Objective To investigate rational management for pregnant women with intermediate risk of Down syndrome (DS) through a retrospective analysis of second trimester maternal screening results for DS.Methods Second-trimester triple maternal serum screening for DS was performed.High risk ( ≥ 1/270) pregnant women received prenatal diagnosis.Intermediate (1/1000 to 1/270) and low (＜1/1000) risk pregnant women received routine obstetric examination.Data of ultrasound diagnosis,karyotype analysis of amniotic fluid and postpartum follow-up were collected.Outcomes of pregnant women were retrospectively analyzed.The incidences of DS among three groups were compared.Data of different groups were compared with Fisher exact or Chi-square test.Results Eighty-six thousand eight hundred and seventy-four pregnant women accepted maternal serum screening and outcomes of 86 126 cases were followed up,among which 4342 cases were DS high risk,8196 intermediate and 73 588 low risk.The incidence of DS was 6.22‰(27/4342) for high risk,0.73 ‰ (6/8196) for intermediate risk and 0.04 ‰ (3/73 588) for low risk group.The incidence of DS was higher in high risk group than in intermediate risk group (Fisher exact probability,P=0.000),and was higher in intermediate risk group than in low risk group (Fisher exact probability,P=0.000).Comparison among the three subgroups within intermediate risk group showed no significant differences (x2 =0.047,P =0.977).Conclusions Pregnant women with intermediate risk of DS should be paid more attention.Reasonable management such as ultrasound diagnosis and prenatal consultation should be provided.

The duck circovirus (DuCV) infection in sick ducks from Fujian Province was investigated. The liver samples of 43 sick Muscovy ducks with infectious serositis were collected from 12 duck farms in Fujian Province.Based on the published sequences of DuCV, two primers were designed for the detection of DuCV and four pairs of primers were designed to amplify four overlapping fragments that cover the complete genome of DuCV. The specific PCR products were amplified from positive samples. The fragments were then cloned into pMD18-T vector and sequenced, and the full length genomic sequence of the FJ0601 isolate of DuCV was obtained. PCR analysis showed that the proportion of ducks which were positive for circovirus was 79% and 10 out of the 12 farms were positive. Sequence analysis showed that the complete genome of DuCV-FJ0601 was 1988 bp and possessed features common to the family Circoviridae which included a stem-loop structure and the Rep protein motifs. Homology analysis showed that FJ0601 isolate of DuCV had 97.3%～97.5% nucleotide sequence identity to all the four Taiwan isolates (TC1/2002, TC2/2002, TC3/2002, TC4/2002), 82.9% identity to the America (33753-52) isolate and 82.3% identity to the Germany isolate. Phylogenetic analysis with Clustal W, however,showed that FJ0601 isolate of DuCV was on a common branch with Taiwan isolates, and Germany and America isolates belonged to the other branch.

Objective To explore the relationship between bone mineral density(BMD) and body tat disrribution in the aged in Ningbo area of China. Methods The BMD of lumbar vertebra and total body bones as well as body composition were measured by dual-energy X-ray absorptiometry (DXA) in 61 aged males, and also in 63 aged females as control group. Results In the aged males, a negative correlation was found between BMD and age, while BMI, muscle, trunk fat were positively correlated with BMD. As for the aged female, age, BMI, muscle and fat were all positively correlated with BMD. Conclusions The correlation between body fat and BMD is closer in females than in males in the aged. There is a positive correlation between trunk fat and lumbar spine BMD, and it indicates that central obesity may have a protective effect on lumbar spine BMD.

Objective To analyze the related factors associated with the effect of Roux-en-Y gastric bypass in Goto-Kakizaki rats.Methods In GK rats undergoing Roux-en-Y gastric bypass,the weight,food intake,and the fasting blood glucose were retrospectively analyzed before surgery and 1,3,6,12,24 weeks after surgery,and the glycosylated haemoglobin concentrations were retrospectively analyzed before surgery and 4,12,24 weeks after surgery.According to preoperative glycosylated haemoglobin concentrations,GK rats were divided into 3 groups(group A,HbAlc 6.5％-7.9％; group B,HbAlc 8.0％-9.9％ ; group C,HbAlc ＞ 10％).Results The fasting blood glucose and the glycosylated haemoglobin concentrations significantly decreased 1 week after surgery(P ＜ 0.01),on 24 weeks after operation,the fasting blood glucose levels decreased from(12.1 ± 3.0)mmol/L to(7.6 ± 1.3)mmol/L,and the glycosylated haemoglobin concentrations declined from(9.2％ ± 1.8％)to(6.3％ ± 0.8％).Preoperative fasting blood glucose was(11.1 ± 2.2)mmol/L and(15.8 ± 2.3)mmol/L respectively,and the preoperative glycosylated haemoglobin concentration was(8.6％ ± 1.4％)and(11.5％ ± 1.4％)respectively(P ＜ 0.01).Non-conditional Logistic regression analysis identified preoperative glycosylated haemoglobin concentrations as an independent predictor for the cure rate(P ＜ 0.01); Differences were significant between group A and group C,and group B and group C on the efficiency of the surgery(P ＜0.01).Conclusions Significant correlation established between glycosylated haemoglobin concentrations and the efficiency of the surgery,especially for those rats with preoperative HbAlc ＜ 10％.

