Table of Content

21 April 2021, Volume 42 Issue 2

Previous Issue    Next Issue

Clinical Study on Obstetrics and Gynecology

Associations between timing of gestational weight gain and maternal and neonatal outcomes in women with polycystic ovary syndrome

Zhang Lirui, Zheng Wei, Liu Cheng, Liang Xin, Zhang Li, Tian Zhihong, Li Guanghui

2021, 42(2):  169-176.  doi:10.3969/j.issn.1006-7795.2021.02.001

Asbtract ( 143 )   PDF (1162KB) ( 37 )  

References | Related Articles | Metrics

Objective To evaluate the relationship between timing of gestational weight gain and maternal and neonatal outcomes in pregnant women with polycystic ovary syndrome (PCOS).Methods A retrospective study was conducted on the data involving the baseline characteristics, weight changes during pregnancy, and pregnancy outcomes of 714 pregnant women with PCOS. According to the recommendations of the 2009 Institute of Medicine (IOM) guidelines, we classified weight gain in the first- and second- trimester (before 28 weeks) into the inadequate, adequate and the excessive weight gain group, weight gain in the third- trimester was classified according to whether it was below, at or above the recommended weight gain. Chi-square test and multivariable Logistic regression analysis were performed to investigate the associations between the timing of gestational weight gain and perinatal outcomes. Results Compared with PCOS women who gained adequate weight gain in the first- and second-trimester, those who gained inadequate weight gain in the first- and second- trimester showed the lowered risk of hypertension disorders of pregnancy (HDP)(OR=0.29,95%CI:0.15-0.56), macrosomia (OR=0.33,95%CI:0.14-0.76)and large for gestational age (LGA)(OR=0.59,95%CI:0.35-0.99). Those with inadequate weight gain in the first- and second-trimester didn't show an increased risk of small for gestational age (SGA) (OR=0.69,95%CI:0.13-3.58) birth. Women who gained excessive weight gain in the first- and second-trimester showed an increased risk of LGA birth(OR=1.84,95%CI:1.18-2.88). Gestational weight gain in the first- and second-trimesters did not appear to be associated with gestational diabetes mellitus (GDM). Higher weight gain in the third-trimester was associated with an increased risk of HDP(OR=3.19,95%CI:1.41-7.21) (for women with adequate gestational weight gain in the first- and second-trimesters) or the occurrence of the HDP was on the rise (for women with inadequate/excessive gestational weight gain in the first- and second-trimesters), higher weight gain in the third-trimester was associated with an increased risk of LGA(OR=3.15,95%CI:1.41-7.04) (for women with excessive gestational weight gain in the first- and second-trimesters) or the occurrence of the LGA was on the rise (for women with inadequate/adequate gestational weight gain in the first- and second-trimesters), regardless of early gestational weight gain. -Conclusions- Excessive weight gain in each trimester of pregnancy in PCOS pregnant women increased the risk of fetal overgrowth. However, some unique trends existed in PCOS pregnant women. Specifically, inadequate gestational weight gain in the first- and second-trimester showed a protective effect on HDP and it did not seem to increase the risk of SGA birth. However, the potential impact on the long-term health of the offspring is still unclear. It is necessary to figure out whether pregnant women with PCOS need less weight gain recommendations before the third-trimester than general pregnant women.

The first successful case report of breast cancer patient's cryopreserved ovarian tissue transplantation in China and literature review

Ruan Xiangyan, Yang Yu, Lu Dan, Du Juan, Cheng Jiaojiao, Gu Muqing, Li Yanglu, Jin Fengyu, Duan Wei, Dai Yinmei, Ju Rui, Xu Xin, Matthias Korell, Alfred O. Mueck

2021, 42(2):  177-182.  doi:10.3969/j.issn.1006-7795.2021.02.002

Asbtract ( 167 )   PDF (13073KB) ( 177 )  

References | Related Articles | Metrics

Objective To prevent and treat iatrogenic premature ovarian insufficiency in breast cancer patient by ovarian tissue cryopreservation and transplantation.Methods Ovarian tissue cryopreservation was performed after modified radical mastectomy in a 35-year-old breast invasive ductal carcinoma [estrogen receptor α(ERα)(-), progestone receptor(PR)(-),T_1CN₂M₀] patient. Subsequently,normative and individual radiotherapy,chemotherapy and targeted therapy were performed. During and after tumor therapy,she had got amenorrhea for more than one year and experienced obvious menopause symptoms. She had been tumor-free survival consulted and evaluated by breast cancer experts. The ovarian function test showed that follicle stimulating hormone(FSH) was 101.83 IU/L and anti-Müllerian hormone(AMH) was less than 0.06 ng/mL. The data suggested that the patient's ovarian function was completely exhausted,and the patient needed and met the physical requirement for cryopreserved ovarian tissue transplantation. Consequently, the transplantation was performed. Results Two months after transplantation,the patient's menopause symptoms disappeared,FSH decreased to 7.29 IU/L, and transvaginal ultrasound showed follicular development and ovulation in the transplanted ovary. Three months after transplantation,her menstruation recovered, indicating that the patient's ovarian function was completely recovered and the cryopreserved ovarian tissue transplantation was successful. Up to now, the patient has been transplanted for nearly 3 years and the ovarian function remains normal. Conclusion This was the first successful case report of breast cancer patient cryopreserved ovarian tissue transplantation in China. Ovarian tissue cryopreservation and transplantation is a new important technology for prevention and treatment of iatrogenic premature ovarian insufficiency and fertility protection. This manuscript also reviews the literature on this issue.

Ultrasonographic features of fetus with 22q11.2 deletion syndrome

Hou Lei, Li Jieyan, Xing Yu, Liu Liheng, Wang Xin

2021, 42(2):  183-187.  doi:10.3969/j.issn.1006-7795.2021.02.003

Asbtract ( 335 )   PDF (1048KB) ( 26 )  

References | Related Articles | Metrics

Objective To assess genotype-phenotype correlation of prenatally diagnosed fetal 22q11 deletion syndrome by fetal molecular genetic analysis and fetal ultrasound.Methods In this retrospective study, we analyzed 19 cases of fetus which were diagnosed prenatally as 22q11.2 deletion syndrome from January 1,2013 to October 31, 2020. Their clinical conditions, prenatal diagnosis indications, genotype and phenotypic features were assessed. Results Four cases were performed preatal diagnosis for abnormal plasma screen or non-invasive prenatal scan (NIPT), while 15 cases were for abnormal ultrasound. The most common fetal phenotype were fetal cardiac anomalies, such as right aortic arch(8/16),ventricular septal defects(5/16) and tetralogy of Fallot (5/16). Conclusion Abnormal ultrasound finding, especially cardiovascular anomalies was the main manifestation of the 22q11.2 syndrome. It is recommended to use copy numbers variation as the first line test for fetus with abnormal ultrasound.

