Practical Experience of Establishing German Standard Level 1 Perinatal Center in Chongqing Health Care for Women and Children

Germany,as a western developed country,has an advanced medical level,especially in the health care of very immature premature infants.We trace the medical history of perinatology to understand the development of perinatal centers in Germany.After analyzing the classification and function,hierarchical management and quality control systems of German perinatal centers,we established a German standard level 1 perinatal center in the Chongqing Health Center for Women and Children(CHCWC).During more than two years of practice,we changed concepts,continuously updated clinical knowledge and skills,developed a series o f high-quality work processes and supervision systems and introduced advanced medical equipment.We believe that the experience of establishing a German standard level 1 perinatal center and perinatal center network in Chongqing is worthy of being promoted to the Chinese maternal and child health care system.

Elimination of methicillin‑resistant Staphylococcus aureus biofilms on titanium implants via photothermally‑triggered nitric oxide and immunotherapy for enhanced osseointegration

Background:Treatment of methicillin-resistant Staphylococcus aureus(MRSA)biofilm infections in implant placement surgery is limited by the lack of antimicrobial activity of titanium(Ti)implants.There is a need to explore more effective approaches for the treatment of MRSA biofilm infections.Methods:Herein,an interfacial functionalization strategy is proposed by the integration of mesoporous polydopamine nanoparticles(PDA),nitric oxide(NO)release donor sodium nitroprusside(SNP)and osteogenic growth peptide(OGP)onto Ti implants,denoted as Ti-PDA@SNP-OGP.The physical and chemical properties of Ti-PDA@SNP-OGP were assessed by scanning electron microscopy,X-ray photoelectron spectroscope,water contact angle,photothermal property and NO release behavior.The synergistic antibacterial effect and elimination of the MRSA biofilms were evaluated by 2′,7′-dichlorofluorescein diacetate probe,1-N-phenylnaphthylamine assay,adenosine triphosphate intensity,O-nitrophenyl-β-D-galactopyranoside hydrolysis activity,bicinchoninic acid leakage.Fluorescence staining,assays for alkaline phosphatase activity,collagen secretion and extracellular matrix mineralization,quantitative real‑time reverse transcription‑polymerase chain reaction,and enzyme-linked immunosorbent assay(ELISA)were used to evaluate the inflammatory response and osteogenic ability in bone marrow stromal cells(MSCs),RAW264.7 cells and their co-culture system.Giemsa staining,ELISA,micro-CT,hematoxylin and eosin,Masson's trichrome and immunohistochemistry staining were used to evaluate the eradication of MRSA biofilms,inhibition of inflammatory response,and promotion of osseointegration of Ti-PDA@SNP-OGP in vivo.Results:Ti-PDA@SNP-OGP displayed a synergistic photothermal and NO-dependent antibacterial effect against MRSA following near-infrared light(NIR)irradiation,and effectively eliminated the formed MRSA biofilms by inducing reactive oxygen species(ROS)-mediated oxidative stress,destroying bacterial membrane integrity and causing leakage of intracellular components(P<0.01).In vitro experiments revealed that Ti-PDA@SNP-OGP not only facilitated osteogenic differentiation of MSCs,but also promoted the polarization of pro-inflammatory M1 macrophages to the anti-inflammatory M2-phenotype(P<0.05 or P<0.01).The favorable osteo-immune microenvironment further facilitated osteogenesis of MSCs and the anti-inflammation of RAW264.7 cells via multiple paracrine signaling pathways(P<0.01).In vivo evaluation confirmed the aforementioned results and revealed that Ti-PDA@SNP-OGP induced ameliorative osseointegration in an MRSA-infected femoral defect implantation model(P<0.01).Conclusions:Ti-PDA@SNP-OGP is a promising multi-functional material for the high-efficient treatment of MRSA infections in implant replacement surgeries.

