Association of maternal isolated thyroid peroxidase antibody positive in the first trimester with fetal growth / 北京大学学报(医学版)

OBJECTIVE@#To investigate the association of isolated thyroid peroxidase antibody (TPOAb) positive in the first trimester with fetal growth.@*METHODS@#A total of 16 446 pregnant women were included in the birth cohort study, whose last menstrual period was between May 2016 and April 2019 and with singleton pregnancy. Maternal serum samples were collected when they firstly came for prenatal care in the first trimester. The pregnant women were consecutively seen and followed in the hospital and the information of pregnant women was extracted from the electronic medical information system. The pregnant women were divided into isolated TPOAb positive group (n=1 654) and euthyroid group (n=14 792). Three fetal ultrasound examinations were scheduled during the routine prenatal visits at the hospital and were performed by trained sonographers. All fetal growth indicators were quantified as gestational age- and gender- adjusted standard deviation score (Z-score) using the generalized additive models for location, scale and shape (GAMLSS). Fetal growth indicators included estimated fetal weight (EFW), abdominal circumference (AC), biparietal diameter (BPD), femur length (FL) and head circumference (HC). Fetal growth restriction (FGR) was defined as AC or EFW Z-score＜3rd centile based on clinical consensus. Generalized estimating equation (GEE) analysis was applied to assess the association of maternal isolated TPOAb positive with fetal growth. The generalized linear model was further used to analyze the association between isolated TPOAb positive and fetal growth indicator at different gestational ages when the fetal growth indicator was significantly associated with isolated TPOAb positive in the GEE mo-del.@*RESULTS@#The median gestational age at three ultrasound measurements was 23.6 (23.3, 24.1), 30.3 (29.7, 30.9), 37.3 (37.0, 37.7) weeks, respectively. The BPD Z-score was higher in isolated TPOAb positive women, compared with the euthyroid pregnant women after adjustment (β=0.057, 95%CI: 0.014-0.100, P=0.009). The generalized linear model showed the BPD Z-score was higher in the isolated TPOAb positive women at the end of 21-25 weeks (β=0.052, 95%CI: 0.001-0.103, P=0.044), 29-32 weeks (β=0.055, 95%CI: 0.004-0.107, P=0.035) and 36-40 weeks (β=0.068, 95%CI: 0.011-0.125, P=0.020), compared with the euthyroid pregnant women. There was no difference in other fetal growth indicators (EFW, AC, FL and HC) and FGR between the isolated TPOAb positive and euthyroid pregnant women.@*CONCLUSION@#The BPD Z-score was slightly increased in the isolated TPOAb positive pregnant women in the first trimester, while other fetal growth indicators were not changed. The reproducibility and practical significance of this result need to be confirmed.

Differential proteomic analysis of children infected with respiratory syncytial virus

Respiratory syncytial virus (RSV) infection is the main cause of lower respiratory tract infection in children. However, there is no effective treatment for RSV infection. Here, we aimed to identify potential biomarkers to aid in the treatment of RSV infection. Children in the acute and convalescence phases of RSV infection were recruited and proteomic analysis was performed to identify differentially expressed proteins (DEPs). Subsequently, promising candidate proteins were determined by functional enrichment and protein-protein interaction network analysis, and underwent further validation by western blot both in clinical and mouse model samples. Among the 79 DEPs identified in RSV patient samples, 4 proteins (BPGM, TPI1, PRDX2, and CFL1) were confirmed to be significantly upregulated during RSV infection. Functional analysis showed that BPGM and TPI1 were mainly involved in glycolysis, indicating an association between RSV infection and the glycolysis metabolic pathway. Our findings provide insights into the proteomic profile during RSV infection and indicated that BPGM, TPI1, PRDX2, and CFL1 may be potential therapeutic biomarkers or targets for the treatment of RSV infection.

