Abstract:Objective:To investigate the expression of DHX37,PD-L1,CD4+and CD8+and the clinicopathological features in lymphoepithelioma-like gastric carcinoma(LELGC).Methods:10 cases of LELGC were collected and immunohistochemistry were used to analyze DHX37,PD-L1,CD4+,CD8+,and mismatch repair gene proteins(MLH1,MSH2,MSH6 and PMS2),in situ hybridization was performed to detect Epstein-Barr virus-encoded RNA(EBER)and investigate their clinicopathological characteristics.Selected 10 cases of conventional gastric adenocarcinoma with similar clinical features for comparison.Results:In a sample of 10 cases of LELGC,the average age was approximately(55.00±10.19)years,there were 8 male and 2 female patients.6 cases occurred in the body of the stomach,2 in the gastric angle,1 in the cardia,and 1 in the antrum,which was also a residual gastric cancer.All 10 surgically resected specimens presented with ulcerative lesions,with the smallest diameter measuring 1.7 cm and the largest 7.0 cm.All 10 LELGC cases showed intact mismatch repair protein function(Mismatch Repair Proficient,pMMR)and were EBER-positive,with the number of CD8+-positive T cells exceeding that of CD4+-positive T cells in each case.The average CPS for PD-L1 was(35.00±14.53),the av-erage positive expression count for DHX37 was(42.26±13.11).In LELGC,the proportion of DHX37 expression in lymphocytes was lower than that in conventional gastric adenocarcinoma(P＜0.05),and this condition also exhibited higher PD-L1 expression levels(P＜0.05).Conclusion:The diagnosis and prognosis assessment of LELGC rely on characteristic pathological morphology and molecu-lar testing.The stroma is predominantly infiltrated by CD8+-positive T cells.Compared to conventional gastric adenocarcinoma,LELGC exhibits higher PD-L1 and lower DHX37 expression.These features may be associated with better prognosis and higher sensitivity to im-munotherapy in these patients,suggesting that different expression patterns of DHX37,CD4+,CD8+,and PD-L1 might have significant implications for the prognosis of LELGC or conventional gastric adenocarcinoma.

Abstract:Objective:To investigate the causal relationship between frailty and kidney function through Mendelian randomiza-tion.Methods:Single nucleotide polymorphisms(SNP)significantly associated with frailty were selected from a large genome-wide as-sociation study(GWAS)database as instrumental variables.Mendelian randomization was performed using three approaches:inverse variance weighted,MR-Egger,and weighted median.The causal link between frailty and kidney function was evaluated using β values and 95％CI.Meanwhile,to ensure the reliability and robustness of the findings,heterogeneity tests,sensitivity analysis,and pleiotropy tests were performed using Cochran's Q test,MR-Egger,MR-PRESSO,and leave-one-out analysis.Results:The IVW estimate revealed a significant negative causal relationship between frailty and blood urea nitrogen(β=-0.030,95％CI:-0.055～-0.006,P=0.013).Similarly,a negative causal relationship was found between frailty and the cystatin C-estimated glomerular filtration rate(β=-0.045,95％CI:-0.065～-0.025,P＜0.001).However,no causal relationship was observed between frailty and the urinary albu-min/creatinine ratio,serum creatinine,or chronic kidney disease.Conclusion:This study confirms the causal relationship between frail-ty and kidney function,providing a reference for the prevention and treatment of frailty and kidney function impairment by integration of traditional Chinese and Western medicine.

Abstract:Objective:To explore the effect of down-regulation of γ-butyrobetaine hydroxylase 1(BBOX1)of patients with inva-sive breast cancer and correlation analysis of tumor immunity.Methods:The expression of BBOX1 in breast cancer was explored by TC-GA and GTEx database.And the relationship between the expression of BBOX1 and pathological features was analyzed by BcGenExMin-erv4.5 database and immunohistochemical methods.Kaplan-MeierPlotter database predicted the prognostic role of BBOX1 in breast cancer,and cancerSEA database evaluated the function of BBOX1 in breast cancer single cells.The Metascape database was used for GO enrichment and KEGG signaling pathway analysis.The TISIDB database was used to analyse of tumor chemotactic factors and tumor immunological cell infiltration related to breast cancer.Results:BBOX1 was highly expressed in breast cancer and its expression level was related to the formation of tumor immune microenvironment.Prognostic analysis showed that high expression of BBOX1 indicates worse recurrence free survival(RFS)and overall survival(OS).Single cell functional analysis revealed that BBOX1 expression was mainly related to angiogenesis,DNA repair,epithelial mesenchymal transformation,invasion,differentiation and stem cell characteristics in breast cancer.Conclusion:The abnormally high expression of BBOX1 in breast cancer indicates a poor prognosis and has a certain correlation with the formation of tumor immune microenvironment in breast cancer.

Abstract:Objective:To construct a Logistic regression model based on baseline CT to predict neoadjuvant chemotherapy re-sponse in advanced gastric cancer.Methods:Pretherapeutic and posttreatment CT imaging data and clinical data of 156 patients with advanced gastric cancer receiving neoadjuvant chemotherapy were retrospectively collected.The collected cases were randomly assigned into the training cohort(n=117)and the validation cohort(n=39)at a ratio of 3∶1.In the training cohort,the univariate analyse were performed to explore the relationship between relevant pretherapeutic indicators and the response of gastric cancer,and the indicators with statistical difference were included in a multivariate Logistic regression to determine the independent predictors.Subsequently,a Logistic regression model was constructed based on above independent predictors.Predictive performance of the model was evaluated by the receiver operating characteristic curve(ROC)and area under the ROC curve(AUC).In the validation cohort,the prediction effi-ciency of the model was verified by Kappa test.Results:In the training cohort,the univariate analysis showed statistically significant difference in cT stage,cN stage,and gross tumor volume(GTV)between patients with and without response(P＜0.05).Multivariate analyses showed that cT stage,cN stage,and GTV were independent influencing factors of the response(P＜0.05).ROC showed that the AUC of the Logistic regression model based on independent predictors to predict the treatment response was 0.724.In the validation cohort,the predictive model also performed well(Kappa=0.623).Conclusion;The Logistic regression model developed based on the cT staging,cN stage,and GTV is of great value in predicting the response of advanced gastric cancer after neoadjuvant chemotherapy.

