Objective To analyze the factors related to the fetal death and to find the effective interventions. Methods 84 women with fetal death were recruited.Clinical data were collected and analyzed based on the retro-spective method.Results Among the 84 women,21 women with pregnancy complications,2 women delivered fetal macrosomia,2 women with oligohydramnios,4 women with polyhydramnios,50 women with abnormal umbilical cord, 1 woman with fetal growth restriction,1 woman with racket -shaped placenta,2 women with unknown causes,and 1 woman with placental calcification.Conclusion The main cause of fetal death was pregnancy complications and umbilical cord abnormalities.The early diagnosis,promptly correct,and timely termination of pregnancy will be the effective interventions to prevent the development of the fetal death.

Objective:To investigate the role of the expression of E-cadherin(E-Cad) and tissue inhibitor of metalloproteinases-2(TIMP-2) in carcinogenesis and progression of colorectal cancer(CRC).Methods:The E-Cad and TIMP-2 expressions were studied immun ohistochemistrically in 30 specimens of colorectal adenoma and 60 specimens of CRC.Results:The expression rates of E-Cad were 87.10% in colorectal adenoma and 55.00% in CRC, the former was apparently higher than that of the later (P0.05);The significant relationship was observed between low TIMP-2 expression and Dukes stage, metastasis of lymph node and distant organs and poor prognosis.Conclusion:The detection of expression about E-Cad and TIMP-2 may be helpful to judge the malignant behavior and metastasis and prognosis with colorectal carcinoma,furthermore the expression of TIMP-2 may be used to know prognosis of patients.

To observe the protective effects of drug-contained serum of Lingqi Huangban Granule (LQHBG), a compound traditional Chinese herbal medicine, on oxidative stress-induced injury in rabbit retinal pigment epithelial (RPE) cells in vitro.

Objective To investigate the correlation between ipsilateral prominent posterior cerebral artery laterality (PCAL) and white matter hyperintensities (WMHs) in patients with severe internal carotid artery (ICA) stenosis. Methods From April 2016 to December 2017, patients with unilateral ICA stenosis≥70% (including occlusion) and contralateral ICA stenosis <50% or no stenosis admitted to the Department of Neurology, Liaoning Provincial People's Hospital were enrolled. According to the presence or absence of PCAL on the ipsilateral side of ICA stenosis, they were divided into positive group and negative group, and the severity of WMHs was compared between the 2 groups. The patients were grouped according to the severity of overall WMHs and deep WMHs (DWMHs) and periventricular WMHs (PWMHs) on the ipsilateral side of ICA stenosis. Multivariate logistic regression analysis was used to determine the independently relevant factors of WMHs. Results A total of 131 patients were enrolled, 65 of them (49.62% ) had ipsilateral PCAL positive. The proportion of severe DWMHs in this group was significantly lower than that in the ipsilateral PCAL negative group (38.46% vs. 59.09% ; χ2 =5.578, P=0.018 ). Multivariate logistic regression analysis showed that advanced age (odds ratio [ OR] 2.196, 95% confidence interval [ CI] 1.278-3.773; P=0.004), hypertension (OR 3.279, 95% CI 1.107-9.709; P=0.032), and high systolic blood pressure (OR 1.027, 95% CI 1.002-1.053; P=0.031) were independently associated with severe overall WMHs; advanced age (OR 1.957, 95% CI 1.141-3.358; P=0.015) and hypertension (OR 4.739, 95% CI 1.570-14.286; P=0.006) were independently correlated with ipsilateral severe DWMHs, ipsilateral PCAL (OR 0.340, 95% CI 0.135-0.856; P=0.022 ) was independently correlated with ipsilateral mild DWMHs; advanced age (OR 1.805, 95% CI 1.175-2.775; P=0.007) and high systolic blood pressure (OR 1.030, 95% CI 1.007-1.053; P=0.010) were independently correlated with ipsilateral severe PWMHs. Conclusion Ipsilateral PCAL is an independent protective factor for ipsilateral DWMHs in patients with severe ICA stenosis.

