ABSTRACT:Objective To explore the risk factors for maternal adverse pregnancy outcomes.Methods An unmatched case-control study based on hospital was performed.Univariate and multivariate Logistic regression were used to analyze the related factors of maternal adverse pregnancy outcomes,including general condition,history of fertility,abnormal symptoms and diseases during pregnancy.Results Univariate analysis results showed that high education level of gravida might be the protective factors of adverse pregnancy outcomes.The risk factors for adverse pregnancy outcome might include advanced maternal age,intensive workload,frequent pregnancy,history of spontaneous abortion,severe morning sickness,and sickness during pregnancy or progestation.Multivariate Logistic regression analysis showed that high education level of gravida (OR=0.63,95% CI:0.50-0.80)was the protective factor of adverse pregnancy outcomes;severe morning sickness (OR=2 .1 3 ,9 5% CI:1 .6 3-2 .7 9 )and sickness during progestation (OR=2.25,95% CI:1.06-4.77)were the risk factors for maternal adverse pregnancy outcomes.Conclusion The level of maternal education should be improved.We should attach great importance to preventive education and thorough treatment of severe morning sickness. Couples should be encouraged to have physical examination before marriage and pregnancy.Corresponding pregnancy care guidance should be given to pregnant women with different physical conditions so as to effectively reduce the occurrence of adverse pregnancy outcomes.

BACKGROUND:The production and release of a large amount of inflammatory factors caused by immune system inflammatory response mainly contributes to secondary spinal cord injury. OBJECTIVE:To investigate the effects of umbilical cord Wharton’s jely mesenchymal stem cel transplantation on repair of injured neurological function and expression of inflammatory factors monocyte chemoattractant protein 1 and interleukin 10 in rats with acute spinal cord injury. METHODS: Eighty-one healthy adult male Sprague-Dawley rats were randomly and equaly divided into sham operation, model and cel transplantation groups, with 27 rats per group. Rats in the latter two groups were subjected to hemisection of the spinal cord to establish acute spinal cord injury models. Rat models in the cel transplantation group received umbilical cord Wharton’s jely mesenchymal stem cel injection (1×106)via the tail vein. Rat neurological function was evaluated using the BBB score at different time points after spinal cord injury. The expression of monocyte chemoattractant protein 1 and interleukin 10 in injured spinal cord tissue was detected using ELISA assay at different time points after spinal cord injury. Migration and neuronal differentiation of umbilical cord Wharton’s jely mesenchymal stem cels in the injured spinal cord tissue were determined using immunohistochemical staining method. RESULTS AND CONCLUSION:Compared with the sham operation and model groups, rat neurological function was significantly recovered in the cel transplantation group (P < 0.05). Compared to the model group, monocyte chemoattractant protein 1 level in the serum and monocyte chemoattractant protein 1 mRNA and protein expression in the injured spinal cord tissue were significantly lower (P < 0.05), but interleukin 10 mRNA and protein expression in the injured spinal cord tissue was significantly higher (P < 0.05), in the cel transplantation group. In the cel transplantation group, umbilical cord Wharton’s jely mesenchymal stem cels could migrate to the injured region and express glial fibrilary acidic protein. These findings suggest that umbilical cord Wharton’s jely mesenchymal stem cels promote rat neurological function recovery by regulating the inflammatory response in the injured spinal cord tissue, which is likely to be one of mechanisms by which transplantation of umbilical cord Wharton’s jely mesenchymal stem cels treats spinal cord injury.

Objective To study the correlation between the electrophysiological features and mechanical ventilation and long?term outcome in Guil?lain?Barré syndrome(GBS)patients. Methods Electrophysiological and clinical data were retrospectively collected,and compared between venti?lated and not ventilated patients,as well as among each subtype of GBS. Results Totally 38 GBS patients were included in the study,among which 12(32%)were ventilated. The p/d CMAP ratio of the common peroneal nerve was significantly lower in ventilated group compared to not ventilated group(48.7±15.3 vs 80.8±24.0,P=0.005). AIDP was the most common subtype in ventilated patients compared with AMAN and undetermined (46%vs 0%and 9%,P=0.027). The long?term outcome score of AMAN was significantly lower than AIDP(4.3±1.3 vs 2.5±0.9,P=0.028). Conclusion Electrophysiological testing was predictive for mechanical ventilation and long?term outcome:low p/d CMAP ratio of the common pero?neal nerve was helpful for predicting mechanical ventilation,AIDP was prone to develop respiratory failure and had a worse outcome compared to AMAN.

