Objective: To analyze the global literature related to functional cure of hepatitis B from 2019 to 2023 by using bibliometric analysis methods, so as to help researchers understand the research hotspots and trends in this field. Methods: The literature related to the topic of functional cure of hepatitis B included in the Science Citation Index Expanded (SCI-Expanded) of the Web of Science Core Collection from 2019 to 2023 was searched. By using VOSviewer and CiteSpace visual analysis tools, analyses were conducted from the perspectives of publication trends, international research cooperation networks, and keyword emergence, and were elaborated with the specific contents of the related literature to elucidate research hotspots and trends. Results: A total of 600 eligible papers in this field were included. Keyword co-occurrence and thematic clustering suggested that the main research directions of functional cure were: serum biomarkers for prediction and monitoring of functional cure, functional cure and immunity, nucleoside analog discontinuation, interferon therapy, and long-term prognosis of functional cure. The research contents of the ESI highly cited original research papers were similar to the clustering of the above, but showed more attention on the novel agents for functional cure. The content of the keyword emergence map showed that hotspots of interest changed from virologic mechanisms and serum markers, to nucleoside analog discontinuation and interferon therapy, and finally to immunologic mechanisms and new drug. Conclusion: The research hotspots and trends of functional cure of hepatitis B were focused on virological mechanism, serum markers, immunological mechanism, nucleoside analog discontinuation, interferon therapy, and long-term prognosis after cure.

Objective: To investigate the effect of cordyceps sinensis (CS) on the activation of fibroblasts through IL-6 trans-signaling pathway and its specific mechanism in the treatment of renal fibrosis. Methods: Renal fibrosis mouse model was established by unilateral ischemia/reperfusion (UIR), and the mice were administered intragastrically CS, soluble glycoprotein 130 Fc (sgp130Fc) or Hyper-IL-6. Masson's trichrome staining was utilized to identify tubulointerstitial fibrosis. PAS staining was utilized to assess the extent of renal injury. Western blot was employed to analyze the expression levels of fibrosis markers [alpha-smooth muscle actin (α-SMA), fibronectin (FN)] and proteins associated with IL-6 trans-signaling pathway [phosphorylated signal transducer and activator of transcription 3(p-STAT3), soluble interleukin-6 receptor (sIL-6R)]. The expression and localization of proteins were additionally detected by immunohistochemistry, immunofluorescence and qPCR. The effect of cordyceps sinensis extract cordycepin on IL-6 trans-signaling in fibroblasts was further investigated in vitro. Results: The results from in vivo experiments showed that administration of CS during the chronic phase demonstrated a beneficial protective impact on inflammation and fibrosis in the affected kidney, and serum creatinine levels and collagen deposition were decreased. Western blot analysis revealed a decrease in the expression levels of α-SMA, FN, as well as IL-6 trans-signaling pathway protein p-STAT3, sIL-6R in the treatment group. Additionally, the mRNA expression levels of chemokines monocyte chemoattractant protein-1 (MCP-1) and C-X-C motif chemokine ligand 12 (CXCL12) were also decreased in the CS treatment group. Additionally, Hyper-IL-6 can partially counteract the therapeutic effects of CS. In vitro experiments further demonstrated that cordycepin inhibited the secretion of IL-6 from NRK-52E. Combined treatment of recombinant IL-6 and sIL-6R protein activated NRK-49F, leading to a significant increase in α-SMA, FN, and p-STAT3 expression levels. Cordycepin or sgp130Fc treatment significantly inhibited the proliferation of fibroblasts induced by IL-6 trans-signaling pathway. Conclusion: CS can significantly reduce IL-6 secretion by renal tubular epithelial cells and inhibit the activation of IL-6 trans-signaling pathway in fibroblasts, thereby ameliorating renal interstitial fibrosis.

Objective: To elucidate the potential mechanisms by which mesothelin (MSLN) contributes to chemotherapy resistance in high-grade serous ovarian cancer (HGSOC). Methods: A Meta-analysis utilizing public ovarian cancer databases was performed to evaluate the correlation between MSLN expression levels and overall survival (OS) in ovarian cancer patients. Pathway enrichment analysis was employed to identify key signaling pathways regulated by MSLN and their roles in chemotherapy resistance. Additionally, the TCGA-HGSOC database was analyzed to examine genomic features associated with MSLN-mediated chemotherapy resistance. To validate the biological function of MSLN in chemotherapy resistance, an intraperitoneal metastasis model was established using MSLN-knockdown ID8 ovarian cancer cells in mice. Results: Elevated MSLN expression was significantly associated with poor patient prognosis (HR: 1.42, 95%CI: 1.16-1.74). Differential gene expression and pathway enrichment analyses revealed that high MSLN expression upregulates resistance-associated genes and pathways involved in drug metabolism and DNA-binding signaling. Genomic association analysis showed a negative correlation between high MSLN expression and chromosomal instability features, specifically CX3, CX11, and CX13 scores. In vivo studies demonstrated that MSLN knockdown enhanced the tumor-suppressive effects of cisplatin. Conclusion: High MSLN expression represents a potential biomarker for poor prognosis and chemotherapy resistance in HGSOC patients, suggesting MSLN as a promising target for therapeutic intervention.

