Objective:To analyze the changes in cardiac structure and function in women with different types of hypertensive disorders in pregnancy (HDP) and explore their influencing factors.Methods:A total of 1 967 pregnant women diagnosed with HDP who delivered at Peking University Third Hospital from January 1, 2014 to April 15, 2022 were included in the study. They were categorized into four groups based on specific HDP diagnoses: gestational hypertension (506 cases, 25.7%), pre-eclampsia (589 cases, 29.9%), pregnancy complicated with chronic hypertension (332 cases, 16.9%) and chronic hypertension with pre-eclampsia (540 cases, 27.5%). Differences in cardiac structure and function among four groups were retrospectively analyzed. Cardiac structure indicators included left atrial diameter (LAD), left atrial area (LAA), right atrial area (RAA), left ventricular end-diastolic diameter (LVEDD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), systolic function indicators included left ventricular ejection fraction (LVEF), lateral systolic mitral annular velocity (Sm), diastolic function indicators included peak early diastolic mitral in flow velocity (E)/peak late diastolic mitral in flow velocity (A), and E/peak early diastolic myocardial velocity of the lateral mitral annulus early diastolic velocity (Em). Influencing factors on cardiac structure and function were analyzed using generalized linear regression. Influencing factors were assessed by generalized linear regression.Results:(1) General clinical data: the differences in age, gestational week at delivery, blood pressure, proportion of diabetes, and length of hospital stay were statistically significant among four different HDP types (all P<0.05). (2) Compared with pregnant women with pregnancy complicated with chronic hypertension, pre-eclampsia, and gestational hypertension, those with chronic hypertension with pre-eclampsia had larger LAD, LAA, RAA and LVEDD (all P<0.001), thicker IVST and LVPWT (all P<0.001), and reduced left ventricular diastolic function (E/A, lateral Em, E/Em) and systolic function (lateral Sm; all P<0.001). Pregnant women with gestational hypertension had the least changes in cardiac structure and function. Compared with pregnant women with pre-eclampsia, those with pregnancy complicated with chronic hypertension had smaller RAA ( P<0.001) and lower E/A ( P<0.001), with no significant difference in other indicators (all P>0.05). (3) Chronic hypertension with pre-eclampsia, pregnancy complicated with chronic hypertension, and pre-eclampsia were associated with larger LAD, LAA, and LVEDD, and lower lateral Em (all P<0.05). Conclusions:Different types of HDP are associated with distinct changes in cardiac structure and function. Chronic hypertension with pre-eclampsia demonstrates the most pronounced alterations, followed by pre-eclampsia and pregnancy complicated with chronic hypertension, and gestational hypertension showed the least changes.

Odontogenic maxillary sinusitis(OMS)is a subtype of maxillary sinusitis(MS).It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion.Due to the lack of unique clinical features,OMS is difficult to distinguish from other types of rhinosinusitis.Besides,the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis.Its current diagnosis and treatment are thus facing great difficulties.The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS.However,this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality.Based on systematically reviewed literature and practical experiences of expert members,our consensus focuses on characteristics,symptoms,classification and diagnosis of OMS,and further put forward multi-disciplinary treatment decisions for OMS,as well as the common treatment complications and relative managements.This consensus aims to increase attention to OMS,and optimize the clinical diagnosis and decision-making of OMS,which finally provides evidence-based options for OMS clinical management.

Endo-periodontal lesions(EPLs)involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.

Objective To screen the distribution frequency of Mur blood group among voluntary blood donors in Hezhou,Guangxi,and further analyze the molecular basis of of Mur antigen positive samples.Methods The Mur pheno-type of voluntary blood donors in Hezhou was serologically screened using microplate method,and the distribution frequency of Mur antigens in different ethnic groups was analyzed.Genetic typing was performed on these positive samples with PCR-SSP method to verify the accuracy of the serological method,and the genetic background was sequenced and analyzed.Re-sults Among 3 298 samples from voluntary blood donors in Hezhou,432(13.10%,432/3 298)were screened positive for Mur antigen,and PCR-SSP genotyping validation showed that all 432 samples were electrophoretic positive.Among them,the proportion of Han blood donors with positive Mur antigen was12.79%(331/2 587),Yao ethnic group was13.25%(64/483),Zhuang ethnic group was 16.51%(36/218),and no statistically significant difference was found in the three groups(P＞0.05).Further sequencing results showed that 428 samples were GYP(B-A-B)Mur,also known as GYP.Mur type(12.98%,428/3 298),the other 4 samples were GYP(B-A-B)Bun,also known as GYP.Bun type(0.12%,4/3 298).Conclusion The Mur blood type frequency is high in the voluntary blood donors in Hezhou,Guangxi,and is predominant characterized by GYP.Mur genotype.Due to ethnic integration,no significant difference was noticed in the frequency of Mur blood type distribution between Han,Zhuang and Yao population.Therefore,conducting extensive Mur blood group antigen and antibody testing in Hezhou is of great significance for ensuring clinical blood transfusion safety.

