Objective To study the expression changes of placental insulin-like growth factor Ⅰ and Ⅱ (IGF-Ⅰ and IGF-Ⅰ) between pregnancies following the in vitro fertilization and embryo transfer (IVF-ET) and those conceived spontaneously.Methods The placenta were collected from 49 cases of pregnancies after IVF-ET(case group) and 49 cases of pregnancies who were normal (control group).The expressions of IGF-Ⅰ and IGF-Ⅱ mRNA in placenta were detected by reverse transcription-polymeras chain reaction (RT-PCR).The levels of IGF-Ⅰ and IGF-Ⅱ protein were determined by immunohistochemistry.Results The mRNA levels of the placental IGF-Ⅰ and IGF Ⅱ were 0.30 ±0.13 and 0.28 ±0.04 in the IVF-ET group,and 0.65 ±0.10 and 0.91 ±0.26 in the control group.The protein levels of the placental IGF-Ⅰ and IGF-Ⅱ were 0.26 ±0.04 and 0.29 ± 0.05 in the IVF-ET group,and 0.32 ± 0.07 and 0.34 ± 0.04 in the control group.The mRNA and protein expressions of IGF-Ⅰ and IGF-Ⅱ in human placenta were significantly decreased in IVF-ET group compared to control group (P ＜ 0.05).The incidence rate of low birth weight infant in IVF-ET group was significantly higher than control(P ＞ 0.05).Conclusions Expressions of placental IGF-Ⅰ and IGF-Ⅱ in the IVF-ET group did not affect fetal growth and development.

Objective To investigate the distribution,drug resistance of bile pathogenic bacteria,and the risk factors for biliary infection.Methods Clinical and laboratory data of patients hospitalized from January 2008 to October 2015 were reviewed for pathogenic bacteria and drug resistance,and the factors related to biliary tract infection were studied.Results Among all 320 cases,there were 249 cases of pathogenic bacteria in bile specimens,the positive rate was 77.81％.There were 356 strains of pathogenic bacteria of 40 species,including 244 strains of gram negative bacteria (68.54％),93 strains of gram positive bacteria (26.12％) and 19 strains of fungi (5.34％).Top three bacteria were Escherichia coli (84 strains,23.60％),Klebsiella pneumonia (60 strains,16.85％),and Enterococcus faecium (40 strains,11.24％).The Escherichia coli and Klebsiella pneumoniae had the highest drug resistance to cefazolin,and they had a lower drug resistance to cefoxitin and amikacin.The multivariate analysis showed that age ≥ 60 years (AOR =2.311,95％ CI:1.292-4.135) and the history of ERCP operation (AOR =3.475,95％ CI:1.587-7.607) were independent risk factors for biliary tract infection.Conclusion Bacteria are mainly gram negative bacteria in the bile of patients with biliary tract infection,suggesting antibiotics with low resistant rate of gram-negative is the first choice.The age ≥ 60 years and history of ERCP surgery are independent risk factors for patients with biliary tract disease.Measures to prevent biliary infections in high-risk patients should be taken.

Objective To prospectively investigate the association between serum uric acid concentration and the risk of brain infarction in Chinese adults.Methods In this prospective cohort study,a total of 95 738 participants (aged 18-98 years old) were included and were categorized into sex-specific quintiles according to serum uric acid concentration which were collected during 2006-2007 by health examinations.The study was followed up for an average of 4 years.We used Cox regression models to calculate hazard ratios (HR) and their 95％ confidence intervals (CI).Results (1) Higher concentrations of serum uric acid were associated with older age,obesity,higher blood pressure,higher serum concentrations of total cholesterol,triglycerides,and high sensitivity C-reactive protein,smoking,alcohol drinking,history of hypertension,hyperlipidemia and atrial fibrillation,and antihypertensive medication use.(2) The incidence of brain infarction for sex-specific quintiles were 0.84％ (33/3913),0.35％ (14/3985),0.44％(17/3888),0.54％ (21/3909),0.91％ (35/3860) in women (x2 =15.676,P =0.003) and 1.18％(180/15 238),1.26％ (191/15 170),1.11％ (170/15 323),1.45％ (221/15 216),1.82％ (277/15 236)in men (x2 =36.641,P =0.000).(3) After adjusting for potential confounders,including age,body mass index,blood pressure,fasting plasma glucose,total cholesterol,triglyceride,smoking,alcohol,and medical history of major chronic conditions and antihypertensive medication use,the HR (95％ CI) of brain infarction across serum uric acid quintiles were 2.06 (1.14-3.72),0.91 (0.45-1.84),1.00 (ref),1.11 (0.58-2.09),1.31(0.73-2.34) in women and 1.07 (0.86-1.34),1.02 (0.47-2.25),1.00 (ref),1.23(1.00-1.52),1.24(1.01-1.52) in men.Conclusions In this prospective cohort study,we find a U-shaped relationship between serum uric acid concentrations and brain infarction,a higher risk of developing brain infarction in association with low or high serum uric acid concentrations.Women with lowest or highest serum uric acid concentrations and men with higher serum uric acid concentrations are more likely to develop brain infarction.This probably because women have lower serum uric acid concentrations relative to men.Confirmation of our findings in larger cohorts with longer follow-up duration is warranted.

