, and to verify its necessity and efficiency. 【Methods】 A three-stage (Hubei import period, Jan 23 to 31; local(Zhejiang) epidemic period( Feb 1 to Mar 1); overseas import period, Mar 2 to 22) prevention and control strategy for physical examination and health consultation during the COVID-19 outbreak from January 23 to March 22, 2020 was adopted by our center, and the consultation of residence history, contact history, and the investigation of related symptoms were added to health consultation.The deferral rates of health consultation and physical examination during the COVID-19 outbreak were compared with the same period in 2019. The deferral rates in each stage were compared, containing those contributed by first-time and regular apheresis donors. 【Results】 The deferral rates of health consultation during the epidemic period and the same period in 2019 were 2.31%(100/4 371) vs 1.62%(78/4 740) (P<0.05), the physical examination 3.75%(160/4 264) vs 1.07%(50/4 655) (P<0.01). The deferral rates of health consultation during the three stages were 2.32%(9/388) vs 3.49%(68/1 947)vs 1.13%(23/2 036) respectively(P<0.01), physical examination 2.12%(8/378)vs 3.68%(69/1 877)vs 4.13%(83/2 009)(P>0.05) The deferral rate of travel contact history was the highest at 2.05%(40/1947)during local epidemic period, and respiratory symptoms at 1.29%(5/388)during Hubei import period. The deferral rates of blood pressure during the three stages were1.85%(7/378)vs 3.57%(67/1877)vs 4.08(82/2009)(P>0.05). The deferral rate of health consultation and physical examination in first-time and regular apheresis donors were 5.86%(38/649)vs 1.65%(61/3 696)and 5.79%(35/604)vs 3.41%(124/3 635)(P<0.01). 【Conclusion】 The deferral rates of health consultation and physical examination increased significantly during the COVID-19 epidemic. Therefore, it is necessary to formulate and adopt a targeted consultation strategy during the epidemic period to block COVID-19 transmission to the greatest extent.

Objective:This study aimed to explore and analyze correlated factors of the characteristics of moderate and severe pain in head and neck cancer (HNC) patients after tissue flap repairment, to provide the basis for the following pain management.Methods:The convenience sampling method was used to enroll 239 patients who underwent tissue flap repairment at the Department of Oral and Maxillofacial Surgery, Peking University Hospital of Stomatology between December 2017 and December 2018 in this study. To classify the types of pain, Verbal Rating Scale (VRS) scores were used to collect the pain symptoms of patients with 6 time periods of wound, throat, infusion, other and non-intervention for 6 days, and analyze the characteristics and correlated factors of moderate and severe pain.Results:Eighty-seven of the 239 patients complained of moderate or severe pain. The distribution of patients age and education level had statistical differences in the presence or absence of moderate to severe pain ( P<0.05) . The cases of sore throat and frequency occurred most frequently among all types of pain. Conclusions:Although patient-controlled analgesia is given to patients after flap repairment, more than one-third of patients still complained of moderate and severe pain. Different types of pain have different characteristics, and throat pain occurred more frequently. Moderate pain was more common in male patients, while severe pain has a much higher proportion in female patients.

Objective:To conduct a longitudinal study on different social support needs of patients with acute myocardial infarction (AMI) at different stages undergoing emergency PCI based on timing it right framework combined with multidimensional model of social support, so as to provide reference for the implementation of accurate nursing.Methods:Using the interpretative phenomenological research method, a total of 21 emergency PCI patients from Department of Cardiology in two ClassⅢ Grade A hospitals in Taiyuan were selected from December 2019 to July 2020 by the purposive sampling method. According to the course of the disease, 4 semi-structured interviews were conducted on the patients, combined with participatory observation. The interpretive phenomenological analysis method was used to analyze the data, and the social support multi-dimensional model was used to classify the results.Results:A total of 23 themes were extracted. The information support requirements of each phase were in order of diagnosis and risk, AMI and PCI related knowledge, medical notification rights, individualized paper discharge guidance, causes of discomfort and first aid knowledge (the latter two phases were the same) . The tool support requirements for each phase were emergency medical services, advanced stents and emergency PCI technology, green channels, economic support and mobile health care resources (the latter two phases were the same) . The emotional support needs of each stage included companionship and sense of security, acceptance and encouragement, psychological adjustment and construction (the same in the next phase) and strengthening independence. The social network support needs of each stage included the assistance of strangers to send to the hospital, the virtue and skill of medical staff, peer support, and reintegration into society (the latter three stages were the same) . The need for self-esteem support in each period was believing that they can survive, taking care of themselves as much as possible, keeping their illness confidential, receiving recognition for their recovery and giving back to others.Conclusions:The social support needs of emergency PCI patients change with the course of the disease. It is recommended that medical staff adopt a dynamic and continuous care concept, establish and improve a framework of social support needs that meets the local humanities, so as to facilitate education, evaluation and intervention.

