Objective To investigate the causations, management and prevention methods on the complications of hysteroscopic procedures. Methods Retrospective analysis of 36 cases with hysteroscopic complication, focusing on their characteristics and clinical management as well as prevention methods during the ten years from 1993 to 2004. Results Among 36 cases, 11 cases with uterine perforation and incomplete perforation, which happened during the complicated procedures, were treated by both laparoscopy and laparotomy. Five cases with heavy bleeding were encountered because of the deeply injury to the uterine wall and Foley catheter was inserted into uterine cavity and it stopped the bleeding successfully except in one case done by hysterectomy. Three cases with fluid overload syndrome were cured by using diuretic agent and saline infusion. There is no serious consequence in one case with air embolism due to prompt diagnosis and treatment. Four cases with postablation-sterilization syndrome were treated effectively by performing hysterectomy plus single or bilateral salpingectomy, dilating cervical canal as well as resecting adhesions. Twelve cases with adhesion inside uterine cavity followed hysteroscopy were also treated by dilating cervical canal, underwent adhesionlysis and hysterectomy. Conclusions The potential factors causing complications of hysteroscopy include complicated procedures inside uterine cavity, higher pressure of irrigation, deep injury of endometrium as well as incomplete removal of endometrium during hysteroscopic operations. It is the necessary measures to reduce the complications by performing laparoscopy or B ultrasound monitoring simultaneously, standardizing the procedure and strengthening postoperation management.

Objective To measure the level of interleukin (IL)-27 in sera of patients with Sj(o)gren's syndrome (SS) and investigate its role in IL-10 in CD3+CD8-T cells.Methods Serum levels of 1L-27 and IL-10 from 34 SS patients and 33 healthy controls were tested by enzyme linked immunosorbent assay (ELISA).Peripheral blood monocytes (PBMCs) from SS patients were collected and cultured in different conditions (one with PHA,the other with PHA and IL-27).Seventy-two hours later,cells were harvested and the percentages of CD3 +CD8-IL-10+ cells were measured by flow cytometry.Expressions of c-Maf,IL-10 transcription factor,were examined using real-time polymerase chain reaction (PCR).The data were analyzed by t test,Pearson's correlation analysis and multiple linear regression analysis.Results Serum level of IL-27 in patients with SS [(158±34) pg/ml] was significantly higher than that in healthy controls [(139±18) pg/ml,t=2.823,P＜0.01].IL-27 level was positively correlated with IL-10 and IgG levels (r=0.384,P＜0.05; r=0.354,P＜0.05),but negatively correlated with SSDAI (r=0.503,P＜0.01).Multiple regression analysis showed independent correlation of IL-27 with IL-10 and SSDAI in SS patients (β=0.412,P＜0.01; β=-0.525,P＜0.01),but not IgG.CD3+CD8-IL-10+ cells was upregulated by IL-27 in vitro (P＜0.01,n=14),so was c-Maf (P＜0.01,n=22).Conclusion IL-27 could ameliorate disease activity of Sjogren's syndrome.