Abstract:Objective:To explore the efficacy of acupuncture combined with tamsulosin in the treatment of type Ⅲ prostatitis and its effect on inflammatory response and hemorheology.Methods:92 patients with type Ⅲ prostatitis were divided into control group(n=46)and observation group(n=46)according to different treatment methods.The control group was given tamsulosin,the observa-tion group was given acupuncture combined with tamsulosin,they were both treated continuously for 8 weeks.The clinical efficacy,symptoms of prostatitis[National Institutes of Health Chronic Prostatitis Symptom Index(NIH-CPSI)score],levels of inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],and hemorheological indicators[whole blood high shear viscosity(HBV),whole blood low shear viscosity(LBV),whole blood reduced viscosity(RV)]before and after treatment were compared be-tween the two groups.Results:The total effective rate of observation group was higher than that of control group(86.96％vs.65.22％,P＜0.05).After 8 weeks of treatment,the NIH-CPS score and the levels of IL-6,TNF-α,HBV,LBV and RV in both groups showed a decrease,and the observation group was lower than the control group(P＜0.05).Conclusion:Acupuncture on the basis of tamsulosin in the treatment of type Ⅲ prostatitis can improve the clinical efficacy,relieve related symptoms,inhibit inflammatory response and im-prove hemorheology.

Abstract:Objective:To investigate the changes of serum vasoactive intestinal peptide(VIP),angiopoietin-2(Ang-2)and nes-fatin-1 in patients with endometriosis(EMS)and the relationship with disease conditions.Methods:A total of 115 patients with EMS confirmed by postoperative pathology after laparoscopic surgery were included in EMS group.According to the different stages of dis-ease,the patients were divided into early group(n=41,stage Ⅰ～Ⅱ)and late group(n=74,stage Ⅲ～Ⅳ).60 healthy women with physical examination were enrolled as healthy group.Baseline data and clinical indicators between EMS group and healthy group and se-rum indicators between early group and late group were compared.Pearson method was used to analyze the correlation between serum indicators and clinical indicators.After 1 year of follow-up,the patients in EMS group were classified into pregnancy group(n=68)and non-pregnancy group(n=47)by means of outcomes,and serum indicators were compared.The clinical value of serum indicators on evaluating prognosis was analyzed by ROC curve.Results:Abortion history and CA125 in EMS group were higher than those in healthy group(P＜0.05),E2,P and FSH were lower than those in healthy group(P＜0.05).The levels of serum indicators were higher in EMS group than those in healthy group(P＜0.05),and were higher in late group than those in early group(P＜0.05).Ser-um indicators were positively correlated with CA125(P＜0.05),and were negatively correlated with E2,P and FSH(P＜0.05).Ser-um indicators levels in non-pregnancy group were higher than those in pregnancy group(P＜0.05).The AUCs of three serum indica-tors were 0.650,0.701 and 0.727 respectively,and the AUC of the combination of the three was 0.798,indicating a higher value of combined diagnosis.Conclusion:Serum VIP,Ang-2 and nesfatin-1 levels are closely related to the pathogenesis and progression of EMS,which can be used as reference indicators for clinical diagnosis,and combined diagnosis has higher value.

Abstract:Objective:To investigate the effects of programmed death receptor 1(PD-1)inhibitor combined with low-dose chemotherapy on immune function and platelets in patients with advanced lung cancer.Methods:77 patients with advanced lung cancer were divided into control group(n=38)and observation group(n=39)according to different chemotherapy regimens.The control group was given conventional dose chemotherapy with paclitaxel and cisplatin,while the observation group was given PD-1 inhibitor(Trepelizumab)combined with reduced dose chemotherapy with paclitaxel and cisplatin,with one cycle every 21 d,and both groups were treated for three cycles.The clinical efficacy[objective response rate(ORR),disease control rate(DCR)],immune cell levels[CD3+cells,CD8+cytotoxic T cells(CD8+CTL),natural killer cells(NK)]and platelet(PLT)levels,adverse reactions and prog-nosis[progression free survival(PFS)and overall survival(OS)]before and after treatment were compared between the two groups.Results:There was no statistically significant difference in ORR and DCR between the two groups(P＞0.05).After treatment,there was no statistically significant difference in the levels of CD3+,CD8+CTL,and NK cells between the control group and before treat-ment(P＞0.05).The levels of CD3+cells,CD8+CTL and NK cells in the observation group increased and were higher than those in the control group(P＜0.05),while the level of PLT decreased but was higher than that in the control group(P＜0.05).There was no statistically significant difference in the incidence of leukopenia,neurotoxicity,liver damage and alopecia between the two groups(P＞0.05).The incidence of grade Ⅰ～Ⅱ gastrointestinal reactions and grade Ⅲ～Ⅳ anemia in the observation group were lower than those in the control group(P＜0.05).PFS and OS in the observation group were longer than those in the control group(P＜0.05).Conclu-sion;PD-l inhibitor combined with low-dose chemotherapy can enhance the immune function of patients with advanced lung cancer,re-duce the decline of PLT and improve the prognosis of patients better.

Abstract:Objective:To investigate the effect of letrozole tablets combined with ethinylestradiol and cyproterone acetate tablets on TIMP-1,CTGF and serum sex hormone levels in patients with polycystic ovary syndrome infertility.Methods:A total of 110 patients with polycystic ovary syndrome-related infertility were divided into a control group and a combined group based on different treatment regimens,with 55 cases in each group.The control group was treated with ethinylestradiol and cyproterone acetate tablets,while the combined group received letrozole tablets in addition to the treatment used in the control group,for a total treatment period of 3 months.Improvement of clinical symptoms,serum factors,serum sex hormones,adverse effects,ovulation rate,pregnancy rate,ovarian volume,follicle number and endometrial thickness were recorded and compared between the two groups.Results:The improvement rate of clini-cal symptoms in the combined group was higher than that in the control group(P＜0.05).After treatment,the levels of matrix metallo-proteinase-9(MMP-9),MMP-9/tissue inhibitor of metalloproteinase-1(TIMP-1)and follicle-stimulating hormone(FSH)were higher in the combined group than in the control group,and the levels of TIMP-1,connective tissue growth factor(CTGF),luteinizing hormone(LH)and estradiol(E2)were lower than those in the control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups of patients compared with each other(P＞0.05).Ovulation and pregnancy rates were high-er in the combined group than in the control group(P＜0.05).After treatment,ovarian volume and follicle count levels were lower and endometrial thickness was higher in the combined group than in the control group(P＜0.05).Conclusion:Compared with treatment with ethinylestradiol cyproterone tablets alone,combined letrozole tablets for the treatment of infertility in polycystic ovary syndrome has a definite efficacy,which can effectively improve the imbalance of MMP-9/TIMP-1 and the hormone level of the gonadal axis,and facili-tate the regulation of the level of CTGF,which can help to improve the ovulation and pregnancy rate.