Effect of dehydroepiandrosterone on clinical outcome and GDF-9 and BMP-15 level in follicular fluid of the diminished ovarian reserve women who underwent IVF

Zhuang Qianying, Wang Qin, Chen Tong, Yang Xiaokui

2021, 42(2):  188-193.  doi:10.3969/j.issn.1006-7795.2021.02.004

Asbtract ( 119 )   PDF (1130KB) ( 59 )  

References | Related Articles | Metrics

Objective To investigate the effects of dehydroepiandrosterone (DHEA) on clinical outcome, the growth differentiation factor-9 (GDF-9), and bone morphogenetic protein-15 (BMP-15) level in follicular fluid of the diminished ovarian reserve (DOR) women who underwent in vitro fertilization embryo transfer/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET).Methods A historical cohort study was performed and the clinical data of 163 DOR women undergoing IVF/ICSI-ET treatment were analyzed. According to pretreatment regiments, the patients were divided into DHEA group and control group. The indexes were compared between two groups, including serum basal hormone levels, anti-Müllerian hormone (AMH), antral follicle counts (AFC), the total doses and duration of gonadotropin (Gn), hormone levels and endometrium thickness on human chorionic gonadotropin (hCG) day, the number of retrieved oocytes, the number of fertilized oocytes, high quality embryo rate, implantation rate, and clinical pregnancy rate. The levels of GDF-9 and BMP-15 in follicular fluid were compared between the two groups, and their correlations with ovarian reserve were analyzed. Results Before pretreatment, there was no significant difference among the two groups in the basal hormone levels, AMH and AFC (P>0.05). Compared with the control group, the AFC of the DHEA group was significantly increased and the basal follicle stimulating hormone (bFSH) was slightly decreased(P<0.05). There was no significant difference between the two groups in the indexes such as the total doses and duration of Gn, hormone levels and endometrium thickness on hCG day, the number of retrieved oocytes, the number of fertilized oocytes , high quality embryo rate, implantation rate, and clinical pregnancy rate (P>0.05). Compared with the control group, the level of BMP-15 in follicular fluid of DHEA group was significantly increased (P<0.05), with no significant difference in GDF-9 (P>0.05). Bilateral Pearson correlation coefficient analysis showed that the expression of BMP-15 in follicular fluid was positively correlated with the basal estradiol (E₂). Conclusion DHEA improved the ovarian reserve of DOR women via increasing AFC and decreasing basal FSH. DHEA also increased the level of BMP-15 in follicular fluid, which was correlated with the basal E₂.

Clinical analysis of primary female genital system lymphoma

Tian Ming, Miao Jinwei

2021, 42(2):  194-199.  doi:10.3969/j.issn.1006-7795.2021.02.005

Asbtract ( 169 )  

References | Related Articles | Metrics

Objective To investigate the clinicopathology features of primary female genital system lymphoma (PFGSL) and analysis the diagnosis, treatment and the factors affecting prognosis.Methods Clinical data of 8 PFGSL patients were collected retrospectively and followed up, who were preliminary diagnosed in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2010 to December 2020. Results The mean age of 8 patients at presentation was (54.3±12.6) years. The lesions of PFGSL mainly involved ovary (4 patients), uterus (2 patients), cervix (1 patient), and vulva (1patient). The main clinical manifestations were postmenopausal vaginal bleeding, abdominal distension, ascites and pelvic mass. All the pathological types were B-cell non-Hodgkin's lymphoma (NHL), positive CD20 and high Ki67 in immunohistochemistry. There were 4 patients with stage IIEA, 1 patient with stage IVA and 1 patient with stage IVB. 6 patients were diagnosed with postoperative pathology, and 2 patients were diagnosed with tumor biopsy. Chemotherapy with C/EBP-homologous protein (CHOP) regimen was used in 5 patients. Among them, 1 patient underwent autologous stem cell transplantation,1 patient lost to follow-up, 2 patients death, 5 patients survival (4 patients with tumor-free survival). Conclusion PFGSL is a rare kind of extranodal lymphoma, with no specific clinical manifestation. It is difficult to distinguish from primary gynecological malignancy. The clinician should be vigilant in diagnosing PFGSL when the mass is milky and carcinoma cells can not be found in ascites extraction after repeated careful examination. Further, biopsy or surgical resection of the tumor is required to make a definite pathological diagnosis. The chemotherapy regimen based on CHOP is the main treatment.

Effects of minimally invasive bariatric surgery on menstrual cycle and reproductive function in severely obese women

Li Jian, Wu Fengyun, Zhang Nengwei, Lian Dongbo, Fan Qing, Xu Guangzhong, Du Dexiao, Sun Zhipeng, Du Yanmin, Bai Wenpei

2021, 42(2):  200-203.  doi:10.3969/j.issn.1006-7795.2021.02.006

Asbtract ( 116 )   PDF (1111KB) ( 35 )  

References | Related Articles | Metrics

Objective To evaluated the impact of minimally invasive bariatric surgery on menstrual cycle and fertility of severely obese women.Methods A total of 55 obese women who underwent minimally invasive bariatric surgery in our hospital from 2015 to 2019 were enrolled. The information of menstrual cycle, weight, pregnancy at 1, 3, 6 and 12 months after surgery were followed up, and those with fertility requirements were followed up to the end of delivery. The differences of weight, menstrual cycle and pregnancy rate before and after operation were compared. Results At baseline, the average age was (27.82±5.16) years old, the average body mass index (BMI) was (39.42±7.39) kg/m², and the average body weight was (108.85±20.84) kg. The rate of menstrual disorder was 70.91%(39/55). The rate of sleeve gastrectomy and gastric bypass was 87.27% and 12.73%, respectively. The median follow-up time was 35(13-67) months. The most obvious weight loss occurred in the first month after surgery, with an average weight loss of (11.21±5.16) kg (-10.18%). At 6 months and one year after surgery, the average weight loss were (29.79±10.28) kg (-26.94%) and (34.15±12.72) kg (-30.56%) respectively, and the BMI dropped to (27.09±4.25) kg/m² one year after surgery. The improvement rate of menstrual disorder was 71.79%(28/39). The median time of menstruation recovery was 1.5(0.5-8.0)months after operation, and the overall menstrual disorder rate decreased to 20%(11/55). The improvement rate of infertility was 54.17% (13/24). The average time of pregnancy and delivery after operation was (24.06±14.91) months and (33.21±15.17) months, respectively, and the average birth weight was (2.89±1.68) kg. Conclusion Minimally invasive bariatric surgery significantly improved the menstrual cycle and pregnancy rate of women with severe obesity. Pregnancy within two years after minimally invasive surgery did not affect the weight of the newborn.

Efficacy and safety of catheter ablation without fluoroscopy in the treatment of pregnancy complicated with tachyarrhythmia

Bao Zhaoliang, Li Songnan, Duan Na, Zhang Haofeng, Gong Jing, Zhang Jun

2021, 42(2):  204-209.  doi:10.3969/j.issn.1006-7795.2021.02.007

Asbtract ( 112 )   PDF (1129KB) ( 26 )  

References | Related Articles | Metrics

Objective To investigate the efficacy and safety of catheter ablation without fluoroscopy in pregnancy with tachyarrhythmia.-Methods- From January 2016 to January 2020, 31 pregnancies with tachycardia were treated by radiofrequency ablation in Beijing Anzhen Hospital, Capital Medical University. The efficacy and safety of radiofrequency ablation were analyzed, and the differences in efficacy and prognosis were compared with those at different stage of pregnancy.Results ①A total of 31 patients were treated with 0 ray under the three-dimensional electromagnetic navigation mapping system. 27 patients were cured (87.1%), 3 patients were improved (9.7%), 1 patient was ineffective (3.2%), and 1 patient relapsed (3.7%). Cardiac function was improved significantly after treatment (P=0.000). ② There was no recurrence of arrhythmia in 31 cases during and after delivery. ③ There were 1 case of spontaneous abortion, 1 case of premature delivery, 29 cases of full-term delivery. The average gestational age was (38.3±1.4) weeks, 21 cases of full-term cesarean section, and 8 cases of vaginal delivery. There was no significant difference in pregnancy outcome after different pregnancy treatments(P=0.107). The average weight of the newborn was (3280±489)g. The Apgar score of the fifth minutes was 10. There was no small for gestational age infant and no neonatal asphyxia death. No abnormal growth and development was found during the follow-up of 1-5 years. There was no significant difference in fetal outcomes after different pregnancy treatments(P=0.527). Conclusion Catheter ablation without fluoroscopy guided by three-dimensional electromagnetic catheter mapping system has good compliance, high cure rate, low recurrence rate and good prognosis of mother and infant. It is a safe and effective way to treat drug intolerant sustained tachyarrhythmia.There was no significant difference in the prognosis of the operation in the middle or late trimester. For patients who were cured after operation and had good cardiac function, vaginal delivery could be performed after multidisciplinary evaluation without contraindications.