Objective     To investigate the risk factors for postoperative complications Clavien-Dindo classification≥grade Ⅱ after lung cancer surgery. Methods     The patients who underwent lung cancer surgery in a multicenter observational study from November 2017 to January 2020 were included. The Clavien-Dindo classification of postoperative complications was analyzed. Logistic regression was used to identify the risk factors for complications≥ gradeⅡ. Results     A total of 388 patients were enrolled, including 203 males and 185 females with a mean age of 56.14±10.36 years. The incidence of postoperative complications was 25.52% (99/388) after lung cancer surgery and the incidence of complications≥gradeⅡ was 20.10% (78/388). The five most common postoperative complications were pneumonia (6.96%), prolonged pulmonary air leak (>7 days, 5.67%), incision dehiscence (4.64%), arrhythmia (3.87%), and postoperative pleural effusion (3.35%). Multivariate analysis showed that open surgery [reference: uniportal thoracoscopic surgery, OR=2.18, 95%CI (1.01, 4.70), P=0.047], extended resection [reference: sublobar resection, OR=2.86, 95%CI (1.11, 7.19), P=0.030; reference: lobectomy, OR=2.20, 95%CI (1.10, 4.40), P=0.026] and operative time≥3 h [OR=2.07, 95%CI (1.12, 3.85), P=0.021] were independent risk factors for postoperative complications≥gradeⅡ after lung cancer surgery. Conclusion     Surgical approach, extent of resection and operative time are independent influencing factors for postoperative complications≥gradeⅡ after lung cancer surgery.

Objective:To explore the application of effect of healthcare failure mode and effect analysis (HFMEA) in emergency waiting risk management.Methods:From May 2020 to April 2021, totally 87 902 emergency waiting patients from the First Affiliated Hospital of Anhui Medical University were assigned to control group by cluster sampling method. From May 2021 to April 2022, 80 594 emergency waiting patients were assigned to observed group. The patients in the control group received routine emergency waiting of itinerant management mode. In contrast, the patients in the observed group received emergency waiting risk management mode based on HFMEA. The process risk priority number (RPN) and waiting risk management index between two groups were compared.Results:The mean RPN of the observed group was (98.48 ± 8.27) points, significantly lower than that of the control group (251.27 ± 16.95) points. The nurses′ pre-identification rates of changes in the condition and adverse reaction in the observed group were 10.77%(8680/80 594) and 13.37%(10 775/80 594), which were higher than those in the control group, 5.77%(5072/87 902) and 8.12%(7134/87 902), the differences were statistically significant ( χ2 values were 1402.32 and 1221.66, all P<0.05). Conclusions:The application of HFMEA to optimize the emergency waiting management process can effectively reduce the risk of emergency waiting and improve the quality of emergency waiting management.

