Objective To explore the value of bedside ultrasound used by ICU doctor in the rapid diagnosis of traumatic abdominal,and to evaluate the advantage of bedside ultrasound in the treatment decision.Methods 60 patients with traumatic abdominal blood in our hospital admitted to the ICU were selected.All patients were checked through bedside ultrasonography by physicians with professional training of ICU,bedside ultrasound and abdominal CT and abdominal flat piece of traumatic hematocelia,and compared the diagnosis of the time of the bedside ultrasound,abdominal CT and abdominal X -ray and ultrasound physician ultrasound examination.Results The difference of abdominal blood detection rate between bedside ultrasonography and abdominal computed tomo-graphy (CT)had no statistical significance (P >0.05);bedside ultrasonography of abdominal blood detection rate was higher than plain film of the abdomen,the difference was statistically significant (χ2 =73.346,P <0.01);bed-side ultrasound received a preliminary diagnosis of time -consuming (4.37 ±2.1)min was significantly lower than that of the examination of ultrasound physicians (13.86 ±5.6)min,abdominal CT (22.13 ±6.9)min and abdominal plain film (28.19 ±7.32)min,the differences were statistically significant (t =3.947,14.607,21.139,26.338,all P <0.01 ).Conclusion By the professional training of ICU physicians for bedside ultrasound traumatic blood abdominal patients can make a more accurate diagnosis,time -shorten,more accord with the requirement of treating critically ill patients in ICU,which has important clinical value for trauma abdominal blood in early rapid diagnosis and treatment.

ObjectiveTo evaluate the efficacy and safety of electrical acupuncture therapy through adhesive surface electrodes and concomitant auricular acupuncture therapy on acute spinal cord injury.MethodsA total of 56 acute spinal cord injury patients with American Spinal Injury Association(ASIA) impairment grading of A and B were recruited into this study.They were randomly divided into the acupuncture and control groups.In the acupuncture group,electrical acupuncture therapy via the adhesive surface electrodes and auricular acupuncture were applied.Rehabilitation therapy was also provided to the patients during acupuncture therapy.In the control group,only rehabilitation therapy was provided to the patients.The ASIA neurologic and functional scores and the Functional Independence Measure(FIM) scores were assessed during the time of admission,hospital discharge,and 1-year postinjury follow-up.There were no adverse events.ResultsThere were significant improvements in neurologic(sensory and motor),functional,and FIM scores in the acupuncture group compared with the control either when hospital discharged or 1-year postinjury follow-up.There was no adverse events.ConclusionThe early use of concomitant auricular and electrical acupuncture therapies are effective and safe in treating acute spinal cord injury.

Objective To investigate the association between polymorphism of cytochrome P450 subfamily Ⅺ A polypeptide 1 (CYP11A1) gene and polycystic ovarian syndrome (PCOS) in Chinese population. Methods From May 2005 to Dec.2008,290 PCOS cases treated in the First affiliated hospital of Anhui Medical University matched with 344 reproductive women as controls were enrolled in this study. Genotypes of 7 tagging single nucleotide polymorphisms(tSNP,rs12438594,rs4077582,rs9806234,rsl6968477,rs4887139,rs1843090,rsl 1632698)covering CYP11A1 gene (r~2≥0.8) and 3 microsatellite markers (D15S1547,D16S520,D15S1546) were chosed from the phase II database of Han population in HapMap data.Genotype and frequency of allele were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and haplotype of gene polymorphism were analyzed in 290 PCOS cases and 344 controls.Results Among 7 tSNPs and 3 microsatellite markers,the frequency of rs4077582,D15S1547,D15S1546 and rsl 1632698 between two groups reached statistical difference (P =0.010,0.044,0.018 and 0.026).The allele frequency of rs4O77582,rs4887139,rsl843090,D15S1547 and Dl 6S520 showed significant difference between two groups(P=0.002,0.048,0.030,0.001 and 0.024).Among 5 haplotype of CYP11A1(ACGCA13/6/9AG,ACGTA16/6/11AA,GCACG12/8/8AA,GTACA14/4/7GG,GTGCA13/6/7AG),the frequency of GTACA14/4/7GG and ACGCA13/6/9AG were 7.8% (45/580) and 25.3% (147/580) in PCOS group and 11.9% and 19.6% in control group,which showed statistical difference (P< 0.05 ).There was no significant difference in the level of serum androgen at difference genotype from rs4077582 between two groups (P>0.05).Conclusion The polymorphism of CYP11A1 gene was associated with PCOS,however,the relationship between gene sequence covered by tSNP/microsatellite markers and hyperandrogenism of PCOS should be further investigated.

Intrahepatic cholangiocarcinoma (ICC) is a primary liver cancer with malignant biological behaviors and ranks only second to hepatocellular carcinoma in incidence rate, and in recent years, the incidence and mortality rates of ICC have been increasing significantly. Since ICC has significant different biological characteristics from hepatocellular carcinoma and extrahepatic cholangiocarcinoma, ICC lacks characteristic clinical symptoms and specific tumor markers and has strong invasion, a low surgical resection rate, and a tendency of recurrence and metastasis after surgery, which results in poor overall prognosis. With the development of molecular biology techniques and the accumulation of diagnosis and treatment experience, there is a gradually deepened understanding of the biological characteristics and clinical outcomes of ICC, and the corresponding surgical diagnosis and treatment strategies and technical means are undergoing profound transformation. At present, multidisciplinary comprehensive treatment, mainly surgery, is the mainstream paradigm for the treatment of ICC, and emphasis on R0 resection and regional lymph node dissection helps to improve clinical outcome and prognosis. However, there are still some problems for consideration on the way to the early diagnosis and the precise, standardized, and individualized treatment of ICC.