Abstract:Objective:To explore the influence of Nance traction device combined with edgewise technique on postoperative swelling,pain and complications in patients with maxillary impacted canines.Methods:105 patients with maxillary impacted canines were enrolled.By means of clinical treatment method,they were divided into control group(n=52)and study group(n=53).The control group used conventional orthodontic fixed correction technique and the study group adopted Nance traction device combined with edgewise technique.The differences in treatment success rate,impacted teeth eruption time,postoperative swelling degree,pain score,cytokines[matrix metalloproteinase-3(MMP-3),interleukin-1β(IL-1 β)]and oral microenvironment were compared between the two groups,and the incidence rates of complications were recorded.Results:The success rate of treatment in study group was higher than that in control group(P＜0.05).The eruption time of impacted teeth in study group was shorter than that in control group(P＜0.05).At different time points after surgery,the postoperative swelling degree and pain score were lower in study group than those in control group(P＜0.05).After treatment,the levels of MMP-3,IL-1 β,gingival index(GI)and plaque index(PLI)were increased in both groups,and the study group had lower levels(P＜0.05).The incidence rates of complications in study group were lower than those in control group(P＜0.05).Conclusion:The application of Nance traction device combined with edgewise technique can signifi-cantly improve the postoperative swelling degree and relieve the pain level of patients with maxillary impacted canines,and it has few complications,good safety and good clinical application prospect.

Abstract:Objective:To investigate the correlation between immunoglobulin levels and recurrence after holmium laser resection of bladder tumors.Methods:80 patients with urothelial carcinoma of the bladder who underwent holmium laser resection of bladder tumors were selected for the study.They were divided into recurrence group(n=20)and non-recurrence group(n=60)according to whether or not it recurred after surgery.The changes in lymphocyte subpopulations,immunoglobulin and complement levels were compared between the two groups,and the correlation analysis was carried out by Spearman's method,and the working curve(ROC)of subjects was made,and the predictive value of each index for postoperative recurrence was analyzed by the area under the curve(AUC).Results:The levels of natural killer cells(NK),CD4+T lymphocyte percentage values,CD4+/CD8+ratio,immunoglobulin A(lgA),immunoglobulin G(lgG),immunoglobulin M(lgM),complement C3,and complement C4 were lower in the relapse group than in the non-relapse group at preoperative,3 months,6 months,and 1 year postoperatively(P＜0.05).The CD8+T lymphocyte percentage values were higher in the re-currence group than in the non-recurrence group in the preoperative,1 and 3 months postoperative periods(P＜0.05).Preoperative NK,CD4+T-lymphocyte percentage values,CD4+/CD8+ratio,IgA,IgG,IgM,complement C3 and complement C4 were negatively correlated with postoperative recurrence(P＜0.05),and CD8+T-lymphocyte percentage values were positively correlated with postoperative recur-rence(P＜0.05),which were analyzed by ROC curve analysis to find that all of these indexes had predictive value for postoperative re-lapse of the patients,and the combined prediction of each index had an AUC=0.890,sensitivity of 0.800 and specificity of 0.900(P＜0.05).Conclusion:Preoperative low levels of NK,CD4+T-lymphocyte percentage value,CD4+/CD8+ratio,IgA,IgG,IgM,complement C3 and complement C4,and high levels of CD8+T-lymphocyte percentage value suggest that patients are at high risk of postoperative re-currence,and the combination of these indexes can be used to clinically assist in predicting the prognosis of patients.

Abstract:Objective:To explore the efficacy of bifidobacterium quadruple viable bacteria combined with micro-feeding in the treatment of feeding intolerance in premature infants and its influence on gastrointestinal function and plasma ghrelin and cholecystoki-nin(CCK)levels.Methods:A total of 120 premature infants with feeding intolerance were included,and were divided into feeding group(n=60,micro-feeding therapy)and viable bacteria group(n=60,bifidobacterium quadruple viable bacteria combined with mi-cro-feeding therapy)by different intervention methods.The clinical efficacy,recovery status(feeding tolerance recovery time,normal body mass recovery time,abdominal distension disappearance time,vomiting disappearance time),gastrointestinal function(motilin,gh-relin,CCK)and liver function[albumin,total bilirubin(TBIL)]before and after treatment and incidence rates of adverse events were compared between the two groups.Results:The total efficacy in viable bacteria group was higher than that in feeding group(96.67％vs.86.67％,P＜0.05).The recovery time of each item was shorter in viable bacteria group than that in feeding group(P＜0.05).Af-ter treatment,the levels of motilin,ghrelin and albumin in the two groups were increased(P＜0.05)while the levels of CCK and TBIL were decreased(P＜0.05).The motilin,ghrelin and albumin levels in viable bacteria group were higher in viable bacteria group(P＜0.05),the levels of CCK and TBIL were lower compared to feeding group(P＜0.05).The total incidence rate of adverse events in via-ble bacteria group was lower than that in feeding group(3.33％vs.15.00％,P＜0.05).Conclusion:Bifidobacterium quadruple via-ble bacteria combined with micro-feeding can effectively treat feeding intolerance in premature infants,improve gastrointestinal function and reduce the incidence rates of adverse events.It is worthy of clinical promotion and application.