Objective To analysis and summary the chromosome abnormal existing in old pregnant women from 2002 to 2013,and to provide basis for clinicians intervene the fetus with chromosome disorders.Methods The 4 539 pregnant women in Ningbo city from 2002 August to 2013 October accepted the fetal karyo type detection,were retrospective analyzed,the frequency of abnormal chromosomal karyotypes was calculated according to different age groups,and the pregnancy outcomes of the old pregnant women were followed up.Thechi-square testswere performed on the frequency dateof the abnormal chromosome karyotype,polymorphism,and serum screening of high risk for fetal chromosome detection of less than 35-years-old pregnant women.Results The total of advanced maternal age pregnancyduring the past 11 years in Ningbo City is 32 080,and the follow-up rate was 99.90％,there are 10 infants borned with chromosomal abnormalities,the 1 290 caseswere detected withadverse pregnancy.A total of 4 539 advanced maternal age pregnancyaccepted amniocentesis,in those we found 107 cases of chromosome abnormality fetus,116 cases of polymorphism.A total of 5 232 high-risk pregnant women accepted the serum screening in the same period (less than 35 years old),finding 135 cases of fetal chromosome abnormal and 69 cases of polymorphism.Conclusion To strengthen the prenatal diagnosis,especially for puerperae above the age of 39,will lower the birth rate of infants with chromosome disease and will be conducive to the high quality of population in Ningbo.

Objective To analyze the clinical value of ultrasound and ultrasound-guided core needle biopsy ( UNB) in the evaluation of axillary lymph node metastasis for breast cancer.Methods A total of 454 cases of breast cancer treated between June 2008 and August 2014 at our hospital were retrospectively analyzed.UNB was performed on patients with abnormal ultrasonic diagnosis of axillary lymph nodes.Among them, 354 cases underwent neoadjuvant chemotherapy or endocrine therapy while 100 cases underwent surgery after UNB.The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and false negative rate of ultrasound and UNB were evaluated.Results Among the 454 patients with abnormal axillary lymph nodes of ultrasound imaging, the metastasis rate with UNB was 70.9%,while the negative rate was 29.1%.Among the 100 cases who underwent surgery after UNB, the metastasis rate was 25% while the ultrasound imaging lymph node longitudinal and transversal ( L/T)≤1.5,the lymph node size>1 cm,and the metastasis rate was 92.3%(12/13).UNB showed that sensitivity was 64.1%, specificity 100%, accuracy 86%, positive predictive value 100%, negative predictive value 81.3%,and false negative rate was 18.7%.The results of UNB seemed consistent with those of postoperative pathological diagnosis, the Kappa value being 0.685.Based on 2 and 3 needles, the above mentioned 6 indices were 50% and 77.8%, 100% and 100%, 77.8% and 92.5%, 100% and 100%, 71.4% and 89.7%,and 28.6%and 10.3%, respectively.The Kappa value of UNB based on 3 needles was higher than on 2 needles (0.822 vs 0.526 ) .Conclusion Ultrasound is a valuable tool for detecting axillary lymph node metastasis in breast cancer.UNB can accurately determine the axillary lymph node metastasis status.UNB based on 3 needles shows a higher accuracy than on 2 needles.

Objective:To study the anatomical correlation between dental arch and the volume of upper airway in patients with obstruc-tive sleep apnea hypoventilation syndrome(OSAHS). Methods: Dental arch architecture and upper airway volume were measured by cone beam CT(CBCT) in the subjects with OSAHS(n=22) and without OSAHS(n=19). The correlation between dental arch and the supper airway volume in OSAHS patients was analyzed. Results:The length of the upper dental arch and the height of palate in OSAHS patients were larger than those of the controls(All, P<0. 05). Cross-sectional area of nasopharynx and retropalatal and the total volume of upper airway were negatively correlated with the palatal height and upper dental arch length(P<0. 05), while positively correlated with upper dental arch of molar regions(P<0. 05). Conclusion:The abnormal shape of upper dental arch is related to the airway vol-ume of nasopharynx and retropalatal region in patients with OSAHS.