Correlation of interleukin-6 and hypersensitive C-reactive protein with cerebral venous and sinus thrombosis in perinatal stage

Zhang Xinhong, Yang Chuqi, Wang Xuan, Shen Xiaguang, Fang Chun, Wang Fengying

2021, 42(2):  210-213.  doi:10.3969/j.issn.1006-7795.2021.02.008

Asbtract ( 119 )   PDF (1046KB) ( 25 )  

References | Related Articles | Metrics

Objective To investigate the correlation between inflammatory cytokines including interleukin-6 (IL-6), hypersensitive C-reactive protein (Hs-CRP) and cerebral venous sinus thrombosis (CVST) during perinatal period.Methods A total of 39 cases of pregnant and puerperal women diagnosed with CVST who were hospitalized in Xuanwu Hospital, Capital Medical University from January 2010 to January 2020 were retrospectively analyzed, and 80 cases were randomly selected as the control group. The values of IL-6 and Hs-CRP in the acute and convalescence stages of CVST group were detected, and the relationship between IL-6, Hs-CRP in the perinatal period and the formation of CVST was analyzed. Results IL-6 and hs-CRP were higher in CVST group, than those in control group and there was statistical difference between the two groups (P<0.05). The level of IL-6 and hs-CRP in the acute stage were significantly higher than that in the recovery stage, and the difference was statistically significant (P<0.05). The results of the multivariate Logistic regression analysis indicated that the high level of IL-6 was positively correlated with CVST. (OR=4.280,95%CI 1.790-10.232). However,there was no significant correlation with Hs-CRP(OR=0.930,95%CI=0.830-1.042).Conclusion When the level of IL-6 and hs-CRP, especially IL-6, increased in the pregnant women with risk factors, the occurrence of CVST should be vigilant.IL-6 and hs-CRP were significantly increased in the acute stage of CVST. After treatment, the expression of inflammatory factors gradually decreased and tended to be normal in the convalescence stage, which could be used to evaluate the short-term prognosis of the disease.

Progress of hysteroscopy application in the evaluation of high risk factors of endometrial cancer

Zhang Ying, Duan Hua

2021, 42(2):  214-218.  doi:10.3969/j.issn.1006-7795.2021.02.009

Asbtract ( 146 )   PDF (1046KB) ( 28 )  

References | Related Articles | Metrics

Endometrial cancer is one of the most common gynecological malignancies. Accurate assessment of its high-risk factors before surgery is the basis for treatment. Hysteroscopy provides valuable information on evaluation of endometrial cancer tissue differentiation, cervical involvement, and the size of endometrial cancer lesions. Hysteroscopic-injection of tracer is an accurate method for sentinel lymph nodes mapping. The above information is very important for formulating individualized surgical plans to improve patient prognosis.

Basic Research on Cerebral lschemic Injury

Effects of chrysophanol on HIF-1α and VEGF expressions in mice with focal cerebral ischemia/reperfusion injury

Fang Yalan, Yang Nan, Zhao Yongmei, Huang Yuyou, Li Jincheng, Duan Yunxia, Gao Li, Luo Yumin

2021, 42(2):  219-224.  doi:10.3969/j.issn.1006-7795.2021.02.010

Asbtract ( 139 )   PDF (7446KB) ( 45 )  

References | Related Articles | Metrics

Objective To investigate the effects of chrysophanol (CHR) on the expressions of hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in the penumbra of focal cerebral ischemia/reperfusion mice and further, to explore the long-term protective effect mechanism of CHR against cerebral ischemia/reperfusion injury.Methods According to the random number table, 18 healthy male 2-month-old C57BL mice were divided into 3 groups: sham operation (Sham) group (n=6), middle cerebral artery occlusion (MCAO) group (n=6), and CHR group (CHR in dose of 0.1 mg/kg was intraperitoneally injected in CHR group mice once a day for 14 days after reperfusion, n=6). The MCAO for 45 min was induced by thread embolism and the reperfusion lasted for 14 days. On the 14th day after reperfusion, the brain tissue was obtained. The expressions of HIF-1αand VEGF in the brain ischemic penumbra were observed with immunofluorescence labeling. The colocalization of HIF-1α or VEGF with neuron marker NeuN was determined with double labeling immunofluorescence. Results 1) There was little HIF-1α positive cell in Sham group. Compared with Sham group, the HIF-1α positive cells in the penumbra of MCAO group obviously increased on the 14th day after reperfusion (P<0.05). Compared with MCAO group, the HIF-1α positive cells decreased significantly in the penumbra of CHR group on the 14th day after reperfusion (P<0.05). 2) There were many VEGF positive cells in Sham group. Compared with Sham group, the VEGF positive cells in the penumbra of MCAO group obviously decreased on the 14th day after reperfusion (P<0.05). Compared with MCAO group, the VEGF positive cells increased significantly in the penumbra of CHR group on the 14th day after reperfusion (P<0.05). 3) In the penumbra of ischemic brain of mice, HIF-1α or VEGF was colocalized with neuron marker NeuN, respectively. Conclusion CHR may inhibit the expression of HIF-1α protein, upregulate the expression of VEGF protein, and reduce neuronal damage, thereby exerting long-term neuroprotection against cerebral ischemia-reperfusion injury.

Effect of remote ischemic preconditioning on PERK/p-eIF2α pathway and autophagy in the penumbra of rats with focal cerebral ischemia/reperfusion injury

Yang Nan, Ding Mao, Yan Feng, Shi Wenjuan, Huang Yuyou, Zhao Yongmei

2021, 42(2):  225-231.  doi:10.3969/j.issn.1006-7795.2021.02.011

Asbtract ( 186 )   PDF (11812KB) ( 36 )  