Objective:To study the effectiveness and safety of different acupuncture therapies in treating Posttraumatic stress disorder(PTSD)after Wenchuan‘5.12’earthquake.And choose a desirable acupuncture therapy.Methods:A total of 276 patients were recruited in this trial and randomly divided into four groups:scalp electric acupuncture group(group A),scalp electric acupuncture with moxibustion group(group B),scalp electric acupuncture with auricular acupuncture group(group C)and paroxetine hydrochloride group(group D).Each group was treated for 12 weeks.Patients were scored using Clinicianadministered Scale for DSM-IV(CAPS),Hamilton Depression Rating Scale for Depression(HAMD),and Hamilton Anxiety Scale(HAMA).Results:The study was finished well with a balanced grouping and fine baseline.After the analysis of integrations of CAPS,HAMD,and HAMA,we found that the score differences before and after the treatment were of statistical significance in all four groups(P

Objective:To summarize the construction and practice of the compulsory postgraduate course "reproductive genetics in gynecology and obstetrics" in Department of Gynecology and Obstetrics, Peking University, and to evaluate the teaching effect of this course.Methods:A total of 139 postgraduates who studied in Department of Obstetrics and Gynecology, Peking University, from 2019 to 2021 were enrolled as subjects, and a syllabus was constructed through a top-level design based on the "biological-psychological-social medicine pattern", with the teaching objectives of reproductive genetics theory, clinical translation, genetic counseling methods, and research advances. The teaching effect was evaluated by analyzing teaching assessment results, teaching evaluation feedback, and teaching achievements. SPSS 26.0 software was used to perform the t-test and the chi-square test. Results:The written test score, usual performance score, and total score of the postgraduate students in 2021 were higher than those in 2019 and 2020 [(73.50±8.19) vs. (70.94±14.90); (68.60±2.82) vs. (68.22±4.58); (90.58±4.18) vs. (89.49±7.60)], with significant differences in written test score and total score ( P<0.05). There was a high degree of satisfaction with the feedback of teaching, and 85.61% (119/139) of the students selected "great satisfaction"; in particular, there were increases in the degree of satisfaction with expanding research ideas and reflecting the advances in this discipline, but with no significant difference. There was a significant increase in the number of published articles. Conclusion:For the active implementation of the course of "Reproductive Genetics in Obstetrics and Gynecology", improving the teaching process in a planned and step-by-step way through a top-level design in advance can help to expand research ideas for future research work among postgraduates in obstetrics and gynecology and promote the sustainable development and improvement of the teaching of the emerging interdisciplinary discipline of reproductive genetics in obstetrics and gynecology.

Mucosal pemphigoid is a rare subepidermal immune bullous disease, mainly involving the oral cavity, eyes and other mucous membranes, with the risk of scarring, which can be life-threatening in severe cases. For patients with mucosal pemphigoid, early diagnosis and early treatment can avoid serious complications. For mild patients, dapsone or topical glucocorticoids can be used; for severe patients, combination of immunosup-pressants helps to improve clinical efficacy and reduce the dosage of glucocorticoid, including cyclophosphamide, azathioprine, methotrexate, and mycophenolic acid esters. For some refractory cases without any response to the treatments of dapsone, glucocorticoids and immunosuppressants, biological agents (including rituximab, etanercept, infliximab, and braziltinib), intravenous immune globulin and other therapies can be selected. For some patients with mucosal scarring, surgery or laser therapy can be considered to improve symptoms. However, it is necessary to further demonstrate the clinical efficacy of some immunosuppressants and biologic agents on mucosal pemphigoid in a lot of larger clinical trials.

