Objective To investigate the clinical manifestation and inspection method about abnormal uter-ine bleeding due to cesarean section scar diverticulum.Methods retrospective analysis of 156 abnormal uterine bleeding cases due to cesarean section scar diverticulum.Analysis the relevance ratio,the starting time of clinical symptom,related influencing factors,the information of examine and misdiagnose.Results there are 12 cases cesare-an section scar diverticulum in 2010;30 cases in 2011;26 cases in 2012;37 cases in 2013;51 cases in 2014.The starting time of clinical symptom is 1 ~6 month pose menstrual in 48 cases;6 months to 2 years pose menstrual in 89 cases,2 years later pose menstrual in 19 cases.98 cases don′t have evidential abnormality even through many times ultrasonograph.43 patients subjected diagnosis curettage.The uterine bleeding time obviously longer comparing retro-position of uterus with anteposition and msposition of uterus.Conclusion the morbidity of abnormal uterine bleeding cases due to cesarean section scar diverticulum is low,but the rate of misdiagnosis and missed diagnosis is little high-er.We need to elevate the rate of diagnosis,and to research the preservation and magagement gradually.

Objective To evaluate the incidence of autoimmune thyroid disease (AITD) in systemic lupus erythematosus (SLE) and examine the correlation between AITD and SLE activity.Methods The study group included 220 SLE patients with the screening of thyroid function (FT3,FT4,TSH) and antithyroid autoantibodies (TgAb,TPOAb) were hospitalized into Affiliated Hospital,Jining Medical College between July 2009 and October 2013.The control group included 160 healthy subjects.We compared the prevalence of AITD between SLE patients and normal controls and also the positive rate of anti-thyroid autoantibodies was observed.We also compared the positive rate of anti-thyroid autoantibodies between AITD in SLE and simple SLE group and also analyzed the correlation between two groups of patients and SLE activity (evaluated by the titer of anti-dsDNA,C3,C4,CH50,SLEDAI score).Results Among them,45 patients suffered from AITD (20.5％).There were hyperthyroidism (n =6,13.3％) and hypothyroidism (including subclinical hypothyroidism) (n =26,57.8％),Hashimoto' s thyroiditis (n =13,28.9％).And 74 SLE cases were positive for anti-thyroid autoantibodies.The prevalence of AITD and the positive rate of anti-thyroid autoantibodies in SLE patients (20.5％,33.6％) were higher than that in normal controls (3.13％,7.50％)(P ＜ 0.05).The positive rate of anti-thyroid autoantibodies of SLE with AITD patients (62.2％) was higher than that in simple SLE (21.5％).No significant differences existed in anti-dsDNA titre,C3,C4,CH50 and SLEDAI score between two groups (P ＞ 0.05).Conclusions The SLE patients have a great prevalence of AITD and a positive rate of anti-thyroid autoantibodies.Those with anti-thyroid autoantibodies have a higher incidence of AITD and it has nothing to do with SLE activity.It is essential to monitor thyroid function and thyroid autoantibodies during the follow-ups.

Objective To analyze the blood perfusion modes of retroperitoneal benign and malignant masses by real-time contrast-enhanced ultrasonography (CEUS). Methods Forty-five patients with retroperitoneal masses, including 18 benign and 27 malignant masses, were performed with CEUS. The perfusion of contrast agent, entering style and the vascular patterns of contrast agent were described. And the diagnosis value of perfusion characteristics was evaluated in retroperitoneal benign and malignant masses. Results The perfusion of CEUS showed significant differences in the entering style of contrast agent and the vascular patterns in malignant masses in comparison to benign masses. In the entering style of contrast agent, center enhancement of malignant masses was 70. 37% (19/27), periphery enhancement of benign masses was 72.22% (13/18) ,there was statistical significane in the result( P = 0.0069). To the vascular patterns level,there were 2 with level 0 and 11 with level 1 in benign group, 10 with level 2 and 9 with level 3 in malignant group, there was statistical significane between malignant group and benign group too( P=0.0206). Conclusions CEUS is benefit to improve the accuracy of diagnosis of retroperitonea malignant and benign masses.

