Objective:To investigate the clinical value of emergency cervical cerclage combined mesh patch suture in the treatment of cervical incompetence.Methods:From January 2011 to August 2016 in our hospital 65 cases of pregnant women with inevitable abortion,32 cases of they had carried out emergency cervical cerclage combined mesh patch suture(group A),33 cases of they had carried out cervical cerclage only(group B),The prolongation of gestation time,delivery gestational age,neonatal outcome,delivery mode and postoperative complications were compared between the two groups.Results:The operation time of A group was higher than that of group B,surgical complications of cervical laceration in group A was less than B group,the difference was statistically significant(P ＜ 0.05);there was no significant difference in the incidence of chorioamnionitis between the two groups(P＞0.05);the gestational age of group A was extended to 84.45 ±35.77 days,and the gestational age of B group was extended to 51.86 ±29.93 days,there was statistically significant difference between the two groups(P＜0.05);there was more than 28 weeks delivery in 23 cases(71.88％) in group A,and 17 cases (51.52％) in group B,the difference was statistically significant(P ＜ 0.05);there were no statistically significant differences in the delivery mode between the two groups(P ＞ 0.05);neonatal birth weight,birth Apgar 1 minutes score of group B were significantly lower than those of group A,the difference was statistically significant (P ＜0.05).Conclusions:Emergency cervical cerclage combined mesh patch suture can effectively prolong the gestational age,improve neonatal outcome,no obvious complication and has certain clinical applicative value.

Objective To evaluate the effect of sitaxsentan on renal microcirculation in beagle dogs undergoing cardiopulmonary bypass(CPB)when ultrasound microbubble angiography was used to monitor renal microcirculation.Methods Eighteen male Beagle dogs,weighing 10-15kg,aged 2-4 yr,were allocated into 3 groups(n=6 each)using a random number table:sham operation group(Sham group),CPB group and sitaxsentan group(S group).Sitaxsentan 0.7 mg/kg was infused over 30min starting from 1 h before CPB in group S.Before CPB(T1),at 1 h of CPB(T2),at the end of CPB(T3)and at 2h after the end of CPB(T4),the time-intensity curve of renal parenchyma perfusion was obtained using ultrasound microbubble angiography,and quantitative parameters including the slope rate of ascending curve(A),area under curve(AUC),derived peak intensity(DPI)and time to peak(TTP)were fitted.Results Compared with Sham group,the value of A was significantly decreased at T2-4,AUC and TTP were increased at T3,4,DPI was decreased at T4 in renal cortex and medulla in CPB group,and the value of A was significantly decreased and TTP was increased at T2-4,AUC was increased at T3,4(P<0.05),and no significant change was found in DPI in renal cortex and medulla in S group(P>0.05).Compared with CPB group,the value of A was significantly increased and AUC and TTP were decreased at T3,4 in renal cortex and medulla(P<0.05),and no significant change was found in DPI in renal cortex and medulla in group S(P>0.05).Conclusion Sitaxsentan can improve renal microcirculation in beagle dogs undergoing CPB.

Objective To detect the expression of ITGB1 in the serum and placenta of pregnant women with preeclampsia and its clinical significance. Methods A total of 150 pregnant women with sever or mild pre-eclampsia and normal pregnant women were collected. The expression change of ITGB in the serum and placenta was detected by real-time PCR. The correlation between the expression of serum ITGB1 and clinical symptoms in normal pregnant women and pregnant women with preeclampsia was explored. Results There was significantly high expression of ITGB1 in the serum and tissue of patients with preeclampsia and placenta and the expression of ITGB1 in patients with preeclampsia and normal pregnant women was positively correlated (P = 0.011). The expression level of serum ITGB1 was positively correlated with systolic blood pressure,diastolic blood pressure,24 h urine protein and vascular disease. Serum ITGB1 was used as a diagnostic marker for preeclampsia,with an AUC of 0.751 ,a specificity of 81% and a sensitivity of 75%. Conclusion ITGB1 is involved in the occurrence and development of preeclampsia,and is positively correlated with clinical symptoms. The expression of serum ITGB1 can be used to predict the occurrence of preeclampsia.

Background and purpose:In recent years, energy-based instruments have been widely used in today’s open surgeries. Harmonic Focus? (HF) and Ligasure Small Jaw? (LSJ) are both custom-made for thyroid open surgery. This study aimed to explore the effcacy and safety of HF and LSJ in open thyroidectomy.Methods:The data from patients who undertook total thyroidectomy with central neck dissection by the same surgeon during last year in this hospital were reviewed. HF was used in 100 patients, and LSJ was used in 104 patients. The effectiveness was appraised by comparing operation time and postoperative volume of drainage on the ifrst postoperative day. The safety was appraised by comparing the incidence of postoperative complications.Results:The results of the effectiveness:the average duration of operation was (95.8±18.0) min for HF group, and (97.8±19.1) min for LSJ group, there was no statistical signiifcance (P=0.363). Postoperative volume of drainage on the ifrst postoperative day was (35.2±20.3) mL for HF group, and (36.3±23.8) mL for LSJ group, there was no statistical signiifcance (P=0.977). One patient (1.0%) had temporary vocal cord paralysis in HF and one had postoperative hematoma (1.0%) in LSJ group. Temporary hypo-parathyroidism was detected in 18 patients (18.0%) of HF group, and 16 patients (15.4%) of LSJ group. The decline of parathyroid hormone during the ifrst postoperative day was (12.3±12.8) pg/mL in HF group, and (13.9±13.4) pg/mL in LSJ group. The decline of serum calcium was (0.20±0.13) mg/dL in HF group, and (0.20±0.16) mg/dL in LSJ group. There were all no statistical signiifcances (P>0.05).Conclusion:Both HF and LSJ are safe and effective in open thy-roidectomy without similar operative complications.