References | Related Articles | Metrics

Objective To investigate the protective effect and mechanism of remote ischemic preconditioning (RIPC) on cerebral ischemia injury via studying the expressions of autophagy-related protein Beclin1, LC3B and chaperone of endoplasmic reticulum GRP78, as well as endoplasmic reticulum stress (ERS)-related pathway PERK/p-eIF2α in the penumbra of rats with focal cerebral ischemia/reperfusion.Methods A total of 24 male Sprague Dawley rats were divided randomly into 3 groups: Sham group, middle cerebral artery occlusion (MCAO) group and RIPC+MCAO group, with n=8 for each group. A model of MCAO was induced with the intraluminal suture method. The rats underwent 90 minutes of MCAO and then were reperfused for 24 h by withdrawal of the filament. Three cycles of RIPC had been given three times a day for 3 days before the MCAO surgery, induced by temporarily occluding the bilateral femoral arteries (10 minutes) prior to 10 minutes of reperfusion. The positive expressions of autophagy-related protein Beclin1 and LC3B, as well as GRP78 and p-eIF2α in the ischemic penumbra of the brain tissues sections were detected with immunofluorescence double staining. Results 1) There was little Beclin1 positive cells in the Sham group. Compared with Sham group, the Beclin1 positive cells in the penumbra of MCAO group obviously increased after 24 h reperfusion (P<0.05). Compared with MCAO group, the Beclin1 positive cells decreased significantly in the penumbra of RIPC+MCAO group. The Beclin1 positive cells were colocalized with NeuN, a general neuronal marker, in the brain ischemic penumbra. 2)In the penumbra of MCAO group rats after 24 h reperfusion, GRP78 was colocalized with Beclin1 and LC3B,respectively, which was examined with immunofluorescence staining. 3)In the penumbra of brain tissue of MCAO group with 24 h reperfusion, Beclin1 was colocalized with p-eIF2α. No Beclin1 and p-eIF2α double positive cell was observed in the Sham group. Lots of Beclin1 and p-eIF2α double positive cells were observed in the ischemic penumbra of MCAO group after 24 h reperfusion. After treated with RIPC, the Beclin1 and p-eIF2α double positive cells in the penumbra of the ischemia rats were significantly decreased compared with that in MCAO group (P<0.05). Conclusion RIPC may inhibit endoplasmic reticulum stress (ERS)-related pathway PERK/eIF2α and reduce the expression of autophagy-related protein, alleviate excessive activation of neuronal autophagy, and thus exerts neuroprotective effects on cerebral ischemia/reperfusion injury.

Effects of mitochondrial reactive oxygen species inhibitor R(+)-pramipexole on JAK2-STAT3 signaling pathway and pro-inflammatory factor TNF-α in rats with cerebral ischemia/reperfusion injury

Ding Mao, Yang Nan, Huang Yuyou, Shi Wenjuan, Yan Feng, Zhao Yongmei, Liu Kejian

2021, 42(2):  232-238.  doi:10.3969/j.issn.1006-7795.2021.02.012

Asbtract ( 148 )   PDF (3664KB) ( 40 )  

References | Related Articles | Metrics

Objective To study the effect of mitochondrial reactive oxygen species (ROS) inhibitor R(+)-pramipexole [R(+)-PPX] on the janus kinase 2 (JAK2)-signal transducer and activator of transcription 3 (STAT3) signaling pathway and pro-inflammatory factor tumor necrosis factor-α (TNF-α) in middle cerebral artery occlusion (MCAO) rats after 6 h reperfusion, and further to investigate the protective mechanism of R(+)-PPX on cerebral ischemia injury at early stage of reperfusion.Methods Thirty healthy male Sprague-Dawley rats were divided into Sham group, MCAO group, and R(+)-PPX group (n=10), according to random number table. MCAO rat model was established with modified suture method, the rats underwent 90 min of right MCAO and then reperfusion by withdrawing the filament. The anus temperature of the rats was monitored during the operation. The rats were sacrificed after 6h reperfusion, and then the brain was collected quickly. The level of p-JAK2 protein in ischemic brain tissue was determined with Western blotting. The expressions of p-STAT3 and TNF-α in the ischemic penumbra of frozen sections of brain tissues were detected with immunofluorescence staining. The ROS positive cells in the ischemic penumbra was detected with dihydroethidium (DHE) staining. Colocalization of ROS with p-STAT3 or TNF-α was examined with double labeling immunofluorescence staining in the ischemic penumbra. Colocalization of p-STAT3 and TNF-α was analyzed with double labeling immunofluorescence staining. Results 1) Compared with Sham group, the level of p-JAK2 protein was upregulated obviously in ischemic brain tissue of MCAO rats after 6 h reperfusion (P<0.05). The level of p-JAK2 protein decreased significantly in the ischemic brain tissue of R(+)-PPX group compared with that of MCAO group (P<0.05). 2) No p-STAT3 positive cell was observed in Sham group. The p-STAT3 positive cells in the ischemic penumbra of MCAO group increased obviously after 6 h reperfusion compared with Sham group (P<0.05). The p-STAT3 positive cells decreased significantly in the ischemic penumbra of R(+)-PPX group compared with MCAO group (P<0.05). ROS was colocalized with p-STAT3 in the ischemic penumbra of rats. 3) No TNF-α positive cell was observed in Sham group. The TNF-α positive cells in the ischemic penumbra of MCAO group increased obviously after 6 h reperfusion compared with Sham group (P<0.05). The TNF-α positive cells decreased significantly in the ischemic penumbra of R(+)-PPX group compared with MCAO group (P<0.05). ROS was colocalized with TNF-α in the ischemic penumbra of rats. 4) p-STAT3 was colocalized with TNF-α with immunofluorescence staining in the ischemic penumbra of MCAO group after 6 h reperfusion. Conclusion The mitochondrial ROS inhibitor R(+)-PPX may play a neuroprotective role at early stage of cerebral ischemia/reperfusion injury via inhibiting the activation of the JAK2-STAT3 signaling pathway and reducing the level of TNF-α in ischemic brain tissue of MCAO rats after 6 h reperfusion.

Application of ultrasound-guided femoral artery puncture and catheterization on endovascular ischemic stroke models of adult rhesus monkeys

Ma Yanhui, Wu Jie, Jia Bin, Yao Dongxu, Xu Na, Wang Tianlong, Chen Jian, Wu Di

2021, 42(2):  239-242.  doi:10.3969/j.issn.1006-7795.2021.02.013

Asbtract ( 133 )   PDF (1041KB) ( 22 )  

References | Related Articles | Metrics

Objective Investigate the effect of ultrasound-guided femoral artery puncture and catheterization in the development of ischemic stroke models of adult rhesus monkeys through endovascular methods.Methods Sixteen male rhesus monkeys were randomized into 2 groups: control group (Group C) and ultrasound-guided group (Group U). Su-mian-xin injection combined with 0.1 mL/kg ketamine was given before endotracheal intubation. After intubation, the animals received mechanical ventilation. Anesthesia was maintained with propofol infusion (5-8 mg·kg^-1·h^-1) in both groups. Classic palpation method was used for femoral artery puncture and catheterization in Group C. Ultrasound-guidance combined in-plane and out-of-plane was used for femoral artery puncture and catheterization in Group U. The first attempt success rate, second attempt success rate, total success rate, numbers of attempts, period of puncture and catheterization time and incidence of complications were compared between two groups. Results The frequency of attempts in Group U was less than that in Group C (P<0.05). Compared with Group C, the mean time to success was shorter in Group U (P<0.05). The success rate of the first and second attempt and total success rates were high in Group U, with no statistical differences (P>0.05). There was no difference in the incidence of complications between the two groups (P>0.05). Conclusion Ultrasound-guidance combined in-plane and out-of-plane used for femoral artery puncture and catheterization improved the initial attempt success rate and total success rate, reduce the frequency of attempts and the mean time on endovascular ischemic stroke models of adult rhesus monkeys.