Objective:This study aimed to evaluate the effect of enhanced external counterpulsation(EECP)on left ventricular function in elderly patients with coronary slow flow phenomenon(CSFP)using two-dimensional speckle tracking echocardiography(2D-STE).Methods:This prospective case-control study included 30 patients aged ≥60 years with no stenotic lesions in the coronary arteries but with slow blood flow phenomenon in more than one major coronary artery who were treated at the Department of Geriatrics, Qilu Hospital, Shandong University, between December 2017 and December 2018, and were divided into a medication group with 16 participants and a medication plus EECP group with 14 participants, using the numerical lottery method.Patients in the group treated with EECP received 6-week 36-h EECP therapy in addition to lifestyle modification and drug treatment.Fourteen patients with normal coronary blood flow served as the control group.Conventional echocardiography and 2D-STE were used to evaluate changes in left ventricular function in the CSF patients before and after drug treatment and EECP.Results:Compared with the control group before treatment, patients in the drug treatment group and the drug treatment plus EECP group showed a decrease in mitral annular early diastolic velocity( P<0.01), an increase in the ratio of peak mitral early diastolic blood flow velocity to the mean peak mitral annular early diastolic velocity( P<0.05), and a decrease in left ventricular longitudinal strain during systole( P<0.01), the longitudinal systolic myocardial strain rate( P<0.01)and the early diastolic longitudinal peak strain rate( P<0.01).There was no statistically significant difference in values from conventional echocardiographic parameters before and after treatment in CSF patients of the medication group(all P>0.05).In the group receiving EECP, there were statistically significant differences in pre-and post-treatment values in ventricular septal early diastolic velocity[(6.22 ± 0.64)cm/s vs.(6.69 ± 0.44)cm/s], lateral wall early diastolic velocity[(8.01±0.68)cm/s vs.(8.41±0.29)cm/s], mitral valve to mitral annulus early diastolic peak velocity ratio[(10.51±1.38) vs.(9.74±0.37)], longitudinal left ventricular systolic strain[(-16.21±0.46)% vs.(-16.80±0.48)%], left ventricular systolic longitudinal strain rate[(-1.29±0.03)s -1vs.(-1.35±0.04)s -1], and early diastolic longitudinal strain rate[(1.35±0.03)s -1vs.(1.40±0.03)s -1](t-values were -3.70、-2.74、2.23、10.25、12.30、-19.15, all P<0.05). Conclusions:2D-STE can evaluate subclinical myocardial dysfunction early and quantitatively in elderly patients with CSF, and objectively reflect changes in left ventricular function before and after clinical intervention with EECP.

Objective:To investigate the efficacy and safety of bevacizumab combined with capecitabine in the treatment of advanced breast cancer.Methods:Seventy-six patients with advanced breast cancer who were diagnosed in the Cancer Center of the People's Liberation Army Navy Anqing Hospital from August 2019 to May 2021 were selected. According to different treatment schemes, the patients were divided into the control group (using single drug capecitabine) and the test group (using bevacizumab combined with capecitabine), with 38 cases in each group. After 4 cycles of treatment, the clinical efficacy, progression-free survival (PFS), overall survival (OS) and adverse reactions were compared between the two groups, and the levels of vascular endothelial growth factor (VEGF) -121, VEGF-145, VEGF-165 and quality of life before and after treatment were compared.Results:The objective remission rate of the test group [57.89% (22/38) ] was higher than that of the control group [42.11% (16/38) ], but there was no statistically significant difference ( χ2=1.89, P=0.169) ; The disease control rate of the test group [81.58% (31/38) ] was better than that of the control group [55.26% (21/38) ], there was a statistically significant difference ( χ2=6.09, P=0.014). The median PFS of patients in the test group (6.3 months) was longer than that in the control group (4.2 months), there was a statistically significant difference ( χ2=0.48, P=0.003) ; The median OS of patients in the test group (14.8 months) was not significantly different from that in the control group (13.2 months) ( χ2=0.15, P=0.704). After treatment, the expression level of serum VEGF-121 [ (201.25±18.37) ng/L vs. (276.83±20.26) ng/L], VEGF-145 [ (102.24±12.16) ng/L vs. (170.39±15.28) ng/L], VEGF-165 [ (135.08±14.32) ng/L vs. (210.53±16.09) ng/L] in the test group was lower than that in the control group, there were statistically significant differences ( t=17.03, P<0.001; t=21.51, P<0.001; t=21.59, P<0.001). After treatment, patients in the test group were assessed according to 36-item Short-Form (SF-36) physiological function [ (80.18±13.96) score vs. (71.72±16.12) score], physiological function [ (67.19±30.62) score vs. (53.12±9.86) score], physical pain [ (70.01±17.97) score vs. (61.06±17.57) score], overall health [ (68.67±18.92) score vs. (57.96±20.97) score], vitality [ (78.39±19.37) score vs. (68.26±18.52) score], social function [ (82.24±19.73) score vs. (70.92±20.31) score], the scores of emotional function [ (73.81±28.86) score vs. (60.23±29.19) score] and mental health [ (76.19±12.82) score vs. (70.31±12.54) score] were higher than those of the control group, there were statistically significant differences ( t=2.45, P=0.017; t=2.03, P=0.046; t=2.19, P=0.031; t=2.34, P=0.022; t=2.33, P=0.023; t=2.46, P=0.016; t=2.04, P=0.045; t=2.02, P=0.047). The incidence of adverse reactions in the test group [18.42% (7/38) ] was lower than that in the control group [76.32% (29/38) ], there was a statistically significant difference ( χ2=25.54, P<0.001) . Conclusion:The combination of bevacizumab and capecitabine chemotherapy has a higher clinical effect on advanced breast cancer, which can significantly reduce the level of VEGF in patients, improve the quality of life of patients, with mild adverse reactions and high safety.

