Postoperative Prognostic Nutritional Index and Fibrinogen Could Well Predict Poor Prognosis of Acute Type A Aortic Dissection Patients After Surgery

ABSTRACT Introduction: Inflammatory and immunological factors play pivotal roles in the prognosis of acute type A aortic dissection. We aimed to evaluate the prognostic values of immune-inflammatory parameters in acute type A aortic dissection patients after surgery. Methods: A total of 127 acute type A aortic dissection patients were included. Perioperative clinical data were collected through the hospital's information system. The outcomes studied were delayed extubation, reintubation, and 30-day mortality. Multivariate logistic regression analysis and receiver operating characteristic analysis were used to screen the risk factors of poor prognosis. Results: Of all participants, 94 were male, and mean age was 51.95±11.89 years. The postoperative prognostic nutritional indexes were lower in delayed extubation patients, reintubation patients, and patients who died within 30 days. After multivariate regression analysis, the postoperative prognostic nutritional index was a protective parameter of poor prognosis. The odds ratios (95% confidence interval) of postoperative prognostic nutritional index were 0.898 (0.815, 0.989) for delayed extubation and 0.792 (0.696, 0.901) for 30-day mortality. Low postoperative fibrinogen could also well predict poor clinical outcomes. The odds ratios (95% confidence interval) of postoperative fibrinogen were 0.487 (0.291, 0.813) for delayed extubation, 0.292 (0.124, 0.687) for reintubation, and 0.249 (0.093, 0.669) for 30-day mortality. Conclusion: Postoperative prognostic nutritional index and postoperative fibrinogen could be two promising markers to identify poor prognosis of acute type A aortic dissection patients after surgery.

Research progress on the association between childhood obesity and pubertal timing / 中国学校卫生

Abstract@#With the increasing prevalence of overweight and obesity in children, the influence of overweight and obesity on pubertal timing has attracted the attention of scholars. This paper reviewed the correlation and mechanism between childhood obesity and pubertal timing, especially for earlier pubertal timing, and found that the regulation of hypothalamic-pituitary-gonadal axis function by nutrition and metabolic signals might under lie those associations. Obesity in girls was positively correlated with early pubertal timing, while the conclusions in boys were inconsistent. Overweight in boys was related to early pubertal timing, obesity in boys could lead to both earlier and later onset of puberty, which warrents further investigation.

Awareness of core information about tuberculosis prevention and control among residents in Jiangxi Province / 预防医学

Objective@#To investigate the core information about tuberculosis prevention and control knowledge among residents in Jiangxi Province, so as to provide insights into formulation of health education strategy for tuberculosis prevention and control. @*Methods@#Permanent residents at ages of 15 years and older were sampled from Jiangxi Province using a multi-stage stratified cluster sampling method from January to June 2021. Participants' demographic features and access to health education for tuberculosis prevention and control were collected through questionnaires, and the awareness of core information about tuberculosis prevention and control was investigated according to Key Points for Core Information and Knowledge about Tuberculosis Prevention and Control (2016 version). @*Results@#A total of 1 280 questionnaires were allocated, and 1 217 valid questionnaires were recovered, with an effective recovery rate of 95.08%. The respondents included 605 men (49.71%) and 612 women (50.29%), and had a mean age of (50.05±15.78) years. The overall awareness of core information of tuberculosis prevention and control was 80.46%, and the awareness rates of “Pulmonary tuberculosis is suspected and timely healthcare-seeking is required if you have cough or expectoration for more than 2 weeks”, “Pulmonary tuberculosis is mainly transmitted via respiratory tract, and everyone is likely to be infected”, “No spit anywhere, covering mouth and nose when coughing or sneezing, and wearing a mouth mask may reduce the transmission of pulmonary tuberculosis”, “Pulmonary tuberculosis is a chronic infectious disease that poses a long-term damage to health” and “Most patients may be cured and others are avoided to be infected following standard whole-process treatment” were 90.22%, 86.52%, 85.95%, 80.03% and 59.57%, respectively. There were 491 respondents that were aware of all core information about tuberculosis prevention and control (40.35%), and network was the predominant route for acquiring health education about tuberculosis prevention and control (62.08%, 586/944).@*Conclusions@#The overall awareness of core information about tuberculosis prevention and control did not achieve the target set in the 13th Five-year Plan for Tuberculosis Prevention and Control, and the awareness of tuberculosis treatment-related knowledge was low.