Health risk assessment of trace metal(loid)s in agricultural soils based on Monte Carlo simulation coupled with positive matrix factorization model in Chongqing, southwest China

This study aimed to investigate the pollution characteristics, source apportionment, and health risks associated with trace metal(loid)s(TMs) in the major agricultural producing areas in Chongqing, China. We analyzed the source apportionment and assessed the health risk of TMs in agricultural soils by using positive matrix factorization(PMF) model and health risk assessment(HRA) model based on Monte Carlo simulation. Meanwhile, we combined PMF and HRA models to explore the health risks of TMs in agricultural soils by different pollution sources to determine the priority control factors. Results showed that the average contents of cadmium(Cd), arsenic (As), lead(Pb), chromium(Cr), copper(Cu), nickel(Ni), and zinc(Zn) in the soil were found to be 0.26, 5.93, 27.14, 61.32, 23.81, 32.45, and 78.65 mg/kg, respectively. Spatial analysis and source apportionment analysis revealed that urban and industrial sources, agricultural sources, and natural sources accounted for 33.0%, 27.7%, and 39.3% of TM accumulation in the soil, respectively. In the HRA model based on Monte Carlo simulation, noncarcinogenic risks were deemed negligible(hazard index <1), the carcinogenic risks were at acceptable level(10^(-6)<total carcinogenic risk ≤ 10^(-4)), with higher risks observed for children compared to adults. The relationship between TMs, their sources, and health risks indicated that urban and industrial sources were primarily associated with As, contributing to 75.1% of carcinogenic risks and 55.7% of non-carcinogenic risks, making them the primary control factors. Meanwhile, agricultural sources were primarily linked to Cd and Pb, contributing to 13.1% of carcinogenic risks and 21.8% of non-carcinogenic risks, designating them as secondary control factors.

Multidetector computer tomography and magnetic resonance imaging of double superior mesenteric veins:A case report

BACKGROUND This study aimed to describe the findings of double superior mesenteric veins(SMVs),a rare anatomical variation,on multidetector computer tomography(MDCT)and magnetic resonance imaging(MRI)images.CASE SUMMARY We describe the case of a 34-year-old male,who underwent both MDC and MRI examinations of the upper abdomen because of liver cirrhosis.MDCT and MRI angiography images of the upper abdomen revealed an anatomic variation of the superior mesenteric vein(SMV),the double SMVs.CONCLUSION The double SMVs are a congenital abnormality without potential clinical manifestation.Physicians need to be aware of this anatomical variation during abdominal surgery to avoid iatrogenic injury.

The Association of Maternal Body Composition and Dietary Intake with the Risk of Gestational Diabetes Mellitus during the Second Trimester in a Cohort of Chinese Pregnant Women

Objective To investigate the association of maternal body composition and dietary intake with the risk of gestational diabetes mellitus （GDM）. Methods A total 154 GDM subjects and 981 controls were enrolled in a prospective cohort study in 11 hospitals from May 20, 2012 to December 31, 2013. Bioelectrical impedance analysis and dietary surveys were used to determine body composition and to evaluate the intake of nutrients in subjects at 21-24 weeks＇ gestation （WG）. Logistic regression analysis was applied to explore the relationships of maternal body composition and dietary intake with the risk of GDIVl morbidity. Results Age, pre-pregnant body weight （BW）, and body mass index （BMI） were associated with increased risk of GDM. Fat mass （FM）, fat mass percentage （FMP）, extracellular water （ECW）, BMI, BW, energy, protein, fat, and carbohydrates at 21-24 WG were associated with an increased risk of GDM. In contrast, fat free mass （FFM）, muscular mass （MM）, and intracellular water （ICW） were associated with a decreased risk of GDM. Conclusion Maternal body composition and dietary intake during the second trimester of pregnancy were associated with the risk of GDM morbidity.

Binary prodrug nanoassemblies combining chemotherapy and ferroptosis activation for efficient triple-negative breast cancer therapy