Objective: To develop an MRI-based habitat radiomics model for the preoperative prediction of endometrial cancer (EC) molecular subtypes. Methods: Patients with pathologically proven EC from two hospitals were included in the training (n=270) and testing (n=70) cohorts. All patients had preoperative MRI and histological and molecular diagnoses. First, the tumor was divided into habitat subregions based on diffusion-weighted imaging (DWI) and contrast-enhanced (CE) images. Subsequently, habitat radiomic features were extracted from different subregions of T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), DWI, and CE images. Three machine learning classifiers, including logistic regression, support vector machines, and random forests, were applied to develop predictive models for p53-abnormal endometrial cancer, with model performance validated. The model demonstrating the best overall predictive performance was selected as the habitat radiomics model. Using the same procedure, a whole-region radiomics model based on T1WI, T2WI, DWI, and CE sequences and a clinical model were constructed. The performance of the models was evaluated using receiver operating characteristic curves, and DeLong's test was employed to compare differences between the models. Decision curve analysis was used to assess the clinical benefits of the models' application. Results: After feature selection, eight habitat radiomic features were retained to construct the habitat radiomics model, ten features for the whole-region radiomics model, and three clinical features for the clinical model. The habitat radiomics model achieved the highest area under the curve (AUC), with 0.855 (0.788-0.922) in the training cohort and 0.769 (0.631-0.907) in the testing cohort. DeLong's test showed that the habitat radiomics model outperformed the whole-region radiomics model in the training cohort (P=0.001), but there was no significant difference in the testing cohort (P=0.543). In both cohorts, the habitat radiomics model outperformed the clinical model (P=0.007, training cohort; P=0.038, testing cohort). Decision curve analysis (DCA) demonstrated that this model provided clinical benefit for diagnosis within a threshold probability range of approximately 0.2-0.8. Conclusion: The MRI-based habitat radiomics model can accurately predict p53-abnormal EC, outperforming both the whole-region radiomics model and the clinical model, and is useful for the non-invasive molecular subtyping of endometrial cancer before surgery.

Small cell neuroendocrine cervical carcinoma (SCNECC) is a rare gynecological malignancy characterized by early invasion and metastasis, resulting in a poorer prognosis compared to cervical squamous cell carcinoma and adenocarcinoma. The clinical management of SCNECC remains in the exploratory phase. Recently, as this uncommon tumor has garnered increasing attention both domestically and internationally, some progress has been made in improving its prognosis. This article summarizes the advancements in combined modality therapy for SCNECC, discussing and providing insights into key issues related to current treatment strategies of surgery, radiotherapy and chemotherapy, as well as targeted and immunotherapies.

Objective: To explore the safety and management mode of hysteroscopy in three different modes: outpatient, daily and inpatient. Methods: The quality control data of patients who underwent hysteroscopic surgery in Hysterscopy Centre, Obstetrics and Gynecology Hospital, Fudan University from Jan 2019 to Dec 2021 were collected through the electronic information system of the hospital and the monthly quality control report of hysteroscopy center. The amount of surgery, the proportion of grade Ⅳ surgery, the analysis of operation types, the indicator including complications, and unanticipated secondary surgery were retrospectively analyzed. Results: From 2019 to 2021, 5 162 outpatient hysteroscopic patients, 15 331 daily hysteroscopic patients and 5 942 inpatient hysteroscopic patients were admitted in our hospital. The age of inpatient hysteroscopic patients was significantly older than those of outpatient and daily patients (P < 0.001). In the past three years, the proportion of daily hysteroscopy gradually increased, and the proportion of inpatient hysteroscopy gradually decreased (P < 0.001). The total percentage of grade Ⅳ hysteroscopic surgery was 12.9%, in which inpatient was higher than daily, and daily was higher than outpatient (P < 0.001). The incidence of complications and accidents during hysteroscopy was 0.117% (31/26 435), including 17 cases of uterine perforation, 7 cases of hysteroscopy failure, 3 cases of excessive intraoperative bleeding, 2 cases of fluid overload, 1 case of intestinal injury, and 1 case of anesthesia accident. The incidence of hysteroscopy in outpatient, daily and inpatient were 0.020% (1/5 162), 0.137% (21/15 331) and 0.151% (9/5 942) respectively. Conclusion: Hysteroscopy in outpatient, daily and inpatient are all safe and reliable. Outpatient and daily hysteroscopy can improve the efficiency of medical services, which has gradually become a trend.

With the development of genetics and advances in genetic testing technology, the demand for cancer genetic counseling has increased dramatically. Advanced practice nurses play a key role in personalized health care delivery. The oncology genetic nurse-led genetic counseling services in foreign countries are becoming more and more mature, but in China, the work of oncology genetic counseling started late, and the combination of genetics/genomics with nursing is still in its infancy. There is still a lack of relevant research on oncology genetic nurses. This article introduced the qualification certification, core competence and clinical practice content of foreign oncology genetic nurses, and summarized the clinical practice effect of oncology genetic nurses and the enlightenment to China's advanced nursing practice, which provided references for the construction of oncology genetic nurses training programs and clinical service models suitable for China's national conditions, so as to meet the needs of the development of advanced nursing practice and the growing demand for precision oncology and high-quality genetic medical care.

Objective: To compare the clinical efficacy and pregnancy outcomes of CO₂ laser and loop electrosurgical excision procedure (LEEP) surgery in the treatment of cervical high-grade squamous intraepithelial lesion (HSIL)in women of childbearing age. Methods: Patients with cervical HSIL of appropriate reproductive age (20-34 years old) who underwent satisfied colposcope, subsequently treated with laser or LEEP between Jan 2019 and Dec 2021 in Obstetrics and Gynecology Hospital, Fudan University were collected. All the patients were interpreted as transformation zone (TZ) type 1/2, and colposcopy biopsy diagnosed as cervical high-grade squamous intraepithelial lesion (HSIL) and received laser or LEEP according to the physician's advice and the patient's wishes.The effectiveness of the two surgeries was evaluated, and postoperative cytology, HPV result, and colposcopic pathology were compared. We monitored the surgical pregnancy rate, pregnancy complications, and pregnancy results after the surgery. Results: A total of 566 cases, including 233 laser cases and 333 LEEP cases, were enrolled. There was no significant difference between the two groups in terms of preoperative cytology, HPV distribution, or the length of cervical canal. After 6 months of surgery, 91.5% of patients who underwent laser therapy and 86.9% of those who underwent LEEP had normal cytology. The histology cure rate was 91.5% and the HPV conversion rate was 74.6% in both groups. The results of cytology, HPV, and colposcopic pathology had no significant difference between the two groups. The length of postoperative cervical canal was significantly longer in laser group than that in LEEP group [(29.09±3.15) mm vs. (27.05±3.84) mm, P < 0.001]. There was no statistically significant difference in postoperative pregnancy rate and pregnancy outcome between the two groups. Conclusion: Laser ablation and LEEP produce comparable effects pregnancy outcomes in cervical HSIL patients with TZ types 1 and 2, while LEEP has pathologic feedback, so its misdiagnosis of invasive cancer reduce.