Objective To investigate the in vivo effects of artesunate (ART) treatment on OAZ gene expressions in MRL/lpr lupus mice.Methods Twenty-four 12-week-old female MRL/lpr lupus mice were randomly divided into two groups by the random number table,i.e.,the lupus control group and the ART treatment group,12 in each group.Besides,another 8 BABL/C mice were recruited as the normal control group.Peripheral blood mononuclear cells (PBMC) were collected from lupus mice before treatment as well as 4 week and 8 week after treatment,and RNA was extracted and reverse transcripted to cDNA.mRNA expression levels of OAZ and Id1-3 were measured by using real-time polymerase chain reaction (PCR),and the data between the two groups were analyzed by t test,a plurality of samples were compared with the single factor analysis of variance.Serum levels of IFN-γ,IL-4,BAFF and ANA were tested by enzyme-linked immunosorbent assay (ELISA).Relationships of the gene expression levels with levels of cytokines and ANA were analyzed.Statistical analysis were uising t test,ANOVA and LSD-t test.Results mRNA expression levels of OAZ,Id1 and Id3 gene (△Ct:12.9±0.8,12.0±0.4,10.2±0.8) in lupus mice were significantly different from 8 weeks after the treatment comparing to those in the lupus control group (△Ct:9.8±1.0,9.3± 1.1,8.1±0.8) and the normal control group (△Ct:13.9±1.2,11.4±0.7,4.7±0.8,10.3±1.0)(F=7.46,P=0.008; F=6.37,P=0.032; F=5.63,P=0.042),and alteration of OAZ mRNA expression levels before and after the treatment were positively correlated with changes of Id1,Id3 levels (r=0.867,0.947; P＜0.05),and levels of IL-4 and ANA were significantly lower 8 weeks after the treatment than those in the lupus control group (P＜0.05); while level of IFN-γwas higher than those in the lupus control group (P＜0.05).Alteration of OAZ mRNA expression levels before and after the treatment were negatively correlated with changes of ANA,BAFF levels (r=-0.955,r=-0.937; P＜0.05) and positively correlated with changes of Th1/Th2 levels (r=0.976,P＜0.01).Conclusion The expression of genes involving in the OAZ and downstream gene are effectively reduced along with the alteration of several cytokines and ANA after ART treatment.OAZ signaling pathway can play an important role in ART treatment for SLE.

Objective To explore the effects of umbilical cord-derived mesenchymal stem cells (UCMSCs) on fibroblast-like synoviocytes(FLSs) from patients with rheumatoid arthritis(RA). Methods collagen-induced arthritis(CIA) models were developed on Wistar rats and 1 ×106 UCMSCs were given by intravenous injection from tail vein on the 17th day. On day 42, rats were sacrificed and synovial tissues were obtained to detect matrix metalloproteinase (MMP)-1, MMP-3 and MMP-13. Synovial tissues from patients with RA and osteoarthritis(OA) treated by knee arthroplasty were used to isolate FLSs. RNA of FLSs were extracted to compare MMP-1, MMP-3 and MMP-13 expression. FLSs and UCMSCs were cocultured through transwell for 72 hours. Then levels of MMPs were compared in the supernatants by Luminex. The MMPs expressed by FLSs and soluble factors expressed by MSCs were detected by real time-polymerase chain reaction(PCR). After adding antibodies to soluble factors, the MMPs expressions of RA FLSs were compared. Results MMP-1 (6.9±5.4, 1.3±1.4, P<0.05), MMP-3 (6.0±6.5, 1.4±1.0, P<0.05) and MMP-13 (21.8± 20.8, 1.5±1.6, P<0.05) expression were much higher in CIA rats compared with healthy controls. MMP-1 (1.3±1.4, 6.9±5.4,8.7±6.8, P<0.05), MMP-3(1.4±1.5, 6.0±6.5, 6.0±5.7, P<0.05) and MMP-13(3.0±3.2,
22±21, 22±26, P<0.05) expression were inhibited by UCMSCs in vivo. In vitro, MMP-1 (1.8±0.9, 0.9±0.7, t=2.44, P<0.05), MMP-3(2.6±1.7, 1.1±1.0, t=2.25, P<0.05) and MMP-13(2.4±2.3, 0.6±0.7, t=2.37, P<0.05) levels were higher in RA than OA FLSs. After coculture, MMP-13(1.3±1.2, 0.9±1.2, t=3.63, P<0.05) expressed by FLSs were down-regulated, however MMP-1 (1.5±1.4, 6.6±6.0, t=3.90, P<0.05) and MMP-3 (7±17, 22±35, t=2.86, P<0.05) were up-regulated when analyzed by paired t-test. Soluble factors such as I-DO, HGF and IL-10 were elevated. Anti-IL-10 antibody could decrease the function of UCMSCs by inhibiting MMP-13 expression in RA FLSs. Conclusion UCMSCs ameliorates RA by secreting soluble factor IL-10, which may inhibit MMPs expressed by FLSs.

