Objective To explore the relationship between prenatal diagnosis indications and fetal chromosomal aberrations , and the security of amniocentesis. Methods The amniotic fluid cells were sampled by amniocentesis and cultured in 572 high-risk pregnant women from January 2012 to August 2015. The chromosomal karyotypes were examined by G-banding. Results The success rate of the first amniotic fluid cells culture reached 99.83%. In all the 572 valid samples , there were 20 cases of chromosomal aberrations and the abnormal rate was 3.50%, including 17 of numeric aberrations and 3 of structural aberrations. There were 7 cases of chromosomal aberrations in all the 299 elderly parturient in high-risk indications and the abnormal rate was 2.34%, and there were 13 cases of chromosomal aberrations in all the 273 non-elderly parturient and the abnormal rate was 4.76%. Conclusions (1)It is necessary to further diagnose in pregnant women with high-risk factors , including high age , abnormal screening and ultrasonic findings , and history of abnormal gestation and birth. (2)The chromosomal karyotype examination of amniotic fluid cells in high-risk pregnant women is one of the effective prenatal diagnosis methods in high security and accuracy , with which it can reduce the incidence of birth defects and the burden of family and society , and improve the quality of the population.

Obiective To evaluate the current status of studies on interventional recallalization of fallopian tube.Methods According to the standard of evidence-based medicine,literatures were analyzed by two readers in three time periods:1997 to 2000,2001 to 2004 and 2005 t0 2008.Two separate evaluation results were tested by the statistical method Kappa to test its consistency.Scores of clinical controlled trials (CCT)and randomized controlled trials(RCT)were calculated according to Jadad score scale.The accurate criteria of case selection,case exclusion,and effect determination;the method of randomization;the number of samples:the comparability of baseline;the blinded procedure;the therapeutic method;the method of statistical analysis:the follow-up cases; the drop-out cases and the conclusions derivation of RCT and CCT into descriptive analysis were evaluated Results One hundred and fifty seven therapeutic articles were searched and 30 RCT and CCT articles(25 RCT and 5 CCT)were analyzed.The Kappa value was 0.85 and P＜0.05 indicating that the evaluation was in good consistency.2,15 and 8 RCT received 0 point,1 point and 2 points respectively in Jadad score scale.RCT and CCT contained 9 articles(30.0%)fulfilled the accurate criteria of case selection and exclusion:12 articles(40.0%)met the accurate criteria of effect determination:4 articles(13.3%)utilized the definite method of randomization;27 articles (90.0%)had the number of sample beyond 60;14 articles(46.7%)met the baseline comparability;only 1 article(3.3%)used the single-blinded method,17 articles(56.7%)utilized the method of statistical analysis;13(43.3%)mentioned follow-up in articles;4(13.3%)mentioned drop-out cases in the articles and 14(46.7%)articles had the conclusions derived by considering the statistical significance and clinical significance.Conclusion The quality of studies on interventional recanalization of fallopian tube is poor and could not meet the standard of evidence-based medicine.

Objective To investigate the effect of berberine anti macrophages apoptosis, initially to determine the concentration of anti-apoptosis and to explore its mechanisms of treatment in atherosclerosis (AS). Methods Apoptosis of RAW264.7 macrophages is induced by 0.5 μmol/L Tg and 50 μg/ml Fuc. The cell survival rate and apoptosis rate was detected by MIT and flow cytometry, respectively. Results There was statistical significance between the berberine group of 800 μg/ml and normal group in the cell sur-vival rate(P<0.01). With the decline in concentration of berberine, the cell apoptosis rate showed a down-ward trend, berberine (0.02-0.63 μg/ml) effectively inhibited the cell apoptosis induced by Tg and Fuc. Conclusion Berberine group has little impact on the cell proliferation. Berberine can effectively inhibit the cell apoptosis induced by Tg and Fuc.

