Embryo damage refers to the pregnancy early embryonic development stops for some reason, and dead fetus in the womb is not yet out. It is clinical common refractory disease in the department of gynecology, and the current prevalence showed significantly increased trend. It had become a high-profil important reproductive health problem, and the research of early diagnosis and treatment scheme for embryo damage was great significance. In this paper, through the summary of the early diagnosis and treatment scheme for embryo damage, we hope that it can provide powerful help for the early detection and treatment of embryo damage and lies a foundation to promote reproductive health.

Objective To investigate the predictive value of cumulative body mass index (cumBMI) on new-onset cholelithiasis.Methods The retrospective cohort study was conducted.The data of 31 794 subjects who participated health examination at the Kailuan Hospital,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital,Kailuan Tangjiazhuang Hospital,Kailuan Fan'gezhuang Hospital,Kailuan Lyujiatuo Hospital,Kailuan Jinggezhuang Hospital,Kailuan Linnancang Hospital,Kailuan Qianjiaying Hospital,Kailuan Majiagou Hospital and Kailuan Branch Hospital in 2006,2008,2010,2012 and 2014 were collected.All the subjects were allocated into 4 groups according to squartiles of cumBMI:7 949 with cumBMI＜ 140.81 kg/m2 ×year in the Q1 group,7 946 with 140.81 kg/m2×year≤ cumBMI＜ 159.69 kg/m2 ×year in the Q2 group,7 949 with 159.69 kg/m2×year≤cumBMI＜ 180.49 kg/m2 ×year in the Q3 group and 7 950 with cumBMI ≥ 180.49 kg/m2×year in the Q4 group.All the subjects received respectively the five health examinations in 2006,2008,2010,2012 and 2014 at the same place.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.Observation indicators:(1) incidence of cholelithiasis in the 4 groups;(2) risk factors analysis affecting newonset cholelithiasis:sex,age,cumBMl,BMI,drinking,smoking,physical exercise,hypertension,diabetes,C-reactive protein (CRP),triglyceride (TG) and total cholesterol (TC).Measurement data with normal distribution were represented as-x±s and comparisons among groups were analyzed using the one-way ANOVA.Pairwise comparison and homogeneity of variance were done using the LSD test.Heterogeneity of variance was done using the Dunnett's T3 test.Measurement data with skewed distribution were described as M (Q) and comparisons among groups were analyzed using the nonparametric test.Count data were analyzed by the chi-square test.The incidence of cholelithiasis in the 4 groups were calculated by the Kaplan-Meier method and comparisons of incidence were done by the Log-rank test.The univariate analysis and multivariate analysis were done using the COX regression model.Results (1) Incidence of cholelithiasis in the 4 groups:31 794 subjects were observed for (2.1 ± 0.4) years,and 236 had new-onset cholelithiasis with an incidence of 7.42‰.Incidences of cholelithiasis in the Q1,Q2,Q3 and Q4 groups were respectively 4.03‰,7.17‰,7.93‰ and 10.57‰,with a statistically significant difference among the 4 groups (x2 =72.39,P＜0.05).(2) Risk factors analysis affecting new-onset cholelithiasis:results of univariate analysis showed that sex,age,cumBMI,BMI,hypertension and CRP were independent risk factors affecting new-onset cholelithiasis of subjects [HR =1.61,1.75,1.64,1.36,1.39,1.39,95％ confidence interval (CI):1.23-2.10,1.49-2.05,1.45-1.86,1.21-1.53,1.07-1.79,1.18-1.62,P＜0.05].Results of multivariate analysis showed that female,age between 50 years and 60 years,age≥60 years,140.81 kg/m2×year ≤cumBMI ＜159.69 kg/m2×year,159.69 kg/m2×year≤cumBMI＜ 180.49 kg/m2 ×year,cumBMI ≥ 180.49 kg/m2 × year were independent risk factors affecting new-onset cholelithiasis of subjects (HR=1.59,1.78,2.33,2.04,2.42,3.66,95％CI:1.21-2.09,1.31-2.44,1.63-3.34,1.29-3.24,1.47-3.95,2.15-6.25,P＜0.05).Conclusion Female,advanced age and increasing cumBMI are independent risk factors affecting new-onset cholelithiasis,and the incidence of cholelithiasis rises as cumBMI increases.