Abstract:Objective:To investigate the correlation between serum uric acid(UA)/albumin(Alb)ratio(sUAR)and sepsis complicated with acute kidney injury(AKI),and to evaluate its predictive value.Methods:The clinical data of 196 patients with sepsis were retrospectively analyzed.According to the occurrence of AKI,they were divided into AKI group(n=95)and non-AKI group(n=101).The differences of serum sUAR level and other clinical indicators between the two groups were compared.Logistic regression anal-ysis was used to screen the risk factors of sepsis-associated AKI(SA-AKI),and the predictive value of related indicators was evaluated by receiver operating characteristic(ROC)curve.Results:Compared with the non-AKI group,the AKI group was older(P＜0.05),the proportion of combined coronary heart disease,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sepsis-related organ failure(SOFA)score,procalcitonin(PCT),serum creatinine,UA level,sUAR level were higher(P＜0.05),and the Alb level was lower(P＜0.05).Logistic regression analysis showed that older age(OR=1.718),combined coronary heart disease(OR=1.478),higher SOFA score(OR=2.201)and higher sUAR level(OR=2.487)were risk factors for SA-AKI(P＜0.05).ROC curve analysis showed that the AUC of sUAR in predicting SA-AKI was 0.778,the cutoff value was＞8.2 μmol/g,the sensitivity was 81.1％,and the specificity was 64.4％.The AUC of sUAR combined with SOFA score in predicting SA-AKI was higher,which was 0.855.Conclusion:The increase of serum sUAR level is closely related to SA-AKI.sUAR has a certain predictive value for AKI in pa-tients with sepsis,and combined with SOFA score can improve the predictive efficacy.

Abstract:Objective:To analyse the characteristics and clinical application of routine electroencephalogram combined with e-vent-related potential P300 in patients with attention deficit and hyperactivity disorder.Methods:Selected 50 patients with attention def-icit as the attention deficit group,50 patients with hyperactivity disorder as the hyperactivity disorder group,and another 50 healthy indi-viduals for physical examination as the control group.All patients in each group underwent general data statistics and routine EEG and event-related potential P300 examinations to obtain the latency,amplitude,8 wave,θ wave,α wave amplitude and frequency of Pz,Cz,and Fz,as well as abnormal EEG conditions.Results:There were no significant differences in gender,age,body mass index,educational level,and malnutrition among the three groups(P＞0.05).Compared with the control group,the attention deficit group and hyperactivi-ty disorder group had a higher proportion of patients with a history of traumatic brain injury and lower MoCA scores(P＜0.05).There was no significant difference in the history of traumatic brain injury and MoCA score between the attention deficit group and the hyper-activity disorder group(P＞0.05).Compared with the control group,patients with attention deficit and hyperactivity disorder had high-er levels of latent periods of Pz,Cz,and Fz,lower levels of wave amplitudes,higher rates of EEG abnormalities,and higher levels of am-plitude of δ,θ,and α waves(P＜0.05).There was no significant difference in the latency and amplitude of Pz,Cz,and Fz,as well as the amplitude levels of δ,θ,and α waves,and the proportion of abnormal EEG between the attention deficit group and the hyperactivity disorder group(P＞0.05).There was no significant difference in the frequency levels of the three groups of δ wave,θ wave,and αwave(P＞0.05).The ROC curve showed that compared with the single diagnosis of event-related potential P300 and conventional e-lectroencephalogram,the combined detection had higher sensitivity and accuracy in diagnosing attention deficit and hyperactivity disor-der(P＜0.001).Conclusion:Patients with attention deficit and hyperactivity disorder have higher latent periods of Pz,Cz,and Fz,ab-normal rates of EEG,and higher levels of amplitude of δ,θ,and α waves,while lower levels of amplitude of Pz,Cz,and Fz waves.The diagnostic value of routine EEG combined with event-related potential P300 for attention deficit and hyperactivity disorder is relatively high.

Abstract:Objective:To explore the characteristics and influencing factors of immune-related adverse events(irAEs)in ad-vanced gastric cancer patients treated with PD-1/PD-L1 inhibitors,analyse clinical features associated with prognosis.Methods:A ret-rospective analysis was conducted on the clinical data of 60 patients with advanced gastric cancer.Based on the occurrence of irAEs,the patients were divided into an irAEs group(n=32)and a non-irAEs group(n=28).Immune-related adverse reactions were assessed using the Common Terminology Criteria for Adverse Events(CTCAE 5.0).Short-term efficacy was evaluated using the Response Evalu-ation Criteria in Solid Tumors(RECIST 1.1).Long-term efficacy was assessed using overall survival(OS)and progression-free surviv-al(PFS).A multivariate Logistic regression model was employed to analyze the factors influencing the occurrence of irAEs.The Kap-lan-Meier survival curve was used to evaluate the impact of clinical characteristics on prognosis,and the Cox proportional hazards model was used to analyze the clinical characteristics affecting patient prognosis.Results:The Ki-67 index in the irAEs group was higher than that in the non irAEs group,and the pepsinogen Ⅱ level was lower than that in the non irAEs group(P＜0.05).Multivariate Logistic regression analysis showed that the Ki-67 index was a risk factor for the occurrence of irAEs(P＜0.05).There was no statistically sig-nificant difference in treatment efficacy between the two groups of patients(P＞0.05).Prognostic analysis showed that OS and PFS in TNM stage Ⅲ patients were higher than those in stage Ⅳ patients(P＜0.05),the median PFS of HER-2 positive patients was higher than that of negative expression patients(P＜0.05).Cox regression analysis indicated that TNM staging and HER-2 expression were independent risk factors for PFS in patients(P＜0.05).Conclusion:The incidence of irAEs in the treatment of advanced gastric canc-er with PD-1/PD-L1 inhibitors is relatively high,but most irAEs are low-grade,indicating a high level of safety.The Ki-67 index is an independent risk factor for the occurrence of irAEs.Patients with stage Ⅲ TNM have longer OS and PFS compared to those with stageⅣ,and patients with positive HER-2 expression have longer PFS.

Abstract:Objective:To explore the effects of Hemabate and oxytocin separately combined with bilateral ligation of the ascend-ing branches of the uterine artery in preventing uterine atony-related postpartum hemorrhage(PPH),and the impact on patients'hemo-dynamics,fibrinogen(FIB)and D-dimer(D-D).Methods:According to the treatment methods,70 patients with uterine atony during cesarean section were grouped.Among them,35 patients treated with oxytocin combined with bilateral ligation of the ascending branches of the uterine artery were included in the control group,while 35 patients treated with Hemabate combined with bilateral ligation of the as-cending branches of the uterine artery were included in the observation group.The intraoperative and postpartum bleeding,postoperative maternal-infant outcomes,hemodynamics,D-D and FIB before and after treatment,clinical efficacy,and the incidence of adverse reactions were compared between the two groups.Results:Operation time,time to off-bed activities,lochia disappearance time,and length of hospital stay in the observation group were shorter than those in the control group.The intraoperative blood loss,2 h postoperative blood loss and 3～24 h postoperative blood loss of the observation group were less than those of the control group(P＜0.05).The blood transfusion rate in the observation group was lower than that in the control group(5.71％vs.22.86％,P=0.040).There was no significant difference in hysterectomy rate,neonatal Apgar score,heart rate(HR),and mean arterial pressure(MAP)between the two groups(P＞0.05).Af-ter treatment,the levels of D-D and FIB in both groups decreased(P＜0.05),and the observation group was lower than the control group(P＜0.05).The total effective rate of the observation group(94.29％)was higher than that of the control group(77.14％)(P=0.040).During the treatment period,there was no statistically significant difference in the incidence of adverse reactions such as abnor-mal blood pressure and nausea and vomiting between the two groups(P＞0.05).Conclusion:Hemabate combined with bilateral liga-tion of the ascending branches of the uterine artery is effective in preventing uterine atony-related PPH.It can reduce blood loss,lower blood transfusion rate,improve D-D and FIB levels,promote postpartum recovery,and shorten hospital stay,with high safety.