Immunological CD4+ T-cell recovery and prognostic influencing factors in elderly HIV/AIDS patients of different genders after antiviral therapy / 中国热带医学

@#Objective　To investigate the prognostic influencing factors and recovery of CD4+ T lymphocytes in elderly HIV/AIDS patients after antiviral therapy by analyzing basic data and clinical follow-up data of elderly HIV/AIDS patients. Methods　The clinical data of 3 618 elderly AIDS patients aged ≥50 yeas who received antiretroviral therapy (ART) at HIV ART sites in Liuzhou City from 2005-2015 were collected. The data, including basic information, CD4+ T cell count, WHO clinical stage, infection route and follow-up, were retrospectively analyzed. Kaplan-Meier method was used to compare the differences in patient survival, multivariate Cox regression to analyze the independent influencing factors influencing the risk of death, and to compare the recovery of CD4+ T cell counts during follow-up of patients of different genders. Results　During the follow-up period, the 5-year cumulative survival rate up to the observation endpoint was 0.82 (female) and 0.66 (male). Multivariate logistic regression analysis showed that the risk factors affecting the effect of antiviral treatment were age (OR=1.909, 95%CI:1.474-2.464, P<0.001), body mass index (BMI) (OR=0.744, 95%CI: 0.574-0.965, P=0.026), opportunistic infections (OI) (OR=1.223, 95%CI:1.028-1.454, P=0.023), gender (OR=0.692, 95%CI:0.503-0.952, P=0.023) and baseline CD4+ T lymphocytes count (OR=0.563, 95%CI:0.429-0.739, P<0.001). Recovery of CD4+ T lymphocyte counts showed when baseline CD4+ T lymphocyte counts were less than 200 cells/mm3, older women with HIV/AIDS had higher CD4+ T lymphocytes than men at all times of ART treatment (P<0.05). Conclusions　Older women have a higher survival rate than older men after five years of antiviral therapy. Age, BMI, gender, OI and baseline CD4+T lymphocyte count may be important indicators that affect the survival of elderly HIV/AIDS patients. Older women showed better recovery of CD4+ T lymphocytes than older men during the 4-year follow-up period after ART.

Research progress on detection methods for nitrobenzene compounds in air / 中国职业医学

@#Abstract: Nitrobenzene compounds (NBCs) are widely used in the world. It has 40 isomers such as nitrobenzene, dinitrobenzene and nitrotoluene, that are highly toxic and difficult to degrade and can cause harm to human health in different degrees. At pres⁃ ent, there is no unified standard method and occupational exposure limit for the detection of NBCs in the air. In terms of sampling medium, solid adsorption tube is mostly used for trapping vapor state NBCs, and filter membrane and solid adsorption tube are mostly used in series for sampling coexist NBCs in vapor state and aerosol state. In the detection methods, gas chromatography and liquid chromatography are common, and ultraviolet spectrophotometry, Raman spectroscopy, ion migration spectrometry and some other rapid response methods and technologies are also used in the detection of NBCs. In the detection of NBCs by gas chro⁃ matography, capillary column separation is commonly used, and the main detectors are flame ionization detector, electron capture detector and mass spectrometry detector. It is of practical significance to establish a method with high sensitivity, strong practica⁃ bility, convenient operation, and can simultaneously collect and detect a variety of NBCs in different states.

