Objective:To investigate the clinical value of ultrasound detection of uterine arcuate artery and umbilical artery blood flow parameters measured by ultrasound imaging during the second trimester of pregnancy in the diagnosis of placenta previa with accreta.Methods:Eighty patients with placenta previa with accreta who received regular prenatal examination and terminated pregnancy from May 2017 to May 2019 in Zhuji People's Hospital and 80 healthy pregnant women were included in this study. Uterine arcuate artery and umbilical artery blood flow parameters pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV), umbilical artery blood flow PI and RI, ratio of peak systolic to diastolic flow velocity (S/D) were measured by color Doppler ultrasound. Uterine arcuate artery and umbilical artery blood flow parameters were correlated with the occurrence of placenta previa with accreta.Results:Uterine arcuate artery PI and RI in patients with placenta previa with accreta were (0.45 ± 0.12) and (0.38 ± 0.08), which were significantly lower than (0.59 ± 0.17) and (0.46 ± 0.11) in healthy pregnant women. In patients with placenta previa with accreta, uterine arcuate artery PVS and umbilical artery blood flow parameters PI, RI, and S/D were (45.13 ± 4.62), (1.16 ± 0.27), (0.73 ± 0.22) and (3.32 ± 0.31), respectively, which were significantly higher than those in healthy pregnant women [(34.27 ± 3.82), (0.79 ± 0.21), (0.52 ± 0.13) and (2.71 ± 0.24), t = 3.057-9.241, all P < 0.01]. The proportion of placenta previa with previa patients exhibiting abundant and chaotic blood flow signals was significantly higher than that in healthy pregnant women [91.25% (73/80) vs. 86.25% (69/80), χ2 = 96.341, P < 0.01]. Uterine arcuate artery blood flow parameters PI and RI were negatively correlated with the occurrence of placenta previa with previa ( r = - 0.742, - 0.716, both P < 0.05). Uterine arcuate artery blood parameter PVS and umbilical artery blood flow parameters PI, RI and S/D were positively correlated with the occurrence of placenta previa with previa ( r = 0.759-0.885, all P < 0.01). Conclusion:Ultrasound detection of uterine arcuate artery and umbilical artery blood flow parameters and monitoring blood flow changes in pregnant women have a great value in the diagnosis of placenta previa with accreta, which needs more attention in the gynecological clinic.

Objective To observe the clinical efficacy of esomeprazole combined with trimebutine maleate in the treatment of reflux esophagitis patients without helicobacter pylori infection.Methods 78 patients with reflux esophagitis were randomly divided into two groups,46 patients in study group and 32 patients in control group.30 minutes before the breakfast,all the patients took Nexium 20mg,twice a day.The study group was given trimebutine maleate 200mg,thrice a day additionally.The treatment course was 4 weeks.The effect and the result of gastroendoscopy were observed.Results The average time of clinical symptoms disappeared in study group was (10.51 ± 2.43) days,which was significantly shorter than (12.31 ± 3.17) days of the control group (t-2.84,P ＜ 0.01).The total effective rate of the study group was 97.83％,which was significantly higher than 81.25％ of the control group (x2 =4.48,P ＜ 0.05).Conclusion Esomeprazole combined with trimebutine maleate in the treatment of reflux esophagitis without helicobacter pylori infection can promote gastric emptying,prevent reflux,control esophageal inflammation and promote ulcer healing effectively.

Health management is developing very fast as a new subject.The ethical problem in which there is rare in reports.Discussion about the ethical problems appears in health management and health examination,such as privacy protection,sex morality,excess service,healthy morality,humanities concern,cooperation between each section and so on,has a important actual significance.

