Objective To retrospectively analyze the main factors of abnormal umbilical blood flow in different stage after 24 weeks' gestation,and to evaluate its treatment outcomes.Methods 256 cases with abnormal umbilical blood flow were selected.The abnormality happened in different stages after 24 weeks' gestation and they were inspected and treated routinely.Latency factors of the different stage were analyzed to discover the primary reason,and the treatment outcomes were compared.Results The significant differences of constructional proportion were observed in different stage(x2 =25.60,P ＜ 0.05).The influence factors of different stages were as following:hypertension relative disease (33.33 ％) between 24 and 27 weeks' gestation,the umbilical cord factor (16.67 ％) ; the incidence rate of abnormal umbilical blood was 42％ between 28 and 36 weeks' gestation,including hypertension disease(28.70％),the umbilical cord factor(15.74％) ;umbilical cord (31.37％) between 37 and 40 weeks' gestation,although gestation period hypertension disease reduced,but still accounted for 22.54％,the placenta factor was 12.74％.After treatment,the cure rate had significant differences (x2 =11.16,P ＜0.01),89.58％ (24-27 week),80.55％ (28-36 week),69.60％ (37-40 week).Conclusion The hypertension relative diseases and abnormal cord are the primary factors which caused abnormal umbilical blood,24-37 gestation week is the key stage for the inspection and treatment,especially for the hypertension relative diseases.

Objective To evaluate the therapeutic effects of ultrasound biomicroscopy (UBM) assisted intraocular lens suspension surgery with one loop suturing for residual lens capsule aphakia.Methods Fifty aphakia patients (50 eyes) with residual lens capsular equal or greater than 180 degrees were chosen.The patients were randomly divided into 2 groups and underwent intraocular lens suspension surgery with one loop suturing:Trial group (25 cases,25 eyes) selected suture site according to the preoperative UBM results,and control group (25 cases,25 eyes) selected the suture site according to the clinical experience.The uncorrected visual acuity (UCVA),astigmatism at preoperative and postoperative 1 week,1 month and 3 months were observed,the eccentric and tilt value of the lens were calculated by UBM measurement at 3 month after operation,and the postoperative complications of the two groups were observed.Results UCVA at each time point after operation were higher than that before operation,and gradually increased with time.There was no significant difference between the two groups at 1 week before and after the operation of UCVA (P ＞ 0.05).At 1 month and 3 months after operation,UCVA in trial group were significantly higher than those of control group (all P ＜ 0.05).The astigmatism value at 1 week after operation in two groups was higher than that before operation and gradually decreased with time.The astigmatism value in trial group at 1 month and 3 months after operation had no significant difference with that of preoperative (P ＞ 0.05),while the astigmatism value in control group increased (all P ＜ 0.05).The astigmatism values had no significant difference between the two groups before and 1 week after operation (all P ＞0.05),which were significantly lower in trial group at 1 month and 3 months after operation (all P ＜ 0.05).Three months after surgery,the proportion of lens accurately implanted in the ciliary sulcus was significantly higher than control group (P ＜ 0.01),the eccentric and tilt values of the lens in trial group were significantly less than control group (P ＜ 0.01).No serious complication was observed in all patients.Conclusion UBM assisted intraocular lens suspension surgery with one loop suturing can significantly improve the postoperative visual quality,safety and lens stability,which can be used as a routine preoperative examination of intraocular lens suspension surgery.In addition,UBM provides an alternative method for the calculation of the eccentricity and tile value of the intraocular lens after the implantation of the intraocular lens.