Clinical effect of gemcitabine combined with high-intensity focused ultrasound in treatment of advanced pancreatic cancer: A Meta-analysis / 临床肝胆病杂志

ObjectiveTo evaluate the clinical effect and safety of high-intensity focused ultrasound (HIFU) combined with gemcitabine in the treatment of advanced pancreatic cancer. MethodsSCI, Cochrane Library, Embase, PubMed, Wanfang Data, CNKI, CBM, and VIP were searched for randomized controlled trials (RCTs) of HIFU combined with gemcitabine in the treatment of advanced pancreatic cancer, with the assistance of expanded search, and these RCTs were screened according to the inclusion criteria. Review Manager 5.3 was used to perform the Meta-analysis. A fixed effects model was used for non-heterogeneous data; heterogeneity was explained by subgroup analysis based on intervention methods, and if it could not be explained by subgroup analysis, a random effects model was used. Relative risk (RR) and 95% confidence interval (CI) were used as evaluation indices, and funnel plots were generated based on the outcome measure involved in the highest number of studies. ResultsA total of 8 RCTs with 474 patients were included. The patients in the experimental group received gemcitabine-based chemotherapy and HIFU, and those in the control group received gemcitabine-based chemotherapy alone. Compared with the control group, the experimental group had significantly better results in 3-, 6-, and 12-month survival rates (3-month: RR=1.07, 95%CI: 1.00-1.14, P＜0.05; 6-month: RR=2.19, 95%CI: 1.75-2.75, P＜0.05; 12-month: RR=235, 95%CI: 1.07-5.14, P＜0.05), tumor control (RR=1.64, 95%CI: 1.21-2.24, P=0.002), and pain control (RR=3.15, 95%CI: 2.45-4.05, P＜0.05). There were no significant differences between the two groups in the incidence rates of leukopenia (RR=1.05, 95%CI: 0.85-1.30, P＞0.05), gastrointestinal reactions (RR=0.89, 95%CI: 0.56-1.42, P＞0.05), and liver injury (RR=1.29, 95%CI: 0.95-1.75, P＞0.05). Since the outcome measure of pain control was involved in the highest number of studies, funnel plots were generated and showed no significant risk of bias. ConclusionCompared with gemcitabine alone, HIFU combined with gemcitabine can increase patients’ survival rate and improve their symptoms, with a similar incidence rate of adverse effects. Further studies are needed for this combined therapy.

Perinatal monitoring of fetal growth restriction / 中国实用妇科与产科杂志

Based on domestic and international guidelines,clinical researches and expert consensus,it is stated that fetal growth restriction is the fetal low weight,clinically accompanied by abnormal placenta and umbilical cord blood flow.This paper summarized the significance and clinical value of the color Doppler detection during perinatal period,and discussed the measures to reduce the adverse outcome of fetal growth restriction during delivery.

Prevalence of gestational diabetes mellitus and its related risk factors among 34 637 pregnant women in Tongzhou district of Beijing from 2013 to 2017 / 中华疾病控制杂志

@# Objective The study aims to investigate the prevalence of gestational diabetes mellitus (GDM) among pregnant women in Tongzhou district of Beijing and its related risk factors. Methods Information of 34 637 singleton pregnancies delivered in a maternal and child health care hospital in Tongzhou district of Beijing were collected from January 1, 2013 to December 31, 2017. GDM prevalence of pregnant women were calculated. Multivariable logistic regression analysis was used to analyze the association between GDM and its related factors. Results The prevalence of GDM in 34 637 singleton pregnant women in Tongzhou district of Beijing was 23.2% (8 034/34 637). Multivariate analysis showed that advanced maternal age(aOR=1.87, 95% CI: 1.71-2.05), high level of education(aOR=1.19-1.23), delivering during 2016-2017(aOR=1.46, 95% CI: 1.38-1.55), macrosomia(aOR=1.27, 95% CI: 1.02-1.59), history of cesarean section(aOR=1.18, 95% CI: 1.08-1.30), history of spontaneous abortion(aOR=1.23, 95% CI:1.10-1.37), history of induced abortion(aOR=1.08, 95% CI:1.01-1.14), family history of diabetes(aOR=1.51, 95% CI:1.26-1.83), multipara(aOR=1.24, 95% CI:1.15-1.34), pre-pregnancy overweight(aOR=2.02, 95% CI:1.89-2.15), pre-pregnancy obesity(aOR=3.11, 95% CI:2.81-3.43)and conceived by assisted reproductive technology(aOR=1.47, 95% CI:1.03-2.10)were the independent risk factors for GDM. Conclusions Prevalence of GDM is high in pregnant women in Tongzhou district of Beijing. Health education before and during pregnancy should be carried out to monitor and prevent the occurrence of GDM in time to ensure maternal and child health.