Objective: To investigate the role of the GPR120 gene in the progression of sepsis, explore the molecular mechanisms through which GPR120 gene regulates NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome activation and macrophage polarization. Methods: The blood and pleural fluid samples were collected from the sepsis patients and the control group. The expression of inflammatory factors and the associated proteins were detected by flow cytometry and ELISA. C57BL/6 mice and monocyte-macrophage cell line (Raw264.7) were treated with lipopolysaccharide (LPS) to construct the sepsis models. After the intervention of GPR120 agonist TUG891, the expression of GPR120 gene, NLRP3 inflammasome protein and macrophage polarization protein were detected between the control group and the sepsis group. Results: The expression of inflammatory factors, such as IL-1β in the serum of septic patients, significantly increased compared with the control (P < 0.001). And the expression of inflammasome proteins such as NLRP3, Caspase-1 and IL-1β in the pleural fluid also increased (all P < 0.05). In vivo, LPS could induce severe inflammation in lung tissue, the GPR120 gene expression decreased in lung tissue, and inflammatory factors were up-regulated in mouse serum (P < 0.01). The inflammasome-associated protein and M1 type polarization of macrophages were enhanced, the TUG891 could reduce the inflammatory response, inhibit the NLRP3 inflammasome activating, and promote the M2 polarization of macrophages (P < 0.01). In vitro, LPS could inhibit the intracellular GPR120 expression. The inflammatory factors secreted more in LPS-induced sepsis cells. TUG891 could promote the up-regulation of GPR120 protein and alleviate the secretion of inflammatory factors (P < 0.05). Conclusion: In sepsis, GPR120 gene activation could inhibit the NLRP3 inflammasome activation, promote macrophage polarization, and reduce the inflammatory damage, thereby delay the rapid progression of sepsis.

Objective: To investigate anxious and depressive emotions in patients underwent cervical cancer surgery and to analyze its influencing factors. Methods: A total of 304 patients who underwent primary cervical cancer surgery in Obstetrics and Gynecology Hospital, Fudan University from Oct 2018 to Jun 2021, were recruited to evaluate the clinical effect based on cervical cancer-patient reported outcome 137 scale (CC-PRO137 scale). This study focused on dimensions of depressive and anxious emotions within this scale and explored their influencing factors. Results: The average scores of their depressive and anxious emotions within half a year after surgery were 4.141±0.798 and 4.020±0.616, respectively; and the average scores of depressive and anxious emotions more than one year after surgery were 4.250±0.802 and 4.097±0.613, respectively. By using statistical methods including analysis of variance and t test, it was found that there were statistically significant differences in the scores of depression and anxiety among cervical cancer patients under different postoperative adjuvant treatments and at different postoperative time points (P < 0.05). However, there were no statistically significant differences in the scores of depression and anxiety among patients with different ages, surgical methods, and clinical stages of cervical cancer (P > 0.05). Conclusion: Patients underwent cervical cancer surgery may suffer varying degree of depressive and anxious emotions, and the main influencing factors are different adjuvant treatments and the length of time for postsurgical recovery. Medical practitioners should strengthen comfort and care for patients with cervical cancer, especially those who receive chemotherapy and radiotherapy treatments and are in the primary stage after the surgery. Formulating positive intervention measures can effectively reduce the psychological pain of patients and safeguard their physical and mental health.

Drug clinical trial is a method of experimental epidemiology to evaluate the effectiveness and safety of medicines. This article introduced the types and design thought of innovation in drug clinical trial design, and provided methodological reference for related researches. Adaptive design is a complex and innovative clinical trial design, which can be divided into group sequential design, sample size re-estimation, seamless trial, enrichment design and master protocol design (basket trial, umbrella trial, platform trial, etc.) according to the purpose of adaptability. The adaptive design has greater adjustment flexibility, which overcomes the shortcomings of conventional clinical trials to a certain extent, then improves the validity of the trial results and the strength of the evidence. The design innovation and remodeling of drug clinical trials will provide more powerful evidence-based evidence for the realization of precision medicine.

Since the concept of artificial intelligence (AI) was proposed in 1956, medicine has been one of its core application fields. At present, AI technology has run through the whole diagnosis and treatment process, and has been extended to innovative scenarios such as drug research and development, surgical robots, and clinical trial optimization. Scenario application is the backbone of the technical system. Multimodal data fusion integrates heterogeneous data such as images, medical records, and genes, and federated learning realizes cross-institutional privacy protection and sharing. Deep learning achieved more than 90% sensitivity in imaging diagnosis for lung nodule detection, while generative AI accelerates drug molecule design. The core applications cover four major areas field: AI is more accurate than professional doctors in breast cancer and diabetic retinopathy screening; robotics shortens hospital stays and improves spinal screw placement accuracy; AI shortens the discovery cycle of drug targets; machine learning improves the efficiency of subject screening and enables real-time data monitoring. The application of AI in the medical field is first constrained by data quality and algorithm bias, and the "black box" characteristics of AI models and the ambiguity of responsibility attribution are the core obstacles to clinical implementation. This paper analyzes key technological breakthroughs and typical cases, discusses the application scenarios and challenges of AI in medicine, and aims to provide a reference for the future development of medical intelligence.

Gallbladder adenoma, a benign tumor of mucosal epithelial origin, is considered to be a pre-cancer to gallbladder cancer (GBC), and its malignant transformation may occur in a relatively short time. The pathological process and molecular mechanism of gallbladder adenoma carcinogenesis are still controversial; ultrasound and CT are widely used to examine gallbladder diseases, and the application of contrast-enhanced ultrasound (CEUS) and high-frame-rate contrast-enhanced ultrasound (H-CEUS) has improved the diagnostic accuracy. In this paper, we summarize the literature on the clinicopathological features, imaging manifestations, gene expression, treatment, and clinical prognosis of gallbladder adenoma carcinogenesis.