Objective To evaluate the effects of enteral immunonutrition on cell immunity level and clinical efficacy in patients with severe tuberculosis. Methods Sixty patients with severe tuberculosis were admitted to the department of tuberculosis intensive care unit of Hangzhou Red Cross Hospital from June 2015 to June 2017, and they were randomly divided into a conventional enteral nutrition group (EN group) and a enteral immunonutrition group (EIN group), each group 30 cases. Based on the patients' gastrointestinal tolerance condition, the EN group was treated with therapies of normal nutrition support, anti-tuberculosis, anti-infection, etc.; the EIN group was treated with enteral immunonutrition (TPF-T), and simultaneously with anti-tuberculosis, anti-infection, etc. therapies according to the disease situation. The target energy maintained at 104.6 kJ·d-1·kg-1and the therapeutic course was 14 days in the two groups. The levels of interleukins (IL-6, IL-10) and interferon-γ (IFN-γ), white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), cell immune indexes (T cell subgroup CD4+, CD8+) were observed before treatment and on day 14 after treatment in the patients of two groups; the changes of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score before treatment and after treatment and 28-day mortality rate were recorded in the two groups. Results After treatment, the levels of WBC, CRP, PCT were obviously lower than those before treatment, while the levels of IL-6, IFN-γ, CD4+in the two groups were significantly higher than those before treatment, and the changes of the EIN group were more significant than those in the EN group [WBC (×109/L): 8.0±3.1 vs. 10.0±2.4, CRP (mg/L): 30.3±9.1 vs. 45.8±6.6, PCT (μg/L): 2.2±1.8 vs. 4.3±2.2, IL-6 (mg/L): 182.53±8.52 vs. 168.42±7.62, IFN-γ (mg/L): 32.52±3.5 vs. 25.41±2.6, CD4+: 0.56±0.06 vs. 0.45±0.08, all P < 0.05]. The level of CD8+after treatment in the two groups was higher than that before treatment (the EN group: 0.28±0.06 vs. 0.27±0.07, the EIN group: 0.27±0.08 vs. 0.26±0.09), the APACHE Ⅱ scores in the two groups were lower than those before treatment (the EN group: 11±6 vs. 18±4, the EIN group: 10±3 vs. 17±6), the 28-day mortality in the EIN group was lower than that in the EN group [13.3% (4/30) vs. 16.7% (5/30)], no statistical significant difference in CD8+, APACHE Ⅱscore, 28-day mortality between the two groups being found (all P > 0.05). Conclusion Enteral immunonutrition can improve the level of cell immunity and decrease the degree of inflammatory response, and increase the clinical curative effect in patients with severe tuberculosis.

Objective:To retrieve, appraise and summarize the evidence for the airway humidification management of the inpatient with laryngectomy and tracheotomy but nonmechanical ventilation and to provide references for the clinical nursing.Methods:The evidence question was raised based on the study objective. The evidence was retrieved from some databases according to the evidence pyramid model during inception to December, 2018. The literature types included clinical practice guideline, evidence summary, best practice information sheet, recommended practice and systematic review. The quality of the literature were evaluated by the suitable evaluated tool based on their types. The level and recommedation grade of the evidence were appraised by the suitable tools of JBI.Results:Thirteen studies were recruited, including one clinical practice guideline, two evidence summaries, one best practice information sheet and nine systematic reviews. Totally thirteen items of best evidence were summarized and generalized to four categories including assessment, method, liquid and operation of airway humidification.Conclusion:The evidences of the studies are scientific and practical, but on the one hand, it is recommended that when applying the evidences in clinic, it is necessary to assess the clinical situation and chose the proper evidence. And on the other hand, there are lacking of some evidences of airway humidification and the level of some evidences is low. So it needs to create more high level evidences.