Objective Secretion and aggregation dysfunction of platelets are closely related with uncontrollable septic inflammation and abnormal blood coagulation.This study was to investigate the effect of emodin on platelet aggregation (PA) and secretion in mice with late sepsis.Methods We randomly divided 111 healthy SPF male C57BL/6 mice into a sham operation (SO) group, a cecal ligation (CL) group, and an emodin (Em) group and treated those of the Em group intragastrically with emodin after cecal ligation.At 72 hours after operation, we recorded the survival rate of the mice, measured the platelet count and the levels of serum alanine aminotransferase (ALT) and creatinine (Cr), and detected the PA rate by aggregometry, the P-selectin level by flow cytometry, the serum 5-HT concentration by ELISA, and the expressions of Rab27 mRNA and protein by RT-PCR and Western blot, respectively.Results At 72 hours after cecal ligation, the survival rates in the SO, CL and Em groups were 100%, 60% and 66.7%, respectively.The platelet count was significantly decreased in the CL group as compared with that in the SO group ([461.00±64.77] vs [775.00±65.89]×109/L, P<0.05) but remarkably increased in the Em group ([635.20±83.57]×109/L) in comparison with that in the CL group (P<0.05);the levels of ALT and Cr were markedly higher in the CL than in the SO group (ALT: [194.02±31.85] vs [41.55±1.24] U/L, P<0.05;Cr: [1.94±0.29] vs [0.72±0.11] mg/dL, P<0.05), but lower in the Em (ALT: [162.56±31.51] U/L;Cr: [1.53±0.30] mg/dL) than in the CL group (P<0.05);the PA rate and serum 5-HT concentration were significantly reduced in the CL group as compared with the SO group (PA: [12.67±4.04] vs [43.33±2.89]%, P<0.05;5-HT: [13.18±2.31] vs [34.35±5.79] ng/L, P<0.05), but the former was remarkably elevated ([24.67±2.52]%) while the latter showed no significant difference in the Em group ([17.41±2.16] ng/L) as compared with the CL group (P<0.05);the P-selectin expression was markedly higher in the CL than in the SO group ([16.78±1.60] vs [2.33±0.14] %, P<0.05), but lower in the Em ([12.58±2.28] %) than in the CL group (P<0.05).No statistically significant differences were observed at 72 hours postoperatively among the SO, CL and Em groups in the expression Rab27b mRNA (1.85±0.04 vs 1.84±0.02 vs 1.87±0.29, P>0.05).The Rab27b protein expression was markedly lower in the CL and Em groups than in the SO group (0.093±0.015 and 0.140±0.026 vs 10.380±0.036, P<0.05) but with no significant difference between the former two groups (P>0.05).Conclusion Emodin can improve platelet count and aggregation, down-regulate the expression of P-selectin, protect the liver and kidney function, and reduce mortality from late sepsis.

Objective To investigate the clinical values of heparinase-modified thromboelastography(hmTEG)in heparin monitoring during continuous renal replacement therapy.Methods A total of 97 cases who were undergoing continuous renal replacement therapy(CRRT)in the intensive care unit of the 94th People's Liberation Army Hospital from Jan 2014 to Jun 2019 were enrolled in this stud-y.The patients were divided into TEG group and APTT group according to different means of heparin monitoring during continuous renal replacement therapy.In total,278 hemofilters were used in all the blood purification therapies.Complication of bleeding,CRRT time,total heparin dose and SOFA(sequential organ failure assessment)score of the patients were compared between the TEG and APTT groups.The filter life span and survival time in hospital were also compared using Kaplan-Meier analysis.Rusults Compared with APTT group,the total heparin dose in TEG group were significantly higher(P＜0.05).The CRRT time of patients and the average filter life span in TEG group were significantly longer than those of APTT group(P＜0.05).Compared to APTT group,the 28-day SOFA in TEG group was significantly lower(P＜0.05).Survival analysis showed that the 28-day risk of death in the patients of APTT group was 2.01 times higher than that in TEG group(P＜0.05).The 72-hour filter life of TEG group was significantly longer than that of APTT group(P＜0.05).Conclusion The use of hmTEG for monitoring heparin in blood purification should be superior in terms of safety and efficacy with longer filter life span and higher survival rate of patients.