Bronchopulmonary dysplasia (BPD) is a detrimental respiratory complication associated with prematurity that still lacks effective treatment. BPD is a multifactorial disease with a pathogenesis involving alveolar simplification and impaired vascularization. Alveolar epithelial cells are the main components of alveoli including alveolar type Ⅰ (AT1) and alveolar type Ⅱ (AT2) epithelial cells. AT1 cells are involved in constructing the air-blood barrier and facilitating gas exchange, while AT2 cells, characterized by proliferative and differentiated stem cell properties, maintain lung homeostasis and contribute to lung injury. The transdifferentiation of AT2 cells into AT1 cells is a core mechanism in the repair of lung injuries, although the key signaling pathway activating transdifferentiation remains unclear. This article introduces the key signaling pathways and research progress in alveolar epithelial cell transdifferentiation through literature retrieval and classification summary, providing a foundation for elucidating the pathogenesis of BPD and exploring new therapeutic regimens for BPD.

Objective: To explore the potential categories of health risk behaviors among students aged 11 to 18 years in Minhang District, Shanghai in order to identify the influencing factors of health risk behaviors among different categories of students. Methods: Using stratified cluster sampling techniques, a random selection of 1 690 middle school students from Minhang District, Shanghai, were chosen as the study sample. Data was collected using the "Shanghai Adolescent Health-Related Behavior Survey Questionnaire" to assess participants' scores on six categories of health risk behaviors. Latent profile analysis (LPA) was employed to cluster students' health risk behaviors, and a multifactorial Logistic regression model was used to analyze the related influencing factors. Results: The health risk behaviors of students aged 11 to 18 in Minhang District, Shanghai, were categorized into 3 groups: Class 1, comprising 915 students (54.14%), with moderate to low scores in health risk behaviors, named "the group with moderately low levels of various health risk behaviors"; Class 2, comprising 539 students (31.89%), with higher scores in psychological addiction, named "the group with psychological addiction as the prominent health risk behavior"; Class 3, comprising 236 students (13.97%), with higher scores in substance addiction, named "the group with substance addiction as the prominent health risk behavior". The results of the univariate analysis for the three potential categories of student health risk behaviors show that there are statistically significant differences in the 3 potential categories of health risk behaviors among students of different schools, ages, ethnicities, and boarding situations (P < 0.05). The analysis results of the multivariate Logistic regression indicate that compared to junior high school students, both senior high school students and vocational high school students have a higher risk of exhibiting unhealthy behaviors characterized by psychological addiction and substance addiction, with all differences being statistically significant (P < 0.05). Conclusion: The latent profile analysis reveals three distinct categories of health risk behaviors among students aged 11 to 18 years in Minhang District, Shanghai, with significant distribution differences among students from diverse backgrounds. Consequently, it is recommended that tailored health education and intervention measures be implemented for students with different school characteristics and at various educational stages.

Objective: To explore the mediating effect of maternal childbirth self-efficacy between reproductive health literacy during pregnancy and expected mode of delivery, in order to provide a reference for obstetric care providers to carry out scientific and reasonable childbirth decision support interventions. Methods: A questionnaire survey was conducted among pregnant women in late pregnancy seeing doctors in Obstetric Clinic of Obstetrics and Gynecology Hospital, Fudan University from Oct 2020 to Feb 2021 using convenience sampling. A general information questionnaire, the Reproductive Health Literacy Scale, and Childbirth Self-efficacy Scale were used in the survey. Linear regression and Logistic regression analyses were used to assess the associations between reproductive health literacy during pregnancy and childbirth self-efficacy and expected mode of delivery, respectively, and to assess the significance of the mediating effect of childbirth self-efficacy between productive health literacy during pregnancy and expected mode of delivery. The MacKinnon's product-of-coefficients method was used to assess the mediating effect of maternal childbirth self-efficacy. Results: A total of 343 participants were included in the study. Regression analysis results of factors influencing expected mode of delivery showed that reproductive health literacy during pregnancy (c'=1.644, 95%CI: 2.223-12.059) and childbirth self-efficacy (β=2.211, 95%CI: 6.300-13.215) were associated with expected mode of delivery (P < 0.001); childbirth self-efficacy was significantly and positively associated with reproductive health literacy during pregnancy (β=1.280, 95%CI: 0.102-0.165, P < 0.01). Childbirth self-efficacy was a mediating variable for health literacy during pregnancy and expected mode of delivery with an effect size of 24.8%. Conclusion: Childbirth self-efficacy mediated the association between reproductive health literacy during pregnancy and expected mode of delivery. Obstetric care providers should focus on strengthening maternal care and childbirth education, improving pregnant women's childbirth self-efficacy and reproductive health literacy during pregnancy, thereby enabling women to make scientific decisions on expected mode of delivery in order to promote normal childbirth.

The incidence of decreased ovarian reserve (DOR) is gradually increasing, with fluctuations in hormone levels causing a series of clinical syndromes.Among these, sleep disorders stand out as prominent symptoms, clinically manifested by difficulties in falling asleep, shortened sleep duration, and poor sleep quality, severely impacting the physical and mental health as well as the quality of life of women. Clinical observations have found a close relationship between decreased ovarian reserve and sleep disorders, where the two interact causally and reciprocally. Western medicine primarily focuses on improving behavioral cognition, administering sedatives and hypnotics, and hormone replacement therapy, albeit with certain limitations in efficacy. Traditional Chinese medicine emphasizes holistic views and syndrome differentiation in treatment, offering low side effects and unique advantages. This review summarizes recent literature on the research progress of sleep disorders and DOR from both Western and traditional Chinese medicine perspectives, providing reference for clinical treatment.