Objective Therapeutic hypothermia has become a standard neuroprotective treatment in term newborn infants following perinatal asphyxia,but active cooling with whole body surface or head cooling is both complex and expensive.The clinical feasibility of passive cooling in treatment of full term infants with severe asphyxia was investigated.Methods Thirty-two severe asphyxiated term newborns treated with hypothermia were analyzed,who were randomly divided into 2 groups:passive cooling group(n =17) and active cooling group(n =15).Active cooling group adopted MTRE ALLONTM-thermo regulatory systems,passive cooling group using natural cooling method.Hypothermia treatment time was 72 hours.At the end of treatment,the clinical manifestations,biochemical parameters and clinical efficacy of infants between the 2 groups were compared.Results During treatment all infants had no cardiac arrhythmia,hypoglycemia,sustained metabolic acidosis,blood-borne infections,local cold injury or bleeding.Infants in passive cooling group had a relatively wide range of rectal temperature fluctuations[average (33.47-0.71) ℃] and infants in active cooling group had a relatively narrow range of rectal temperature fluctuations[average (33.66 ± 0.29) ℃],but there was no statistically significant difference in their mean rectal temperature(t =1.941,P =0.055).One patient died in active cooling group,but there were no significant differences in suckling age,length of hospital stay,neonatal behavioral neurological assessment score,abnormal cranial ultrasound and MRI between the survivors of the two groups(all P ＞0.05).Conclusions In NICU,environmental temperature is relatively stable,passive cooling for asphyxiated newborns appears to be feasible for maintenance of hypothermia with a lower risk of adverse reactions.

ObjectiveTo establish an HPLC analytic method for amygdalin inKuxingrenFormula Granules and HPLC characteristic chromatogram.MethodsRP-HPLC method was adopted. The determination was performed on Dionex C18 column (4.6 mm×250 mm, 5μm) with acetonitrile-0.1% phosphoric acid solution (8:92) at the flow rate of 0.6 mL/min. The detection wavelength was set at 207 nm and sample size was 10μL. The column temperature was 30℃. The peak of amygdalin was set as refernce, and 10 batches of samples were analyzed. TCM Chromatogram Fingerprint Similarity Evaluation System (2004 A) was adopted to evaluate similatity.Results The linear equation of amygdalin wasY=6.176×10-7X?3.058×10-3, with a good linear relationship in the range of 0.122 5–1.225μg (r= 0.999 8). The average recovery rate was 98.75% (RSD=1.30%). There were 6 common peaks in the characteristic chromatogram ofKuxingrenFormula Granules, and the similarity of 10 batches of samples was higher than 0.981. ConclusionThe HPLC method is simple, accurate and reproducible, which can be used for the quality control of Kuxingren Granules.