Abstract:Objective;To explore the clinical curative effect of cefoperazone sulbactam sodium(CPZ-SBT)combined with mero-penem in children with severe pneumonia induced by bacterial infection.Methods:108 children with severe pneumonia induced by bac-terial infection were selected as the research subjects.According to different treatment methods,children were divided into control group(CPZ-SBT)and combination group(CPZ-SBT combined with meropenem),54 cases in each group.The course of treatment was 7 days.The curative effect,fading time of symptoms,bacterial clearance rates,scores of critical illness(PICS score and APACHE Ⅱscore),T cell subsets(CD4+T cells,CD8+T cells,and CD4+/CD8+T),inflammatory factors[C-reactive protein(CRP),procalcito-nin(PCT),soluble intercellular adhesion molecule-1(sICAM-1)]and adverse drug reactions were compared between the two groups.Results:Compared with control group,response rate of treatment was higher in combination group(P＜0.05),antipyretic time,remis-sion time of cough and disappearance time of moist rale were shorter(P＜0.05),bacterial clearance rate was higher(P＜0.05).cough score was higher(P＜0.05),and PICS score and APACHE Ⅱ score were lower(P＜0.05).The levels of CD4+T cells and CD4+/CD8+ratio in combination group were higher than those in control group,while the levels of CD8+T cells was lower in combina-tion group(P＜0.05).The levels of CRP,PCT and sICAM-1 in combination group were lower than those in control group(P＜0.05).The difference in the total incidence of adverse reactions between combination group and control group was not statistically significant(P＞0.05).Conclusion:Curative effect of CPZ-SBT combined with meropenem is significant in children with severe pneumonia induced by bacterial infection,which can effectively clear infectious bacteria,enhance immune function and relieve inflammatory response.

Abstract:Objective:To explore the potential impact of liraglutide and semaglutide on reducing homocysteine(Hey)levels in patients with type 2 diabetes mellitus(T2DM).Methods:A total of 108 patients with T2DM were selected and divided into liraglutide group(n=56,all received liraglutide)and semaglutide group(n=52,all received semaglutide)according to different treatment meth-ods,both treated continuously for 12 weeks.The levels of glucose and lipid metabolism indicators,serum Hey levels,inflammatory factor levels,incidence of adverse reactions,and cost-effectiveness of treatment were compared between the two groups.Results:After 4 and 12 weeks of treatment,the levels of fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2 hPG),glycosylated hemoglobin(HbA1c),homocysteine(Hey),ApoA1/ApoB,and C-reactive protein(CRP)in both groups exhibited a decrease compared to pre-treatment levels.Additionally,the level of 25-hydroxyvitamin D[25(OH)D]showed a notable increase after treatment initiation(P＜0.05).After 12 weeks of treatment,the FPG,2 hPG,HbA1c,and Hcy levels in liraglutide group were lower compared to those observed after only 4 weeks of treatment.Moreover,their level of 25(OH)D was higher than that seen after 4 weeks of treatment(P＜0.05).There were no statistically significant differences between the two groups regarding FPG,2 hPG,HbA1c,Hcy,ApoA1/ApoB CRP or 25(OH)D levels following 4 weeks of treatment(P＞0.05).However,after completing a full course of twelve-weeks'therapy with sema-glutide or liraglutide respectively,the semaglutide group displayed higher FPG,2 hPG,Hb AIC,and HCy values when compared to the liraglutide group.Furthermore,the levelof vitamin D(25-OHD3)was lower in patients treated with semagluti decomparedtothose treated with liraglutide(P＜0.05).There was no statistically significant difference in terms o f adverse reactions incidence between these two groups(P＞0.05).The cost-effectiveness analysis revealed that liraglutide was more economical than semaglutide.Conclusion:In the initial phase of T2DM,liraglutide and semaglutide demonstrate effective enhancement in glucose and lipid metabolism while reducing in-flammatory factors and Hcy levels.Their clinical effects are comparable.However,with prolonged treatment duration,liraglutide showed better improvement in glucose and lipid metabolism,inflammatory factors,and Hcy compared to semaglutide,and had higher economic benefits.

Abstract:Objective:To explore the efficacy of combined white peony total glycosides with conventional clinical treatment for rheumatoid arthritis(RA)complicated by coronary heart disease,and to analyze the mechanism of action.Methods:60 patients with RA complicated by coronary heart disease were selected and divided into a control group and an experimental group based on different treatment plans,30 cases in each group.The control group received conventional treatment with non-steroidal anti-inflammatory drugs,glucocorticoids,and methotrexate,while the experimental group received white peony total glycosides in addition to the control group treatments.Both groups received continuous treatment for 24 weeks.The serological indicators[erythrocyte sedimentation rate(ESR),complement C3,rheumatoid factor(RF),anti-citrullinated peptide antibody(ACCP)],coagulation function[platelets(PLT),platelet activating factor(PAF)],inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),interleukin-1(IL-1),tumor necrosis factor-alpha(TNF-α)],T lymphocyte 17(Th17),the ratio of Th17 to regulatory T cells(Treg),Treg levels,as well as pain[visual analog scale(VAS)score],swelling(joint swelling index score),and incidence of adverse reactions were compared between the two groups.Results:After 4,12,and 24 weeks of treatment,the ESR,complement C3,RF,ACCP,PLT,and PAF levels gradually decteased in both groups(P＜0.05),and the experimental group was lower than the control group(P＜0.05).At 24 weeks post-treatment,both groups showed reductions in CRP,IL-6,IL-1,TNF-α,Th17,Th17/Treg,VAS scores and joint swelling indices compared to pre-treat-ment(P＜0.05),with the experimental group showing lower values than the control group(P＜0.05).Treg levels increased compared to pre-treatment,with the experimental group having higher levels than the control group(P＜0.05).There was no significant differ-ence in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:The combination of white peony total glyco-sides with conventional treatment for RA complicated by coronary heart disease is beneficial in improving clinical symptoms such as pain and swelling.The mechanism may be related to the inhibition of inflammatory factor release,modulation of Th17/Treg balance,re-duction of immune indicators,and improvement of coagulation function.