Awareness of Colorectal Cancer among the Urban Population in the Klang Valley

@#Background: Colorectal cancer (CRC) is the second most common cancer in Malaysia. Awareness of risk factors, symptoms and warning signs of CRC will help in early detection. This paper presents the level of CRC awareness among the urban population in Malaysia. Method: A cross-sectional study was conducted from November 2015 till December 2016 at three government clinics in the Klang Valley. The validated Bowel Cancer Awareness Measure questionnaire in both English and Malay was used. The mean knowledge scores for the warning signs and risk factors of CRC in different socio-demographic groups were compared using ANOVA in SPSS version 23. Statistical significance was set at p<0.05 and a 95% confidence level. Results: Of the 426 respondents, 29.1% were unable to recall the warning signs and symptoms of CRC. Average recall was less than two warning signs and symptoms (mean 1.62, SD 1.33). The mean total knowledge score for CRC was 9.91 (SD 4.78), with a mean knowledge scores for warning signs and risk factors at 5.27 (SD 2.74) and 4.64 (SD 2.78), respectively. Respondents with a higher level of education were found to have higher level of knowledge regarding the warning signs of CRC. There was a significant positive association between knowledge score for warning signs and level of confidence in detecting warning signs. Regarding the total knowledge score for CRC, 3.3% of respondents scored zero. For warning signs and risk factors, 8.2% and 8.5% of respondents had zero knowledge scores, respectively. Conclusions: Generally, awareness of CRC is poor among the urban population of Klang Valley. Greater education and more confidence in detecting warning signs are significantly associated with better knowledge of warning signs. CRC awareness programs should be increased to improve awareness.

Effect of Early Ambulation after Radiofrequency Catheter Ablation via Femoral Vein Approach / 中国康复理论与实践

Objective To investigate the effect of early ambulation on the comfort and complications in patients undergoing radiofre-quency catheter ablation via femoral vein approach. Methods From April,2016 to April,2017,120 patients were randomly assigned into control group(n=40),group A(n=40)and group B(n=40).The control group received the routine care of remaining bed rest for eight hours with the affected leg immobilized at least four hours.Group A ambulated after four hours of the affected leg immobili-zation,and group B changed their position after ablation and ambulated after four hours of bed rest.They were assessed with the General Comfort Questionnaire,Numerical Rating Scale of back pain and State Anxiety Inven-tory.Their vascular complications were recorded. Results The incidence of bleeding and hematoma was not significantly different among the groups(P>0.05).Group B was more comfortable than the control group(P<0.05).Compared with the control group,groups A and B were less in back pain intensity(F>10.376,P<0.001),and had less anxiety(t=3.278,P<0.05),less incidence of limb numbness, difficulty falling asleep, and loss of appetite and dysuria (χ2>6.409, P<0.05). Group B was the best among them. Conclusion There is little risk of early physical activity and ambulation in the vascular complications after radiofrequen-cy catheter ablation via femoral vein approach,which may reduce their discomfort.

Progress of clinical medication for differentiated thyroid carcinoma / 医学研究生学报

The main treatment model for differentiated thyroid cancer is surgery -based individualized treatment .Due to the in-ert cancer characteristics of DTC , drug therapies such as thyrotropin suppressive therapy , molecular targeted therapy, neoadjuvant chemotherapy and Chinese medicine treatment have become the current research hotspots .Here, we reviewed the progress of clinical medication for DTC to improve the understanding of DTC drug therapy .