ObjectiveTo observe the effect of co-stimulated factor B7-1 and granulocyte-macrophage colony-stimulating factor(GM-CSF) genes mediated by recombinant adenovirus on immunogenicity of neuroblastoma(NB)cell line SH-SY5Y.MethodsAfter NB cell line SH-SY5Y was transfected with recombinant adenovirus mediating green fluorescent protein(Ad-GFP) in different multiplicity of infection(MOI),the transfer efficiency was tested by flow cytometry(FCM).SH-SY5Y cells were transfected separately with recombinant adenovirus,recombinant adenovirus mediating B7-1 and GM-CSF genes or only B7-1 gene,and they were named as Ad,B7-GM and B7 group.The cells which were not transfected were named as SH group.The protein expression of B7-1 and GM-CSF were detected by using FCM and enzyme linked immunosorbent assay(ELISA).Peripheral mononuclear cells were separated and purified with Ficoll density gradient centrifugation.Cpm and cytokine(IFN-? and IL-2) secretory were evaluated by mixed lymphocyte culturing with different ratio(5 to 1 and 10 to 1) on target cells and effect cells.ResultsTransfer efficiency of recombinant adenovirus to SH-SY5Y was high.After transfection,B7-1 and GM-CSF genes were expressed.Proliferation of lymphocytes was stimulated and cytokine increased vigorously in B7-GM group and B7 group,and the effect in B7-GM group was stronger than that in B7 group.And the effect in ratio 5 to 1 group was stronger than that in 10 to 1 group.ConclusionsB7-1 and GM-CSF genes have synergistic effect.After transfection with recombinant adenovirus mediated B7-1 and GM-CSF genes,the immunogenicity of SH-SY5Y is greatly enhanced.

Sarcopenia is closely related with age-related loss of muscle fiber, reduced physical activity, hormone level decline and nutrition deficiency. Though torque generation in knee extension, relative skeletal muscle index, lean body weight, electromyogram, gait analysis, grasp force, nuclear magnetic resonance and B ultrasonic examination are generally accepted as diagnostic method, there is not an unified standard in diagnosis. Through the physical activity and diet can prevent and reverse the tendency of sarcopenia, which also improve the activity of the hypothalamic-GH-insulin-like growth factor-1 axis. In future, the characteristic therapy of Chinese medicine science can be added into resistance exercise and nutrition method, or combined compound hormones with nutrition intervention to design orthogonal test for seeking the best interaction, and explore the long-term safety and effectivity by follow-up observation.

Objective To study of relationship of the mRNA expression of protection of telomeres 1(POT1) and the activity of telomerase with the incidence of gastric carcinoma.Methods Lesioned gastric mucosal tissues and the corresponding normal tissues from 30 cases of gastric cancer,30 cases of moderate or severe atypical hyperplasia,and 30 cases of intestinal metaplasia were collected in this study.The expression of POT1 mRNA was detected with real time-PCR and the activity of telomerase was examed with TRAP-ELISA.Results Real time-PCR analysis showed that POT1 expression was increased in the gastric carcinoma tissues compared with the paracancerous normal mucosal tissues,increased in the severe atypical hyperplasia than in the corresponding normal tissues,but there was no difference between intestinal metaplasia tissues and normal tissues.The activity of telomerase in the advanced gastric tumors and severe atypical hyperplasia was significantly higher than that in intestinal metaplasia tissues and normal gastric mucosal tissues.However no obvious difference was found in the activity in gastric tumors and severe atypical hyperplasia with intestinal metaplasia tissues and normal gastric mucosal tissues.Conclusion Although the activity of telomerase in gastric cancer and severe atypical hyperplasia is significantly higher than that in normal and intestinal metaplasia tissues,POT1 mRNA has no relationship with this change.

Objective To investigate the effect and psychological intervention of the treatment of hemodialysis internal fistula with Hirudoid combined with far infrared ray. Methods 80 cases of hemodialysis fistula were diagnosed and treated from January 2014 to December 2016 in Lishui Central Hospital,according to different treatment intervention methods, which were divided into two groups, each group with 40 cases. The control group was treated with routine nursing and far infrared therapy, and the observation group was treated withpsychological intervention and Hirudoid+far infrared therapy. The clinical efficacy, the improvement of clinical symptoms and the incidence of complications were compared between the 2 groups. Results The clinical effect of the observation group was better than that of the control group, the improvement of the clinical symptoms was better than that of the control group,the complication rate was lower than the control group,the difference was statistically significant (P<0.05). Conclusion The clinical effect of psychological intervention plus Hirudoid+far infrared ray in the treatment of hemodialysis fistula patients is significant,which can effectively improve the clinical symptoms and complications in patients with less, and is worthy of clinical application.