Objective To observe the changes of interleukin-18 (IL-18),interleukin-33 (IL-33) and fractional exhaled nitric oxide (FeNO) in children with acute respiratory syncytial virus (RSV) bronchiolitis,and explore the potential mechanism of the transformation from acute RSV bronchiolitis to recurrent wheezing.Methods Fifty-three children with RSV bronchiolitis (RSV bronchiolitis group),32 children with repeated wheeze (repeated wheeze group) and 30 children receiving regular physical examination (healthy control group) from January 2016 to January 2017 in Cangzhou People's Hospital of Hebei Province were selected.The serum IL-18 and IL-33 at the time of inclusion and 2,3 months after inclusion were detected by enzyme linked immunosorbent assay,the FeNO at the same time was detected by multiple breathing technique,and the indexes were compared.The correlation between FeNO and IL-33,IL-18 was analyzed by Spearman method.Results The IL-18 at the time of inclusion and 2,3 months after inclusion in RSV bronchiolitis group and repeated asthmatic group were significantly higher than those in healthy control group:(10.89 ± 1.54) and (14.86 ± 5.54) ng/L vs.(7.26 ± 3.25) ng/L,(13.74 ± 4.16) and (15.45 ± 5.75) ng/L vs.(7.28 ± 3.56) ng/L,(11.38 ± 6.21) and (14.86 ± 5.28) ng/L vs.(7.18 ± 3.41) ng/L,those in repeated asthmatic group were significantly higher than those in RSV bronchiolitis group,and there were statistical differences (P＜0.05).The IL-33 levels at the time of inclusion and 2,3 months after inclusion in RSV bronchiolitis group and repeated asthmatic group were significantly higher than those in healthy control group:(17.68 ± 5.25) and (13.14 ± 5.01) ng/L vs.(3.69 ± 1.61) ng/L,(15.68 ± 4.16) and (15.11 ± 5.24) ng/L vs.(3.28 ± 1.56) ng/L,(13.87 ± 6.21) and (14.11 ± 5.14) ng/L vs.(3.18 ± 1.41) ng/L,IL-33 levels at the time of inclusion in RSV bronchiolitis group were significantly higher than those in repeated asthmatic group,and there were statistical differences (P＜0.05).The FeNO levels at the time of inclusion and 2,3 months after inclusion in repeated asthmatic group were significantly higher than those in RSV bronchiolitis group and healthy control group:(13.14 ± 4.47) ppb vs.(1.89 ± 1.54) and (7.26 ± 4.25) ppb,(14.75 ± 5.15) ppb vs.(7.74 ± 4.16) and (7.28 ± 4.12) ppb,(13.68 ± 5.62) ppb vs.(11.38 ± 6.21) and (7.18 ± 3.41) ppb;compared with that in healthy control group,FeNO at the time of inclusion in RSV bronchiolitis group was significantly decreased,and at 3 months was significantly increased,and there were statistical differences (P＜0.05).Correlation analysis result showed that FeNO at 2 and 3 months after inclusion in RSV bronchiolitis group had positive correlation with IL-18 level at the time of inclusion and 2,3 months after inclusion (P＜0.05),and negative correlation with IL-33 (P＜0.05);FeNO at 2 and 3 months after inclusion in repeated asthmatic group showed positive correlation with IL-18 at the same time (P＜0.05),and was negatively correlated with IL-33 level (P＜0.05);there was no correlation between FeNO and IL-18,IL-33 in healthy control group (P＞0.05).Conclusions IL-18 and IL-33 may be involved in the pathogenesis of acute RSV bronchiolitis and recurrent wheezing,and the concentration of IL-18 and IL-33 is correlated with the level of FeNO.Its potential mechanism needs further study.

Objective:To investigate the incidence of high-risk human papillomavirus (hrHPV) negative cervical lesions in the screening population, and based on this, to preliminarily evaluate the potential harm (missed diagnosis) and benefits (reduced colposcopy referral) of HPV primary screening compared to combined screening so as to provide reference for the selection of cervical cancer primary screening methods.Methods:This study was a single center cross-sectional study. Women who underwent joint screening [hrHPV typing test combined with cervical liquid based cytology test (LCT)] at the Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 1, 2018 to December 31, 2019 were included in the cervical cancer screening. The proportion of hrHPV negative cytological abnormalities and cervical lesions in the population was analyzed and the theoretical colposcopy referral rate of the combined screening and HPV initial screening protocol was calculated. In the population with cervical pathological results, the number of colposcopy examinations required for the diagnosis of cervical intraepithelial neoplasia grade 2 and above (CIN2+ ) was calculated.Results:A total of 35 321 screened women were included. The overall incidence of hrHPV infection, LCT abnormalities and severe LCT abnormalities in the population was 17.13%(6 051/35 321), 18.07%(6 384/35 321), and 3.97%(1 402/35 321), respectively. The negative rate of hrHPV in women with severe cervical cytology abnormalities was as high as 51.28%(719/1 402), and in CIN2+ lesions diagnosed by cervical biopsy, hrHPV negative accounted for 7.15% (49/685). The theoretical colposcopy referral rates for combined screening and initial HPV screening were 11.28%(3 985/35 321) and 8.33%(2 943/35 321), respectively, with an average diagnosis of CIN2+ requiring 3.51 and 2.81 colposcopy examinations, respectively.Conclusions:In the opportunistic screening population, the proportion of hrHPV negative CIN2+ lesions cannot be ignored, and the HPV initial screening strategy may cause missed diagnosis of these lesions. However, compared to combined screening, HPV initial screening has the potential to improve the efficiency of colposcopy. These results suggest that we should carefully choose the HPV initial screening plan.