Early Immunosuppressive Exposure of Enteric-Coated-Mycophenolate Sodium Plus Tacrolimus Associated with Acute Rejection in Expanded Criteria Donor Kidney Transplantation / 中华医学杂志(英文版)

<p><b>Background</b>Immunosuppressive agents are still inefficient in preventing biopsy-proven acute rejection (BPAR) after expanded criteria donor (ECD) kidney transplantation. The aim of this study was to investigate the relationships between early immunosuppressive exposure and the development of BPAR.</p><p><b>Methods</b>We performed a retrospective study of 58 recipients of ECD kidney transplantation treated with enteric-coated-mycophenolate sodium, tacrolimus (Tac), and prednisone. The levels of mycophenolic acid-area under the curve (MPA-AUC) and Tac Cwere measured at the 1 week and the 1 month posttransplant, respectively. The correlation was assessed by multivariate logistic regression.</p><p><b>Results</b>The occurrence rates of BPAR and antibody-mediated rejection were 24.1% and 10.3%, respectively. A low level of MPA-AUC at the 1 week posttransplant was found in BPAR recipients (38.42 ± 8.37 vs. 50.64 ± 13.22, P < 0.01). In addition, the incidence of BPAR was significantly high (P < 0.05) when the MPA-AUClevel was <30 mg·h·L at the 1 week (15.0% vs. 44.4%) or the Tac Cwas <4 ng/ml at the 1 month posttransplant (33.3% vs. 21.6%). Multivariable logistic regression analysis showed that the MPA-AUC at the 1 week (OR: 0.842, 95% CI: 0.784-0.903) and the Tac Cat the 1 month (OR: 0.904, 95% CI: 0.822-0.986) had significant inverse correlation with BPAR (P < 0.05).</p><p><b>Conclusions</b>Low-level exposure of MPA and Tac Cin the early weeks posttransplant reflects an increased acute rejection risk, which suggested that MPA-AUC <30 mg·h·L and Tac C <4 ng/ml should be avoided in the first few weeks after transplantation.</p>

Effect of preoperative triamcinolone acetonide with 25G minimally invasive vitreous retinal surgery for patients with PDR / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect of preoperative injection of triamcinolone acetonide(TA)with 25G minimally invasive vitreoretinal surgery(VRS)in treating proliferative diabetic retinopathy(PDR)and the prognosis of patients. <p>METHODS: A total of 108 patients(108 eyes)with PDR to be treated by VRS were randomly divided into two groups. Fifty-four patients, treated with intravitreal injection of TA at 1wk before surgery were included into the VRS+TA group, and 54 cases directly treated by VRS were included into the VRS group. The surgical effect, uncorrected visual acuity(at 3mo after surgery), the best corrected visual acuity, the intraocular pressure(before surgery and at 1wk, 1 and 3mo after surgery)and complications were observed. <p>RESULTS: The surgical time, electrocoagulation rate, rate of iatrogenic hole and bleeding rate during surgery were significantly shorter or lower in VRS+TA group than in VRS group(<i>P</i><0.05)while the intraocular filler showed no significant difference between the two groups(<i>P</i>>0.05). At 3mo after surgery, the uncorrected visual acuity and the best corrected visual acuity were improved significantly(<i>P</i><0.05)while there was no significant difference between groups(<i>P</i>>0.05). At 1 and 3mo after surgery, the intraocular pressure of VRS+TA group was significantly higher than that before surgery(<i>P</i><0.05)while there were no significant differences between groups(<i>P</i>>0.05). The rate of anterior chamber exudation was significantly lower in VRS+TA group than in VRS group(<i>P</i><0.05)while there was no significant difference in the total incidence of complications between groups(<i>P</i>>0.05). <p>CONCLUSION: The application of intravitreal injection of TA in patients with PDR at 1wk before surgery can reduce the difficulty of surgery, shorten the surgical time and reduce complications, which is beneficial to the improvement of visual acuity after surgery.