Objective: To explore the clinical value of vaginoscopy in the diagnosis and treatment of uterine cavity diseases in virgins. Methods: We retrospectively reviewed the data of 450 patients who underwent vaginoscopy and traditional hysteroscopy in Obstetrics and Gynecology Hospital, Fudan University from Jan 2020 to Dec 2023, including vaginoscopy group (n=232) and traditional hysteroscopy group (n=218). The average ages of the two groups were 24.9±4.7 years and 25.5±5.4 years, and there was no significant difference between the two groups (P > 0.05). The operation time, estimated blood loss, fluid deficit, false passage, surgical failure, incidence of complications and postoperative pain score were compared between vaginoscopy group and traditional hysteroscopy group. Results: Compared with the traditional hysteroscopy group, the average operation time in the vaginoscopy group was shorter, the fluid deficit was less, and the VAS pain score was lower, but the rate of surgical failure was higher (7.8% vs. 0), all the differences were statistically significant (P < 0.05). In terms of complications, the incidence of false passage in the vaginoscopy group was less (0 vs. 3.2%) and the rate of hymen injury was lower (0 vs. 85.3%), the differences were statistically significant (P < 0.05). There was no significant difference in the estimated blood loss between the two groups, and the incidence of postoperative infection was similar in both groups. There were no complications such as uterine perforation and air embolism in both groups. Conclusion: Vaginoscopy is safe and effective, more minimally invasive than traditional hysteroscopy, does not damage the hymen, and is suitable for virgins. This technology is worthy of clinical application.

A bicornuate uterus is a rare congenital uterine anomaly and structural abnormality that significantly impacts fertility and pregnancy outcomes. It is intimately linked with complications including infertility, miscarriage, preterm birth, fetal malformations, and placental abnormalities. This review delves into the effects of a bicornuate uterus on fertility, discusses prevalent obstetric complications, and highlights the adverse pregnancy outcomes for fetuses and newborns. Although reconstructive surgery can improve reproductive outcomes, spontaneous miscarriages and severe pregnancy complications may still occur. This article reviews the relevant literature, and explores the implications of a bicornuate uterus on pregnancy outcomes and its management strategies.

Objective: To develop a nurse-led case management practice program for ovarian cancer patients, and to investigate its application effect initially. Methods: The case management practice model of ovarian cancer was formed through literature analysis, qualitative research and expert meeting method. Ovarian cancer patients who were given conventional nursing interventions from Aug 2022 to Jun 2023 and from Jul 2023 to Mar 2024 in Obstetrics and Gynecology Hospital, Fudan University were selected as the control group (n=16) and the intervention group (n=16). The patients'supportive care needs, disease symptoms and unplanned readmission rates were compared before and after intervention between two groups. Supportive Care Needs Survey Shortform 34 (SCNS-SF34) was used to collect patients' supportive care needs, and M.D. Anderson Symptom Inventory (MDASI) was used to assess disease symptoms. Results: The ovarian cancer case management practice program was constructed and revised to determine the qualification and professional competence of the ovarian cancer case manager, the core of practice, and the specific implementation pathway. After intervention, the total score and scores of all dimensions of SCNS-SF34 in the intervention group were lower than those of the control group (P < 0.001), the total score and scores of all dimensions of MDASI in the intervention group were lower than those of the control group (P < 0.05). There was no statistically significant difference in unplanned readmission rates between the two groups. Conclusion: The case management practice program for ovarian cancer patients was constructed with scientific validity, which can effectively meet the care needs of patients and alleviate their disease symptoms.

The incidence of premature ovarian insufficiency (POI) is increasing and showing a trend of affecting younger women, which not only affects women's fertility, but also has the risk of low estrogen in the short and long term. The etiology of POI is complex and highly heterogeneous, including genetic factors, iatrogenic factors, autoimmune dysfunction, infection and environmental factors, but idiopathic POI still accounts for the majority. A lot of researches have focused on the correlation between autoimmune diseases and POI, among which autoimmune thyroid disease (AITD) plays an important role. Therefore, this article will review the current status of POI, the possible pathogenesis of AITD and related treatment progress.

Objective: To understand the disease experiences of women with endometriosis (EMs), so as to provide a basis for improving the diagnosis, treatment, nursing and support of this population. Methods: The databases of PubMed, Web of Science, Scopus, Embase, Cochrane Library, VIP, Wanfang Data, CNKI, CBM were retrieved on qualitative research about the disease experiences of endometriosis patients from inception to Jun 2023. The quality of the literature was evaluated by Joanna Briggs Institute (JBI) Critical Appraisal Tool for qualitative studies. Results: A total of 17 studies were included, 51 clear research findings were extracted, which were summarized into 10 new categories and 3 integrated results: (1) Cyclical episodes of the disease not only bring physical and psychological distress, but also lead to decreasing the patient's sense of female identity, destroying social and intimating relationships; (2) The doctor and patient interaction is influenced by imbalance of cognitive, the process of diagnosis and treatment is full of challenges, and patients have a demand for professional information and social support; (3) Growing up in pain, patients actively self-adjust and positively cope with the disease. Conclusion: EMs affects patients' quality of life physiologically and psychologically, with prevalent issues of delayed diagnosis and repeated treatments. The professional information supported by health professionals needs to be improved. Healthcare providers should pay more attention to patients' physical and emotional experiences in their clinical work, improve their informal support, participate in long-term management, and improve patients' ability to manage their diseases.

Objective: To compare the pain relief and long-term clinical success rate of vital pulp therapy and root canal treatment in mature permanent teeth with carious irreversible pulpitis. Methods: A total of 90 patients diagnosed with carious irreversible pulpitis in mature permanent teeth were collected at Shanghai Stomatological Hospital from Jan 2021 to Jun 2022. They were randomly divided into two groups: test group (n=45) undergoing vital pulp therapy (VPT) and control group (n=45) undergoing root canal treatment (RCT). Pain scores were recorded before treatment, 24 hours after operation and 7 days after operation. We conducted clinical evaluation and imaging analysis at 1, 6, and 12 months after the surgery, then compared the pain scores and treatment success rates between the two groups. Results: Eighty-one patients, including 39 patients in group VPT aged (31.00±1.43) years old and 42 patients in group RCT aged (30.60±1.54) years old, received follow-up for more than 1 year, and the success rate of the test group and control was 97.44% and 95.24%. The pain degree of the two groups was reduced at 24 hours and 7 days after operation (P < 0.05), and the pain score of the test group was reduced compared with that in the control group 7 days after operation (P < 0.01). Conclusion: Compared with root canal treatment, vital pulp therapy for mature permanent teeth with carious irreversible pulpitis can achieve good results in short-term pain evolution and long-term clinical success.