Objective To explore the characteristics of lipid profile in children with systemic lupus erythematosus (SLE) and its risk factors.Methods A total of 225 untreated children with SLE were enrolled in this study.According to the values of low-density lipoprotein cholesterol (LDL-C),very low density lipoprotein cholesterol (VLDL-C),high-density lipoprotein cholesterol (HDL-C),totalglycerin (TG) and triglyceride (TG),they were grouped into LDL-C normal group and elevated group,VLDL-C normal group and elevated group,HDL-C normal group and lower group,TG normal group and elevated group,TC normal group and elevated group.We used x2 test,binary logistic regression and t-test to analyze the relationship between various lipid groups and clinical symptoms,laboratory tests,disease activity,hormones and complications.Results One hundred and eighty-five cases (82.22％) of children with SLE developed dyslipidemia,mainly manifested as increased LDL-C,VLDL-C,TG,TC levelsand decreased HDL-C level.There was a positive correlation between urea nitrogen and TG (r=0.257,P＜0.01),positive correlation with LDL-C (r=0.129,P＜0.05)and positive correlation with VLDL-C (r=0.225,P＜0.01).Albumin and TG (r=-0.464,P＜0.01),TC (r=-0.246,P＜0.01),LDL-C (r=-0.138,P＜0.05),VLDL-C (r=-0.426,P＜0.05) were negatively correlated.Urine protein level (2 h) was positively correlated with TG (r=0.257,P＜0.01).Systemic lupus erythematosus disease activity index (SLEDAI) was positively correlated with TG (r=0.597,P＜0.01),positively correlated with VLDL-C (r=0.565,P＜0.01) and negatively correlated with HDL-C (r=-0.324,P＜0.01).Complement C3 was negatively correlated with TG (r=-0.284,P＜0.01).The positive proportion of anti-dsDNA antibody [TG-increased group (58/89) was higher than TG normal group (70/136) (x2=4.1 16,P=0.042);TC normal group (112/186) was higher than TC-increased group (16/39) (x2=4.841,P=0.028);LDL-C elevated group (7/21) was higher than LDL-C normal group (121/204) (x2=5.240,P=0.022)].The proportion of coronary involvement events in the TG increased group (25/89) was higher than that in the TG positive group (17/136) (x2=8.612,P=0.003).The proportion of LN was higher in each dyslipidemia group [TG increased group (54/89) was higher than TG normal group (34/136) (x2=28.75,P＜0.01);TC increased group (23/39) was higher than TC normal group (65/186)(x2=7.816,P=0.005);LDL-C elevated group (14/21) was higher than LDL-C normal group (75/204) (x2=7,385,P=0.007);VLDL-C elevated group (12/17) was higher than the VLDL-C normal group (76/208) (x2=7.651,P=0.006)] (P＜0.05).Conclusion Children with SLE have significant dyslipidemia.A variety of factors are involved in children with SLE dyslipidemia.Dyslipidemia can cause multiple organ damage in children with SLE.