Abstract:Objective:To explore the relationship between eradication therapy of different virulence types of Helicobacter pylori(Hp)and kidney injury.Methods:130 patients undergoing Hp eradication therapy were selected as the research subjects,and 50 healthy individuals who underwent physical examinations during the same period were selected as controls.The levels of urinary specific proteins[neutrophil gelatinase-associated lipocalin(NGAL),retinol binding protein(RBP),microalbumin/creatinine(MALB/CREA)]were compared between the two groups.Patients were divided into kidney injury group(n=29)and non kidney injury group(n=101)based on whether kidney injury occurred.The levels of urinary specific proteins(NGAL,RBP,MALB/CREA)in the two groups were compared,and the diagnostic value of urinary specific proteins for kidney injury was analyzed using receiver operating char-acteristic curve(ROC).Detected Hp virulence genes in all patients and analyzed the relationship between different Hp virulence genes and kidney injury.Results:The levels of NGAL,RBP,and MALB/CREA in the study group were higher than those in the control group(P＜0.05).The levels of NGAL,RBP,and MALB/CREA in the kidney injury group were higher than those in the non kidney injury group,and their levels had good diagnostic efficacy for Hp eradication treatment patients with kidney injury.The combination of the three had the highest diagnostic efficacy,with an AUC of 0.764,sensitivity of 82.76％,and specificity of 66.34％.The positive expres-sion rates of CagA,Vac A,Ure,and CagA+Vac A in Hp eradication treatment patients were higher than those in healthy individuals(P＜0.05),but there was no significant difference in the positive expression rates of CagA,Vac A,Ure,and CagA+Vac A between the kidney injury group and the non kidney injury group(P＞0.05).Conclusion;NGAL,RBP,and MALB/CREA are highly expressed in patients undergoing Hp eradication therapy,and their expression levels have a certain predictive power for renal injury in patients.How-ever,there is no significant correlation between Hp virulence typing and renal injury in patients.

Abstract:Objective:To investigate the therapeutic effect and safety of ertugliflozin combined with metformin in the treatment of patients with overweight/obese type 2 diabetes mellitus(T2DM).Methods:108 overweight/obese T2DM patients were included and divided into metformin group(n=54)and ertugliflozin group(n=54)according to different treatment methods.The metformin group received metformin,whereas the ertugliflozin group was given metformin+ertugliflozin.The blood glucose indexes[FBG,2 h postpran-dial blood glucose(2 hPBG),glycosylated hemoglobin(HbA1c)],insulin function indexes[fasting insulin(FINS),HOMA-β,HO-MA-IR],body mass index(BMI),waist hip ratio(WHR),lipid metabolism indexes(TC,TG,LDL,HDL)and adverse reaction were compared between the two groups at 3 months of treatment.Results;At 3 months of treatment,the FPG,2 hPBG,HbA1c,FINS,HOM A-IR,BMI,WHR,TC,TG and LDL in both groups were reduced(P＜0.05),and the levels in ertugliflozin group were lower than those in metformin group(P＜0.05).The HOMA-β and HDL were enhanced(P＜0.05),and the levels were higher in ertugliflozin group(P＜0.05).There were no statistical differences in the incidence rates of adverse reactions between groups(P＞0.05).Conclusion:Ertugliflozin combined with metformin can reduce the blood glucose,and improve the insulin function and lipid metabolism indexes of patients with overweight/obese T2DM,and will not increase the incidence rates of adverse reactions,it has a good clinical application preospect.

Abstract:Objective:To explore the analgesia effect of preemptive analgesia on patients after thoracoscopic lobectomy under spontaneous breathing.Methods:116 patients who received thoracoscopic lobectomy were included as the study subjects.According to the intervention methods,58 patients who received thoracic paravertebral nerve block under spontaneous breathing were randomly col-lected as control group,and 58 patients who adopted preemptive analgesia combined with thoracic paravertebral nerve block under spon-taneous breathing were included in study group.The intraoperative vital signs[heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SPO2)],analgesia and sedation effects[visual analogue scale(VAS)score,Ramsay sedation score],pain factors[prostaglandin E2(PGE2),substance P(SP),dopamine(DA)]and inflammatory factors[tumor necrosis factor-α(TNF-α),inter-leukin-6(IL-6),C-reactive protein(CRP)]after surgery and incidence rates of adverse reactions were compared between the two groups.Results:There were no statistical differences in HR,MAP,and SPO2 before anesthesia between groups(P＞0.05).After anes-thesia,HR and MAP in study group were lower than those in control group(P＜0.05)while SPO2 was higher than that in control group(P＜0.05).After surgery,the VAS score,Ramsay score,and levels of PGE2,SP,DA,TNF-α,IL-6,and CRP in study group were lower than those in control group(P＜0.05).There were no statistical differences in the incidence rates of adverse reactions between groups(P＞0.05).Conclusion:For patients undergoing thoracoscopic lobectomy,the application of nalbuphine hydrochloride for preemptive analgesia can enhance the analgesia effect,stabilize hemodynamic indicators,and alleviate postoperative pain and inflammatory reac-tions.

