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Objective:To explore the application value of ultrasonic measurement of the pubic symphysis distance in predicting pubic symphysis diastasis(PSD) during delivery.Methods:A total of 262 pregnant women from June 2021 to July 2022 who delivered at Suzhou Wuzhong People′s Hospital and Jiangyin People′s Hospital were retrospectively analyzed. The patients were divided into PSD group of 26 cases and normal pregnant women group (control group) of 234 cases according to whether or not PSD was confirmed during postpartum follow-up. Relevant data of the two groups were collected, including the biparietal diameter and femoral length of the fetus within 7 days before delivery, the pubic symphysis distance of pregnant women when the cervix was not dilated, pubic symphysis distance when the cervix dilated to 5 cm during the first stage of delivery, and the pubic symphysis distance after delivery, the age of the pregnant woman, the gestational week, the number of pregnancies, and the birth weight of the fetus. The differences of the above relevant data between the two groups were compared.Spearman correlation analysis was used to analyze the correlation between various parameters. The occurrence of postpartum PSD, and Logistic regression was used to analyze the predictive value of various parameters on the occurrence of postpartum PSD. ROC curve was used to analyze the diagnostic efficacy of each parameters to predict PSD.Results:The fetal birth weight, number of pregnancies, pubic symphysis distance in three time points in the PSD group were significantly higher than those in the control group (all P<0.05). The age of the pregnant women was negatively correlated with the occurrence of postpartum PSD ( rs=-0.152, P=0.014). The fetal birth weight, the number of pregnancies, the pubic symphysis distance in the cervix no-dilated and the first stage of labor were positively correlated with the occurrence of postpartum PSD( rs=0.160, 0.166, 0.678, 0.581, all P<0.05). Logistic regression analysis showed that the increase of pubic symphysis distance before labor would increase the risk of postpartum PSD, and the difference was statistically significant ( OR=2 506.028, 95% CI=14.293-439 402.630, P=0.003). The increase of pubic symphysis distance at the first stage of labor increased the risk of postpartum PSD, with a statistically significant difference ( OR=10 704.027, 95% CI=33.830-3 386 803.429, P=0.002). The ROC curve analysis showed that the area under the curve of the pubic symphysis distance in the cervix no-dilated and the first stage of labor for the diagnosis of PSD were 0.896 and 0.917 respectively, the sensitivity were 0.731 and 0.885, the specificity were 0.940 and 0.829, and the corresponding critical values were 0.87 cm and 1.06 cm respectively. The area under the curve of the combination of the two parameters for the diagnosis of PSD was 0.930, the sensitivity was 0.885, and the specificity was 0.876. Conclusions:Ultrasonic measurement of pubic symphysis distance during delivery can predict the occurrence of postpartum PSD in pregnant women and can provide a basis for the occurrence and treatment of postpartum pubic symphysis separation in pregnant women.
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Objectives To identify the Francisella strain isolated from blood of a patient with drowning-associated pneumonia.Methods The whole genome of the strain,designated Wenzhou1,was sequenced using the high throughput sequencing technology by 2000/miSeq system of Illumina platform,and the obtained genome draft was assembled by MicrobeTrakr Plus software.The phylogenetic neighbors of Wenzhou1 were obtained by NCBI BLAST analysis from GenBank database for the gene sequences of 16S rRNA,malate dehydrogenase(mdh),DNA-directed RNA polymerase subunit beta (rpoB) and succinate dehydrogenase subunit alpha (sdhA).The average nucleotide identity(ANI) between Wenzhou1 and its phylogenetic neighbors was analyzed by the software OrthoANI using NCBI BLAST search under the Java Runtime Environment Version 8.Results The genome size of Wenzhou1 was 1.96 × 106 bp,containing 74 contigs.The genomic G + C mol％ of Wenzhou1 was 32.1％,which was similar to the other species of genus Francisella and Allofranicella.Based on the analysis of NCBI BLAST of GenBank for the similarities of 16S rRNA gene,mdh gene,rpoB gene and sdbA gene sequences,Wenzhou1 was most closely related to F.hispaniensis FSC454 and Francisella cf.novicida 3523.The ANI of Wenzhou1 was 97.8％ to F.hispaniensis FSC454,97.5％ to 97.6％ to Francisella cf.novicida 3523,but only 91.3％ to 91.5％ to the four subspecies of F.tularensis.Conclusion ANI analysis based on whole genome sequence should be an accurate,effective method for bacterial identification.Wenzhou1 could be identified as F.hispaniensis by ANI with high-throughput whole genome sequencing technology.
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ObjectiveTo evaluate the clinical value of prenatal ultrasonography combined with maternal serology screening for chromosomal abnormality in 15 to 20+6 gestational weeks.MethodsSix hundred and twenty-eight pregnant women (628 fetuses) in 15 to 20+6 gestational weeks were selected to undergo prenatal ultrasonography, who were in critical risk of trisomy 21 or trisomy 18 by maternal serology screening. Transabdominal ultrasonography were performed and fetal nasal bone and nuchal fold were detected. Those who had nasal bone hypoplasia, thickened nuchal fold (NF>6 mm) and other abnormal fetal soft markers underwent amniocentesis for karyotyping analysis. ResultsThere were 6 cases of nasal bone hypoplasia (0.96%, 6/628), including one case of thickened nuchal fold, two cases of echogenic bowel, two cases of choroid plexus cysts and 1 case of echogenic cardiac focus. All these 6 cases underwent amniocentesis and 2 were trisomy 21 (33.3%, 2/6). The other 4 cases had no significant chromosomal abnormality.ConclusionsPrenatal ultrasonography may improve the detection rate of chromosomal abnormality for those pregnant women who are in critical risk of chromosomal abnormality prompted by serology screening. But invasive procedures are still needed to verify the chromosomal abnormality.
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Objective To observe the therapeutic effect of Chinese medicine combined with ion-introduction of Radix Astragali Injection (RAI)for herpes simplex keratitis (HSK).Methods Ninety HSK patients (104 affected eyes)were randomized into two groups.Both of the two groups received anti-virus drugs,and the treatment group (45 patients with 53 affected eyes)received oral use of decoction of Chinese medicines (mainly composed of Semen Cassiae,Fructus Viticis,Periostracum Cidadae,Ramulus Uncariae cum Uncis,Fructus Gardeniae,Fructus Forsythiae,Flos Chrysanthemi,Rhizoma Chuanxiong,etc.),and ion-introduction of RAI.The changes of vision and clinical symptoms before and after treatment were observed,and a 2-year follow-up was carried out.Results In the treatment group,19 eyes were cured,27 effective,7 ineffective,and the total therapeutic effective rate being 86.79%;in the control group,10 eyes were cured,21 effective,20 ineffective,and the total therapeutic effective rate being 60.78%.The therapeutic effect in the treatment group was superior to that in the control group (P