Objective To investigate the value of thromboelastography ( TEG) in evaluating the prognosis of polytrauma patients. Methods A retrospective case control study was conducted to analyze the clinical data of 155 polytrauma patients admitted to 94th Hospital of People's Liberation Army from September 2015 to December 2017. There were 118 males and 37 females, aged 18-88 years [(49. 0 ± 1. 3)years]. Injury severity score (ISS) was (26. 4 ± 11. 0)points. According to the prognosis of patients 90 days after injury, the patients were divided into survival group ( 143 patients ) and death group (12 patients). The ISS on admission, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), Glasgow coma score ( GCS ) , systolic blood pressure ( SBP ) , respiratory rate ( RR ) and outcome of 90 days after injury were collected. Red blood cells( RBC) , hemoglobin( Hb) , plasma prothrombin time ( PT) , activated partial thromboplastin time ( APTT) , fibrinogen ( FIB) , international normalized ratio ( INR) , thrombin time ( TT) , platelet count ( PLT) and TEG-related indicators within 2 hours after ICU admission were collected. TEG-related indicators including TCG clotting reaction time ( R ) , clot formation rate (K), clot formation kinetics (α angle), maximum amplitude (MA), coagulation index (CI), blood clotting strength (G), elasticity constant (E) and clot lysis time (CLT) were collected within 2 hours after admission to ICU. The changes of TEG-related indicators were compared between the two groups, and logistic regression analysis and receiver operating characteristic ( ROC) curve analysis were performed. Results Compared with the survival group, ISS and APACHE II scores in the death group were significantly higher, while GCS, SBP, RR, RBC and Hb were significantly lower (P<0. 05). Compared with the survival group, death group showed significantly prolonged PT [(21. 1 ± 9. 1) s vs. (16. 5 ± 4. 3)s] as well as reduced FIB [(1. 7 ± 1. 5)g/L vs. (2. 7 ± 1. 7)g/L] (P<0. 05). Compared with the survival group, the K value in the death group was significantly prolonged [5. 2(1. 8,8. 0)min vs. 2. 9(2. 1,4. 2)min] (P<0. 05). Compared with the survival group, death group showed significant decrease in G value (3762. 4 ± 3346. 7 vs. 6366. 5 ± 3886. 1), E value (75. 3 ± 67. 0 vs. 127. 3 ± 77.7),αangle[(38.4±19.7)°vs. (49.4±16.6)°],MA[(37.4±17.5)mmvs.(52.0±13.3)mm], CI [-6. 8(-9. 5, 1. 5) vs. -2. 9 ( -5. 9, -0. 7)] and CLT [39. 2 (32. 5, 46. 9) min vs. 46. 4 (32. 7, 60.8) min] (P<0. 05). There were no significant differences in APTT, TT, INR, PLT and R between the two groups (P>0. 05). Logistic regression analysis showed that MA was significantly associated with the prognosis of polytrauma patients (OR=1. 15, 95％ CI 1. 04-1. 28, P<0. 05). The area under the ROC curve of MA was 0. 756 (P <0. 05). When the MA threshold was 43. 1 mm, the sensitivity, specificity, positive predictive value and negative predictive value of predicted survival were 77. 5％, 76. 9％, 76. 1％ and 97. 3％, respectively. Conclusion TEG index MA can determine the prognosis of polytrauma patients, and the mortality rate is significantly increased at MA<43. 1 mm.

OBJECTIVETo observe the effect difference between fire needle combined with chemotherapy and fire needle on quality of life in patients with chemotherapy of non-small cell lung cancer (NSCLC).