Objective To retrospectively analyze the prognostic factors for locoregionally recurrent early?stage extranodal nasal?type natural killer/T?cell lymphoma ( NKTCL) . Methods A total of 56 patients with early?stage extranodal nasal?type NKTCL, who had locoregional recurrence after initial treatment and then received salvage treatment from 1995 to 2014, were enrolled as subjects. The effects of salvage treatment on the overall survival ( OS) rate were analyzed after initial treatment and recurrence. Univariate and multivariate prognostic analyses were performed on the OS rate after recurrence. Results The median follow?up time was 35. 9 months after initial treatment and 14. 8 months after recurrence. The 3?year OS rate was 73% after initial treatment and 58% after recurrence. Compared with chemotherapy alone, radiotherapy?containing salvage treatment significantly improved the OS rates after initial treatment and recurrence ( P=0. 040, 0. 009 ) , and re?irradiation also significantly improved the OS rates after initial treatment and recurrence (P=0. 018, 0. 019). Most (84%) of the acute and late adverse reactions after re?irradiation were grade 1?2 ones. The univariate and multivariate analyses showed that the Karnofsky Performance Status score, radiotherapy in initial treatment, and radiotherapy in salvage treatment were influencing factors for the OS rate after recurrence. Conclusions Radiotherapy achieves improved survival and tolerable toxicities, making it indispensable in the treatment of locoregionally recurrent extranodal nasal?type NKTCL.

ObjectiveTo explore the Apolipoprotein-E （ApoE） gene polymorphism in patients with Alzheimer's disease （AD）, vascular dementia (VD) or mild cognitive impairment (MCI). MethodsPeripheral blood was taken from patient with AD, VD or MCI to determine the ApoE genotypes. ResultsThe most of the patients were ε3/ε3 genotype, while the ε2/ε2 and ε4/ε4 could not be detected. ε3/ε4 genotype （P=0.001） and ApoE ε4 allele （P=0.013） was more frequent in AD than in MCI. ApoE ε4 was more frequent in VD than in MCI （P=0.044）. ConclusionApoE ε4 allele is a risk factor in AD, and may be associated with VD and MCI.

Objective To analyze the blood perfusion characteristics of retroperitoneal benign and malignant tumors by real-time contrast enhanced ultrasonography and discuss its value in the differential diagnosis.Methods The study involved 42 patients with pathological evidence through surgery or needle biopsy,including 12 patients with benign retroperitoneal tumors and 30 patients with malignant retroperitoneal tumors.The blood perfusion characteristics of two groups were observed under low mechanical index after the injection of contrast ultrasound agent(SonoVue),and the changes of twodimensional ultrasonography and the time-intensity curve(TIC)were analyzed. Results During real time contrast enhancement,the different characteristics of retroperitoneal benign and malignant tumors were observed.Malignant tumors in retro peritoneum presented the pattern of ultrasound contrast agent(UCA) enhancement from center to periphery and enhanced overall uneven mainly,begin tumors presented peripheral enhancement pattern or uniformity and overall strengthening of the main.TIC curve between benign and malignant tumors displayed that contrast enhanced intensity of region of interest(P＜0.00 1),ascending slop and halftime of descending were statistically significant(P＜0.05).Conclusions Real-time contrast-enhanced ultrasonography is a valued method to provide information for the differential diagnosis in retroperitoneal benign and malignant tumors.

Objective To quantitative the changing information of estrogen receptor βgene which was in tissue and organ of sex gland during oestrus and dioestrus of Beagles, and to show the different expression situation of hypothalamus-pituitary-gonad axis during oestrus and dioestrus, and providing the basic of theory to research deeply the mechanism of heat of Beagles. Methods As the key gene in regulation reproduction, ERβgene is located in hypothalamus-pituitary-gonad axis, so using Beagles which was in oestrus and dioestrus, and extract the RNA from hypothalamus、pituitary、ovary and uterus respectively,after reverse transcription we detected the expression of ERβgene by real-time quantitative PCR.Results The expression of ERβgene mRNA from ovary、uterus、pituitary、hypothalamus of Beagles which was in dioestrus was 0.35 times, 0.17 times, 0.44 times and 0.43 times than the expression of ERβgene mRNA from ovary, uterus, pituitary, hypothalamus of Beagles which was in oestrus.Conclusion The expression of ERβgene was up-regulation in hypothalamus-pituitary-ovary axis of Beagles which was in oestrus.