Objective : To identify the factors affecting microvascular complications among patients with type 2 diabetes (T2DM), so as to provide insights into the management of microvascular complications of T2DM. Methods: T2DM patients hospitalized in the Department of Endocrinology of a tertiary hospital in Weifang City, Shandong Province from January 2021 to January 2022 were enrolled, and subjects' basic information, lifestyle and medical history were collected using questionnaire surveys. Fasting insulin, fasting blood glucose and glycated hemoglobin were measured, and factors affecting microvascular complications were identified among T2DM patients using a multivariable logistic regression model and a decision tree model. Results: Totally 1 003 T2DM inpatients were enrolled, including 515 men (51.35%) and 488 women (48.65%), and the prevalence of microvascular complications was 40.18%. Multivariable logistic regression analysis showed that age of 60 years and older (OR=2.510, 95%CI: 1.441-4.374), T2DM duration of 10 years and longer (OR=3.205, 95%CI: 2.242-4.581), fasting insulin of lower than 3.21 μIU/mL (OR=1.749, 95%CI: 1.239-2.469), using of agents or insulin to control blood glucose (OR=1.880, 95%CI: 1.143-3.092), glycated hemoglobin level of 7% and higher (OR=1.751, 95%CI: 1.172-2.615) as factors affecting microvascular complications among T2DM patients. Decision tree analysis identified course of T2DM as a major factor affecting the risk of microvascular complications among T2DM patients, and the prevalence of microvascular complications was 70.22% among T2DM patients with disease course of 10 years and longer and fasting insulin of lower than 3.21 μIU/mL or 16.32 μIU/mL and higher, 44.23% among T2DM patients with disease course of 5 to 10 years and at ages of 60 years and older, and 43.10% among T2DM patients with disease course of less than 5 years and fasting insulin of lower than 3.21 μIU/mL. Conclusion Advanced age, long course of T2DM, low fasting insulin and high glycated hemoglobin may increase the risk of microvascular complications among T2DM patients.

Objective To improve the processing protocol of the frozen erythrocyte ( RBC) washing machine of the dialysis type to enhance its efficiency of treating the 2 U frozen RBCs .Methods The frozen RBC washing machine for dialysis was used to deglycerolize the 2 U frozen RBCs after thawing .Measures including adjustment of the Pump speed , washing buffer adding and solution osmolarity were taken to decrease the processing time .Hemoglobin(Hb) content, Hb recovery, residual glycerol, free Hb content, deforming ability, and apoptosis of the deglycerolized RBCs were assessed to evaluate the efficiency of the improved protocol .Results As for the cells processed respectively by the previous and improved protocols, contents of Hb were (35.03 ±4.20) g and (53.82 ±2.08) g, respectively; Hb recoveries were (61.10 ±8.46)% and (80.22 ±3.73)%,respectively.Osmolarities representing residual glycerol were (307.00 ± 14.50)mOsm and (322.00 ±29.00)mOsm.Free Hb values were (0.74 ±0.04) and (0.80 ±0.08)g/L.The processing time was (1.64 ±0.31) and (1.04 ±0.16) h,respectively.There were significant differences in Hb content , Hb recovery, and deforming ability between the cells processed by the two protocols respectively .However , there were no significant changes in glycerol contents , free Hb, and apoptosis extent between the cells processed by the two protocols .Conclusion The innovated protocol can improve the quality of washed frozen RBCs , decrease the processing time and enhance the efficiency of the machine.

Objective To evaluate the application values of diffusion tensor tractography (DTT) combined with neuronavigation in microsurgery of insular gliomas. Methods The clinical data of 27 patients with insular gliomas, admitted to our hospital from March 2013 to October 2017, were analyzed retrospectively. All DTT images were transferred to the neuronavigation system, and the three-dimensional location of tumors and pyramidal tracts were re-constructed. Surgical approaches were designed and excision scopes were defined before the surgery. Techniques on how to distinguish and protect the key blood vessels and pyramidal tracts were discussed. The treatment efficacies were analyzed. Results Total lesion resection was achieved in 22 patients (81.5％), subtotal resection in 4 (14.8％ ), and partial resection in one (3.7％ ). Postoperative pathology indicated 7 were oligodendrogliomas, and 20 were astrocytomas, including WHO grade I in one, grade II in 18, and grade III in one. One patient had transient aphasia (recovery after two weeks), 2 experienced worsened hemiplegia on opposite side of their bodies (normal after one month), and the left 24 patients remained intact function after operation. Conclusions The combination of DTT and neuronavigation is safe and effective in surgical treatment for insular gliomas, which can protect the brain function at greatest degree and maximize lesion resection, and improve the postoperative quality of life.