Pulmonary alveolar proteinosis (PAP) is a rare progressive respiratory dysfunction disease of the lung characterized by insidious onset and non-specific clinical manifestations, often leading to misdiagnosed and mistreated. Herein, we reported a case of PAP patient admitted to Jiading District Central Hospital with an atypical appearance of alveolar lavage fluid and whose condition improved significantly after treatment with subcutaneous injection of recombinant human granulocyte-macrophage colony stimulating factor (GM-CSF). Additionally, we have reviewed and summarized the relevant literature to enhance the understanding of the diagnosis and treatment of this disease.

Objective: To introduce how to import and analyze data using the Research Electronic Data Capture(REDCap) system, taking a multi-center randomized controlled clinical research of total knee arthroplasty as an example. Methods: Various tools within the REDCap system, including data import tools, data export functions, reports and statistics, project dashboards, and coding manuals, were used to systematically process and analyze the multi-center randomized controlled clinical trial data for total knee arthroplasty. Initially, electronically collected clinical data were adjusted and standardized, then uploaded in bulk to the system using the REDCap data import tool. Subsequently, the data were organized through REDCap's data export feature, and basic descriptive statistical analysis was performed using its reporting and statistical functions to ensure data quality and completeness. Results: An electronic data collection and management platform for clinical research on knee osteoarthritis wase successfully created by the REDCap system. The platform enabled real-time data collection from multiple centers, and ensured data accuracy and consistency through built-in data management and quality control mechanisms. With the statistical analysis features of REDCap, the research team could monitor the progress of data in real time, conduct effective quality assessments, and perform dynamic analysis for further in-depth statistical evaluations. Conclusion: The REDCap system can be used not only to build a new clinical research project, but also to import and analyze data that has been previously digitized of ongoing clinical researches into the system, which improved the scientificity of data management and research efficiency.

Objective: To explore the construction and verification of the classification model for the five properties of traditional Chinese medicine: warm, cool, cold, hot, and neutral. Methods: Urine samples of mice after taking Chinese medicine of different properties were selected as research objects, and Raman spectroscopy-related technology was used for detection. The obtained data set was classified into training set and test set, and the classification model was constructed using four machine learning methods: random forest, extreme gradient boosting, support vector machine, and logistic regression. The model performance was evaluated using precision, recall, F1 score, and accuracy. Results: A total of 4 888 sets of spectra were collected in this study, of which 80%, totaling 3 910 sets of spectral data, were used to build the model, and the remaining 20%, totaling 978 sets of spectral data, were used to test model performance. The accuracy of the random forest model was 92%, the extreme gradient boosting model was 87%, the support vector machine model was 83%, and the logistic regression model was 75%. The Raman shifts with the highest classification weights were 872, 1 012, 1 108, 1 190 and 1 668 cm^-1. Conclusion: Raman spectroscopy combined with machine learning algorithms can be used to classify the five medicinal properties of traditional Chinese medicine, among which the random forest model has the best effect.

Objective: To investigate the correlation between serum uric acid (SUA) levels and incident chronic kidney disease (CKD) in middle-aged and elderly Chinese population and gender differences. Methods: Based on the longitudinal survey data of China Health and Retirement Longitudinal Study from 2011 to 2015, the CKD-Epidemiology Collaboration cystatin C formula was used to estimate the glomerular filtration rate (eGFR), and 4 119 participants with normal renal function (eGFR≥60 mL·min^-1·1.72 m^-2) at baseline were included. Incident CKD was defined as eGFR<60 mL·min^-1·1.72 m^-2 at the follow-up in 2015. Logistic regression analysis was used to analysis the association of SUA levels at baseline and incident CKD among different genders. Restricted cubic spline analysis was used to analyze the dose-response relationship. Results: After 4-year follow-up, 127 participants developed incident CKD, including 57 males and 70 females. Multivariate Logistic regression analysis showed that elevated SUA levels were independently associated with the risk of incident CKD (OR=1.532, P<0.001). For each 1 mg/dL increase in SUA, the risk of incident CKD increased by 33.6% in males (OR=1.336, P=0.012) and 77.5% in females (OR=1.755, P<0.001). Restricted cubic spline analysis showed a linear positive correlation between SUA levels and incident CKD in both males and females. Participants were divided into four groups according to SUA quartiles (Q1-Q4). Multivariate Logistic regression analysis indicated a significant increase in the risk of incident CKD in Q3 group (3.75 mg/dL<SUA≤4.43 mg/dL) and Q4 group (SUA>4.43 mg/dL) compared with Q1 group in females (Q3 group: OR=2.571, P=0.045;Q4 group: OR=3.666, P=0.005). Conclusion: SUA is an independent risk factor for incident CKD in the middle-aged and elderly population. In females, serum uric acid levels exceeding 3.75 mg/dL are associated with an increased risk of incident CKD.

Objective: To construct and identify an organoid model of human placental site trophoblastic tumor (PSTT). Methods: The tumor cells were obtained by digesting and separating the PSTT tissues and then embedded in Matrigel. The organoids were cultured in the specific organoid medium. The histological morphology of the organoid model was observed by HE staining and the expression levels of the PSTT specific markers [human placental prolactin (HPL), human leukocyte antigen-G (HLA-G) and placental alkaline phosphatase (PLAP)] were detected by immunohistochemistry and immunofluorescence, so as to evaluate the consistency between the organoid model and the PSTT tissue. Meanwhile, the morphology and forming efficiency of the constructed model were observed under a microscope after primary culture, passage generation and cryopreservation to evaluate its potential application as an organoid model in basic and clinical translational research of PSTT. Results: The constructed organoid model could proliferate stably, growing from small microspheres into compact solid spheres or spheres with follicle-like structures, and could passage after fully grown in 7-10 days. The cell state remained stable after passage, frozen storage and recovery. HE staining showed that the morphology of the cells in the organoids was similar to that of the primary PSTT tumor cells, and immunofluorescence staining showed that the organoids highly expressed HLA-G and lowly expressed β-HCG, indicating that the constructed organoid model mainly contained intermediate trophoblast. Conclusion: The adult-derived PSTT organoid (ADPO) models were successfully established.