Abstract:Objective:To investigate the effect of citicoline combined with butylphthalide in patients with acute cerebral infarc-tion(ACI),and to explore the possible mechanism.Methods:A total of 150 patients with ACI were divided into control group and ob-servation group according to the different treatment options received,with 75 cases in each group.The patients in the control group was treated with butylphthalide,and patients in the observation group was treated with citicoline combined with butylphthalide.Both groups were treated for 14 days.The National Institutes of Health Stroke Scale(NIHSS),Barthel index(BI)and modified Rankin score(mRS)were used to evaluate the patients.The cerebral blood flow velocity[blood flow velocity of anterior cerebral artery(AC A)and middle cerebral artery(MCA)]was measured,and the serum neuron-specific enolase(NSE),brain-derived neurotrophic factor(BD-NF),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were measured.The indexes and curative effects of the two groups were compared.Results:The total effective rate of clinical efficacy in the observation group was higher than that in the control group(93.33％vs.78.67％,P＜0.05).After treatment,the NIHSS score and mRS score of patients in the observation group were lower than those of the control group(P＜0.05),and the BI score and blood flow velocity of AC A and MCA were higher than those of the control group(P＜0.05).Compared with the control group,the levels of serum NSE,TNF-α and IL-6 of patients in the observation group were lower(P＜0.05),and the level of BDNF was higher(P＜0.05).Conclusion:The treatment of ACI patients with citicoline combined with butylphthalide can achieve better curative effect,and the related mechanism may be related to the regulation of serum NSE and BD-NF levels and the reduction of inflammation.

Abstract:Objective:To investigate the clinical efficacy of bromocriptine combined with endoscopic transsphenoidal resection for the treatment of pituitary tumors and its impact on patients'sex hormone levels.Methods:A total of 98 patients with pituitary tumors who were scheduled to undergo endoscopic transsphenoidal resection of the pituitary gland were selected for the study.They were divid-ed into a bromocriptine group and a control group according to whether bromocriptine was used before surgery,49 cases in each group.Both groups underwent endoscopic transsphenoidal resection of the pituitary gland,and the bromocriptine group was treated with bro-mocriptine three days before surgery,both groups was followed up for 3 months after surgery.The clinical efficacy,stress indicators[adrenaline(E),norepinephrine(NE),cortisol(R),and angiotensin Ⅱ(ATⅡ)levels],sex hormone levels[growth hormone(GH),prolactin(PRL),and thyroid stimulating hormone(TSH)],and quality of life(SF-36 score)before and after surgery were compared between the two groups.Results:The total effective rate of the bromocriptine group was higher than that of the control group's(95.92％vs.83.67％,P＜0.05).Compared with preoperative levels,the E,NE,R,and AT Ⅱ of both groups of patients increased 1 month after surgery(P＜0.05),the bromocriptine group was lower than the control group(P＜0.05).Compared with preoperative levels,both groups of patients showed a decrease in GH,PRL,and TSH levels(P＜0.05),and the bromocriptine group was lower than the control group(P＜0.05).At 1 and 3 months after surgery,the SF-36 scores of both groups of patients improved(P＜0.05),and bromocrip-tine group was higher than the control group(P＜0.05).Conclusion:The clinical efficacy of bromocriptine combined with endoscopic transsphenoidal resection for pituitary tumors is definite,which can effectively reduce the patient's sex hormone levels,stabilize the patient's postoperative stress indicators,and improve the patient's quality of life.

Abstract:Objective:To evaluate the efficiency and predict the outcome of platinum-containing dual drugs treatments,the re-searchers examined the neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and Ki67 levels in the peripheral blood of stage Ⅲ-Ⅳ non-small cell lung cancer(NSCLC)patients.Methods:A retrospective analysis was conducted on 147 patients diagnosed with advanced NSCLC in this research.The patients underwent treatment with platinum-containing dual drugs therapy.NLR and PLR were divided into high-level group(n=73)and low-level group(n=74)based on the median value,and according to the pathological immunohistochemistry results of Ki67 expression,they were divided into a high expression group(n=91)and a low ex-pression group(n=56).The effectiveness of NLR,PLR,and Ki67 in various subgroups was analyzed,and their correlation with overall patient survival(OS)was examined through Kaplan-Meier analysis.Between-group comparisons were performed using the Log-rank test.Prognostic factors were analyzed through univariate and multivariate COX regression.The prognostic value of NLR,PLR,and Ki67 was further assessed using the"time ROC"for individual and combined analyses.Results:The objective response rate(ORR)and control rate of diseases(DCR)in the high NLR group and the high Ki67 group were lower than those in the lower NLR and low Ki67 group(P＜0.05).There was no statistically significant difference in the efficacy analysis of PLR groups at different levels(P＞0.05).The median survival time in the high NLR group,high PLR group,and high Ki67 expression group was lower than that in the low NLR group,low PLR group,and low Ki67 expression group(P＜0.05).Univariate analysis showed that clinical stage,N stage,multiple metastases,ECOG score,NLR,PLR,Ki67 were associated with decreased OS in patients(P＜0.05).Multivariate analysis showed that ECOG score and Ki67 were important independent influencing factors for OS in patients with advanced NSCLC(P＜0.05).The combination of NLR,PLR,and Ki67 exhibited the highest AUC value(73.36)and C-index(0.689)for prognosis prediction.Conclusion:NSCLC patients with high NLR and high Ki67 before treatment have poorer response to platinum-containing du-al drugs chemotherapy.Patients with high NLR,PLR and Ki67 have shorter OS.The combination of NLR,PLR and Ki67 predict the highest prognostic efficacy in patients with NSCLC treated with platinum-containing dual drugs chemotherapy.It can be more effective for clinicians to carry out risk stratification management and individualized treatment of patients.

Abstract:Objective;To observe the curative effect of dapagliflozin tablet(Farxiga)combined with irbesartan(ARB)in pa-tients with early type 2 diabetic nephropathy.Methods:According to different treatment methods,110 patients with early type 2 diabet-ic nephropathy were divided into ARB group(n=52)and combination group(n=58).All patients were treated for 2 months.After treatment,curative effect,fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG),24 h urinary protein(24 h-PRO),uri-nary microalbumin(U-mAlb),thrombin time(TT),activated partial thromboplastin time(aPTT),D-dimer,plasma protein c(PC)and incidence of adverse reactions were compared between the two groups.Results;After treatment,response rate of treatment was high-er in combination group than ARB group(P＜0.05).After treatment,levels of FPG,2 hPG,24 h-PRO,U-mAlb,D-dimer and PC were lower in combination group than ARB group,while TT and aPTT were higher in combination group(P＜0.05).After treatment,the difference in the total incidence of adverse reactions between the two groups was not statistically significant(P＞0.05).Conclusion;Dapagliflozin tablet combined with irbesartan can improve response rate of treatment,reduce blood glucose,urinary protein and improve coagulation function in patients with early type 2 diabetic nephropathy.