Basic Research

Bioinformatic analysis of the influence of IL-33 on IFN-γ expression in tumor microenvironment

Han Hongju, Su Ziyang, Zhou Yujie, Wang Xi

2021, 42(2):  243-250.  doi:10.3969/j.issn.1006-7795.2021.02.014

Asbtract ( 197 )   PDF (7131KB) ( 55 )  

References | Related Articles | Metrics

Objective To analyze the impact of interleukin-33 (IL-33) on tumor microenvironment by bioinformatic methods. To find the mechanism by which IL-33 upregulates interferon-gamma (IFN-γ) expression.Methods We analyzed the impact of IL-33 expression on patients' survival time by the Kaplan Meier Online analyzing tool. Data were downloaded from gene expression omnibus (GEO), which were subject to a gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. We found the function and signal pathway of genes influenced by IL-33 and downloaded data from Clinical Proteomic Tumor Analysis Consortium (CPTAC) from which we extracted the expression of IL-33 and AU-rich element binding factor 1 (AUF1) and analyzed the correlation between IL-33 and AUF1. Results Kaplan Meier Online analysis results showed that patients who expressed IL-33 at high level had a better prognosis. In the St2 (the receptor of IL-33) knockout mouse colon carcinoma model, the expression of IFN-γ significantly decreased. The genes influenced by IL-33 were mainly annotated by genes respond to interferon-gamma, genes of cellular response to interferon-gamma, genes responding to virus, genes regulating response to biotic stimulus. The data from CPTAC revealed that the expression of IL-33 and AUF1 had a significant negative correlation. Conclusion IL-33 can upregulate the expression of IFN-γ of immune cells in tumor microenvironment. IL-33 could downregulate the expression of AUF1, which belongs to AUF1- and signal transduction-regulated complex (ASTRC). AUF1 attacked mRNA whose 3'UTR have an AU-rich element (ARE). IL-33 could protect IFN-γ mRNA by downregulating AUF1.

Changes of Pbk and its correlation with cytokine IGF-1 in glial cells after oxygen and glucose deprivation

Wang Yuqing, Chen Zhigang, Li Fangfang, Zhang Sijia, Luo Yumin, Zhao Haiping

2021, 42(2):  251-256.  doi:10.3969/j.issn.1006-7795.2021.02.015

Asbtract ( 126 )   PDF (1450KB) ( 25 )  

References | Related Articles | Metrics

Objective To investigate the changes of PDZ-binding-kinase(Pbk) and its correlation with cytokine insulin-like growth factors-1(IGF-1) in glial cells at different time points after oxygen and glucose deprivation.Methods BV2 microglia cells were cultured, primary astrocytes were isolated, and the oxygen and glucose deprivation(OGD) model was prepared. The expressions of cytokines IGF-1 and signal molecules Pbk and HDAC2 in two kinds of glia cells after 1, 3 and 6 h of oxygen and glucose deprivation were observed by reverse transcription-polymerase chain reaction(RT-PCR). Pearson correlation analysis of cytokines and signal molecules was carried out. Results With the time extension of OGD, the transcription level of Pbk was increased firstly and then decreased in microglia cells, and gradually increased in astrocytes, with statistically significant differences between groups (P<0.05). The transcription level of HDAC2 was decreased gradually in microglia cells and increased gradually in astrocytes, with statistically significant differences between groups (P<0.05). The transcription level of IGF-1 was decreased gradually in microglia cells and increased gradually in astrocytes, with statistically significant differences between groups (P<0.05).The transcription levels of Pbk and HDAC2 in microglia cells and astrocytes were positively correlated with the transcription level of IGF-1 after oxygen and glucose deprivation (P<0.05).Conclusion During the early stage of hypoxic-ischemic injury, the secretion of IGF-1 decreased in microglia and increased in astrocyte, which may be related to the activation of the Pbk/HDAC2/IGF-1 pathway. It provides a basis for further research on the neuroprotective mechanism after ischemia.

Epidemiological analysis of first-aid poisoning in Beijing from 2010 to 2017

Liu Mengyang, Zhu Yingxuan, Liu Yue, Li Zhiwei, Zhang Jinjun, Guo Xiuhua

2021, 42(2):  257-261.  doi:10.3969/j.issn.1006-7795.2021.02.016

Asbtract ( 104 )   PDF (2324KB) ( 35 )  

References | Related Articles | Metrics

Objective To analyze the epidemiological characteristics of first-aid poisoning in Beijing from 2010 to 2017 and to provide a scientific basis for formulating comprehensive prevention and control measures.Methods Data on first-aid poisoning cases from 2010 to 2017 were collected from the Beijing Emergency Medical Center. The data were analyzed by descriptive epidemiological analysis from the perspectives of different populations, time, and space, respectively. Results Totally 101 052 patients with first-aid poisoning were rescued by Beijing Emergency Center from 2010 to 2017. Alcohol poisoning, drug poisoning, and carbon monoxide poisoning were the leading causes, accounting for 92.30% of the total number. The male-to-female ratio is 2.09∶1, and the high-risk age group is 20-40 years old. First-aid poisoning cases occurred throughout the year with a peak in January, February, and December, and there are more patients in urban areas than in the suburbs. Conclusion The focus of Beijing's poisoning prevention and control work should be on alcohol intoxication, drug poisoning, and carbon monoxide poisoning. Particularly, the medical and health departments should reinforce the prevention and control of poisoning incidents for the population of young and middle-aged men, the period of January, February, and December around the Spring Festival, and the region of urban areas.

An efficient and convenient intelligent dietary assessment system for patients with chronic diseases

Ma Lanfang, Xue Yirong

2021, 42(2):  262-268.  doi:10.3969/j.issn.1006-7795.2021.02.017

Asbtract ( 312 )   PDF (2357KB) ( 87 )  

References | Related Articles | Metrics

Objective To built a diet evaluation system based on artificial intelligence to evaluate the daily diet of patients with chronic diseases.Methods Deep learning technology and traditional image processing method were used to realize intelligent segmentation, recognition and nutrient estimation of food image, so that patients with chronic diseases could obtain the nutrient information of food directly with only the food images taken by smart phones. The system also supported the fine-grained recognition of 172 Chinese food recipes and 353 food ingredients which had been verified in the food dataset Vireo Food-172. Results The predictive accuracy of the recipes based on the convolutional neural network model was 89.72%, the micro-averaging(Micro-F1) and macro-averaging(Macro-F1) of ingredients improved to 79.06% and 64.28% respectively. The state-of-the-art performance of ingredients recognition was achieved on food dataset Vireo Food-172; The food nutrients were estimated based on the results of recipe classification and ingredients recognition, and the error between the estimated values and the reference values was within a reasonable range. Conclusion The system could realize intelligent dietary assessment for patients with chronic diseases, which could facilitate patients to self-supervise their daily diet and assist nutritionists to complete the daily diet record and assessment. It had practical value and research significance.

Clinical Research

Study on the correlation between cerebrospinal fluid drainage and intracranial infection after craniotomy in children

Wang Zhenmin, Gong Jian

2021, 42(2):  269-272.  doi:10.3969/j.issn.1006-7795.2021.02.018

Asbtract ( 269 )   PDF (1819KB) ( 51 )  

References | Related Articles | Metrics

Objective To explore the correlation between external cerebrospinal fluid(CSF) drainage and intracranial infection after craniotomy in children.Methods The clinical data of 253 children who received craniotomy in pediatric neurosurgical ward of Beijing Tiantan Hospital, Capital Medical University between December 2018 and September 2019 were analyzed retrospectively. Results Among the 253 children cases, 113 cases had CSF external drainage after operation, the average retention time was 9 days (2-23 days). The incidence of postoperative intracranial infection was 30% (76/253) in all the 253 children and 54% (61/113) in those with external CSF drainage. Univariate analysis (χ²=55.702, P<0.001) and multivariate analysis (OR=8.045, 95% CI: 4.121-15.703, P<0.001) showed that indwelling external drainage tube was an independent risk factor for intracranial infection. Among 113 cases, 41 cases were treated with open external drainage system of CSF after operation. Statistics showed that the rate of intracranial infection in the open group was higher than that in the closed group (75.6% vs 41.6%, χ²=12.116,P<0.001). The incidence of intracranial infection was directly proportional to the drainage time. On the fifth day, the infection rate and the accumulated infection rate were the lowest, 25% and 27%, respectively. The time for antibiotics use and postoperative hospital stay of the patients with intracranial infection who received CSF drainage within one week were shorter than those longer than one week (9.37 d vs 12.32 d, t=-2.441, P=0.018; 24.33 d vs 36.29 d, Z=-2.624, P=0.009). Conclusion Reasonable retention of external CSF drainage after craniotomy in children, keeping the drainage tube system closed and pulling out the drainage tube as early as possible may help to reduce the incidence of intracranial infection related to drainage.