Objective To observe the clinical application of extraperitoneal cesarean section(ECS) plus forceps vs transperitoneal cesarean sections(TCS) in repeated cesarean section.Methods 98 multiparous women with scar uterus for elective repeated cesarean sections were recruited retrospectively,47 cases for ECS plus forceps(group A),and 51 cases for TCS(group B).The multiparous women with hyperglycemia not controlled,severe preeclampsia,heart disease,placenta previa,premature rupture of membrane,a history of ＞ 1 cesarean section,myoma and/or ovarian neoplasm were excluded.Results Skin incision to baby delivery time and total operation time of group A were (7.7 ± 2.8) min and (42.8 ± 9.7) min,respectively,which were significantly shorter than (9.3 ± 3.2) min and (47.6 ± 9.4) min of group B,(t =2.700,2.497,P =0.008,0.014).There was significant difference in blood loss volume during the operation and postoperative 2 hours,which was (310.4 ± 106.3) mL,(365.3 ± 142.8) mL respectively(t =2.142,P =0.035).The Visual Analog Scale for pain (VAS pain) was (2.8 ± 1.8) in group A and (4.1 ± 1.9) in group B,respectively (t =3.252,P =0.002).The gastrointestinal function recovery mean time of group A was significantly shorter than that of group B (12.5 h versus 16.0h,t =2.771,P =0.007).And the postoperative febrile morbidity was significantly lower in group A than in group B(8.5％ versus 25.5％ ;x2 =4.918,P =0.033).The patients with chronic pelvic pain followed up after operation was 3 versus 12,and the difference was significant (x2 =5.143,P =0.026).There were no differences in neonatal Apgar score at 1 minute,birth asphyxia and wound healing rates.Conclusion ECS plus forceps can be safely used for repeated cesarean section,with the advantages of less operation time,less bleeding volume,lower postoperative morbidity,and fewer complications than TCS.

Purpose To investigate the expression and significance of androgen receptor (AR) in breast carcinoma with different ER and PR status.Methods Immunohistochemical method was used to detect AR, ER and PR expression in 173 cases of breast carcinoma, and all the cases were grouped according to: (1) AR status: AR~- positive subgroup and AR~- negative subgroup, (2) ER status: En subgroup (negative for both ER and PR), Ep subgroup (positive for ER and/or PR), (3)AR, ER and PR status: En-AR~+ subgroup (AR~- positive cases of En subgroup), En-AR~- subgroup (AR~-negative cases of En subgroup), Ep-AR~+ subgroup (AR~- positive cases of Ep subgroup), and Ep-AR~- subgroup (AR~-negative cases of Ep subgroup).En-AR~- subgroup also was called negativE-for-all subgroup, and the rest three subgroups were called partly-or-completely positive subgroup (positive for at least one of the three markers), and then, the groups were compared with clinicopathological features.Results The positive rate of AR was 62.8% (54/86) in Ep subgroup and 37.9%(33/87) in En subgroup, and there was significant difference between them (P=0.001).Compared to AR~-negative subgroup, AR~-positive subgroup had smaller tumor size, less mitosis count and lower grade(P<0.05).Compared to the other three subgroups, En-AR~- subgroup had more mitosis count and higher grade (P<0.01).In En subgroup,AR~- positive cases had less mitosis count and lower grade (P<0.05), and in Ep subgroup,AR~- positive cases had higher stage(P=0.000), but no significant difference were found among partly or completely positive subgroups.Conclusions The expression of AR may play a different role in breast carcinoma with different ER and PR status, because it indicates good prognosis in negative for both ER and PR subgroup, but bad in ER and/or PR positive subgroup. When choosing a personalized therapy, all the combinations of hormone receptor status should be considered for the patients.

Purpose To investigate the relationship between molecular phenotype of ductal carcinoma in situ ( DCIS) and that of inva-sive ductal carcinoma ( IDC) of the breast. Methods Immunohistochemical method was used to detect ER, PR, HER-2 and CK5 ex-pression in 165 cases of breast cancer, with DCIS and IDC existed in every one of the samples. Results In the 165 cases of breast cancer, the ER, PR, HER-2 and CK5 expression of IDC was positively correlated with that of DCIS, respectively. To evaluate IDC phenotype, the number of basal phenotype was 18 (10. 9%), HER-2-overexpression 20 (12. 1%), luminal A 102 (61. 8%), lumin-al B 20 (12. 1%), null phenotype 6 (3. 6%);to evaluate DCIS phenotype, the number of basal phenotype was 19 (11. 5%), HER-2-overexpression 20 (12. 1%), luminal A 104 (63%), luminal B 17 (10. 3%), null phenotype 5 (3%). 157 cases (95. 2%) of IDC had the same phenotype with DICS, but the rest 8 cases (4. 8%) not, three cases of luminal A DCIS transformed into one HER-2-overexpression and two null phenotype IDC, three of HER-2-overexpression DCIS transformed into luminal B IDC, one null pheno-type DCIS transformed into one luminal A IDC, and one basal phenotype DCIS transformed to HER-2-overexpression IDC. Conclusion Most of IDC have the same phenotype with DCIS, but there exist small part of DCIS which could transform into other phenotype IDC.