Objective To investigate the nutritional management level of Department of Clinical Nutrition in elderly inpatients through analyzing the actual hospital dietary intakes in elderly inpatients in Peking Union Medical College Hospital from 2013-2015.Methods Using continuous sampling, the nutrients contents and the eating rates of hospital meals ordered by the elderly inpatients on the 1st, 15th, 29th of every month from May 2013 to October 2015 were selected.The intake levels of energy, protein, calcium, vitamin A, vitamin B1 , and vitamin C were calculated and compared with the Chinese dietary reference intakes (DRIs).The nutritional in-take differences between diabetes diet and the basic hospital diet were also compared.Results A total of 90 days of hospital dietary data from 8 402 elderly inpatients were included in the study.The average eating rate was (50.1 ±4.2)%, which was lower than the general eating rate of the hospital [ (59.0 ±4.0)%, P<0.001]. Only protein intake from hospital diet reached the requirement target [male (103.1 ±47.3)%, femal (98.3 ± 33.8)%].Individual compliance rates were 63.2%and 59.8%, respectively, while the other kinds of nutrients were lower.The compliance rates of energy [ (73.3 ±26.3)%vs.(62.1 ±38.2)%, P<0.001] and ma-jor nutrient intake [ protein: ( 119.1 ±41.2 )% vs.( 93.3 ±65.1 )%, P <0.001; calcium: ( 55.5 ± 26.7)% vs.(34.3 ±34.2)%, P <0.001; vitamin A: (75.2 ±48.3)% vs.(57.4 ±97.1)%, P<0.001;vitamin B1:(76.4 ±38.2)%vs.(52.1 ±46.6)%, P<0.001;vitamin C:(92.2 ±51.4)%vs. (49.3 ±55.0)%, P<0.001) in diabetes diet group were significantly higher than those in the basic hospi-tal diet group.Conclusions The nutritional intakes from hospital diets may not meet the nutritional require-ments based on DRIs in elderly inpatients.Medical diet designed by physicians and dietitians should be ex-panded to improve the nutritional management level for these patients.

Objective To retrospectively study the clinical and electrodiagnostic features in subacute combined degeneration of spinal cord (SCD)patients. Methods The clinical and electrodiagnostic recordings of all SCD patients conformed in our Neurology Department from Janu?ary 2013 to July 2015 were retrospectively reviewed. Totally 29 patients diagnosed as SCD,whom received no treatment before admitted in our hos?pital,were recruited for the study. Correlation analysis between serum level of vitamin B12(VB12),course of disease and degree of neural lesion was performed,and the electrodiagnostic features were summarized and analyzed. Results The course of disease had significant correlation with the degree of neural lesion(P=0.001),but there was no significant relevance between serum VB12 level and neural damage(P>0.05). Electrodi?agnostic examination revealed:The abnormal rate of motor nerve(15.20%)was lower than that of sensory nerve(42.75%,P<0.001)and the up?per limb nerve(27.1%)was lower than that of lower limb nerve(30.87%,P=0.578). There was no remarkable difference of abnormal rate in all kinds of nerves of motor and sensory nerve(P1=0.320,P2=0.755). In the analysis of the parameters of electromyograph,there was statistical signif?icance of the abnormal rates of compound muscle action potential(CAMP)between each motor nerve(P=0.005). There was statistical signifi?cance of the abnormal rates of CAMP and no function between each sensory nerve(all P<0.001). Conclusion The course of disease has signifi?cant correlation with the degree of neural lesion. Sensory nerve is tended to be betreffend than motor nerve. Phil.always nervous are more likely to be affected than others in motor nerve at CAMP. Tibial nerve is easier to be influenced at CAMP in sensory nerve ,and the lesion is more serious.