Objective:To explore the dyadic coping of diabetes couples and the status of patients' stigma, and analyze its correlation.Methods:This study is a cross-sectional study. A total of 304 inpatients with diabetes and their spouses from the Department of Endocrine and Metabolic Diseases of two ClassⅢ Grade A hospitals in Weifang were selected by convenience sampling. A questionnaire survey was conducted using the General Information Questionnaire, Self-Stigma Scale (SSS) , and Dyadic Coping Inventory (DCI) . The relationship between the dyadic coping of diabetes patients and their spouses and the stigma of diabetes patients were analyzed by correlation analysis and multiple linear regression analysis.Results:The scores of stigma and dyadic coping of patients, and the score of dyadic coping of couples were (55.67±10.41) , (120.62±17.39) and (121.49±16.59) , respectively. Pearson correlation showed that the dyadic coping scores of both spouses were negatively correlated with the total score of the patient's stigma and dimension scores, and the differences were statistically significant ( r=-0.514- -0.208, P<0.05) . Multiple linear regression analysis showed that the dyadic coping of diabetes patients and their spouses, per capita monthly family income, occupational status (retired) , need of caregivers, and comorbidity with chronic diseases were the influencing factors of the stigma of diabetes patients, and the difference was statistically significant ( P<0.05) , which could explain 39.0% of the variation of the regression equation. Conclusions:The stigma of patients with diabetes is at a low level. The dyadic coping of both spouses is the influencing factor of stigma in diabetes patients.

Objective To analyze the disease burden of chronic kidney diseases (CKD) attributed to high body mass index (BMI) in China from 1992 to 2021 and predict the disease burden for the next decade, and to provide evidence for the prevention and treatment of CKD. Methods Using the Global Burden of Disease (GBD) database and the Joinpoint model, the average annual percentage rate change (AAPC) of the mortality rate and disability-adjusted life year (DALY) rate was calculated to describe and analyze the CKD disease burden attributed to high BMI in China from 1992 to 2021. The ARIMA model was employed to predict and analyze the change trend of the CKD disease burden. Results From 1992 to 2021, the mortality rate and DALY rate attributed to high BMI-induced chronic kidney disease showed an upward trend. Compared to 1992, the attributed number of deaths increased by 324.38%, and DALYs increased by 268.56%; the mortality rate increased by 64.00%, and the DALY rate grew by 51.62%. From 1992 to 2021, the mortality rate and DALY rate for males were lower than those for females, but the growth rate for males exceeded that of females. From 1992 to 2021, the mortality rate and DALY rate of chronic kidney disease attributed to high BMI in China increased with age. The average annual change rate of chronic kidney disease attributed to high BMI in China from 1992 to 2021 (mortality rate: 1.40 per 100,000 (95% CI: 1.04–1.76), DALY rate: 1.43 per 100 000 (95% CI: 1.17–1.70)) was higher than thHuaiyin Normal University, Huai'anher social demographic index (SDI) regions. The ARIMA model predicted that the age-standardized mortality rate increased from 2.91 per 100 000 in 2022 to 3.05 per 100 000 in 2026, and the age-standardized DALY rate increased from 69.65 per 100 000 in 2022 to 73.58 per 100 000 in 2026. Conclusion Chronic kidney disease attributed to high BMI in China is on the rise, and it will continue to grow in the future. The focus of CKD prevention and control should be on males and the elderly, while active measures should be taken to reduce the occurrence and progression of chronic kidney disease.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.