Screening analysis of tuberculosis patients and their close contacts in some schools in Beijing

Duan Huijuan, Dai Guangming, Chu Hongqian, Yang Zhen, Bao Cheng, He Yanping, Sun Zhaogang

2021, 42(2):  273-279.  doi:10.3969/j.issn.1006-7795.2021.02.019

Asbtract ( 176 )   PDF (1198KB) ( 48 )  

References | Related Articles | Metrics

Objective To understand the prevalence of tuberculosis among students by screening and analyzing tuberculosis patients and their close contacts in some schools in Beijing for the provide theoretical guidance for the prevention and control of tuberculosis in schools at different stages.Methods The tuberculosis patients and their close contacts found in the schools at different stages from 2015 to 2018 were collected as the research object. A total of 6 215 cases of data were included in this study, including 114 index cases and 6 101 close contacts. The close contacts were determined by tuberculin skin test with purified protein derivative(PPD) and X-ray chest radiography to identify potential tuberculosis patients, and to analyze the related risk factors of close contacts. Results Among close contacts,a total of 29 cases of tuberculosis were screened out, including 22 male (75.86%) and 7 female (24.14%); vocational schools and universities had higher rates of tuberculosis, 41.38%(12/29) and 48.28%(14/29), respectively, which mainly were students. Among close contacts, 2206 cases (36.16%) were positive for PPD (induration diameter≥5 mm) and 676 cases (11.08%) were strong positive (induration diameter≥15 mm); The positive rate of PPD from kindergarten to university showed an upward trend, with statistically difference (χ²=59.879,P<0.05), and the detection rate of tuberculosis gradually increased, with statistical difference(χ²=8.403,P=0.015). With the increase of PPD induration, the detection rates of tuberculosis also increased and the Chi-square test was statistically different(χ²=168.509,P<0.05). Conclusion Screening of close contacts of tuberculosis in schools of different ages should focus on the students at the vocational and university. At the same time, new methods should be adopted to improve the sensitivity of tuberculosis tests, to detect infected people early, and to avoid tuberculosis outbreaks in schools.

Role of ^99mTC-diethylenetriaminepentaacetic acid orbital SPECT/CT in subtype analysis and activity evaluation of thyroid associated ophthalmopathy

Yang Yilin, Luo Sha, Shi Tingting, Xin Zhong

2021, 42(2):  280-285.  doi:10.3969/j.issn.1006-7795.2021.02.020

Asbtract ( 120 )   PDF (1676KB) ( 37 )  

References | Related Articles | Metrics

Objective To investigate the classification of thyroid associated ophthalmopathy(TAO)subtypes by single photon emission computed tomography(SPECT)/computed tomography(CT) image analysis of ^99mTC-diethylenetriaminepentaacetic acid (DTPA), and to evaluate its role in activity assessment of TAO by calculating imaging agent uptake rate(UR).Methods An analysis was conducted on 205 patients who were diagnosed with TAO.According to ^99mTC-DTPA orbital SPECT/CT image analysis, TAO patients were divided into two types: type I was mainly retrobulbar lesions, type Ⅱ was mainly periorbital lesions. The clinical indexes were compared and the relationship between the uptake rate of imaging agents and clinical activity scores (CAS) were analyzed. Results The uptake rate of retrobulbar region (URR) of type Ⅰ TAO was significantly higher than that of type Ⅱ TAO, while the uptake rate of periorbital region (URP) of type Ⅱ TAO was higher. The difference was statistically significant (P<0.001). Type I and Ⅱ had significant differences in gender(P=0.001),age (P<0.001), CAS (P<0.001), diplopia scores (P<0.001)and thyrotropin receptor antibody(TRAb)(P=0.004). In type Ⅱ TAO, UR was correlated with the CAS(r=0.407,P<0.001).Receiver operating characteristic curve(ROC) curve analysis showed that the sensitivity of the type1 Ⅱ TAO when UR≥1.596 to judge the disease was active, the sensitivity is 68.4%, the specificity is 64.3%,and the clinical application value was limited. TRAb was correlated with CAS (r =0.215,P=0.007), but the correlation was weak.Conclusion ^99mTC-DTPA orbital SPECT/CT can provide an objective basis for the classification of patients with TAO, but it is not ideal for the evaluation of activity.

Study of apparent diffusion coefficient and glioma grading and molecular IDH1 mutant

Yan Xinting, Song Shuangshuang, Lu Jie

2021, 42(2):  286-292.  doi:10.3969/j.issn.1006-7795.2021.02.021

Asbtract ( 191 )   PDF (5403KB) ( 29 )  

References | Related Articles | Metrics

Objective To investigate the value of apparent diffusion coefficient (ADC) from diffusion weighted imaging (DWI) in determinate glioma grades and subtype, and investigate the correlation between ADC and isocitrate dehydrogenase-1 (IDH1) mutant.Methods We retrospectively analyzed 82 patients with glioma confirmed by postoperative pathology in our hospital. ADC values of the tumor parenchymal area and contralateral normal white matter were measured, and minimum ADC values, mean ADC values, relative minimum ADC values, relative mean ADC values were calculated. All ADC values in glioma at each grade and subtype were statistically compared. The correlation between all ADC values and IDH1 mutation status were analyzed. Results There were 27 cases,22 cases and 33 cases of World Health Organization (WHO) Ⅱ, Ⅲ and Ⅳ grades glioma respectively, low-grade 27 cases and high-grade 55 cases. The pathology subtype of Ⅱ and Ⅲ grades glioma were astrocytoma and oligodendroglioma, astrocytoma 26 cases and oligodendroglioma 23 cases respectively. There were 28 cases of IDH1^mut and 21 cases of IDH1^wild in all the Ⅱ and Ⅲ grades glioma. Minimum ADC (ADC_min), mean ADC (ADC_mean), relative minimum ADC (rADC_min),relative mean ADC (rADC_mean) between grade Ⅱ glioma group and grade Ⅳ glioma group, grade Ⅲ glioma group and grade Ⅳ glioma group were statistically significant (P<0.05), grade Ⅱ glioma group and grade Ⅲ glioma group were not statistically significant (P>0.05), All ADC values between high and low grade glioma were statistically significant(P=0.023,0.029,0.024,0.035). ADC_min,rADC_min,rADC_mean between astrocytoma and oligodendroglioma were statistically significant(P=0.044,0.025,0.040). All ADC values between IDH1^mut and IDH1^wild were not statistically significant(P>0.05). -Conclusions- ADC values could be used to predict the preoperative pathological grade and subtype of glioma, however those couldn’t be used to predict the preoperative IDH1 mutant.