Objective: To explore the feasibility and clinical effects of a novel hysteroscopic levonorgestrel-releasing intrauterine system (LNG-IUS) fixation at the fundus of uterus. Methods: From Aug 2023 to Jan 2024, a prospective and novel hysteroscopic LNG-IUS fixation at the fundus of uterus surgery was performed at Obstetrics and Gynecology Hospital, Fudan University. The patient's clinical symptoms, surgical time, surgical complications, postoperative LNG-IUS expulsion, and other follow-up information were recorded. Results: A total of 21 patients were included in this study, with an average age of (37.8±6.8) years old. The average uterine depth was (9.06±0.74) cm. Among them, 8 cases had a history of LNG-IUS expulsion (uterine depth > 8.5 cm in 5 cases, uterine depth≤8.5 cm in 3 cases, but the cervical canal was relatively loose), and other 13 cases had no history of LNG-IUS expulsion, but the uterine depth was all deeper than 8.5 cm. The average surgical time was (14.0±4.3) minutes, and the average intraoperative blood loss was (4.5±3.3) mL. All patients did not experience complications such as uterine perforation, massive bleeding, fluid overload, or postoperative infection. The average follow-up time after surgery was (3.2±0.8) months, and there was no LNG-IUS expulsion occured. The pain assessment and mean menstrual flow after operation were less than those before operation, and the endometrial thickness and mean uterine volume after operation were lower than those before operation, with statistically significant differences. For patients with dysmenorrhea, the postoperative relief rate was 95.0% (19/20), and for those with excessive menstruation, the postoperative effective rate reached 94.4% (17/18). The main adverse reaction was irregular vaginal bleeding, with an incidence rate of 57.1% (12/21). Conclusion: Hysteroscopic LNG-IUS fixation at the fundus of uterus is safe and effective. The procedure is simple, minimally invasive, has a short surgical time, minimal bleeding, and fast recovery. It is suitable for patients with dysmenorrhea, excessive menstruation, or large uterine cavity who have previously experienced LNG-IUS expulsion.

This paper introduces a transfer learning approach based on regression models and demonstrates its application in the medical field through an example. Using data from the 2013-2014 U.S. National Health and Nutrition Examination Survey, the study investigates the association of sleep duration with depression levels and depressive disorder. It employs demographic characteristics and lifestyle factors as predictor variables to predict depression levels and depressive disorder across different racial groups. Compared to models built solely on target racial groups, transfer learning enhances the accuracy of estimating the effect of sleep duration in the target group and improves the prediction accuracy for depression levels and depressive disorder. The results illustrate that transfer learning effectively integrates source data to significantly improve estimation and prediction capabilities of target models, especially in situations with limited target data and heterogeneous data sources.

Objective: To investigate the value of pre-treatment MRI features in predicting cachexia in hepatocellular carcinoma (HCC). Methods: A retrospective analysis was conducted on 399 patients with hepatocellular carcinoma, recording their pre-treatment clinical and MRI data. All patients underwent MRI plain and enhanced scan, and their weight was followed up 6 months after the MRI examination. According to the diagnostic criteria for cachexia, patients were divided into cachexia group and non-cachexia group. They were randomly divided into the training set (n=279) and the validation set (n=120). Univariable and multivariable logistic regression analyses were used to screen variables associated with cachexia in hepatocellular carcinoma and to establish a predictive model. The receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of different models. The DeLong test was used to compare the AUC values of different models, and the best-performing model was used to establish a predictive nomogram for cachexia in hepatocellular carcinoma. Results: Multivariable logistic regression analysis showed that serum albumin < 40 g/dL, serum alpha-fetoprotein > 100 ng/mL, tumor diameter > 5 cm, portal vein tumor thrombus, intratumoral arterial enhancement, and arterial phase peritumoral enhancement were independent predictors of cachexia in hepatocellular carcinoma. The clinical-imaging model showed the best predictive performance, with an AUC of 0.843 in the training set and 0.854 in the validation set. Conclusion: The nomogram based on MRI features can predict cachexia in hepatocellular carcinoma 6 months earlier than clinical diagnosis, which has important clinical guidance significance.

Helicobacter pylori (HP), a well-established carcinogenic factor, is implicated in the pathogenesis of gastric ulcer, gastric cancer, and other related diseases. Recent studies have unveiled a significant association between HP infection and an increased prevalence of non-alcoholic fatty liver disease (NAFLD). Furthermore, it has been observed that eradication of HP can ameliorate metabolic disorders and relieve NAFLD. Some studies have explored the possible mechanism, which may be related to energy metabolism disorder and gut microbiota imbalance caused by HP. This review outlined the current research status regarding the association between HP and NAFLD, as well as elucidated the potential mechanisms through which HP promoted the onset and progression of NAFLD.

Objective: To investigate the latent classes of mental workload and related factors among cardiovascular nurses. Methods: A convenience sample of 664 cardiovascular nurses were surveyed from Jun to Jul 2023. General information questionnaire, the Nurse Workload Index Scale and the Nursing Interruption Event Scale were conducted in the investigation. Latent class analysis and multiple Logistic regression analysis were employed to analyze the latent classes of nurses' mental workload and its related factors. Results: Two latent classes were identified, named low mental workload group (25.90%) and a high mental workload group (74.10%). Multiple Logistic regression analysis revealed that educational qualifications (OR=1.641, 95%CI: 1.036-2.598), nursing interruption event scores (OR=1.060, 95%CI: 1.044-1.076), and the region of nurses (OR=0.688, 95%CI: 0.542-0.874) were the influencing factors for cardiovascular nurses' mental workload. Conclusion: There are obvious categorical characteristics of cardiovascular nurses' mental workload, nurses with higher education, frequent interruption events, and from the eastern region have higher mental workload. Nursing managers need to focus on human resource allocation and optimize processes to reduce the occurrence of nursing interruptions.