METHODSWith randomized controlled method, a total of 60 patients with chemotherapy of NSCLC were divided into an observation group (fire-needle plus chemotherapy group) and a control group (chemotherapy group), 30 cases in each one. The observation group was treated with fire needle atpoints which consisted of Geshu (BL 17) and Danshu (BL 19), combined with chemotherapy selected from TP (paclitaxel+cisplatin)/GP (gemcitabine+cisplatin)/DP (docetaxel+cisplatin)/NP (vinorelbine+cisplatin) by the oncologist according to patients' condition. The fire needle was given once a day for 7 days, and chemotherapy was given for 21 days. The control group was treated with chemotherapy alone for 21 days. Before and after treatment, response evaluation criteria in solid tumors (RECIST) was applied for evaluation, and Karnofsky performance status (KPS) and functional assessment of cancer therapy-lung (FACT-L) were applied for evaluation of quality of life in patients with chemotherapy of NSCLC.

RESULTSThe effective rate was 20.0% (6/30) and the stability rate was 73.3% (22/30) in the observation group, which were insignificantly higher than 16.7% (5/30) and 63.3% (19/30) in the control group, respectively (both>0.05). The KPS after treatment was lower than that before treatment in the control group (<0.05); the KPS after treatment was similar to that before treatment in the observation group (>0.05); the KPS in the observation group after treatment was higher than that in the control group (<0.05). The total score and each item score of FACT-L after treatment were higher than those before treatment in the observation group (all<0.05); the physical score and emotional score of FACT-L after treatment were higher than those before treatment in the control group (both<0.05); the total score, physical score, functional score and subscale score in the observation group were significantly higher than those in the control group after treatment (all<0.05), while the social/family score and emotional score in the observation group were insignificantly higher than those in the control group (both>0.05). The differences of KPS total score before and after treatment in the two groups had moderate positive correlation with differences of FACT-L total score (<0.01).

CONCLUSIONFire needle can improve quality of life in patients of NSCLC chemotherapy.

ObjectiveTo compare the efficacy and safety of acupuncture combined with auricular acupoints patches and nicotine transdermal patch in treating moderate to severe nicotine dependence. MethodsIn a rando-mized controlled trial， 64 quit smoking voluntary subjects with moderate to severe nicotine dependence were randomly divided at a ratio of 1∶1 into a treatment group and a control group， with 32 cases in each group. The treatment group was given acupuncture combined with auricular acupoints patches， twice weekly， four weeks as a course for two courses. The control group was given nicotine transdermal patch， one patch per day for 24 hours， 8 weeks. The cure rate was assessed after treatment and at follow-up （the 16th week after treatment）.The daily smoking volume， exhaled carbon monoxide （CO） value， Nicotine Dependence Scale （FTND）， Minnesota Nicotine Withdrawal Symptoms Scale （MNWS）， and Pittsburgh Sleepiness Index Inventory （PSQI） were evaluated before and after treatment and at follow-up， and adverse effects were recorded. ResultsIn terms of the cure rate， there were both six cured cases （20%） after treatment and at follow-up in the treatment group， while in the control group， seven （23.3%） and five （16.7%） patients were cured after treatment and at follow-up， respectively， with no statistically significant differences between the two groups both after treatment and at follow-up （P＞0.05）. The daily smoking volume and exhaled CO value significantly decreased after treatment and at follow-up in both groups （P＜0.05）， but were not significantly different between the groups after treatment and at follow-up （P＞0.05）. After treatment and at follow-up， FTND， MNWS， and PSQI scores were significantly reduced in both groups compared with those before treatment （P＜0.05）. There was no statistically significant difference in the FTND scale scores between the two groups after treatment and at follow-up （P＞0.05）， while the MNWS and PSQI scale scores were lower in the treatment group than in the control group （P＜0.05）. ConclusionAcupuncture combined with auricular acupoint patches for moderate to severe nicotine dependence has comparable effect with the first-line drug nicotine patch in terms of increasing the cure rate and decreasing the degree of nicotine dependence， and is superior to nicotine patch in terms of relieving withdrawal symptoms and improving sleep， with stable long-term effect.