Objective:To investigate the mediating effect of hope on resilience and post traumatic growth (PTG) in patients with refractory secondary hyperparathyroidism (rSHPT).Methods:It was convenient to select rSHPT patients and non-refractory SHPT patients who received maintenance hemodialysis treatment in China-Japan Friendship Hospital from September 2018 to September 2021. Totally 495 patients with rSHPT and 1 295 patients with mild secondary hyperparathyroidism (SHPT) were surveyed by the Chinese Version of The Herth Hope Scale, the Chinese version of the Connor-Davidson Resilience Scale and the Post Traumatic Growth Rating Scale (PTGI). After matching according to the 1∶1 Propensity Score Matching (PSM), 436 cases were set in each of the two groups. The differences of hope, resilience and PTG scores between the two groups were compared. Pearson correlation analysis was used to analyze the correlation between hope, resilience and total score of PTG in rSHPT group. Regression analysis and SPSS Process mediation Model 4 were used to test the mediating effect of hope on resilience and PTG.Results:The hope score (32.16 ± 4.15), psychological resilience score (61.22 ± 14.38), and the PTG score (52.34 ± 18.92) of rSHPT patients was significantly lower than 33.41 ± 2.97 ( t=-5.72, P<0.05), 63.19 ± 7.25 ( t=-2.77, P<0.05), 57.95 ± 10.07 ( t=-6.34, P<0.05) of SHPT patients. There was a positive correlation between hope, resilience and PTG score ( r=0.671, 0.488, 0.523, all P<0.01). Regression analysis showed that resilience could positively predict PTG ( β=0.518, P<0.01). Psychological resilience positively predicted hope ( β=0.188, P<0.01). Resilience ( β=0.204, P =0.002) and hope ( β=1.442, P<0.01) could positively predict PTG. Hope played a partial mediating role in the relationship between resilience and PTG, and the mediating effect accounted for 60.23%. Conclusions:rSHPT patients generally had lower levels of hope, resilience and PTG. Resilience can affect PTG directly or indirectly through hope. Medical staff should improve the resilience and hope level of patients with rSHPT through positive psychological intervention measures, so as to enhance the positive promoting effect of psychological resilience on PTG.

Objective:To determine the spiritual needs of shrinking man syndrome (SMS) in young and middle-aged patients, and to provide reference for determining targeted intervention plans.Methods:From May to July, 2021, 14 young and middle-aged patients with SMS who received hyperparathyroidism thermal ablation in the Interventional Medicine Department of China-Japan Friendship Hospital were selected by purpose sampling method. Qualitative research phenomenology was used to conduct semi-structured in-depth interviews, and the interview data were analyzed by Colaizzi 7-step analysis method.Results:There were 4 themes and 14 sub-themes: "understanding and self-acceptance of illness" (attribution to illness; disease uncertainty; acceptance and illness), "need for social support" (love and respect; connection and companionship; family support; medical support; patient support), "life value and sense of meaning" (life meaning and goal; self-esteem; religious belief), "self-actualization and transcendence" (hope for improvement; eager for miracles; realize your value).Conclusions:Medical staff should pay attention to the spiritual needs of young and middle-aged patients with SMS, and specifically meet their spiritual needs during diagnosis, treatment, nursing and follow-up, so as to improve the patients′ sense of life meaning and value, and help them to better survive with disease and return to society.