Risk factors of adjacent vertebral body fracture secondary to percutaneous vertebral augmentation in elderly patients with osteoporotic vertebral compression fracture

Yang Bo, Wang Qinglei, Ma Jianhua, Liang Zhilin, Tang Jie, Zhao Xiaolin, Gao Maolong

2021, 42(2):  293-298.  doi:10.3969/j.issn.1006-7795.2021.02.022

Asbtract ( 124 )   PDF (1064KB) ( 33 )  

References | Related Articles | Metrics

Objective To assess the risk of adjacent vertebral fractures following percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF) in the elderly, the risk factors for secondary adjacent vertebral fractures were included.Methods The patients with symptomatic single-segment osteoporotic thoracolumbar vertebral compression fractures who were hospitalized in the Orthopedics Department of Beijing Geriatric Hospital from July 2014 to June 2018 were selected as the study subjects, among them, patients with PKP were in the PKP group (189 cases), and patients with PVP were in the PVP group (173 cases). They were followed up for 1 year. The risk of compression fractures of adjacent vertebral bodies after the two surgical methods were compared by statistical analysis.Results Both PKP and PVP significantly reduced visual analogue scale (VAS) scores in 362 patients, and there was no significant difference in the rate of adjacent vertebral fractures between the two groups. Age (OR=1.075,95%CI:1.040-1.112,P<0.001), bone density T value decreased (OR=0.576,95%CI:0.351-0.946,P=0.030), cement leakage(OR=2.284,95%CI:1.200-4.344,P=0.018), postoperative correction of local sagittal Cobb's angle (OR=1.188,95%CI:1.124-1.255,P=0.009)are independent risk factors for adjacent vertebral fractures after OVCF. Conclusion Both PKP and PVP can provide comparable pain relief rates, and there was no difference in the risk of secondary adjacent vertebral fractures between the two procedures. Age, bone mineral density, bone cement leakage (intradiscal leakage) and overcorrection of sagittal Cobb's angle were independent risk factors for secondary adjacent vertebral fractures after OVCF.

The effect of suture anchors in anterior cruciate ligament reconstruction and its influence on kneeling pain

Zhao Xiaoxiong, Ren Shixiang, Lin Yuan, Zhang Bo

2021, 42(2):  299-305.  doi:10.3969/j.issn.1006-7795.2021.02.023

Asbtract ( 143 )   PDF (6922KB) ( 46 )  

References | Related Articles | Metrics

Objective To investigate the application of suture anchors (SA) combined with bio-absorbable interference screw (BIS) for graft fixation on tibia in anterior cruciate ligament (ACL) reconstruction.Methods Seventy-six patients who were diagnosed with ACL tear for ACL reconstruction were recruited from March 2015 to May 2017 at Beijing Chaoyang Hospital. According to the principle of baseline feature matching between groups, they were divided into two groups: SA group (37 cases) and Staple group (39 cases). During surgery, Endobutton was used for cortical femoral suspensory fixation in both groups. BIS with SA were used for tibial fixation in SA group. Respectively, BIS with staples were used for tibial fixation in Staple group. Lysholm, the International Knee Documentation Committee Knee Evaluation Form (IKDC) scores, visual analogue score (VAS), range of motion (ROM) and the incidence of kneeling pain were evaluated. Anterior drawer test, Lachman test and pivot shift test were recorded. Besides, the baseline information [age, body mass index (BMI), operation time, incision length, intraoperative hemorrhage and hospitalization expenses] was also collected. Baseline information was analyzed by ANOVA. Repetitive measurement and analysis of variance was used to analyze Lysholm score, IKDC score, VAS and ROM between both groups. Results At the last follow-up, all patients, were associated with negative anterior drawer, pivot shift and Lachman tests. Lysholm, IKDC scores and range of motion were significantly better than those before surgery (P<0.05), but there was no statistical difference between the two groups (P>0.05). Besides, at 6 months after surgery, kneeling pain was performed in 8 patients in Staple group, five patients of whom were performed secondary surgery for removing staples and debridement. Relatively, kneeling pain was preformed in 1 patients in SA group. This difference was statistically significant (P<0.05). Conclusion This study demonstrates that both tibial cortical fixation, either BIS with staples or BIS with SA, achieved similar satisfactory clinical outcomes for ACL reconstruction. Besides, lower incidence of kneeling pain was performed in BIS with SA.

Effect of periodontal status on blood glucose control in patients with diabetic nephropathy

Zhang Dongxue, Lin Mei, Zhou Xuan, Liu Wenyan, Gu Yanan, Wang Zuomin

2021, 42(2):  306-311.  doi:10.3969/j.issn.1006-7795.2021.02.024

Asbtract ( 120 )   PDF (1069KB) ( 26 )  

References | Related Articles | Metrics

Objective This study explores the association between periodontal status and glycosylated hemoglobin (HbA1c)in patients with diabetic nephropathy (DN).Methods An observational study was conducted in 119 patients with DN. Patients were divided into two groups according to the presence of HbA1c<7% group (n=27) and HbA1c≥7% group (n=92), and oral health behavior-related variables were obtained by questionnaire. All patients underwent clinical examination, including probing depth(PD), bleeding index, clinical attachment loss(CAL) and the number of remaining teeth in the mouth. Laboratory tests include fasting blood glucose, glycosylated hemoglobin, creatinine and urine protein, etc. Results Comparied with HbA1c<7% group patients, probing depth (3.99±1.05 vs 3.49±0.93, P=0.031), blood index (3.45±0.58 vs 3.10±0.67, P=0.001), CAL (6.40±2.18 vs 5.37±1.99, P=0.003),the percentage of PD≥4 mm (median: 54.17% vs 38.15%, P=0.001) and PD≥5 mm (median: 24.13% vs 12.85%, P=0.028) were increased in HbA1c≥7% group patients. The results of multivariate Logistic regression analysis showed that in addition to fasting blood glucose, increasing of CAL was highly correlated with HbA1c ≥7% (OR=1.36, 95% CI:1.01-1.83,P=0.043) in DN patients. Conclusion There was a relationship between periodontal disease and HbA1c in patients with DN, increased CAL is highly correlated with poor HbA1c control in patients with diabetic nephropathy in DN.

Diagnostic value and related factors about computed tomography angiography after intracranial and extracranial stents placement

Qi Yi, Zhang Weiguo, Jia Jianwen, Zhong Hongliang, Yang Hongchao, Liu He

2021, 42(2):  312-316.  doi:10.3969/j.issn.1006-7795.2021.02.025

Asbtract ( 106 )   PDF (3414KB) ( 38 )  

References | Related Articles | Metrics

Objective To investigate the diagnostic accuracy and related affecting factors of computed tomography angiography (CTA) after intracranial and extracranial stents placement.Methods A total of 26 patients with intracranial and extracranial stent placement from December 2016 to November 2019 were retrospectively reviewed. There are 18 males and 8 females with the mean age (62.6±10.6) years and 37 stents were placed. All of them were followed up by CTA and digital subtraction angiography(DSA). CTA imaging quality inside stents was graded according to follow up DSA. The related factors including the diameter of the artery, the intracranial or extracranial, close to skull or not, presence or absence of the coil, were analyzed statistically. Results The imaging quality grade of in the stent was closely related to the diameter of the artery. According to the Youden index, the best cut-off value for the vessel diameter was 2.5 mm. There was significant difference between the intracranial and extracranial groups (P<0.001). There was no significant difference of imaging quality between the two groups, stay close to the skull or not(P=0.321). There was significant difference between the two groups about the coil existence (P<0.001). Conclusion After intracranial and extracranial stents placement, the accuracy of CTA follow-up is related to the diameter of the artery where the stent is located. When it is larger than 2.5 mm, it seems to have higher accuracy. The skull has no influence on image quality. The adjacent coils seriously attenuate the image quality.