Chemotherapy has been recommended as the standard protocol for triple-negative breast cancer(TNBC)at the advanced stage.However,the current treatment is unsatisfactory due to inefficient drug accumulation and rapid chemo-resistance.Thus,rational design of advanced drug delivery systems that can induce multiple cell death pathways is a promising strategy to combat TNBC.Ferroptosis is a powerful non-apoptotic cell death modality,showing potential in tumor inhibition.Herein,we propose a binary prodrug nanoassemblies that combines chemotherapy with ferroptosis for TNBC treatment.In this system,paclitaxel is linked with paracetamol(ferroptosis activator)by a disulfide linkage to construct self-assembly prodrug.Meanwhile,2-distearoyl-sn-glycerol-3-phosphoethanolamine-N-methyl(polyethylene glycol)-2000-tyrosine(DSPE-PEG2k-tyrosine)is applied for large neutral amino acid transporter 1(LAT1)targeting,which is highly expressed in TNBC.The prodrug nanoassemblies exhibit good stability and a glutathione(GSH)-responsive release profile.Furthermore,the LAT1-targeted nanoassemblies show stronger cytotoxicity,higher cellular uptake,and more obvious ferroptosis activation than non-decorated ones.In a TNBC mice model,the prodrug nanoassemblies demonstrate strong anti-tumor efficacy.The application of ferroptosis-assisting chemotherapy may provide a promising strategy for TNBC therapy.

Analysis of TORCH results of retinal exudative changes in neonates

AIM:To explore the relationship between retinal exudative changes in neonates and perinatal toxoplasmosis,others,rubella,cytomegalovirus,and herpes simplex virus(TORCH)infections,as well as the characteristics of TORCH infection in neonates with retinal exudative changes.METHODS:Retrospective study.A total of 612 neonates with retinal exudative changes detected during ophthalmic screening in our hospital from May 2019 to March 2023 were selected.TORCH tests were performed on these neonates,and the results were subjected to statistical analysis to determine the infection characteristics.The neonates with retinal exudative changes were grouped by sex and age,the characteristics of TORCH infection were analyzed,and the positive rates were compared.RESULTS:Among the 612 neonates with retinal exudative changes,the highest positive rate was observed for cytomegalovirus(CMV-IgG)(96.7%),followed by rubella virus(RV-IgG)(73.9%).Mixed infections with two or three viruses were also observed,with the highest positive rate for mixed infection of RV-IgG and CMV-IgG reaching 71.2%.There was no statistically significant difference in TORCH infection among neonates of different sex(P>0.05).However,there were statistically significant differences in RV-IgG and CMV-IgM infections with retinal exudative changes among neonates of different age groups(P<0.05).CONCLUSION:Perinatal TORCH infection may be an important factor causing retinal exudative changes in neonates.The differences in various infections are not related to sex but are related to different age groups.

Efficacy of intrauterine balloon stent or oral estrogen on prevention of adhesion after transcervical resection of septum in septate uterus:Study protocol for a randomized controlled multicenter study in China

To the Editor:The septate uterus is the most common uterine anomaly and is associated with an increased risk of adverse reproductive outcomes.Transcervical resection of septum(TCRS)is widely performed in patients with adverse reproductive outcomes.The incidence of de novo intrauterine adhesions(IUAs)after TCRS is approximately 5%to 25%.[1]Various anti-adhesion methods are widely used in the clinical management of patients with septate uteri,including intrauterine devices,Foley balloons,estrogen,antibiotics,and hyaluronic acid gel.However,insufficient evidence supports or opposes any of these methods(Level C),[2]lacking high-grade evidence.

Successfully Man aging Cornual Heterotopic Pregnancy: A Case Report and Literature Review

Cornual heterotopic pregnancy is an extremely rare,life-threatening complication during pregnancy.Here,we report a 33-year-old woman who suffered cornual heterotopic pregnancy after in vitro fertilization embryo transfer.To prevent rupture during heterotopic pregnancy,she received laparoscopic surgery to remove the ectopic gestational sac at 7^(+2) weeks of gestation.Ultimately,she delivered a healthy boy at 38^(+3) weeks of gestation.Here,we also review the clinical presentations,risk factors,treatment options and outcomes of cornual heterotopic pregnancy.