Objective:To analyze clinical characteristics and high-frequency ultrasound features of localized scleroderma, and to construct and validate a non-invasive prediction model for staging of skin lesions based on the high-frequency ultrasound features.Methods:Patients with localized scleroderma were retrospectively collected from the Department of Dermatology and Venereology, Second Xiangya Hospital of Central South University from February 1, 2021 to February 28, 2023, and clinical data as well as high-frequency ultrasound and pathologic features of 85 lesions from these patients were analyzed. Lesions were divided into modeling cohort and validation cohort according to the chronological order of patient enrollment. The univariate analysis and multivariable logistic regression models were used to analyze the independent influential factors in the staging of localized scleroderma lesions in the modeling cohort, construct the regression equation, and to build a nomogram prediction model. The Bootstrap validation method was used for internal validation, and the predictive performance of the nomogram model in the modeling cohort and validation cohort was further evaluated by the calibration curve and receiver operating characteristic (ROC) curve.Results:In the modeling cohort, 60 patients with localized scleroderma, including 16 males and 44 females, were enrolled, with the age [ M ( Q1, Q3) ] being 22.0 (10.0, 39.2) years, and there were 28 lesions in the oedematous phase and 32 lesions in the fibrotic and atrophic phase; in the validation cohort, 25 patients with localized scleroderma, including 8 males and 17 females, were enrolled, with the age being 18.0 (7.0, 30.0) years, and there were 9 lesions in the oedematous phase and 16 lesions in the fibrotic and atrophic phase. Univariate analysis in the modeling cohort showed no significant differences in the age and gender of patients or the location of lesions between the oedematous phase group and the fibrotic and atrophic phase group (all P > 0.05) ; compared with the oedematous phase group, the fibrotic and atrophic phase group showed an increased proportion of patients with disease duration ≥ 2 years (20/32 cases vs. 10/28 cases, χ2 = 4.29, P = 0.038), decreased thicknesses of the subcutaneous fat layer in skin lesions (1.4 [0.0, 26.0] mm vs. 1.8 [0.1, 14.3] mm, Z = -2.14, P = 0.032), increased decrements in the subcutaneous fat layer thickness in the lesional sites compared with non-lesional control sites (1.8 [0.5, 11.0] vs. 0.3 [-1.9, 8.0] mm, Z = -4.72, P < 0.001), increased ratios of the lesional elasticity values to control elasticity values (2.9 [1.8, 6.9] vs. 1.8 [1.1, 5.9], Z = -4.34, P < 0.001), and increased ultrasound-based lesional activity scores (5.0 [3.0, 8.0] points vs. 3.0 [0.0, 5.0] points, Z = -4.76, P < 0.001). Multivariable logistic stepwise regression analysis showed that the disease duration ≥ 2 years ( P = 0.032), increased ratios of the lesional elasticity values to control elasticity values ( P = 0.019), increased ultrasound-based lesional activity scores ( P = 0.013), and increased decrements in the subcutaneous fat layer thickness in the lesions compared with the controls ( P = 0.013) helped to confirm localized scleroderma lesions in the fibrotic and atrophic phase. Based on the results of regression analysis, a total of 4 factors were included in the nomogram prediction model, including the disease duration, the decrement in the subcutaneous fat layer thickness in lesions compared with controls, the ratio of the lesional elasticity values to control elasticity values, and the ultrasound-based lesional activity score; additionally, the constructed logistic regression model formula for predicting the probability (p) of skin lesions in fibrotic and atrophic phase was "ln (p/[1 - p]) = -9.595 + 2.204 × the disease duration + 0.784 × the decrement in the subcutaneous fat layer thickness in the lesions compared with the controls (mm) + 0.887 × the ratio of the lesional elasticity values to control elasticity values + 1.374 × the ultrasound-based lesional activity score". The calibration curve showed a good predictive performance of the model through the Bootstrap validation method, and the ROC curve demonstrated good discrimination and accuracy (modeling cohort: area under the curve = 0.936, 95% CI: 0.879 - 0.994; validation cohort: area under the curve = 0.889, 95% CI: 0.748 - 1.000) . Conclusions:High-frequency ultrasound could provide essential details for staging the localized scleroderma lesions. Based on the disease duration, subcutaneous fat layer thickness, skin elasticity values, and ultrasound-based lesional activity scores, the constructed prediction model could predict the stages of localized scleroderma lesions with excellent discrimination, accuracy, and predictive performance.