Effects of epidural analgesia on the outcomes of forceps delivery

Jiang Haili, Zhou Jianxin, Xing Yu, Lu Chang

2021, 42(2):  317-322.  doi:10.3969/j.issn.1006-7795.2021.02.026

Asbtract ( 113 )   PDF (1060KB) ( 40 )  

References | Related Articles | Metrics

Objective To analyze the clinical characteristics of forceps delivery in full-term singleton primiparas and explore the influence of epidural analgesia on the outcomes of forceps delivery.Methods A total of 706 cases of forceps delivery in the delivery room of Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 1,2016 to December 31,2016 were included in this study.Totally 706 cases were divided into epidural analgesia group(324 cases)and control group(382 cases)according to whether epidural analgesia was performed or not and the outcomes of two groups were compared and observed. Results ① Forceps delivery rate was 7.2% (706/9 818),postpartum hemorrhage rate was 33.6% (237/706) ),the incidence of third-fourth degree laceration was 0.99% (7/706), and neonatal asphyxia rate was 4.4% (31/706) in full-term singletons primiparas. ②Postpartum hemorrhage rate in the epidural analgesia group was significantly higher than that in the control group (P=0.002), but there was no significant difference in postpartum hemorrhage (≥1000 mL) between the two groups (P=0.742). ③The fetal distress rate in the epidural analgesia group was significantly lower than that in the control group (P=0.000), but there was no significant difference in neonatal asphyxia rate between the two groups (P=0.513). Conclusion In full-term singletons pimiparas, the epidural analgesia was more likely to be associated with high risk of postpartum hemorrhage in forceps deliveries, but did not increase severe postpartum hemorrhage (≥1000 mL) and neonatal asphyxia.

Analysis of influencing factors of risk behaviors of inpatients with schizophrenia

Yi Yuwei, Yan Fang, Jin Yuhong, Xiao Cunli

2021, 42(2):  323-327.  doi:10.3969/j.issn.1006-7795.2021.02.027

Asbtract ( 235 )   PDF (1043KB) ( 28 )  

References | Related Articles | Metrics

Objective To explore the influencing factors of risk behaviors inpatients with schizophrenia.Methods Using retrospective research methods, 5 psychiatric hospitals in 4 districts were selected in Beijing based on geographical distribution using convenient sampling methods, and 625 patients with schizophrenia who were hospitalized from January 2016 to October 2016 were selected as the survey subjects, and the self-made questionnaire was used for investigationtoassess and analyze the occurrence of patients' risky behaviors and related factors.Results Univariate analysis showed that compared with the non-risk group, there were significant differences in gender, age stage, family-neighborhood relationship, work status, stressful events, mental symptoms, medication status, medical treatment attitude, and history of threatening speech in the risk behavior group(P<0.05). Logistic regression analysis showed that risk behaviors in patients with schizophrenia were related to age stage(OR=0.62,P=0.017),stress events(OR=2.08,P=0.001), hallucinations(OR=1.77,P=0.026),weird behaviors(OR=1.61,P=0.02), medical attitudes,(OR=2.60,P=0.029) and history of threatening speech(OR=6.77,P<0.001).Conclusion Under 45 years of age, hallucinations, weird behaviors, passive medical attitudes, stress events, and history of threatening speech are the main related influencing factors of risky behaviors in hospitalized patients with schizophrenia.

Clinical features of pulmonary and extrapulmonary cryptococcal infection

Wang Chaoyu, Wei Ming, Liu Yongzhe, Chen Yunxia, Gu Li

2021, 42(2):  328-333.  doi:10.3969/j.issn.1006-7795.2021.02.028

Asbtract ( 133 )   PDF (1120KB) ( 22 )  

References | Related Articles | Metrics

Objective The aim was to summarize the clinical characteristics of patients with pulmonary and extrapulmonary cryptococcal infection and analyze the independent risk factors of extrapulmonary cryptococcal infection.Methods Data of inpatients with cryptococcal disease who were admitted in Beijing Chaoyang Hospital, Capital Medical University from January 2014 to December 2019, including clinical data, clinical manifestations, laboratory examination, diagnosis, therapy and prognosis were analyzed. According to the prognosis, the patients were divided into pulmonary cryptococcosis group (PC group) and extrapulmonary cryptococcosis group (EPC group). The data of the two groups were analyzed by statistical method. The multivariable Logistic regression analysis was used for risk factors of extrapulmonary infection. Results A total of 51 cases, 30 males and 21 females, with the median age of 55(40, 64) years, were collected. Totally 39 cases were complicated with basic disease. There were 41 cases in PC group and 10 in EPC group. The proportion of solid organ transplantation and chronic liver disease(40.0% and 40.0%) in EPC group was higher than that in PC group(7.3% and 7.3%), the difference was statistically significant (P<0.05). The incidence of headache in patients with EPC group(50.0%) was higher than that in PC group (2.4%), the difference was statistically significant(P<0.05). The levels of procalcitonin, aspartate transferase and creatinine in EPC group were higher than those in PC group, the difference was statistically significant(P<0.05). Albumin, peripheral blood CD4⁺ T cells and peripheral blood CD8⁺ T cells in EPC group were lower than those in PC group, the difference was statistically significant(P<0.05). The mortality rate of EPC group (60.0%) was higher than that of PC group (2.4%), the difference was statistically significant(P<0.05). Multivariable Logistic regression analysis showed that solid organ transplantation(OR=10.470, 95%CI:1.089-100.651, P=0.042) and lower serum albumin (OR=0.783, 95%CI:0.637-0.962, P=0.020) were independent risk factors for extrapulmonary infection. Conclusion The prognosis of patients with extrapulmonary cryptococcal infection is worse than that of patients with pulmonary cryptococcal infection. Solid organ transplantation and low albumin are independent risk factors for extrapulmonary cryptococcal infection

Study and analysis of neuropsychological development status and related risk factors in infants aged 6 months

Bao Ling, Ren Junshuang, Wang Rui

2021, 42(2):  334-337.  doi:10.3969/j.issn.1006-7795.2021.02.029

Asbtract ( 181 )   PDF (1035KB) ( 60 )  

References | Related Articles | Metrics

Objective To understand the neuropsychological development of infants at 6 months of age, and to analyze the developmental differences between different genders and related risk factors.Methods The neuropsychological development scale of 0-6 years old children supervised by Capital Institute of Paediatrics was used to measure 1 470 out-patient infants, and the test results were analyzed with developmental quotient assessment. Results A total of 1 470 infants were investigated in this study, including 781 male infants and 689 female infants, with a sex ratio of 1.13∶1 and average monthly age of (6.12±0.24) months. Among them, there were differences in the neuropsychological development of infants of different genders at6 months of age (P<0.05), with statistical significance. At the same time, there were significant differences in fine movement, adaptive ability, and social behavior energy area (P<0.05). The scores of boys were significantly lower than those of girls. Multifactorial logistic analysis showed that low developmental quotient of babies, born gestational age (OR=14.215), the smaller and pregnancy associated with other risk factors babies (OR=4.738), the possibility of delay, the greater the infants with low developmental quotient, gender is a boy (OR=5.061), the smaller the gestational age of birth (OR=80.604) and pregnancy associated with other risk factors (OR=5.673) possibility of slow baby. Conclusion Male infant development quotient is more prominent than that of female infants, showing significant performance in the three functional areas of fine movement, adaptability and social behavior, small gestational age,other high-risk factors associated with pregnancy, and the risk factors of abnormal neuropsychological development in infants aged 6 months.