Noninherited Factors in Fetal Congenital Heart Diseases Based on Bayesian Network:A Large Multicenter Study

Background:Current studies have confirmed that fetal congenital heart diseases(CHDs)are caused by various factors.However,the quantitative risk of CHD is not clear given the combined effects of multiple factors.Objective:This cross-sectional study aimed to detect associated factors of fetal CHD using a Bayesian network in a large sample and quantitatively analyze relative risk ratios(RRs).Methods:Pregnant women who underwent fetal echocardiography(N=16,086 including 3,312 with CHD fetuses)were analyzed.Twenty-six maternal and fetal factors were obtained.A Bayesian network is constructed based on all variables through structural learning and parameter learning methods to find the environmental factors that directly and indirectly associated with outcome,and the probability of fetal CHD in the two groups is predicted through a junction tree reasoning algorithm,so as to obtain RR for fetal CHD under different exposure factor combinations.Taking into account the effect of gestational week on the accuracy of model prediction,we conducted sensitivity analysis on gestational week groups.Results:The single-factor analysis showed that the RRs for the numbers of births,spontaneous abortions,and parental smoking were 1.50,1.38,and 1.11(P<0.001),respectively.The risk gradually increased with the synergistic effect of ranging from one to more environmental factors above.The risk was higher among subjects with five synergistic factors,including the number of births,upper respiratory tract infection during early pregnancy,anemia,and mental stress as well as a history of spontaneous abortions or parental smoking,than in those with less than 5 factors(RR=2.62 or 2.28,P<0.001).This result was consistent across the participants grouped by GWs.Conclusion:We identified six factors that were directly associated with fetal CHD.A higher number of these factors led to a higher risk of CHD.These findings suggest that it is important to strengthen healthcare and prenatal counseling for women with these factors.

Relationship between subgroups of central and lateral lymph nodemetastasis in clinically node-negative papillary thyroid carcinoma

BACKGROUND Lymph node metastasis(LNM) of papillary thyroid carcinoma(PTC) has a certain regularity and occurs first to the central lymph node and then to the lateral lymph node. The pathway of PTC LNM can guide surgical prophylactic lymph node dissection(LND) for clinical surgeons.AIM To investigate the relationship between subgroups of central LNM and lateral LNM in unilateral clinically node-negative PTC(cN0-PTC).METHODS Data were collected for 1089 PTC patients who underwent surgical treatment at the Department of Endocrine and Breast Surgery of the First Hospital of Chongqing Medical University from January 2016 to December 2017. A total of 388 unilateral cN0-PTC patients met the inclusion criteria and were enrolled in this study. The clinical and pathological data for these 388 patients who underwent total thyroidectomy + central LND + lateral LND were retrospectively analyzed. The relationship between the central LNM and lateral LNM subgroups was investigated.RESULTS The coincidence rate of cN0-PTC was only 30.0%.Optimal scaling regression analysis showed that sex(57.1% vs 42.9%, P = 0.026), primary tumor size(68.8% vs 31.2%, P = 0.008), tumor location(59.7% vs 40.3%, P = 0.007), extrathyroid extension(ETE)(50.6% vs 49.9%, P = 0.046), and prelaryngeal LNM(57.1% vs 42.9%, P = 0.004) were significantly associated with ipsilateral level-II LNM. Their importance levels were 0.122, 0.213, 0.172, 0.110, and 0.227, respectively. Primary tumor size(74.6% vs 30.2%, P = 0.016), pretracheal LNM(67.5% vs 32.5%, P < 0.001), and paratracheal LNM(71.4% vs 28.6%, P < 0.001) were significantly associated with ipsilateral level-Ⅲ LNM. Their importance levels were 0.120, 0.408, and 0.351, respectively. Primary tumor size(72.1% vs 27.9%, P = 0.003), ETE(70.4% vs 29.6%, P = 0.016), pretracheal LNM(68.3% vs 31.7%, P=0.001), and paratracheal LNM(80.8% vs 19.2%, P < 0.001) were significantly associated with ipsilateral level-IV LNM. Their importance levels were 0.164, 0.146, 0.216, and 0.472, respectively.CONCLUSION The LNM pathway of thyroid cancer has a certain regularity. For unilateral cN0-PTC patients with a tumor diameter > 2 cm and pretracheal or ipsilateral paratracheal LNM, LND at ipsilateral level Ⅲ and level IV must be considered. When there is a tumor in the upper third of the thyroid with prelaryngeal LNM, LND at level II, level Ⅲ and level IV must be considered.