Determination of dimethyl sulfate in workplace air by pre-column derivatization-high performance liquid chromatography / 中国职业医学

@#Abstract: Objective - - To establish a pre column derivatization high performance liquid chromatography method for detecting Methods dimethyl sulfate (DMS) in workplace air. DMS in workplace air was collected with mercaptopyridine impregnated （ silicone tube. The derivative of DMS and mercaptopyridine was eluted by mobile phase phase A: water, phase B: acetonitrile, ∶ the volume ratio was 40 60) , and separated with a C18 column, then detected with diode array detector and quantitated by a Results - standard curve. The linear range of DMS was 0.17 40.00 mg/L, with the correlation coefficient of 0.999 95. The detection limit and the lower limit of quantitation were 0.05 and 0.17 mg/L respectively. The minimum detection concentration and minimum quantitation concentration were 0.02 and 0.04 mg/m³, respectively (air sample volume of 4.5 L, 1.0 mL sample - - - solution). The average desorption efficiency was 98.40% 102.00%. The within run and between run relative standard deviations - - were 0.61% 3.92% and 1.71% 6.00%, respectively. The samples could be stored at room temperature for at least 14 days. Conclusion This method can be used to detect DMS in workplace air.

Determination of trans-1,1,1,4,4,4-hexafluoro-2-butene in workplace air by gas chromatography / 中国职业医学

@#Objective - ，，，，，- - - To establish a gas chromatographic method for the determination of trans 1 1 1 4 4 4 hexafluoro 2 ［ - （）］ Methods - （） butene HFO 1366mzz E in workplace air. HFO 1366mzz E in air was directly collected with aluminum foil ， ， ， composite plastic bag separated by dimethylpolysiloxane capillary column detected by flame ionization detector and Results - （） - 3， quantified with external standard method. The linear range of HFO 1366mzz E was 6.82 68 200.00 mg/m with the 3， correlation coefficient of 0.999 9. The detection limit and the lower limit of quantitation were 0.59 and 1.98 mg/m respectively. - - - The recovery rate was within 95.45% 103.05%. The relative standard deviation of within batch precision and between batch - - ， precision were 2.26% 5.07% and 4.09% 6.82% respectively. The samples can be stored at room temperature for at least seven Conclusion ， ， days. This method is simple to use with a wide linear range low detection limit high accuracy and precision and - （） good sample stability. It can be used for the detection of HFO 1366mzz E in the air of workplace

Chloro-nitrobenzene compounds air sampling tube preparation and determination method / 中国职业医学

@#Objective - - To prepare the GDH 5 air sampling tube for simultaneous collection of eight kinds of chloro nitrobenzene （ ） ， compounds CNBs in the air of workplace and establish a matching determination method using gas chromatography. Methods - - ， Eight kinds of CNBs in vapor and aerosol state were collected by self developed GDH 5 air sampling tube desorbed ， ， ， by toluene separated by polysiloxane gas chromatography column detected by microcell electron capture detector and Results - （ - quantified by external standard method. It was determined that the air sampling tube was assembled by XAD 2 ion ） - ， exchange resin and glass fiber filter membrane. The linear range of CNBs was 0.80 240.00 mg/L and the linear correlation - - coefficients were greater than 0.999 9. The detection limit was 7.87 13.03 μg/L. The minimum detectable concentration was 0.60 3， - 3（ ） 1.33 μg/m and the minimum quantitative concentration was 2.00 4.22 μg/m sample 45.00 L . The average desorption - - （RSD） - ， - RSD efficiency was 101.2% 110.0%. The within run relative standard deviation was 0.8% 4.1% and the between run - Conclusion - was 0.3% 5.8%. The samples could be stored for more than 30 days at room temperature. GDH 5 air sampling tube and its associated determination method can be used for the collection and determination of eight kinds of CNBs in workplace air.