Objective:The roles of HMGA2 in maintaining malignant phenotypes of the osteosarcoma U2OS cells was studied to explore the possibilities for it to be developed as a target for gene therapy.Methods:U2OS cells were stably transfected with a DNA based shRNA expression vector which targeted to HMGA2.The expression of HMGA2 mRNA was proved by RT-PCR;Cell growth,migration and apoptosis were determined with CCK8,hoechst33342 staining and Boyden ventricle,respectively.The mRNA levels of Caspase 3 and Caspase 9 were determined by real time quantitative RT-PCR.Results:The transfection with shRNA expression vector significantly decreased HMGA2 mRNA levels of U2OS cells.Cell growth and migration were decreased,but apoptosis and the mRNA levels of Caspase 3 and Caspas 9 were increased following the decrease of HMGA2 mRNA.Conclusion:The abnormal expression of HMGA2 plays an important role in maintaining the malignant phenotypes of U2OS cells.Gene therapy targeted to HMGA2 could be helpful in the treatment of human osteosarcoma.

Objective To measure the total β radioactive background level in the urine of normal adults,and to establish the method which can be universally used and satisfy the needs of rapid screening of samples in large batch.Methods A total of 83 urine samples from healthy adults were prepared by evaporation.And the gross β activity in urine was detected by using low background measuring instrument.Results The optimal experimental conditions were in place.The sampled volume was 200 ml,and the samples were turned to nitric acid salinization,ashed at 300℃ for 2 h,and the measured time was 1000 min.To get a more stable result,the urine residues were put aside for 24 h before measurement.The radioactivity in urine of healthy adults was between 9.40-55.92 Bq/L,and showed no correlation with age and sex.Conclusions When the radioactivity in urine is detected under the conditions mentioned above,the sample preparation process is simple and quickly,which can satisfy the needs of large batch sample screening.

Objective:To discuss the oncologic safety, aesthetic outcome, and upper extremity function of single-port insufflation endoscopic nipple-sparing mastectomy (SIE-NSM) in the treatment of early breast cancer.Methods:From January 2014 to August 2019, a total of 80 patients with stage Ⅰ and Ⅱ breast cancer underwent SIE-NSM, at Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed and followed up. Estimated the oncologic safety, aesthetic outcome, and upper extremity function.Results:SIE-NSM was performed successfully on all 80 patients.There was no serious complication after surgery.The follow-up time was 16-82 months and the median follow-up time was 42 months. Local recurrence occurred in two patients, and there was no distant metastases. Four (5%) patients developed grade 1-3 nipple-areola complex ischemia. There were no cases of subcutaneous effusion.The satisfaction with breasts, chest well-being, psychosocial well-being, and sexual well-being scores were confirmed to be highly rated by Breast-Q scale. Upper extremity function score confirmed that good upper limb function was preserved after surgery. The mean length of incision was (3.6±0.8) cm, and the blood loss was (24.7±19.3) mL.Conclusions:SIE-NSM can achieve a higher cosmetic score and a better recovery of upper limb function on the premise of ensuring the safety of the tumor.This novel method is an appropriate surgical option for patients with early breast cancer.

Objective To observe the effects of Dong's Extraordinary Acupoints acupuncture and rehabilitation on upper limb spastic hemiplegia after stroke. Methods 105 patients with upper limb spastic hemiplegia after stroke were randomized into 3 groups as groups A, B, C equally, and receiving Baclofen and rehabilitation training, acupuncture at Dong's Extraordinary Acupoints, and both acupuncture at Dong's Extraordinary Acupoints and rehabilitation training for 8 weeks, respectively. They were assessed with China Stroke Scale (CSS) and modified Ashworth Scale (MAS) before and after treatment Results The CSS and MAS scores obviously improved after treatment in each group (P<0.01), and improved more in the group C than in the group A and B for CSS (P<0.05). Conclusion Both acupuncture at Dong's Extraordinary Acupoints and rehabilitation can improve the neural function and upper limb muscle tension in patients with upper limb spastic hemiplegia after stroke, with the synergistic effects.