EFFECT OF MASSOTHERAPY ON THE IN V IVO FREE RADICAL METABOLISM IN PATIENTS WITH PROLAPSE OF LUMBAR INTER VERTEBRAL DISC AND CERVICAL SPONDYLOPATHY

The endogenous free radical scavenger superoxide dismutase (SOD) and blood catalase (CAT) in 2 groups of patients with prolapse of lumbar intervertebral disc and cervical spondylopathy were lower than that of the healthy control group, while the -SH reflecting the metabolic disturbance of free radical was higher. After massotherapy, blood SOD and CAT were increased, while lipid peroxide (LPO), -SH in urine were decreased, demon-strating that there are distinct parallel relationships existing in the changes of these enzymes in blood and urine.

Effects of granulocyte colony-stimulating factor and stem cell factor, alone and in combination, on the biological behaviours of bone marrow mesenchymal stem cells

Aim: The effects of granulocyte colony- stimu-lating factor (G-CSF) and stem cell factor (SCF) on the proliferation and osteogenic differentia-tion capacity of bone marrow mesenchymal stem cells (MSCs) were studied in the experi-ment. Methods: Bone marrow MSCs were col-lected from rabbits successfully, and treated with various concentrations of G-CSF, SCF or a combination of the two. Flow cytometric ana-lyse, MTT test, CFU-F assay, and alkaline phosphatase (ALP) activity measurement were employed. Results: The results of flow cytome-try showed that immunophenotype of the cells were CD29+/CD45-, CD105+/ CD34–, CD90+/ HLADR–. MSCs were shown to constitutively express low levels of c-kit which could be en-hanced by SCF. G-CSF and SCF had an obvious facilitative effect on the proliferation of MSCs in a dose-dependent fashion. In addition, G-CSF and SCF would be effective in reversibly pre-venting their differentiation, as showed by the decrease of ALP activity, leading to self-renewal rather than differentiative cell divisions. The effects of G-CSF were superior to SCF. And cells in the group treated with combination of G-CSF and SCF showed more powerful effects than the groups treated with G-CS, SCF, or none of the two. Conclusion: On the whole, these studies demonstrated that MSCs responsed to G-CSF, SCF, and to G-CSF plus SCF in a manner that suppressed differentiation, and promotes proliferation and self-renewal, and support the view that these factors could act synergistically.

Best time for progesterone supplementation in aid ovulation induction cycles by letrozole

Objective:To explore the best time for progesterone supplementation in AID ovulation induction cycles by Letrozole.Methods: The data analysed in this study were collected from 509 patients who were performed AID (Artificial Insemination by Donor) administrated letrozole (LE) between 2014.8-2015.7. All patients were randomly divided into 4 groups by the time of progesterone administrated, including experimental group and the control group. The experimental group was divided into group 1-72 h after ovulation, group 2-48 h after ovulation, group 3-24 h after ovulation and control group—without administrated LE. The gestation and live birth rate were evaluated by monitoring vaginal ultrasound and HCG blood value 14 d after AID.Results: The pregnancy rate with administrated progesterone added 72 h after ovulation was 31.9%, which was significantly higher than those of other groups, the same situation as groups added progesterone was significantly higher than the control group. However, there was no significant difference in the numbers of abortions among the four groups. The LBR of group 4 was significantly lower than that of group 1.Conclutions: Progesterone administrated 72 h after ovulation can promoted the gestation rate, but did not affect the rate of miscarrage .

A multicenter prospective study of next-generation sequencing-based newborn screening for monogenic genetic diseases in China