Objective:To explore the correlation between autoantibodies and organ involvement in children with systemic lupus erythematosus (SLE).Methods:From June 2006 to October 2020, 581 children with SLE who were hospitalized in Beijing Children's Hospital for the first time and had autoantibody detection and clinical data in our hospital were selected. A correlation study was carried out on the clinical manifestations and autoantibodies. Data were analyzed with Pearson χ2 or Fisher's exact test. P<0.05 was considered statistically significant. Results:A total of 581 children with SLE were included in this study, with a male to female ratio of 1∶3.6. The average age at diagnosis was (10.6±2.8) years, and the main symptoms were rash (388, 66.8%), fever (335, 57.7%), and joint swelling and pain (170, 29.3%). The most commonly affected organ is the blood system (414, 71.3%), followed by lupus nephritis (257, 44.2%) and arthritis (170, 29.3%). In this study, the positive rate of ANA was 100%, and the positive rates of anti-dsDNA antibody and anti-Sm antibody were 59.7% and 21.2%, respectively. The children with anti-dsDNA antibody positive were more likely to have fever (64.6% vs 47.4%, χ2=16.77, P<0.001), and the kidneys (53.3% vs 30.8%, χ2=28.80, P<0.001) and blood systems (76.1% vs 64.1%, χ2=9.79, P=0.002) were more likely to be involved than anti-dsDNA antibody negative. The proportion of renal involvement (27.8% vs 47.5%, χ2=12.69, P<0.001), blood system (57.7% vs 74.0%, χ2=10.40, P=0.001), lung involvement (12.4% vs 21.1%, χ2=3.88, P=0.049) and cardiac involvement (9.3% vs 17.8%, χ2=4.11, P=0.042) in patients with anti-SSB antibody positive were lower than those in patients with anti-SSB antibody negative. Anti-histone antibody-positive patients were prone to lupus nephritis (56.9% vs 36.6%, χ2=22.62, P<0.001), arthritis (37.6% vs 24.2%, χ2=11.77, P=0.001) and lung involvement (24.3% vs 16.8%, χ2=4.87, P=0.027). Anti-Sm antibody positive patients were prone to skin manifestations such as butterfly erythema (52.8% vs 31.7%, χ2=11.38, P<0.001) and sunlight allergy (13.8% vs 7.4%, χ2=4.96, P=0.026), but the proportion of joint involvement (22.0% vs 31.2%, χ2=4.03, P=0.045) and thrombocytopenia (17.1% vs 27.3%, χ2=5.38, P=0.026) were lower than those of anti-Sm antibody negative. Arthritis (44.4% vs 24.8%, χ2=19.00, P<0.001), secondary SS (28.6% vs 5.4%, χ2=57.98, P<0.001) and parotid gland involvement (25.6% vs 2.9%, χ2=70.84, P<0.001) were more common in RF factor positive children, but the proportion of kidney involvement (30.8% vs 48.2%, χ2=12.57, P<0.001) was lower than in RF negative children. Conclusion:The clinical manifestations of childhood SLE are diverse and highly heter-ogeneous. A variety of autoantibodies are associated with organ involvement and clinical phenotypes, and anti-SSB antibodies may have protective effects in kidney and other organ damage.

Objective:To investigate clinical and histopathological features of adult erythema nodosum (EN) .Methods:Clinical data were collected from 54 adult inpatients with histopathologically confirmed EN in Department of Dermatology and Venereology, the First Affiliated Hospital of Wannan Medical College from November 2019 to July 2022, and analyzed retrospectively.Results:Among the 54 EN patients, there were 6 males and 48 females, their ages were 42.50 ± 11.68 years (range, 18 - 73 years), and their disease course ranged from 1 day to 10 years; 30 patients (55.56%) were diagnosed with idiopathic EN, and 24 (44.44%) with secondary EN. The most common etiological factor in secondary EN was infection (17 cases), including respiratory tract infection (9 cases), tuberculosis infection (6 cases), upper respiratory tract infection comorbid with active hepatitis B virus infection (2 cases) ; the following common etiological factor was connective tissue disease (7 cases), including Behcet′s syndrome (4 cases), Sj?gren′s syndrome (1 case), and undifferentiated connective tissue diseases (2 cases). The patients′ ages were significantly younger in the secondary EN group (38.33 ± 12.15 years) than in the idiopathic EN group (46.17 ± 10.20 years, t = 2.58, P = 0.013). All patients had skin lesions on their lower limbs, lesions were limited to both lower limbs in 24 patients with idiopathic EN and 12 with secondary EN, and the proportion of patients with lesions limited to both lower limbs was significantly lower in the secondary EN group than in the idiopathic EN group ( χ2 = 5.44, P = 0.020). Compared with the idiopathic EN group, the secondary EN group showed significantly increased white blood cell counts ([7.56 ± 2.46] × 10 9/L vs. [6.04 ± 1.60] × 10 9/L, t = 2.62, P < 0.05) and C-reaction protein levels (34.34 ± 46.48 mg/L vs. 11.45 ± 18.13 mg/L, t = 2.28, P < 0.05). In the idiopathic EN group, 23 patients mainly showed histopathological features of septal panniculitis, while 17 patients in the secondary EN group mainly showed histopathological features of mixed panniculitis or lobular panniculitis, and the proportion of patients with histopathological features of mixed panniculitis or lobular panniculitis was significantly higher in the secondary EN group than in the idiopathic EN group ( χ2 = 12.18, P < 0.001) . Conclusion:EN was more common in female adults; idiopathic EN was the most common type, and secondary EN may be a cutaneous sign of systemic diseases; for EN patients at a relatively young age, with lesions involving both lower limbs or more sites, higher white blood cell counts and C-reaction protein levels, and histopathological manifestations of lobular panniculitis, systemic examinations were required to rule out underlying causes.