【Objective】 To strengthen the management of transfusion adverse events, so as to reduce the occurrence of medical damage and accidents, and guarantee the safety of blood transfusion. 【Methods】 The adverse events of blood transfusion reported in our hospital from July 2016 to December 2022 were collected, the reasons were tracked, and continuous improvements were made. 【Results】 From 2016 to 2022, a total of 315 transfusion adverse events were reported, including 233(73.97%, 233/315) cases of transfusion reactions and 82(26.03%, 82/315) transfusion adverse events. There were 271 328 transfusion cases in the same period, and the incidence of transfusion reactions was 0.858 7‰(233/271 328). The number of transfusion application was 129 887, and the incidence of transfusion adverse event is 0.631 3‰(82/129 887). Sixty-eigtht(82.93%, 68/82) cases of transfusion adverse events were caused by human factors, while the other 14(17.07%, 14/82) cases were non-human factors. According to the linear regression analysis, we have concluded that the year is a significant indicator for transfusion reaction rates (P<0.05), but not for transfusion adverse event rates (P>0.05). 【Conclusion】 Strengthening the management of reporting adverse events in clinical blood transfusion, monitoring the incidence, analyzing and improving different types of adverse events by management tools can reduce the medical risks of blood transfusion and help to guarantee the safety of clinical blood transfusion.

【Objective】 To investigate the factors influencing the length of hospital stays of the acute fatty liver of pregnancy (AFLP) patients, so as to establish the prediction model. 【Methods】 A total of 49 patients diagnosed as AFLP)in ShenZhen People’s Hospital between January 2008 and January 2023 were retrospectively analyzed. According to the median length of hospital stays, the patients were divided into two groups: Group A(n=21)and Group B(n=28). Preoperative general laboratory data, clinical features and postpartum adverse outcomes in both groups were analyzed. Multivariate binary logistic regression was used to analyze the independent factors affecting the length of hospital stays for AFLP, and a prediction model for hospitalization time was established. 【Results】 Comparison between Group B and Group A were as follows: hospital stays(d)(15.5 vs 8), preoperative icterus(%)[16(57.1%)vs 3(14.3%)], thrombin time(TT)(s)(24.2 vs 21.3), prothrombin time(PT)(s)(16.8 vs 15.3), activated partial thromboplastin time(APTT)(s)(52.3 vs 40.7), total bilirubin(TBIL)(μmol/L)(77.2 vs 45.2), indirect bilirubin(IBIL)(μmol/L)(21.2 vs 10), creatinine(Cre)(μmol/L)[(171.97±53.34) vs (131.81±45.06]), TT extension(%)[24(85.7%)vs 11(52.4%)], APTT extension(%)[27(96.4%)vs 7(33.3%)], IBIL elevation(%)[19(67.9%)vs 4(19%)], Cre concentration rise(%)[21(75%)vs 8(38%)], number of postpartum plasma exchange sessions(%)[23(82.1%)vs 5(23.8%)], postpregnancy co-infection phenomenon(%)[21(75%)vs 4(19%)], with Group B significantly higher than Group A. The preoperative platelet count(×10⁹/L)(128 vs 221)and the concentration of fibrinogen(g/L)[0.9 vs 1.6] in Group B were significantly lower than those in Group A. Univariate logistic regression analysis showed that preoperative icterus, postpregnancy co-infection phenomenon, number of postpartum plasma exchange sessions, preoperative TT extension, preoperative APTT extension, Cre concentration rise were influencing factors for the hospital stays of AFLP patients. According to the minimum result of Akaike information criterion, the multivariate binary logistic regression analysis (step-wise selection) showed that the number of postpartum plasma exchange sessions, icterus, preoperative APTT extension were the independent risk factor influencing the hospital stays of AFLP patients, and the logistic regression prediction model was established by incorporating the above three factors. Regularization techniques were further employed in linear regression to address and assess overfitting issues. Additionally, the confidence interval for the estimated effect sizes in each model have been acquired by bootstrapping techniques. 【Conclusion】 Preoperative icterus, preoperative APTT extension(APTT>43s)and the number of postpartum plasma exchange sessions were the independent risk factor influencing the hospital stays of AFLP patients and the logistic regression prediction model with high predictive effectiveness was established successfully.

Atrial functional mitral regurgitation (AFMR) is mitral regurgitation in patients with atrial fibrillation (AF), whose left atrium (LA) is enlarged, the left ventricle is not enlarged or only slightly enlarged, the left ventricular ejection fraction is preserved, and the mitral valve itself has no apparent lesion. At present, the etiology, pathophysiology and mechanism of this disease have not been completely clear yet. Existing studies have found that the causes of AFMR mainly include AF, enlargement of LA and mitral annulus, destruction of mitral annular shape, inability of mitral valve remodeling to compensate for mitral annular expansion, and hamstringing of the posterior mitral leaflet by atriogenic tethering. AFMR is demonstrated to be associated with an increased risk of mortality and readmission due to heart failure. Therefore, it serves as a primary therapeutic target for patients with heart failure and AF. However, the optimal treatment of AFMR still remains controversial. Therefore, this article will mainly expound the current definition, etiology, pathophysiological mechanism, treatment, and prognosis of AFMR.