Body mass index changes among children and adolescents in Suzhou before and after COVID 19 outbreak / 中国学校卫生

Objective@#To explore body mass index (BMI) changes among children and adolescents in Suzhou before and after COVID-19 outbreak, and to provide a reference for improving physical health of children and adolescents.@*Methods@#A total of 569 children and adolescents who had complete BMI information in 2019 were enrolled through stratified cluster sampling from June to July, 2020. Questionnaire survey was conducted, and height and weight were measured to calculate BMI and BMI Z scores.@*Results@#After the epidemic, overweight/obesity rate were 32.0%, compared to 31.6% before the epidemic(χ 2=0.07, P>0.05). Difference of BMI Z scores before (0.37±1.28) and after (0.38±1.27) the epidemic did not show statistically significant (t=-0.28, P>0.05), No significant changes in BMI Z score were found before and affer COVID-19 outbreak similar results were observed (P>0.05), BMI Z scores after the epidemic (0.45±1.32) was higher than it before the epidemic (0.37±1.35) among primary school group (t=2.57, P=0.01), while BMI Z scores after the epidemic (0.27±1.17) was lower than it before the epidemic (0.39±1.18) among middle school group (t=-4.29, P<0.01). Proportion of sweet food consumption and outdoor activities was statistically different before and after the epidemic(P>0.05), proportion of sugar-sweetened beverages consumption and fried food intake were statistically different before and after the epidemic (P<0.05), sleep time after the epidemic (8.52±1.83)h was higher than it before the epidemic (8.05±1.70)h (t=4.96, P<0.05).@*Conclusion@#Before and after COVID-19 outbreak, BMI and overweight/obesity rates are significantly different among children and adolescents in Suzhou, and there is a slight difference in different studying phases.

Influencing factors for myopia among primary and secondary schoolstudents in Suzhou / 预防医学

Objective@#To investigate the influencing factors for myopia among primary and secondary school students in Suzhou, so as to provide basis for myopia prevention and control. @*Methods@#The students in Grade 4-12 were recruited by stratified cluster random sampling method. Gender, grade, parents＇ myopia history, outdoor activity time and video display terminal time were collected through the questionnaire of National Surveillance Program of Influencing Factors for Common Diseases and Health in Students. Uncorrected visual acuity and cycloplegic refraction were tested. Multivariate logistic regression analysis was performed to explore myopia-related factors.@*Results@#A total of 990 questionnaires were distributed, and 882 valid questionnaires were recovered, with an effective rate of 89.09%. The prevalence rate of myopia was 78.23% ( 690 cases ). Multivariate logistic regression analysis showed that females ( OR=1.703, 95%CI: 1.173-2.474 ) , middle school students ( OR:5.597-11.949, 95%CI: 3.573-28.349 ) , both parents＇myopia ( OR=2.445, 95%CI: 1.597-3.742 ) , video display terminal time over 3 hours per day ( OR=2.026, 95%CI: 1.235-3.325 ) were risk factors for myopia; outdoor activity time over 2 hours per day ( OR: 0.493-0.510, 95%CI: 0.273-0.943 ) was a protective factor for myopia. @*Conclusion@#The prevalence of myopia among primary and secondary school students in Suzhou is 78.23%. Gender, grade, parents＇ myopia history, outdoor activity time and video display terminal time are influencing factors for myopia.

miR-22 and cerebral microbleeds in brainstem and deep area are associated with depression one month after ischemic stroke

In this study, we aimed to explore the relationship among miR-22, deep cerebral microbleeds (CMBs), and post-stroke depression (PSD) 1 month after ischemic stroke. We consecutively recruited 257 patients with first-ever and recurrent acute cerebral infarction and performed PSD diagnosis in accordance with the Diagnostic and Statistical Manual IV criteria for depression. Clinical information, assessments of stroke severity, and imaging data were recorded on admission. We further detected plasma miR-22 using quantitative PCR and analyzed the relationship among miR-22, clinical data, and PSD using SPSS 23.0 software. Logistic regression showed that deep (OR=1.845, 95%CI: 1.006-3.386, P=0.047) and brain stem CMBs (OR=2.652, 95%CI: 1.110-6.921, P=0.040), as well as plasma miR-22 levels (OR=2.094, 95%CI: 1.066-4.115, P=0.032) were independent risk factors for PSD. In addition, there were significant differences in baseline National Institutes of Health Stroke Scale scores (OR=1.881, 95%CI: 1.180-3.011, P=0.007) and Widowhood scores (OR=1.903, 95%CI: 1.182-3.063, P=0.012). Analysis of the receiver operating curve (AUC=0.723, 95%CI: 0.562-0.883, P=0.016) revealed that miR-22 could predict PSD one month after ischemic stroke. Furthermore, plasma miR-22 levels in brainstem and deep CMBs patients showed an upward trend (P=0.028) relative to the others. Patients with acute ischemic stroke, having brainstem and deep cerebral microbleeds, or a higher plasma miR-22 were more likely to develop PSD. These findings indicate that miR-22 might be involved in cerebral microvascular impairment and post-stroke depression.