Congenital heart disease (CHD) is a prevalent birth defect in clinical practice, constituting one of the primary causes of infant death. As research on the placenta deepens and the imaging technology continually advances, researchers have found that there may be associations between CHD and placenta dysfunction. Investigating the correlation between placenta dysfunction and CHD has gradually become a research focus. The placenta and the fetal heart develop concurrently and share common signaling pathways, influenced by both genetic and environmental factors, known as the placenta-heart axis. This paper reviewed the current research landscape of the placenta-heart axis and the utilization of advanced ultrasound imaging technology to assess placental structure and function, in order to provide help for management and treatment of CHD.

Objective: To investigate the prevalence of post-traumatic stress disorder (PTSD) in patients during the postoperative period following cardiac surgery and to identify its influencing factors. Methods: Post-cardiac surgery patients hospitalized during Sep to Nov, 2023 were surveyed using questionnaires consisting of a general information questionnaire, PTSD checklist, resilience scale, social support rating scale, anxiety and depression self-rating scale, and simple coping style questionnaire. Then we analyzed the factors influencing PTSD symptoms after cardiac surgery. Results: A total of 267 cases were enrolled.The mean PTSD score of the post-cardiac surgery patients was 16.51±12.31, with 29 patients at high risk for developing PTSD. Stepwise regression analysis revealed that low educational level, use of cardiopulmonary bypass, long stay in ICU, high pain scores, low levels of psychological resilience and social support, as well as high depression score were associated with higher PTSD scores in post-cardiac surgery patients (P < 0.05). Conclusion: The occurrence of PTSD symptoms in patients after cardiac surgery is common and varies in severity. The influencing factors include the patient's educational level, use of extracorporeal circulation during surgery, length of ICU stay, duration of ventilator use, pain, patient's depression score, psychological resilience, and social support. Medical staff should pay more attention to the mental health level of high-risk patients and take targeted intervention measures in a timely manner.

With the important trend of body shape in whole lifecycle management of breast cancer patients and the emergence of new evidence-based medical and nursing data, it is necessary to sort out and update the body shape management of breast cancer patients. Experts of Breast Cancer Integrated Nursing Professional Committee of Chinese Anti-Cancer Association, Breast Cancer Case Manager Branch of Chinese Medical Education Association and Breast Cancer Professional Committee of Chinese Anti-Cancer Association convened domestic experts in the field of breast cancer nursing, including breast surgery, medical oncology, radiotherapy, nursing management and other nursing fields, who jointly discussed and formulated the "expert consensus on body shape management of breast cancer patients". The consensus has elaborated on the management of surgery-related body, comprehensive treatment-related body and other related body management, hoping to provide homogenized suggestions for personnel in various breast specialties to carry out body shape management of patients, and improve the standardization of care.

Objective: To establish a mouse model of human Escherichia coli (E. coli) colonization in early mammalian intestines, and to explore the trend and influencing factors of E. coli colonization in mouse intestines. Methods: A wild-type E. coli strain LFYP5, derived from an infant, was inoculated into the SPF mice via gavage. The abundance change curves of E. coli were plotted by collecting intestinal contents or fecal samples from the mice and utilizing plate counting colony forming unit (CFU) methods. This study investigated the effects of different intestinal locations, inoculation ages, weaning time, and cage-changing time on the colonization abundance of E. coli. Additionally, 16S rRNA sequencing was used to explore the changes in the microbial composition of the mouse gut after inoculation with E. coli. Results: E. coli LFYP5 was able to colonize the intestinal tract of mice before the weaning age. Its abundance decreased rapidly at the weaning stage, independent of the inoculation age, and whether to change the cages. When weaning occurred too early, the abundance of E. coli declined correspondingly earlier. Mice inoculated with E. coli LFYP5 had a lower alpha diversity of the gut microbiota composition and higher relative abundance of the lactobacillus genus compared to mice without E. coli LFYP5 inoculation. Conclusion: A mouse model of human E. coli colonization in the early mammalian gut has been successfully established. This model may be used to study the colonization mechanisms of human E. coli in the mammalian gut in the future.

Objective: To investigate the degree of fibrosis, the expression of estrogen and progesterone receptors, and the expression of angiogenesis-related molecules in polypoid endometriosis, with the aim of further elucidating its histopathological characteristics. Methods: The study retrospectively analyzed the clinicopathological data of 42 patients diagnosed with polypoid endometriosis through surgical treatment at Obstetrics and Gynecology Hospital, Fudan University from Apr 2014 to Aug 2020. Additionally, tissue samples from 19 cases of ovarian endometriotic cysts, 20 cases of adenomyosis, 20 cases of deep infiltrating endometriosis, and 20 cases of endometrial polyps, all pathologically confirmed, were collected as a control group. The degree of fibrosis, the expression of estrogen and progesterone receptors, and the expression of angiogenesis-related molecules in the lesions of each group were determined using Masson staining and immunohistochemistry. Results: The mean age of onset of the 42 patients with polypoid endometriosis was 41.24 years. And the most usual clinical manifestation is pelvic mass (24/42 patients). Immunohistochemical experiments showed that polypoid endometriosis was less fibrotic than ovarian endometriotic cysts, adenomyosis and deep infiltrating endometriosis but more fibrotic than endometrial polyps. Polypoid endometriosis also has a higher vascular density, increased expression of estrogen receptor-β (ER-β), and down-regulated expression of progesterone receptor B (PR-B). Conclusion: Polypoid endometriosis is a distinct subtype of endometriosis characterized by a lower degree of fibrosis, higher levels of estrogen receptor expression, and relatively rich vascularization, generally associated with a favorable prognosis.