Objective: To investigate the current status of screen time in preschoolers during the outbreak of Corona Virus Disease 2019 (COVID-19), and the influences of parent-child active play and school online education on screen time. Methods: A total of 2 370 preschoolers were chosen through clustering sampling from 7 kindergartens in Wuxi urban areas. Questionnaire survey was administered to parents for child screen time, active play, online education as well as characteristics information. Results: A total of 1 428(60.3%) preschoolers reported more than 1 hour screen time a day, and 1 915(80.8%) preschoolers reported more than 20 minutes consecutive screen time. Compared with the weekend before the COVID-19 outbreak, 1 551(65.4%) preschoolers reported an increase of 10 minutes in screen time perday, and 1 444(60.9%) reported an increase of 5 minutes for one sersion. Logistic regression analysis showed that after controlling for confounding factors, high frequency of parent-child active play, parents’ exercise habits, online education from kindergartens and children’s active participation in the online education were negatively associated with preschoolers’ excessive and increased screen time during this period(OR=0.39-0.79, P<0.05). Conclusion During the COVID-19 outbreak, preschoolers’ media use in Wuxi city is worrisome. Parent-child active play, parents’ exercise and online education from kindergartens may play a positive role in reducing preschoolers’ media use.

Objective To study the changes of serum metabolites in the patients with chronic kidney disease osteoporosis(CKD-OP)to provide the new biomarkers for the early diagnosis of CKD-OP.Methods A total of 22 patients with definitely diagnosed CKD visiting in this hospital from April to Novem-ber 2023 were selected as the study subjects,and 22 subjects with physical examination in this hospital at the same period were included for conducting the control study.With the lumbar vertebral T value ≤-2.5 as the standard,the subjects were divided into the CKD-OP group(n=11),CKD non-OP group(CKD-NOP group,n=11),simple osteoporosis group(OP group,n=11)and healthy control group(NC group,n=11).The liq-uid chromatography-mass spectrometry(LC-MS)coupling technique was used to analyze the differences in se-rum metabolites among the four groups,the potential biomarkers of CKD-OP was screened,and the correla-tion between the potential biomarkers with lumbar vertebra bone mineral density(BMD),serum bone-derived alkaline phosphatase(BALP)and serum tartrate-resistant acid phosphatase-5b(TRACP-5b)was studied.Re-sults With the receiver's operating characteristic(ROC)curve's area under curve(AUC)＞0.9 as the con-dition,and four potential biomarkers of CKD-OP were screened,which were phosphorylcholine,lysophosphati-dylcholine(18∶2/0∶0),capric acid,and allantoin respectively.Serum phosphorylcholine was positively corre-lated with lumbar vertebra BMD(r=0.601,P＜0.05)and negatively correlated with serum BALP and TRACP-5b(r=-0.729,-0.623,P＜0.05).Serum allantoin was positively correlated with lumbar vertebra BMD(r=0.483,P＜0.05)and negatively correlated with serum BALB(r=-0.494,P＜0.05).Serum lyso-phosphatidylcholine(18∶2/0∶0)was positively correlated with lumbar vertebra BMD(r=0.640,P＜0.05),and negatively correlated with serum BALP and TRACP-5b(r=-0.628,-0.548,P＜0.05).Serum capric acid was negatively correlated with lumbar vertebra BMD(r=-0.444,P＜0.05)and positively corre-lated with serum BALB(r=0.587,P＜0.05).Conclusion The screened four endogenous potential biomarkers provide the new research ideas for the early diagnosis and treatment efficacy monitoring of CKD-OP.

Objective:To elucidate the primary elements pertaining to the perception of relapse risk and to in-vestigate the characteristics and alterations of perception of the risk of recurrence in patients with schizophrenia.Methods:By using the method of phenomenological study,semi-structured in-depth interviews were conducted among schizophrenic patients with first onset,first recurrence and multiple recurrences.Twenty-three 23 outpatient and inpatient cases that met the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)were included,and all patients had PANSS scores below 60.The interview data were collated and analyzed according to Colaizzi analysis.Results:The perception of recurrence risk in patients with schizophrenia en-compassed 4 major themes and 11 sub-themes,namely susceptibility(limited overall understanding,transition from optimism to objectivity),detection of early warning symptoms(dynamic escalation,assistance from family mem-bers in identification),understanding risk factors(lack of understanding,the relationship between psychosocial fac-tors and relapse,dynamic understanding of medication-relapse relationship),and apprehension of the consequences of recurrence(care burden and financial constraints,impaired social functioning and maladjustment,impact on pub-lic safety,personal health risks).Conclusion:The content of risk perception of recurrence in patients with schizo-phrenia is relatively substantial.The overall level of risk perception of recurrence in patients with schizophrenia is low.