Relationship between high blood pressure and body mass index, waist circumference, and waist-height ratio among children and adolescents in Suzhou / 中国学校卫生

@#To assess the relationship between high blood pressure (HBP) and body mass index (BMI), waist circumference (WC), and waist-height ratio (WHtR) among children and adolescents in Suzhou.@*Methods@#A total of 3 150 children and adolescents aged 7-17 years were enrolled through stratified cluster sampling from September to October, 2019. Questionnaire survey was conducted, and height, weight, WC and BP were measured to calculate BMI and WHtR, relationship of HBP and adiposity indicators were evaluated.@*Results@#The prevalence of HBP was 11.3%, overweight/obesity rate was 28.5%, and centrality obesity based on WC and WHtR was 20.6% and 23.7%, respectively. There were significant relationships between HBP and BMI, WC, and WHtR (χ2=157.80,105.87,124.17,P<0.01). As Logistic regression showed, compared to normal weight group, overweight/obesity based on BMI had positive relation with HBP (OR=3.89, 95%CI=3.09-4.90); compared to normal WC/WHtR, centrality obesity showed positive association with HBP (WC: OR=3.05, 95%CI=2.41-3.86; WHtR: OR=3.35, 95%CI=2.67-4.21). Meanwhile, BMI had joint effects on HBP with WC/WHtR. Specifically subjects with overweight/obesity and center obesity had higher risk of HBP, compared to normal BMI and WC subjects(OR=4.28, 95%CI=3.31-5.53).@*Conclusion@#Significant relationships between HBP and BMI, WC, and WHtR were found. BMI had joint effects on HBP with WC/WHtR. Keeping normal body weight and WC/ WHtR would have significant effects on HBP.

Adrenal insufficiency after cardiovascular surgery with cardiopulmonary bypass / 中国胸心血管外科临床杂志

@#Relative/absolute adrenal insufficiency is not uncommmon in the patients undergoing cardiovascular surgery with cardiopulmonary bypass. However, this complication was rarely reported due to its unspecific clinical presentations and the unawareness of ICU physicians and cardiac surgeons. However, this puts them on a higher risk of hemodynamic instability and cardiovascular adverse events during hospitalization. Systematic reviews concentrated on it are rarely reported currently. We aim to review the etiology, risk factors, potential pathogenesis and related research progress for this complication.

Research progress on acute lung injury and lung protective strategies by cardiopulmonary bypass / 中国胸心血管外科临床杂志

@#Acute lung injury is a kind of common complication after cardiopulmonary bypass. Acute lung injury is attributed to the ischemia-reperfusion injury and systemic inflammatory response syndrome. Several factors common in cardiac surgery with cardiopulmonary bypass may worsen the risk for acute lung injury including atelectasis, transfusion requirement, older age, heart failure, emergency surgery and prolonged duration of bypass. Targets for prevention of acute lung injury include mechanical, surgical and anesthetic interventions that aim to reduce the contact activation, systemic inflammatory response, leukocyte sequestration and hemodilution associated with cardiopulmonary bypass. We aim to review the etiology, risk factors and lung protective strategies for acute lung injury after cardiopulmonary bypass.