Objective:To evaluate the nutritional status of patients in intensive care unit (ICU) by using nutritional risk screening 2002 scale (NRS2002), subjective general assessment (SGA) and critical illness nutritional risk score (NUTRIC), and to compare the characteristics and applicability of three scoring tools.Methods:A cross-sectional survey was conducted. 315 patients admitted to the comprehensive ICU of Affiliated Qingdao Municipal Hospital of Qingdao University from April 2018 to July 2019 were enrolled. Basic information of patients was collected, and patients were divided into two groups with 65 years old as the standard to compare the nutritional status of patients among different genders and ages. The nutritional status of patients were assessed by NRS2002, SGA, and NUTRIC. Height, weight, body mass index (BMI), triceps skinfold thickness (TSF), upper arm circumference (AC), leg circumference (LC), and other related parameters of human nutrition were measured. Total protein (TP), albumin (Alb), prealbumin (PA), serum creatinine (SCr), blood urea nitrogen (BUN), total cholesterol (TC), triglyceride (TG), total number of lymphocytes (LYM), hemoglobin (Hb), C-reactive protein (CRP) and other blood biochemical indicators were performed. Spearman rank correlation analysis was used to analyze the correlation between the three nutrition evaluation scales and other objective nutrition parameters. Binary multivariate Logistic regression analysis was used to evaluate the influencing factors of nutritional status with three scales of patients in ICU.Results:Among 315 patients in ICU, 183 were male and 132 were female. There were 143 patients < 65 years old and 172 ≥ 65 years old. In male patients, the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, age and BUN of patients aged ≥ 65 years old were significantly increased, and the height, weight, BMI, TSF, AC, LC, Alb and PA were significantly lowered as compared with those aged < 65 years old, while the difference in other indicators was not statistically significant. In the female patients, the APACHEⅡ score, age, SCr and BUN of the patients aged ≥ 65 years old were significantly increased, the height, Alb, PA and Hb were significantly decreased as compared with those aged < 65 years old, and the difference in other indicators was not statistically significant. The proportion of patients with nutritional risk evaluated by NRS2002 (NRS2002 score ≥ 3) was 87.62% (276/315). SGA showed that the proportion of malnourished patients (SGA was grade B or C) was 62.86% (198/315). NUTRIC showed 66.03% of patients (208/315) in high nutritional risk (NUTRIC score ≥ 5). Spearman rank correlation analysis showed that there were significant correlations among NRS2002, SGA and NUTRIC of patients in ICU ( rNRS2002 with SGA = 0.522, rNRS2002 with NUTRIC = 0.392, rSGA with NUTRIC = 0.442, all P < 0.01). Among the three assessment tools, SGA had the best correlation with blood biochemical indicators and body measurements to assess nutritional status, followed by NRS2002, and NUTRIC had the worst correlation. Binary multivariate Logistic regression showed that APACHEⅡ score, BMI, AC, BUN and TG were factors influencing NRS2002 assessment of nutritional status in ICU patients [odds ratio ( OR) were 2.535, 0.404, 1.438, 0.858, and 2.391, respectively, all P < 0.05]; APACHEⅡ score, age, weight, TP, BUN, LYM and CRP were influence factors of SGA for evaluating the malnutrition of patients in ICU ( OR values were 1.074, 1.038, 0.921, 0.947, 1.077, 1.625 and 0.991, respectively, all P < 0.05); APACHEⅡ score, age, LYM and CRP were the influence factors of NUTRIC assessment for malnutrition of patients in ICU ( OR values were 1.159, 1.049, 0.715 and 0.995, respectively, all P < 0.05). Conclusions:The nutrition status of ICU patients evaluated by NRS2002, SGA and NUTRIC was simple and easy to operate, and the positive screening rate of NRS2002 was the highest, which was suitable for patients with mild conditions in ICU. SGA is the most valuable tool to evaluate the nutritional status of ICU patients. NUTRIC has a poor correlation with objective indicators reflecting nutritional status, while its indicators are objective and easy to obtain, which is suitable for ICU patients with critical condition and unclear consciousness. Nutritional assessment tools should be integrated with the patient's gender, age, anthropometric and biochemical indicators.