Coronary CT 3D post-processing standardized display and construction of digital teaching platform / 医疗卫生装备

Objective To explore coronary CT three-dimensional post-processing standardized display and the construction of digital teaching platform. Methods The conventional display positions of 3D post-processing image were summarized during daily coronary CTA examination, the common place was refined. The construction mode was explored for CTA digital teaching demonstration platform. Results Coronary CTA 3D post-processing standardized display with common and individual property contributed to enhancing the display of coronary images. The CTA digital teaching demonstration platform met the teaching requirements. Conclusion The coronary CT 3D post-processing standardized display and digital teaching platform facilitate the student to master related knowledge.

Study on the role of miRNA-183 family in malignant cancer / 天津医药

MiRNAs have a close relation with the development of malignancy. As a new type of regulatory factor, miRNA plays an important role in the development and progression of tumors, and plays the role of oncogene or tumor suppressor gene. Abnormal expression of miRNA is found in tumors. Most of the abnormal expression of miRNA are related to tumor staging, malignancy, treatment and prognosis, which provides a new strategy for the evaluation of early diagnosis, treatment and prognosis of tumors. The miRNA-183 family is composed of three types of miRNAs including miRNA-96, miRNA-182 and miRNA-183. They present abnormal expressions in tumors of digestive system, urogenital system and respiratory system. More and more researches have been done on the relationship between miRNA-183 family and tumor, and the mechanism has been deeply studied.

Improvement and practice of high-frequency electrotome detection / 医疗卫生装备

Objective To discuss the technical specifications of current high-frequency electrotome detection,to avoid the hidden danger of high-frequency electrotome power detectors,and to measure the leakage current of different kinds of highfrequency electrotome accurately.Methods The power and leakage current of the high frequency electrotome were measured by FLUCK QA-ES Ⅱ high frequency electrotome analyzer.The safety of the two methods was compared before and after the improvement of the power measurement.Four parameters of leakage current were repeatedly measured with the ways of high frequency earthing and high frequency isolation respectively.The maximum measurement of leakage current was recorded.Results The improved connection method was safe in the power measurement.For the high-frequency electrotome in the model of high frequency earthing,the values of leakage current were restrained within the range of error with two ways of monopolar loading operation electrode and neutral electrode.For the high-frequency electrotome in the model of high frequency isolation,the values of leakage current were limited within the range of error withtwo ways of monopolar empty operation electrode and neutral electrode.Conclusion The improved high-frequency electrotome power detection method is safe for detectors.The data obtained from the leakage current detection method using the national standard correction method reflect the actual state of the high-frequency electrotome,when the electrotome with earth as the reference is used to detect the leakage current with loading or the insulated electrotome is applied to measuring the leakage current with no loading.

Application of quality control circle for improving coronary sinus CT examination / 医疗卫生装备

Objective To compare the image quality of sinus coronal CT scan before and after the involvement of quality control circle (QCC) to explore QCC's effect.Methods A QCC team was founded in April 2014,in which 10 key steps of QCC activities were executed,and the related data from April to November 2014 were analyzed to determine the effect of QCC on coronary sinus CT examination.Results The rate of excellent film was increased from 69.5％ to 96.3％ after the involvement of QCC,and the desired requirement was met.Conclusion QCC contributes to improving coronary sinus CT examination and enhancing the ability of the members,and thus is worthy promoting clinically.

Design and implementation of Magphan-phantom-based image parameters auto evaluation system for MRI quality inspection / 医疗卫生装备

Objective To design and implement an automatic analysis and evaluation system for the image parameters of medical MRI quality testing.Methods The system was developed and debugged by the study on MRI image quality parameters,the image denoising,integration,extraction and etc by MATLAB processing platform as well as the comparison and comparative calculation of the obtained data.Results The system replaced manual operation by auto processing and parameters analysis of MRI quality inspection image.Conclusion The system enhances the efficiency and avoids artificial error,and has a promising prospect in the future.