Objective To compare the clinical efficacy of extra vascular occlusion of low abdominal aorta and low abdominal aorta balloon occlusion in the treatment of placenta previa with placenta previa.Methods From January 2014 to July 2017,68 implantable placenta previa patients were divided into two groups,elective cesarean section of extra vascular occlusion of low abdominal aorta in 34 cases(group A)and cesarean section on the lower abdominal aorta balloon occlusion in 34 cases(group B),and observation of pregnant women was compared between surgery of two groups. Results Operation time,complications of vascular injury and thrombosis,fetal radiation exposure in group A were significantly lower than that of group B(P<0.05);two groups of patients with sensory dysfunction incidence,cesarean operation time,intraoperative blood loss,blood transfusion rate,the uterus resection rate,hospitalization time had no statistically significant difference postoperatively(P > 0.05). Conclusion Two kinds of operation can safely and effectively reduce the bleeding during the treatment of placenta previa. While group A surgery operation time is short,without intraoperative and postoperative bleeding of the puncture site,without pelvic and lower extremity arterial thrombosis,without X-ray exposure,more safety of the womb and can be popularized in clinic.

Objective:To analyze the application value of autophagy related molecular markers in placenta tissue in predicting fetal growth restriction in pregnant women with preeclampsia.Methods:A total of 46 pregnant women admitted to Changsha Hospital for Maternal and Child Health Care from January 2021 to August 2023 were collected. A cross-sectional study was conducted, and they were divided into a normal delivery group (control group, 23 cases) and an observation group with preeclampsia combined with fetal growth restriction (observation group, 23 cases) based on pregnancy outcomes. Transmission electron microscopy was used to observe the occurrence of autophagic vesicles in trophoblast cells in the placental tissue of both groups; The expression of Beclin-1, LC3, and P62 in placental tissues of two groups was detected by immunohistochemistry, real-time fluorescence quantitative polymerase chain reaction (qRT-PCR), and Western blot.Results:The transmission electron microscopy results showed that the presence of autophagic vesicles could be observed in the placental trophoblast cells of both the control group and the observation group, but the number of autophagic vesicles in the trophoblast cells of the observation group was higher than that in the control group ( P<0.05). The immunohistochemical results showed that the colorimetric values of Beclin-1 and LC3 in the placental tissue sections of the observation group were higher than those of the control group (all P<0.001), while the colorimetric values of p62 were lower than those of the control group ( P<0.001). The qRT-PCR and Western blot results showed that the mRNA and protein expression levels of Beclin-1 and LC3 in the observation group were significantly higher than those in the control group (all P<0.001), while the expression levels of p62 mRNA and protein were lower than those in the control group (all P<0.001). Conclusions:The autophagy activity of placental tissue trophoblasts in patients with preeclampsia combined with fetal growth restriction is enhanced, indicating a close correlation between elevated autophagy levels and the occurrence of preeclampsia combined with fetal growth restriction. Excessive autophagy may be involved in the occurrence of preeclampsia combined with fetal growth restriction.

Objective To study clinicopathologic factors related to central lymph node (CLN) metastasis in different subregions for unilateral papillary thyroid carcinoma (PTC) with clinical N0.Methods A total of 145 PTC cases with clinical N0 treated in the same group of the department of head and neck surgery,Cancer Hospital,Chinese Academy of Medical Science between Jan.2011 and Jan.2014 was analysed retrospectively.Clinicopathologic factors related to CLN metastasis in different subregions were analyzed,including sex,age,tumor size,extrathyroidal extension,and multifocal tumor.Results CLN metastases existed in 57.9％ (84/145) cases and the incidences of ipsilateral paratracheal,pretracheal,and prelaryngeal metastasis were 53.8％,24.1％ and 11.3％ respectively.Right paratracheal lymph node metastasis occurred in anterior (17/38,44.7％)and posterior(12/38,31.6％) to the recurrent laryngeal nerve.Multivariate analysis indicated that extrathyroidal extension(OR =4.49,95％ CI 1.80-11.20,P =0.001) and tumor size (OR =2.17,95％ CI 1.06-4.45,P =0.034) were independent risk factors for ipsilateral paratracheal CLN metastasis ;ipsilateral paratracheal CLN metastasis(OR =2.12,95％ CI 0.08-4.60,P =0.003) was an independent risk factor for pretracheal CLN metastasis.Conclusions A high risk of CLN metastasis especially ipsilateral paratracheal metastasis exists in DTC with clinical N0.Ipsilateral paratracheal,pretracheal and prelaryngeal CLN dissection should be conducted when maximum tumor diameter more than 1 cm or extrathyroidal extension.CLN anterior and posterior to the recurrent larygeal nerve should be removed simultaneously when the ipsilateral paratracheal CLN metastasis at right side.Total thyroidectomy and contralateral paratracheal CLN dissection should be conciderded in multifocal tumor.