Objective To investigate long-term data of dry eye after LASIK in young myopia patients.Methods Young myopia patients were divided into treated group (group A) and control (group B),who were interviewed before surgery and on 1 year,3 years and 5 years after surgery.Their diopters,uncorrected visual acuity (UCVA),tear breakup time test,Schirmer I test and corneal fluorescent staining were taken,then dry eye was diagnosed and OSDI questionnaire were scored.Results The postoperative incidence of dry eye in group A was higher than that before surgery (35.6％) and decreased with time (51.7％,44.9％ and 40.7％,respectively),and there was no significant difference in group B at each time point (P ＞ 0.05).The preoperative incidence of dry eye was equal between two groups (P ＞ 0.05),which were much higher in group A after surgery (all P ＜ 0.05).In group A,the postoperative constituent ratio of mild dry eye was the majority and decreased with time (65.6％,52.8％,41.7％,respectively),while moderate and severe dry eye was increased,especially the latter (6.6％,11.3％ and 16.7％,respectively;P ＜ 0.05).At 5 years after surgery,the UCVA and visual function score in dry eye patients were lower than those of non-dry eye patients (all P ＜ 0.05),while the residual refraction and ocular symptom score were higher than those of dry eye patients (all P ＜ 0.05).Conclusion Dry eye disease may last for a long time and may getting worse after LASIK.Therefore,we should pay more attention to the development of dry eye long after LASIK in young myopic patients.

Objective To prepare serum cholesterol and triglycerides reference materials.Methods Blood units were collected from healthy donors and the sera separated and screened for cholesterol and triglycerides levels.Four serum pools were prepared by pooling sera grouped according to cholesterol and triglyceride levels.The materials were tested for homogeneity and stability and their values for total cholesterol,total glycerol and free glycerol and triglycerides were assigned by HPLC methods.Results The materials were tested to be homogeneous and stable for at least 4 years at-20℃.The certified values (reference value±expanded uncertainty)of the 4 materials for total cholesterol were(5.110±0.065) mmol/L,(4.761±0.062)mmol/L,(3.941±0.050)mmol/L and(3.158±0.041)mmol/L,respectively;for total glycerol(2.212±0.043)mmol/L,(1.679±0.033)mmol/L,(1.275±0.027)mmol/L and(1.067±0.023)mmol/L;for free glycerol(0.142±0.005)mmol/L,(0.149±0.004)mmol/L,(0.146±0.003)mmol/L and(0.122±0.003)mmol/L;and for triglycerides(2.069±0.043)mmol/L,(1.530±0.033)mmol/L,(1.129±0.027)mmol/L and(0.945±0.023)mmol/L.Conclusion Certified reference materials for serum total cholesterol,total glycerol,free glycerol and triglycerides have been prepared.

Objective: To investigate the inlfuence of angiotensin converting enzyme 2 (ACE2) on lectin-like oxidized low density lipoprotein receptor-1 (LOX-1) protein expression and to explore the protective effect of ACE2 on vascular endothelial cells. Methods: Our work includedin vitro andin vivo studies. For in vitro experiment, the human umbilical vein endothelial cell (HUVEC) were cultured and transfected with replication deficient recombinant adenovirus of ACE2 (Ad-ACE2), and LOX-1 protein expression stimulated by angiotensin 2 was examined by Western blot analysis. Forin vivo study, atherosclerosis plaques were induced in 20 apolipoprotein E-deifcient (ApoE-/-) mice, and then randomly divided them into 2 groups: ACE2 group, the mice received Ad-ACE2 (2.5×109 pfu/ml) injection through caudal vein, EGFP (enhanced green lfuorescent protein) group, the mice received equal replication deifcient recombinant adenovirus of EGFP (Ad-EGFP) injection through caudal vein.n=10 in each group. The animals were executed after 1 month treatment to collect abdominal aorta. Lipid content in atherosclerosis plaque was evaluated by Oil red O staining and LOX-1 protein expression was examined by immunohistochemistry and Western blot analysis. Results: Bothin vitro andin vivo experiments conifrmed that endothelial cell LOX-1 protein expression was signiifcantly inhibited by ACE2 transfection. The lipid content in ACE2 group was obviously lower than that in EGFP group byin vivo study. Conclusion: ACE2 may inhibit LOX-1 protein expression and therefore reduce the progress of atherosclerosis.