Teaching environment of primary middle and high schools in Suzhou during 2019 / 中国学校卫生

Objective@#To analyze the teaching environment of primary, middle and high schools in Suzhou, and to explore the relevance of students’ myopia with teaching environment, as well as the key problems in teaching environment.@*Methods@#1 253 classrooms in 204 schools rom 10 districts and counties in Suzhou were selected by proportionate stratified sampling. The qualified rate of each indices was described and the teaching environment by county, learning stage were compared by using chi-squared test. The Spearman test is used to explore correlations between myopia with monitoring indicators.@*Results@#The qualified rate of the distance from lamp to table was the highest (98.56%), while matching rate of student desk and chair was the lowest(0.96%). Minimum lamp table spacing, blackboard average illumination, reflectance from blackboard wall, classroom per capita area, classroom microclimate differed significantly in urban and rural (P<0.05); daylighting coefficient, reflectance from walls, average illumination of desktop and blackboard, classroom per capita area, and microclimate indicator were statistically different by learning stages(r=0.42,P<0.05). Prevalence of myopia correlated with the index of lighting.@*Conclusion@#Qualified desks and matched chairs, as well as the daylighting design in classroom should receive more attention in Suzhou. The findings lend support to identification of key health priorities and formulation of the localized health practice for health administrations.

Comparison of high blood pressure among children and adolescents in Suzhou based on different references / 中国学校卫生

Objective@#The current study aimed to determine the prevalence of high blood pressure (HBP) among children and adolescents aged 7-17 years in Suzhou by using different references, and to provide a reference for the application of standard of blood pressure among children.@*Methods@#Data of 6 972 children and adolescents aged 7 to 17 years were collected by stratified cluster random sampling method to determine the prevalence of HBP based on 2017 AAP Guidelines for Childhood Hygertension(America 2017), National Blood Pressure Reference for Chinese Han Children based on Chinese National Survey on Students’ Constitution and Health in 2010 (Ma 2017), blood pressure guidelines based on their investigation in mainland children and adolescents (Mi 2017) and blood pressure guidelines based on data from the China Health and Nutrition Survey during the year of 1999-2009 (CHNS 2013).@*Results@#Referred to Ma 2017 reference, the prevalence of HBP was highest with 12.7%, followed by America 2017 with 16.3%, Mi 2017 with 17.4%, and CHNS2013 with 25.5%. In boys, HBP prevalence based on America 2017 was close to that using Mi 2017 among children younger than 13 years old, and was close to that using Ma 2017 among those≥14 years old. In girls, HBP prevalence based on America 2017 was close to that using Mi 2017 among those≤12 years old, and was close to that using Ma 2017 among those ≥13 years old. Compared with America 2017 reference, kappa value based on Mi 2017 was better than Ma 2017 in boys(0.81, 0.77), opposite result was found in girls(0.86, 0.85). Kappa value were the lowest based on CHNS 2013.@*Conclusion@#The prevalence of HBP among children in Suzhou achieve a high level. Ma 2017, Mi 2017, and CHNS2013 references show different advantages among various gender and age groups.

Influence of statins on incidence rate of short‐and long‐term cardio‐and cerebrovascular events in pa‐tients with hypertensive nephropathy／ / 心血管康复医学杂志