Background Newborn screening(NBS)is an important and successful public health program that helps improve the long-term clinical outcomes of newborns by providing early diagnosis and treatment of certain inborn diseases.The develop-ment of next-generation sequencing(NGS)technology provides new opportunities to expand current newborn screening methodologies.Methods We designed a a newborn genetic screening(NBGS)panel targeting 135 genes associated with 75 inborn disorders by multiplex PCR combined with NGS.With this panel,a large-scale,multicenter,prospective multidisease analysis was conducted on dried blood spot(DBS)profiles from 21,442 neonates nationwide.Results We presented the positive detection rate and carrier frequency of diseases and related variants in different regions;and 168(0.78%)positive cases were detected.Glucose-6-Phosphate Dehydrogenase deficiency(G6PDD)and phenylketonuria(PKU)had higher prevalence rates,which were significantly different in different regions.The positive detection of G6PD variants was quite common in south China,whereas PAH variants were most commonly identified in north China.In addi-tion,NBGS identified 3 cases with DUOX2 variants and one with SLC25A13 variants,which were normal in conventional NBS,but were confirmed later as abnormal in repeated biochemical testing after recall.Eighty percent of high-frequency gene carriers and 60%of high-frequency variant carriers had obvious regional differences.On the premise that there was no significant difference in birth weight and gestational age,the biochemical indicators of SLC22A5 c.1400C>G and ACADSB c.1165A>G carriers were significantly different from those of non-carriers.Conclusions We demonstrated that NBGS is an effective strategy to identify neonates affected with treatable diseases as a supplement to current NBS methods.Our data also showed that the prevalence of diseases has significant regional charac-teristics,which provides a theoretical basis for screening diseases in different regions.

Improvement of antibacterial, anti-inflammatory, and osteogenic properties of OGP loaded Co-MOF coating on titanium implants for advanced osseointegration

The bacterial infection,especially for methicillin-resistant Staphylococcus aureus(MRSA),and the associated severe inflammatory response could extremely limit the crosstalk of RAW264.7 cells and mesenchymal stem cells(MSCs)and lead to the undesirable osseointegration of peri–implants.It is highly demanded to modify the surface of titanium(Ti)implant to improve its anti-bacterial and anti-inflammatory properties and facilitate its disabled osseointegration.Herein,in our study,a multifunctional coating of zeolitic imidazolate frameworks-67 encapsulated osteogenic growth peptide(OGP)(ZO)was fabricated on titanium dioxide nanotubes(TNT)substrates(TNT-ZO)via the electrophoresis deposition(EPD)approach.The TNT-ZO substrates exhibited excellent antibacterial activity indicated by the reactive oxygen species(ROS)generation,outer membrane(OM)and inner membrane(IM)permeabilization change,adenosine triphosphate(ATP)decrease,and intracellular compounds(DNA/RNA)leakage.Importantly,the regulation effects of TNT-ZO coating modified titanium substrates on the RAW264.7-MSCs crosstalk could induce the anti-inflammatory and osteogenic microenvironment via multiple paracrine signaling of Runx2,BMP2,VEGF,and TGF-β1.The promoted effects of coating structure were investigated in vivo,including antibacterial effect,osteogenic differentiation of mesenchymal stem cells,and anti-inflammation of RAW264.7 cells,as well as infected bone regeneration and repair in bone defect transplantation model.The results demonstrated that MRSA was effectively eliminated by the hydrolysis of ZIF-67 nanoparticles on TNT-ZO substrates.Furthermore,the excellent osseointegration of peri–implants was realized simultaneously by modulating the crosstalk of RAW264.7-MSCs.This study could provide a novel approach to designing a multifunctional coating on the Ti implants for infected bone regeneration in orthopedic applications.

Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread worldwide and threatened human’s health.With the passing of time,the epidemiology of coronavirus disease 2019 evolves and the knowledge of SARS-CoV-2 infection accumulates.To further improve the scientific and standardized diagnosis and treatment of maternal SARS-CoV-2 infection in China,the Chinese Society of Perinatal Medicine of Chinese Medical Association commissioned leading experts to develop the Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection under the guidance of the Maternal and Child Health Department of the National Health Commission.This recommendations includes the epidemiology,diagnosis,management,maternal care,medication treatment,care of birth and newborns,and psychological support associated with maternal SARS-CoV-2 infection.It is hoped that the recommendations will effectively help the clinical management of maternal SARS-CoV-2 infection.