OBJECTIVES: To explore the effect mechanism of electroacupuncture (EA) on functional constipation (FC) at the combined lower he-sea and front-mu points of large intestine based on enteric neuronal autophagy. METHODS: A total of 40 SPF Kunming mice were randomly divided into 5 groups (n = 8), i.e. a control group, a model group, an acupuncture group, a 3-methyl adenine (3-MA) group, and a 3-MA + acupuncture group. Except the control group, the FC model was established by gavage with compound diphenoxylate suspension for 14 days in the other 4 groups. After successful modeling, the mice of the acupuncture group and the 3-MA + acupuncture group received EA at bilateral "Tianshu" (ST 25) and "Shangjuxu" (ST 37), stimulated for 30 min with disperse-dense wave, 2 Hz/15 Hz of frequency, 1 mA of intensity. EA was delivered once daily. One course of treatment was composed of 5 days and 2 courses were needed, with an interval of 2 days. An intraperitoneal injection of 3-MA (15 mg/kg) was administered 30 min before EA in the mice of the 3-MA group and the 3-MA + acupuncture group, once daily. Before and after intervention, the time of the first black stool defecation and defecation behaviors in 6 h were observed in each group. After intervention, in every group, the small intestine propulsion rate was calculated, the colon tissue morphology was observed using HE staining, the ultrastructure of enteric neuronal autophagy was observed under transmission electron microscope, and the expressions of microtubule-associated protein 1 light chain 3 (LC3), Beclin-1 and neuronal nuclear antigen protein (NeuN) in neurons of colonic muscularis were determined by immunohistochemistry. RESULTS: Before intervention, when compared with those in the control group, the time of the first black stool defecation was prolonged (P<0.01, P<0.05), and numbers (P<0.01), wet weight (P<0.01, P<0.05) and water content (P<0.05, P<0.01) of stool in 6 h were reduced in the model, acupuncture, 3-MA and 3-MA + acupuncture groups. After intervention, compared with those in the control group, the time of the first black stool defecation was longer (P<0.05), and numbers (P<0.01), wet weight (P<0.01) and water content (P<0.01) of stool in 6 h were decreased in the model group. The time of the first black stool defecation was shortened (P<0.01), and numbers (P<0.01), wet weight (P<0.01) and water content (P<0.01) of stool in 6 h were increased in the acupuncture group when compared with those in the model group. The time of the first black stool defecation was extended (P<0.01), and numbers (P<0.01), wet weight (P<0.01) and water content (P<0.01) of stool in 6 h were declined in the 3-MA + acupuncture group in comparison with those in the acupuncture group. All layers of colon tissue were normal and intact in each group. When compared with the control group, the small intestine propulsion rate and the average optical density (OD) values of LC3, Beclin-1 and NeuN in neurons of colonic muscularis were decreased (P<0.01), and autophagosomes were dropped in the model group. In the acupuncture group, the small intestine propulsion rate and the average OD values of NeuN, LC3 and Beclin-1 in neurons of colonic muscularis increased (P<0.01,P<0.05), and autophagosomes were elevated when compared with those in the model group. The small intestine propulsion rate and the average OD values of NeuN, LC3 and Beclin-1 in neurons of colonic muscularis were dropped (P<0.05,P<0.01) in the 3-MA + acupuncture group in comparison with those in the acupuncture group. CONCLUSIONS Electroacupuncture may promote enteric neuronal autophagy and increase the number of neurons so that the intestinal motility can be improved and constipation symptoms can be relieved in FC mice.
Mice ; Animals ; Electroacupuncture ; Beclin-1 ; Acupuncture Points ; Constipation/therapy* ; Intestine, Small ; Autophagy ; Water