Objective: To explore the association between the frequency of prenatal care in childbearing aged women and risk of small for gestational age (SGA) among neonatal twins in Shaanxi Province. Methods: From July to December 2013, a total of 30 027 childbearing aged women, who were pregnant from January 2010 to November 2013 and had definite outcomes, were selected from 30 districts (counties) of Shaanxi Province by using the multi-stage random sampling method. The questionnaires with a face-to-face survey method were used to retrospectively collect demographic information, pregnancy history, lifestyle during pregnancy, disease history, nutritional supplements, and health care during pregnancy. Information on the gestational age and birth weight of the newborn were obtained by consulting the medical certificate of birth and were registered as twin A and twin B by birth order. Finally, 356 childbearing aged women and their twin babies with complete data were included in the analysis. A generalized estimation equation model was used to analyze the association between the frequency of prenatal care and the risk of SGA among neonatal twins. Results: The age of childbearing aged women was (27.44±4.68) years old, of which 79.49% (283 women) were rural residents and 44.38% (158 women) had seven or more times prenatal care. The gestational age and birth weight were (37.64±2.51) weeks and (2 510±497) g, respectively. The prevalence of SGA was 51.40% (183/356) for twin A and 53.37% (190/356) for twin B, respectively. The prevalence of SGA was 44.30% (70/158) for twin A with seven or more times prenatal care and 42.41% (67/158) for twin B with seven or more times prenatal care, which was lower than that for twins with less than seven times prenatal care, respectively [57.07% (113/198) and 62.12% (123/198)] (P values were 0.017 and <0.001). The results of generalized estimation equation model suggested that compared to those with less than seven times prenatal care, after adjusting for parity, birth order, place of residence, maternal age, occupation, education, family wealth index, passive smoking, pregnancy-induced hypertension syndrome, folic acid, and iron supplement during perinatal period, and gender of the newborn, the OR (95%CI) of risk of SGA among childbearing aged women with seven or more times prenatal care was 0.60 (0.40-0.91). Conclusion Seven or more times prenatal care could reduce the risk of SGA among neonatal twins in Shanxi Province.

Objective:To investigate the influence of indoxyl sulfate(IS), a typical protein-bound uremic toxin, on left atrial (LA) functional strains using three-dimensional speckle tracking echocardiography (3DSTE).Methods:From May 2019 to January 2020, 128 individuals were consecutively enrolled, including 37 healthy controls and 91 patients, who received maintenance hemodialysis (MHD) in the blood purification center of Zhongshan Hospital affiliated to Fudan University. Conventional echocardiographic parameters and 3DSTE datas of LA were obtained on interdialytic days.LA reservoir, conduit and contraction strains (LASr, LAScd and LASct) were calculated and compared. IS concentration in plasma was assessed by high-performance liquid chromatography tandem mass spectrometry in the MHD cohort.According to the IS concentration, the MHD group was divided into high and low IS (HI and LI) groups. The LA data were also compared between the two groups and linear regression analysis was used to identify independent impact factors of LA strains.Results:Compared to the control group, MHD group had markedly enlarged LA volumes( P<0.05). With regard to the LA phasic strains, both of LASr and LAScd were decreased( P<0.05), while LASct remained unchanged( P>0.05). Compared to the LI group, LASr, LAScd and LASct of the HI group were significantly decreased(all P<0.05). Correlation analysis showed IS concentration correlated well with LASr( rs=-0.674, P<0.001), LAScd( rs=0.454, P<0.001) and LASct( rs=0.376, P<0.001). After adjustment of age, systolic blood pressure, left ventricular mass index(LVMI), and pulmonary systolic pressure, IS concentration remained independently associated with LASr (β=-0.206, 95% CI=-0.353--0.059, P=0.007). Conclusions:In MHD patients, LA is enlarged, and its reservoir function and conduit function are impaired.LA strains derived from 3DSTE are independently related to the IS concentration in plasma, which can be used for the monitoring and evaluation of IS induced cardiac injury.

Objective: To investigate the relationship between maternal disease in early pregnancy of women of childbearing age and congenital heart disease of neonates. Methods: A cross-sectional design was used in this study and stratified multistage random sampling method was used. A questionnaire survey was conducted in the childbearing-aged women during 2010-2013 in Shaanxi province. Propensity score (PS) matched (1∶1) analysis was used to match participants with diseases to those without disease in early pregnancy. Through the control of the confounders step by step, a logistic regression model was established to evaluate the ORs of congenital heart disease according to the independent variable of maternal disease. Results: A total of 28 680 pairs of mothers and infants were included in this study, the proportion of the women with disease in early pregnancy was 20.25% (5 807). After PS matching, 5 436 pairs were matched. After adjusting all confounding factors, the multivariable logistic regression analysis results showed that maternal disease (OR=1.86, 95%CI: 1.23-2.81), especially cold (OR=2.19, 95%CI: 1.46-3.28), gynecological disease (OR=4.74, 95%CI: 2.03-11.09) and diabetes (OR=14.00, 95%CI: 1.64-119.21), in early pregnancy were the risk factors for congenital heart disease of neonate. Conclusion In women of childbearing age, disease in early pregnancy, especially cold, gynecological disease and diabetes, can increase the risk of congenital heart disease in neonates.