Sensory threshold for defecation and its correlation with pelvic organ prolapse:An exploration of related factors

Objectives This research aimed to investigate changes in defecation sensory threshold and related factors in patients with posterior vaginal wall prolapse.Methods A total of 214 patients with pelvic organ prolapse were recruited between October 2019 to January 2021.All patients underwent a defecation sensory threshold examination,physical examination,and pelvic floor ultrasound examination.Factors related to the defecation sensory threshold were analyzed.Results(1)Among the participants,57 patients(26.6%)had a defecation sensory threshold of more than 90ml.Patients with a threshold>90ml showed higher scores of defecation dysfunction in the Constipation Scoring System(CSS)score(p=0.003)and higher scores of constipation in the Colorectal-anal Distress Inventory 8(CRADI-8)score(p=0.002).(2)The defecation sensation threshold positively correlated with the Ap point(r=0.448,p<0.001),the Bp point(r=0.345,p=0.009),the area of the levator-ani hiatus measured by transvaginal ultrasound(r=0.403,p=0.002),and parity(r=0.355,p=0.007).Conclusions Patients diagnosed with pelvic organ prolapse commonly experience an increased threshold of defecation sensation.Elevated thresholds were associated with more frequent constipation symptoms.Additionally,the severity of posterior pelvic prolapse positively correlated with the defecation sensory threshold.

A Clinical Observation Report on Prenatal Management and Postnatal Treatment of Congenital Granular Cell Epulis

Introduction Congenital granular cell epulis(CGCE)is a rare,benign tumor that manifests on the mucosal surface of the alveolar ridge in newborns.It was initially described by Neumann in 1871 and has been referred to by various names such as congenital epulis,congenital epulis of the newborn,and congenital granular cell tumor.1 Documentation on larger tumors is limited and reported diameters vary.2 Diagnosis necessitates histological examination and immunohistochemical staining,typically revealing negative immunoreactivity for S-100 and cluster of differentiation 68(CD68).3,4 This article presents a case of CGCE with weakly positive S-100 and CD68 staining,alongside a relatively large size.Additionally,it conducts a literature review on diverse aspects,encompassing multidisciplinary prenatal diagnosis,antenatal management,choice of delivery mode during childbirth,and postnatal treatment,with the objective of augmenting clinicians’comprehension of the ailment.The study adhered to the guidelines of the Declaration of Helsinki and obtained informed consent from the patient and approval from the medical ethics committee of Chongqing Health Center for Women and Children.

Deciphering the mechanism of Liu Wei Di Huang Wan in treating premature ovarian failure:a comprehensive exploration through network pharmacology and molecular docking analysis

Premature ovarian failure(POF)is a prevalent gynecological disorder with significant implications for the physical and mental well-being of affected individuals.Liu Wei Di Huang Wan(LWDHW),a Chinese herbal compound,has demonstrated efficacy in alleviating the effects of POF.However,the underlying mechanism of action of LWDHW remains unclear.This study aimed to elucidate the potential molecular mechanism of LWDHW in treating POF using network pharmacology and molecular docking techniques.The active ingredients of LWDHW were initially screened through the TCMSP platform.At the same time,the relevant target genes associated with POF were identified using databases such as Disgenet,TTD,Drugbank,Gene Cards,OMIM,and Pharm GKB.Data analysis was conducted using the R language,Cytoscape,and STRING to construct and analyze the traditional Chinese medicine(TCM)regulatory network and protein-protein interaction(PPI)network maps.Subsequently,GO and KEGG enrichment analyses were performed using the R language.Finally,molecular docking was carried out between the protein receptors of the core genes and the corresponding small-molecule ligands.The study revealed 49 components and 189 predicted targets(after de-duplication)of LWDHW,along with 4524 targets(after de-duplication)associated with POF.Through comparative analysis,163 potential genes were identified as common targets of LWDHW and POF,participating in biological processes such as response to chemical substances,molecular function regulation,and signaling receptor binding.Key biological pathways implicated included the MAPK signaling pathway,IL-17 signaling pathway,and HIF-1 signaling pathway,among others.Molecular docking results demonstrated a robust binding ability between the core genes of LWDHW and their corresponding ingredients.In conclusion,this comprehensive analysis provided insights into the potential molecular mechanisms of LWDHW in treating POF.The identified common targets and associated pathways contributed to our understanding of how LWDHW exerted its therapeutic effects,paving the way for further research and clinical applications.It is worth noting that future studies with experimental validation and clinical trials are essential to confirm these findings and establish the safety and efficacy of LWDHW in the treatment of POF.