Objective To observe the clinical effect of Yanshu compound radix sophore injection combined with radiotherapy in treatment of patients with bone metastases from lung cancer. Methods A total of 116 patients with bone metastases from lung cancer admitted to the Department of Radiation Oncology of Gansu Provincial Cancer Hospital from January 2014 to December 2018 were selected. The 58 patients were treated by using three-dimensional conformal radiotherapy (3D-CRT), zoledronic acid and oxycodone sustained-release tablets (control group); the others 58 patients were treated radix sphore injection on basis of control group (integrated Chinese and western medicine). The two groups were treated continuously for 10 days as 1 course of treatment, taking a rest for one week in the middle, then they took the second course of treatment; after the end of 2 courses, the therapeutic effects were evaluated in the two groups. The pain grading, Karnofsky functional status (KPS) score and myelosuppression were observed before and after treatment in two groups, respectively. Results The proportions of patients with painless and mild pain after treatment in the integrated Chinese and western medicine group were significantly lower than those in control group [painless: 22.41% (13/58) vs. 39.66% (23/58), mild pain: 10.35% (6/58) vs. 46.55% (27/58)], while the proportions of patients with moderate pain and severe pain in the integrated Chinese and western medicine group were significantly higher than those of the control group [moderate pain: 53.45(31/58) vs. 12.07% (7/58), severe pain: 13.79% (8/58) vs 1.72% (1/58), both P < 0.05]. After treatment, the proportion of patients with improved KPS score in integrated Chinese and western medicine group was significantly higher than that in control group [55.17% (32/58) vs. 36.21% (21/58), P < 0.05], and the proportion of patients with stable and decreased KPS score were less than that of control group [stable KPS score:18.97%(11/58) vs. 27.59%(16/58), decreased KPS score:25.86% (15/58) vs. 36.21% (21/58)]. The proportions of patients with blood cell count (WBC), hemoglobin (Hb) and platelet count (PLT) showing no myelosuppression (at the zero degree) after treatment in integrated Chinese and western medicine group were obviously higher than those in control group [WBC: 77.59% (45/58) vs. 36.21% (21/58), Hb: 77.59% (45/58) vs. 70.69% (41/58), PLT: 58.62% (34/58) vs. 32.76% (19/58), all P < 0.05]. Conclusion Yanshu compound radix sphore injection combined with radiotherapy can reudce bone metastasis pain, reduce bone marrow suppression and improve quality of life in patients with advanced lung cancer and bone metastasis.

Objective: To investigate the association of the risk of overweight/obesity in children and adolescents with their early life factors and parental weight. Methods: From June 1 to June 30 of 2022, the stratified randomized cluster sampling method was used to collect information using questionnaires from 5 370 primary and secondary school students in Hohhot City, Inner Mongolia Autonomous Region, and multivariate analysis were performed using multiple Logistic regression model estimation in a generalized linear model for parental BMI and early life factors in children and adolescents. Results: The prevalence of overweight/obesity was 32.2% , and the prevalence of overweight/obesity among male students was 37.8%, which was higher than that of female students 26.1% χ 2= 84.59 , P <0.01). The results of the multirariate Logistic regression anaysis showed that the prevalence of overweight/obesity was higher in only paternal overweight ( OR=1.52, 95%CI =1.30-1.77), only maternal overweight ( OR=1.61, 95%CI = 1.31 -1.97), and parentl overweight ( OR=2.42, 95%CI =2.03-2.87)( P <0.05). The risk of overweight/obesity was higher in children with high birth weight ( OR=1.29, 95%CI =1.08- 1.55 ), children born by caesarean section ( OR=1.32, 95%CI =1.17- 1.48 ), and children whose mothers gained excessive weight during pregnancy ( OR=1.24, 95%CI =1.06-1.46), and the results were statistically significant ( P <0.05). Conclusions Overweight parents, excessive maternal weight gain during pregnancy, cesarean delivery, and high birth weight are associated with increased risk of overweight/obesity in children and adolescents. Attention should be paid to these aspects in obesity prevention and control.