Lateral flow immunoassay (LFIA) is a rapid detection technique that allows researchers to move the antigen-antibody reaction from a test tube or laboratory vessel to a test strip. Due to the chromatographic effect of the test strip, the solution would move to a specified direction based on the test and complete the whole antigen-antibody specific reaction. A qualitative judgment can be made with the naked eye by observing the color change of the reagent strip at a specific location. Because of its advantages of being fast, simple, specific, inexpensive, and requiring no specialized personnel, LFIA is now widely used in medical testing, food quality monitoring, environmental monitoring, agriculture and animal husbandry. A major bottleneck for the development of LFIA technology is the hook effect. This paper summarizes the current methods, means and research progresses to combat the hook effect, hoping to provide a strong technical reference for researchers to design test strips, select suitable nanoparticles, and achieve quantitative LFIA detection.

Objective: To analyse the postoperative metastasis or recurrence of cervical lymph nodes in individual neck levels for papillary thyroid carcinoma and to evaluate the outcomes and complications of re-surgery. Methods: A retrospective cohort study of 259 patients who underwent lymph node dissection for PTC relapse from January 2010 to June 2011. Lymph node metastases in each of neck levels were detected, postoperative complications were evaluated, and the patients were followed up with examining thyroglobulin levels to assess the therapeutic effect.Continuous variables were compared with t test.Categorical variables were compared with Fisher′s exact test. Results: Lymph node metastasis was found in 259 cases and lymph node metastasis rates in levels Ⅱ, Ⅲ, Ⅳ, Ⅴ and Ⅵ were 43.2%, 50.2%, 45.6%, 8.1% and 59.1% respectively. In 44 cases received the neck dissection of level Ⅱ, the metastasis rates in the levels Ⅱa and Ⅱb were respectively (52.3% vs 18.2%, P=0.887). Recurrence in unilateral lateral neck was more common than that in bilateral lateral neck (73.1% vs 20.6%, P<0.001). The lymph nodes in lateral neck were more likely to metastasize than those in central region (80.7% vs 59.1%, P<0.001). There were 47 cases (18.1%) had postoperative complications, including 10 cases with permanent hypocalcemia. Conclusions The scope of re-operation for neck metastasis or recurrence in papillary thyroid carcinoma should include the dissection of levels Ⅱ-Ⅳ and Ⅵ. The incidence of postoperative complications for re-surgery is high, and re-surgery should be performed by experienced surgeon.

OBJECTIVE To systematically evaluate the risk factors for cefoperazone/sulbactam-induced coagulation dysfunction in adult patients. METHODS Retrieved from CNKI， VIP， CBM， Wanfang data， PubMed， Embase and Cochrane Library， randomized controlled trial （RCT）， case-control study or cohort study about cefoperazone/sulbactam-induced coagulation dysfunction in adult patients were collected from the inception to Apr. 30th， 2023. After literature screening， data extraction and quality evaluation， meta-analysis was carried out by using RevMan 5.3 software. RESULTS A total of 13 studies were included， among which 11 studies were case-control studies， and 2 studies were cohort studies， involving 18 387 patients in total. Meta- analysis showed that the proportion of advanced age [OR＝2.04， 95%CI （1.14， 3.64）， P＝0.02]， liver insufficiency [OR＝5.95， 95%CI （4.21， 8.40）， P＜0.000 01]， renal insufficiency [OR＝3.51， 95%CI （3.04， 4.05）， P＜0.001]， hypoproteinemia [OR＝ 1.90， 95%CI（1.37， 2.62）， P＜0.001]， poor diet [OR＝7.25， 95%CI （5.13， 10.24）， P＜0.000 01]， daily dose of cefoperazone/ sulbactam ≥9 g [OR＝3.95， 95%CI （2.45，6.37）， P＜0.001]， medication duration of cefoperazone/sulbactam ≥10 d [OR＝2.43， 95%CI （1.81， 3.28）， P＜0.001]， combined use of anticoagulant drugs [OR＝2.84， 95%CI （2.03， 3.97）， P＜0.001]， combined with malignant tumor [OR＝1.60， 95%CI （1.20， 2.15），P＜0.001] in patients with abnormal coagulation function were significantly higher than those with normal coagulation function. CONCLUSIONS Advanced age， liver insufficiency， renal insufficiency， complicated with malignant tumors and hypoalbuminemia， combined use of anticoagulant drugs， poor diet， daily dose ≥9 g， and medication duration≥10 days are risk factors for coagulation dysfunction caused by cefoperazone/sulbactam.