Abstract:Objective:To explore the predictive value of changes in vaginal microecology during pregnancy on adverse pregnancy outcomes in pregnant women with threatened preterm labor.Methods:The clinical data of 208 women with threatened preterm labor were retrospectively analyzed.According to the pregnancy outcomes,the pregnant women were divided into preterm group(n=75)and full-term group(n=133).The pH value of vaginal secretion,relative abundance of microbial flora and related biochemical indicators[hydrogen peroxide concentration(H2 O2),sialidase activity(SNA)and leukocyte esterase(LE)]were detected and compared be-tween the two groups.Receiver operating characteristic(ROC)curve were used to analyze the predictive value of vaginal microecologi-cal flora and related biochemical indicators on adverse pregnancy outcomes.Results:Compared with full-term group,the relative abun-dance of Lactobacillus in preterm group was lower(P＜0.05)while the pH value,relative abundances of Genus Gardnerella and posi-tive rates of H2O2 and LE were higher(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)for predicting ad-verse pregnancy outcomes for pH value,Lactobacilli,and Genus Gardnerella was 0.712,0.931,and 0.921,with cutoff values of 4.14,59.95％,and 17.7％,respectively.Conclusion:The adverse pregnancy outcomes of pregnant women with threatened preterm labor are closely related to the changes of vaginal microecology.The relative abundance of Lactobacillus is lower than 59.95％,relative abun-dances of Genus Gardnerella is higher than 17.7％,pH value is higher than 4.14,suggesting that pregnant women have the risk of ad-verse pregnancy outcomes of threatened preterm labor.

Abstract:< positive >1 case data the patient, a 57 year old female, presented with limb weakness two years ago and fell while walking on the flat road, and then fell more and more frequently; Half a year before admission, he began to react slowly, and his personality gradually developed from cheerful to less talkative with a giggle. One month before admission, in addition to falling and giggling, he also had unstable sitting and standing, occasionally choking and coughing with drinking water, and there was no headache, dizziness, limb twitching and visual impairment during the course of the disease. Denied the history of hypertension and diabetes in the past; Deny the history of cerebrovascular disease, genetic history and mental disease; Denied the history of surgery and trauma. Physical examination: vital signs were stable.

Abstract:Objective:To explore the impact of comprehensive nursing care on the postpartum role adaptability and breastfeeding status of women with high-risk pregnancy for mother-infant separation.Methods:74 high-risk pregnant women with mother infant sepa-ration were divided into two groups based on nursing methods.The control group(n=37)received routine care,while the observation group(n=37)received comprehensive care.The role adaptation ability,initial lactation time,7-day milk production,breastfeeding,and breast swelling were compared between the two groups.Results:Before nursing,there was no statistically significant difference in the scores of role adaptation ability between the two groups(P＞0.05).After nursing,both groups showed an increase in various scores of role adaptation ability,the observation group was higher than the control group(P＜0.05).The observation group had a shorter initial lactation time,and the number of cases with sufficient lactation within 7 days was higher than that of the control group(P＜0.05).The observation group had a higher breastfeeding rate compared to the control group(P＜0.05).Comparison of postpartum breast swelling and pain levels between two groups of mothers,with the observation group had a higher proportion of grade Ⅰ and Ⅱ compared to the con-trol group(P＞0.05).Conclusion:Comprehensive nursing has significant advantages in postpartum care for mothers with high-risk pregnancy.It can more comprehensively meet the multi-faceted needs of mothers,improve their role adaptability,and promote the suc-cess rate of breastfeeding.It is worthy of promotion and application.

Abstract:Objective:To explore the application effect of first aid process based on medical failure mode and effect analysis(HFMEA)method in the treatment of pernicious placenta previa(PPP).Methods:80 PPP patients were selected and divided into the control group(n=40)and the observation group(n=40)according to the different emergency procedures.The control group was giv-en PPP treatment routine process,and the observation group was given emergency process based on HFMEA method.The time of each link of maternal admission treatment process,occurrence of complications and neonatal outcomes[1 min Apgar score,neonatal intensive care unit(NICU)transfer]were compared between the two groups.Results:The time from admission to green channel start-up,the time from admission to B-ultrasound report,the time from admission to laboratory examination results,and the time from admission to operat-ing room in the observation group were shorter than those in the control group(P＜0.05).The amount of bleeding,red blood cells and platelets in the observation group were less than those in the control group(P＜0.05),and the hospitalization time was shorter than that in the control group(P＜0.05).The total complication rate of pregnant women in the observation group was lower than that of the control group(P＜0.05).The 1 min Apgar score of newborns in the observation group was higher than that in the control group(P＜0.05),and the proportion of 1 min Apgar score≤7 points was less than that in the control group(P＜0.05),the NICU transfer rate between the two groups showed no significant difference(P＞0.05).Conclusion:The implementation of the first aid process based on HFMEA method for PPP patients can optimize the process,shorten the time of each link,improve the efficiency of patient treatment,and improve maternal and infant outcomes.

Abstract:Objective:To explore the application of quality management combined with preventive nursing model in postoperative infection control of puerperae receiving cesarean section.Methods:155 postpartum women were selected as the research subjects,77 puerperae with cesarean section before the quality management combined with preventive nursing model were listed as control group and were given routine nursing model,and 78 puerperae after the implementation were included in observation group and received quality management combined with preventive nursing model.The intervention time for both groups was 48 hours.The infection status during in-tervention(including incision,lung,and urinary tract infections),colony-related indicators(incision gram-negative bacteria,gram-posi-tive bacteria,fungi,etc.),postoperative recovery status(first exhaust time,first ambulation time,and postoperative hospital stay)and nursing quality(nursing satisfaction scale score)as well as pain degree[Numeric Rating Scale(NRS)score]and postpartum fatigue[Postpartum Fatigue Scale(PFS)score]before intervention and at 48 hours after intervention were compared between the two groups.Results:During the intervention period,the total infection rate,postoperative recovery time and incidence of nursing risk events in ob-servation group were lower than those in control group(P＜0.05).The nursing satisfaction in observation group was higher than that in control group(P＜0.05).There was no statistically significant difference in colony-related indicators between the two groups(P＞0.05).At 48 hours after intervention,the NRS score and PFS scores were reduced in both groups than those before intervention,and the scores were lower in observation group(P＜0.05).Conclusion:Quality management combined with preventive nursing model can effectively control the postoperative infection,promote the recovery,reduce the pain degree and postpartum fatigue,and improve the nursing quality in puerperae with cesarean section.