BACKGROUND: Functional constipation (FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Numerous systematic reviews (SRs) examining the use of acupuncture to treat FC have reported inconsistent results, and the quality of these studies has not been fully evaluated. OBJECTIVE: In this overview, we evaluated and summarized clinical evidence on the effectiveness and safety of acupuncture for treating FC and evaluated the quality and bias of the SRs we reviewed. SEARCH STRATEGY: The search strategy was structured by medical subject headings and search terms such as "acupuncture therapy" and "functional constipation." Electronic searches were conducted in eight databases from their inception to September 2020. INCLUSION CRITERIA: SRs that investigated the effectiveness and safety of acupuncture for managing FC were included. DATA EXTRACTION AND ANALYSIS: Two authors independently extracted information and appraised the methodology, reporting accuracy, quality of evidence, and risk of bias using the following critical appraisal tools: (1) A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2); (2) Risk of Bias in Systematic Reviews (ROBIS); (3) Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A); and (4) the Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A κ index was used to score the level of agreement between the 2 reviewers. RESULTS: Thirteen SRs that examined the clinical utility of acupuncture for treating FC were identified. Using the AMSTAR 2 tool, we rated 92.3% (12/13) of the SRs as "critically low" confidence and one study as "low" confidence. Using the ROBIS criteria, 38.5% (5/13) of the SRs were considered to have "low risk" of bias. Based on PRISMA-A, 76.9% (10/13) of the SRs had over 70% compliance with reporting standards. The inter-rater agreement was good for AMSTAR 2, ROBIS, and PRISMA-A. Using the GRADE tool, we classified 22.5% (9/40) of the measured outcomes as "moderate" quality, 57.5% (23/40) as "low" quality, and 20.0% (8/40) as "very low" quality. The inter-rater agreement was moderate when using GRADE. Descriptive analyses indicated that acupuncture was more efficacious than sham acupuncture for improving weekly complete spontaneous bowel movements (CSBMs) and for raising the Bristol Stool Form Scale (BSFS) score. Acupuncture appeared to be superior to anti-constipation drugs for improving weekly spontaneous bowel movements, the total effective rate, and the Patient Assessment of Constipation Quality of Life score. Although ten SRs mentioned the occurrence of adverse events, serious adverse events were not associated with acupuncture treatment. CONCLUSION: Acupuncture may be more efficacious than sham acupuncture for improving CSBMs and BSFS scores and may be superior to anti-constipation drugs for improving bowel movement frequency, as well as quality of life. Limitations to current studies and inconsistent evidence suggest a need for more rigorous and methodologically sound SRs to draw definitive conclusions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020189173.
Acupuncture Therapy ; Constipation/therapy* ; Humans ; Quality of Life ; Systematic Reviews as Topic

OBJECTIVE: To determine the feasibility of conducting a full-scale randomized controlled trial (RCT) and investigate the basic information and safety of acupuncture for patients with chronic spontaneous urticaria (CSU). METHODS: A total of 80 participants with CSU from July 2018 to July 2019 were randomly assigned to receive active acupuncture (n=41) on a fixed prescription of acupoints or sham acupuncture (n=39) with superficial acupuncture on non-acupuncture points through the completely randomized design. Patients in both groups received 5 sessions per week for 2 weeks, and participants were followed for a further 2 weeks. Feasibility was assessed by recruitment and randomization rates, retention of participants, treatment protocol adherence, and the incidence of adverse events (AEs). The clinical primary outcome was the changes from baseline weekly urticaria activity scores (UAS7) after treatment at 2 weeks. Secondary outcomes included the Visual Analogue Scale (VAS) score of itching intensity, Dermatology Life Quality Index (DLQI), Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA). RESULTS: A total of 80 participants were enrolled. The recruitment rate of 24.02%, randomization rate of 100%, a loss rate of 6.25%, and no obvious AEs were observed in either group. The decrease from baseline in the mean UAS7 total score at week 2 in the active acupuncture group was -8.63 (95%CI, -11.78 to -5.49) and -6.21 (95%CI, -9.43 to -2.98) in the sham acupuncture group for a between-group difference of -2.42 (95% CI, -6.93 to 2.07). The change in the DLQI, VAS of itching intensity, HAMA, and HAMD were a slightly better improvement trend in the active acupuncture group than the sham acupuncture group, but the between-group difference was not significant. CONCLUSIONS Active acupuncture had a better improvement trend in alleviating symptoms, improving quality of life and regulating the mood of anxiety and depression in patients with CSU than sham acupuncture. (Registration Nos. AMCTR-ICR-18000190 and ChiCTR2100054776).

ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.