Objective To investigate the effects of growth-discordant twin pregnancies on neonatal thyroid stimulating hormone (TSH) level and congenital hypothyroidism (CH).Methods A total of 3 444 live-birth twin neonates born between January 1,2012 and December 30,2014 in Ningbo City were enrolled.Blood samples via heel puncture were collected and tested.Incidence of CH in singleton and twin neonates was compared.Deviation of birth weight larger than 25％ in twin neonates was set as the criteria for discordant growth.TSH and 17 α-hydroxylase levels in CH twins and normal twins,with or without discordant growth,were compared.Chi-square and non-parametric statistics were performed for data analysis.Results The incidence of CH in twin neonates was 0.56％ (19/3 444),higher than that in singleton neonates [0.09％ (203/225 712),x2=76.225,P＜0.01].Among nineteen CH twins,CH occurred in both twins in eight cases (four twins) and in one of the twins in eleven cases.The gestational age at birth in the eight CH twins were less than 37 weeks,with four males and four females;five were low birth weight infants;one twin were dichorionic,and three twins were monochorionic.In the eleven cases of CH occurring in one of the twins,the gestational age was less than 37 weeks in nine cases,eight were low birth weight infants,six were male and five female;seven were monochorionic and four were dichoronic twins.Five cases of temporary hypothyroidism were all low birth weight infants among the growth-discordant twins.CH cases in growth-discordant group had lower birth weight than their normal twins [M(P25-P75),2 100 (1 800-2 600) vs 2 770 (2 530-2 960) g,Z=4.369],and a higher TSH level [15.4 (11.8-18.5) vs 6.4 (4.8-7.9) mU/L,Z=6.339] (both P＜0.05).In normal twins with or without discordant growth,the neonates with a lower birth weight had a higher TSH level [3.6(2.5-4.7) vs 2.4(1.8-2.9) mU/L,Z=0.962] in weight consistent group,compared with 6.0(4.4-7.8) vs 3.4(1.9-4.1) mU/L in weight inconsistent group (Z=4.369),both P＜0.05.Conclusions In the growth-discordant twins,neonates with a lower birth weight have a higher TSH level and a higher risk of temporary hypothyroidism.

With thousands of sequenced 16 S rRNA genes available,and advancements in oligonucleotide microarray technology,the detection of microorganisms in microbial communities consisting of hundreds of species may be possible.The existing algorithms developed for sequence-specific probe design are not suitable for applications in large-scale bacteria detection due to the lack of coverage,flexibility and efficiency.Many other strategies developed for group-specific probe design focus on how to find a unique group-specific probe that can specifically detect all target sequences of a group.Unique group-specific probe for each group can not always be found.Hence,it is necessary to design non-unique probes.Each probe can specifically detect target sequences of a different subgroup.Combination of multiple probes can achieve higher coverage.However,it is a time-consuming task to evaluate all possible combinations.A feasible algorithm using relative entropy and genetic algorithm (GA) to design group-specific non-unique probes was presented.

Objective:To provide scientific evidence for infection prevention and control by analyzing the risk factors of surgical site infection, which can move forward the gateway of infection prevention and control.Methods:The surgery-related information of patients admitted to the Department of General Surgery and Department of Orthopedics, People's Hospital of Guangnan Hospital of Yunnan province from November 2016 to August 2019 was retrospectively analyzed. According to whether postoperative surgical site infection occurred, the patients were divided into an infection group and a non-infection group. Logistic regression model was used to analyze the risk factors of surgical site infection.Results:A total of 9 346 patients, consisting of 117 patients in the infection group and 9 229 patients in the non-infection group, were included for final analysis. In the infection group, the incidence of surgical site infection was 1.25%. Multivariate analysis showed that hypoproteinemia ( OR = 2.585), unclean incision ( OR = 3.243 and 5.125), and operation duration more than 3 hours ( OR = 2.315), blood transfusion ( OR = 2.239), drainage tube placement ( OR = 2.133) and indwelling catheter placement ( OR = 1.973) were the independent risk factors for surgical site infection, while prophylactic use of antibiotics was a protective factor ( OR = 0.383). Conclusion:Individual factors, operation-related factors, and treatment-related factors are closely related to the occurrence of surgical site infection. Much attention should be paid to the clinical issues like preoperative hypoproteinemia, perioperative prophylactic use of antibiotics and postoperative drainage tube and indwelling catheter placement.