In recent years,nano - materials have represented the superior biocompatibiliry and the arena of medical nano - materials have been extensively studied by various means all over the world. Is it possible that nano - bone implants overcome the existing limitations of the traditional bone implants for fusing operations in the future? State Food and Drug Administration (SFDA, CN) authorized the nano-bone implants- - nHA/ PA66 (YZB/0063 -2003) in 2005 but there were still lots of counterviews in this field. This review considers the advanced researches via comparing and analyzing the correlatire literatures recently.

Objective To observe the effect of transduetion of human wild type gene(wt-p53) mediated by recombinant adenovirus on cell growth, cell cycle and apoptosis of neuroblastoma (NB) cell line SH-SY5Y. Methods The NB cell line SH-SY5Y were transfected by recombinant adenovirus with green fluorescent protein(Ad-GFP). The suitable muhiplieity of infection (MOI) was determined after trans-fer efficiency was tested by flow cytometry (FCM). Both recombinant adenovirus(Ad) and recombinant adenovirus mediating wt-p53 gene (Ad-p53) were transfected into SH-SY5Y cells. SH-SY5Y cells without any transfection were used as blank group. The p53 protein expres-sion was validated by Western blot. Cell number was counted and growth curve was drawn. Both cell cycle and apoptesis were detected by FCM. Results The results indicated that the transfer efficiency of recombinant adenovirus to SH-SY5Y was satisfied, and 100 MOI was suitable. After transfection with Ad-p53, p53 protein was high expressed. Cell growth were inhibited, apoptosis and cell cycle arrest were in-duced in p53 gene transfeetion group. Conclusions Our results indicate that clinical application of the in vitro p53 gone modified tumor cell vaccine might be feasible and effective in clinical treatment of NB.

Objective To systematically evaluate the efficacy of traditional Chinese medicine/herbal decoction combined with ursodeoxy-cholic acid (UDCA)in the treatment of primary biliary cirrhosis (PBC),and to provide a reference for clinical medication.Methods Lit-erature published before July 31,2014 was searched in databases as follows:Cochrane Library,PubMed,China National Knowledge Infra-structure (CNKI),Chinese Scientific Journals Full-text Database (VIP),Chinese Biomedical Literature Database (CBM),and Wanfang Data.The randomized controlled trials (RCTs)comparing the efficacy of traditional Chinese medicine/herbal decoction combined with UD-CA versus UDCA alone in PBC patients were included in the analysis.The methodological quality of included trials was assessed and the data were extracted,followed by meta-analysis using RevMan 5.0 software.Results A total of 12 RCTs were included,involving 681 patients with 346 in the test group and 335 in the control group.The results of meta-analysis showed that,after 6 months of treatment,the overall response rate,improvement rate,and biochemical indices of liver function (ALT,ALP,GGT,and TBil)and hepatic fibrosis in the test group were significantly improved compared with those in the control group (all P<0.05).There were no significant differences between the two groups in the immunological indices such as IgA,IgG,anti-mitochondrial antibody (AMA),and AMA M2 subtype (all P>0.05 ). Conclusion Traditional Chinese medicine/herbal decoction combined with UDCA markedly improves the indices of hepatocellular necrosis and cholestasis,degree of hepatic fibrosis,and clinical symptoms in PBC patients after 6 months of treatment,but leads to no significant im-provement in immunological indices.Due to the limited number of included RCTs and patients through systematic evaluation,and the pres-ence of selection bias and publication bias,more double-blind randomized controlled trials with large sample size,multicenter involvement, and high quality are required to provide convincing evidence.