To observe influence of atorvastatin on incidence rate of short‐and long‐term cardio‐and cere‐brovascular events in patients with hypertensive nephropathy (HNP).Methods :A total of 130 HNP patients treated in our hospital were enrolled ,randomly and equally divided into routine treatment group and atorvastatin group (re‐ceived atorvastatin based on routine treatment ).After three‐month treatment ,renal function ,inflammatory fac‐tors ,vascular endothelial function ,hemorheology ,levels of blood lipids and blood pressure etc .before and after treatment were observed in two groups ;after one‐year follow‐up ,incidence rates of short‐(six months) and long‐term (one year) cardio‐and cerebrovascular events were recorded in two groups .Results : Compared with routine treatment group after three‐month treatment ,there were significant reductions in levels of urinary albumin [ (35. 85 ± 4. 98) mg／ml vs.(29.63 ± 4.51) mg／ml] ,serum creatinine [ (92. 11 ± 10.52) μmol／L vs.(86. 43 ± 10. 16) μmol／L] , blood urea nitrogen [ (8. 16 ± 0. 45) mmol／L vs.(7.19 ± 0. 36) mmol／L] ,serum procalcitonin [ (1. 21 ± 0. 67) ng／ml vs .(0.67 ± 0. 31) ng／ml] ,C reactive protein [(49. 51 ± 8.79) mg／L vs.(33. 37 ± 8.15) mg／L] ,blood pres‐sure [(152.78 ± 4.52)／(94.37 ± 3.69) mmHg vs.(141.89 ± 4.13)／(91.52 ± 3. 24) mmHg] ,blood lipids (except HDL‐C) ,high shear whole blood viscosity ,low shear whole blood viscosity ,hematocrit ,plasma viscosity and fi‐brinogen level in atorvastatin group , P＜0. 01 all.Compared with routine treatment group ,there were significant reductions in incidence rates of short‐ and long‐term unstable angina pectoris ,carotid artery stenosis and coronary stenosis ,and long‐term hemorrhagic stroke in atorvastatin group , P＜0.05 or ＜0.01. Conclusion :Statins can sig‐nificantly reduce incidence rates of short‐ and long‐term cardio‐ and cerebrovascular events in patients with hyper‐tensive nephropathy .

Research progress of bone morphogenetic protein-4 in pulmonary vascular remodeling in patients with pulmonary hypertension / 中国胸心血管外科临床杂志

@#Pulmonary hypertension is a disease characterized by pulmonary artery pressure increased, with or without small artery pathological change, which ultimately leads to right heart failure or even death. Pulmonary hypertension seriously threatens to human health, however, the pathogenesis of pulmonary hypertension is unclear. Previous studies have found that bone morphogenetic protein (BMP) signaling system played an important role in the progress of pulmonary hypertension. In the current review, we describe the mechanism of BMP4 in the development of pulmonary hypertension.

Clinical characteristics and postoperative complications of elderly patients with biliary pancreatic disease treated with ERCP / 中国内镜杂志

Objective To investigate the clinical characteristics and postoperative complications of elderly patients with biliary pancreatic disease treated with endoscopic retrograde cholangiopancreatogra. Methods The clinical data of 236 patients with ERCP were analyzed retrospectively. According to the age of over 80 years or not, the patients were divided into the elderly group and non-elderly group, and the clinical characteristics and complications of elderly patients were explored. Results In 116 cases of elderly patients, the common bile duct stones also were the primary disease, but the proportion of malignant obstructive jaundice was significantly increased. Compared with the non-elderly patients, the incidence of hypertension, coronary heart disease, diabetes mellitus, COPD and duodenal papillary diverticulum were increased significantly in the elderly group. Moreover, the proportion of biliary stent implantation were increased significantly. The incidence of postoperative bleeding in the elderly patients were significantly higher than that in the non-elderly patients, and the high risk factors might be primary malignant obstructive jaundice, with hypertension, coronary heart disease and duodenal papillary diverticulum. Conclusion The prevalence of malignant diseases in elderly patients was increased, and they have a lot of complications, such as hypertension, coronary heart disease, diabetes mellitus, COPD and duodenal papillary diverticulum, which resulting in increased risk of postoperative bleeding. In general, therapeutic ERCP was safe and effective for elderly patients with biliary pancreatic diseases.

Ultrasound Diagnosis of Fetal Thanatophoric Skeletal Dysplasia:Three Cases Report and a Brief Review / 华中科技大学学报（医学）（英德文版）

Congenital skeletal deformity of ferns varies and may be attributed to a range of reasons.Congenital skeletal deformity seriously affects body function or even leads to neonatal death directly.The disease brings great pain to victim and their family.We reviewed the fetal prenatal ultrasonic data conducted during period from Jan.2013 to June 2016,and there were 84 fetuses with skeletal abnormalities among 12 000 cases,and 3 fetuses with thanatophoric dysplasia.Our report described and reviewed three common types of thanatophoric dysplasia,aiming to explore the value of standardized prenatal ultrasonic diagnosis of fetal abnormalities in the skeletal system.