Improvement and practice of high-frequency electrotome detection / 医疗卫生装备

Objective To discuss the technical specifications of current high-frequency electrotome detection,to avoid the hidden danger of high-frequency electrotome power detectors,and to measure the leakage current of different kinds of highfrequency electrotome accurately.Methods The power and leakage current of the high frequency electrotome were measured by FLUCK QA-ES Ⅱ high frequency electrotome analyzer.The safety of the two methods was compared before and after the improvement of the power measurement.Four parameters of leakage current were repeatedly measured with the ways of high frequency earthing and high frequency isolation respectively.The maximum measurement of leakage current was recorded.Results The improved connection method was safe in the power measurement.For the high-frequency electrotome in the model of high frequency earthing,the values of leakage current were restrained within the range of error with two ways of monopolar loading operation electrode and neutral electrode.For the high-frequency electrotome in the model of high frequency isolation,the values of leakage current were limited within the range of error withtwo ways of monopolar empty operation electrode and neutral electrode.Conclusion The improved high-frequency electrotome power detection method is safe for detectors.The data obtained from the leakage current detection method using the national standard correction method reflect the actual state of the high-frequency electrotome,when the electrotome with earth as the reference is used to detect the leakage current with loading or the insulated electrotome is applied to measuring the leakage current with no loading.

Application of quality control circle for improving coronary sinus CT examination / 医疗卫生装备

Objective To compare the image quality of sinus coronal CT scan before and after the involvement of quality control circle (QCC) to explore QCC's effect.Methods A QCC team was founded in April 2014,in which 10 key steps of QCC activities were executed,and the related data from April to November 2014 were analyzed to determine the effect of QCC on coronary sinus CT examination.Results The rate of excellent film was increased from 69.5％ to 96.3％ after the involvement of QCC,and the desired requirement was met.Conclusion QCC contributes to improving coronary sinus CT examination and enhancing the ability of the members,and thus is worthy promoting clinically.

Design and implementation of Magphan-phantom-based image parameters auto evaluation system for MRI quality inspection / 医疗卫生装备

Objective To design and implement an automatic analysis and evaluation system for the image parameters of medical MRI quality testing.Methods The system was developed and debugged by the study on MRI image quality parameters,the image denoising,integration,extraction and etc by MATLAB processing platform as well as the comparison and comparative calculation of the obtained data.Results The system replaced manual operation by auto processing and parameters analysis of MRI quality inspection image.Conclusion The system enhances the efficiency and avoids artificial error,and has a promising prospect in the future.

Efficacy and safety observation after implantation of TICL in the treatment of high myopia with astigmatism / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To study the efficacy and safety of Toric implantable contact lens (TICL) implantation in the treatment of patients with high myopia and astigmatism.METHODS: Totally 90 patients (178 eyes) diagnosed as this disease were selected in our hospital during September 2012 to September 2016 by the method of random.The UCVA, BCVA, refraction, astigmatism coefficient, corneal endothelial cell, intraocular pressure, manifest refraction examination were accessed and compared before and after 3 and 9mo of surgery.RESULTS: After 3 and 9mo of the surgery, the UCVA and BCVA were much higher than those before treatment, which the difference was statistically significant (P0.05).The corneal endothelial cells at 3 and 9mo after operation were compared with those of before treatment, and we found that the differences were statistically significant (P0.05).CONCLUSION: TICL implantation in the treatment of patients with high myopia and myopic astigmatism has a more obvious clinical efficacy and safety and reliability.

The Research of the Medical Students’ Education Cost Control / 中国卫生经济

The objective of the medical students’ education cost control is to reasonably reduce the education cost differences caused by mismanagement and insufficient investment. The budget is an important tool for the control;the elabrate cost accounting is the essential information condition for the control. It is proposed that enhancing the control power must clear responsibility cost, the education quality cost is guaranteed through both increasing income and reducing expenditure.