Objective:To explore therapeutic effect of noninvasive bilevel positive airway pressure ventilation (Bi- PAP)on aged patients with acute left heart failure (ALHF)and evaluation value of NT-proBNP for therapeutic effect in these patients.Methods:A total of 80 aged ALHF patients treated in our hospital were selected.According to random number table,they were equally divided into routine treatment group and BiPAP group (received BiPAP therapy based on routine treatment group ).NT-proBNP level,heart rate (HR),systolic blood pressure (SBP),di- astolic blood pressure (DBP),respiratory rate (RR)and arterial blood gas were compared between two groups be- fore and after treatment.Linear correlation analysis was used to evaluate the correlation among plasma NT-proBNP level and above indexes.Results:There were no significant difference in all indexes between two groups before treatment (P>0.05 all).Compared with before treatment,on 4h after treatment,there were significant reductions in levels of HR,SBP,DBP,RR and NT-proBNP,and significant rise in partial pressure of oxygen in artery (PaO2 ) in both groups (P<0.05 or<0.01),and compared with routine treatment group,there was significant rise in PaO2 [(75.13±19.93)mmHg vs.(85.88±18.47)mmHg],and significant reduction in NT-proBNP level [(3786.71± 1270.38)pg/ml vs.(2658.65±1222.08)pg/ml]in BiPAP group (P<0.05 both).Linear correlation analysis indi- cated that NT-proBNP level was significant positively correlated with HR (r=0.383),SBP (r=0.360),RR (r=0.345)and PaCO2 (r=0.413),and significant inversely correlated with PaO2 (r=-0.471),P<0.05 or<0.01. Conclusion:BiPAP ventilation therapy can improve clinical therapeutic effect in aged ALHF patients,and NT-proB- NP is help to evaluating its therapeutic effects.

Objective To investigate the statistical.method for analyzing nurse job burnout Data. Methods Hotelling T2 test and multivariate analysis of variance(MANOVA)were used to analyze nurse job burnout datum. Results There was statistical significance between different cities,different ethnieities in the personal achievements,hut from three dimensions of the whole job burnout,there are no statistical sig-nificant differences among different cities, different ethnicities and different ages. Conclusions The use of Hotelling T2 test and multivariate analysis of variance to analyzing nurse job burnout data, not only ob-tain overall conclusion, and further use of single-variable analysis may also gain comparative results of each dimensions.

Objective To explore MR perfusion imaging characteristics of rabbit liver.Methods MR perfusion imaging was performed in 10 New Zealand rabbits)weight:2.5～3.0 kg)respectively.The MR perfusion imaging protocol consisted of T1-weighted fast field echo(FFE)sequences with a field of view of 355 mm×75 mm,matrix 89×256,TR/TE of 4.3/1.4 millisecond,slice thickness of 5 mm,intersection gap of 1 mm,NSA of 1.This sequence was repeated 65 times,in 4 slices(in total,80 seconds).The original data were transmitted to PHILIPS workstation and formed MR perfusion images automatically.The MR perfusion images in different liver tissues were observed and analyzed.Results The rabbit liver profiles were depicted on hepatic blood flow(HBF)and hepatic blood volume(HBV)images.Time-intensity curves derived from ROIs drawn in abdominal aorta appeared as a type of rapid increase and decrease,gradually increase in hepatic vein and slowly increase and decrease in normal liver tissues.The peak of MR signal intensity of abdominal aorta,hepatic vein and normal liver tissues were 496±131,323±92,194±58 separately.Conclusion MR perfusion imaging can be performed for rabbit liver successfully by using MR TFE series.The rabbit liver profiles are depicted by HBF and HBV images.The hemodynamics of different liver tissues can be responded by time-intensity curves preliminarily.

Objective: To study the correlation between MR perfusion imaging and pathology after transcatheter arterial chemoembolization (TACE) using VX2 liver cancer model and to provide a theoretical basis to evaluate the curative effect of TACE. Methods; Fifteen New Zealand white rabbits (weight: 2.5-3.0kg) were randomly divided into three groups, with 5 in each group (group 1, pre-TACE; group2, 3 days after TACE; group 3,1 week after TACE). The rabbit VX2 hepatic carcinoma models were presented in all rabbits. All of the three groups received TACE at three weeks after the tumor was implanted. The MR perfusion imaging was performed before chemoembolization, at 3 days and 1 week after chemoembolization respectively for group 1, 2 and 3. Each animal was then sacrificed for pathology observation after MR examination. Results: The lesions assessed before TACE were hyperintense compared with the surrounding liver parenchyma on DWI images. The volume of neoplastic cells became large. Nucleus was hypertrophic with different size and shape. Phase of nucleous mitosis showed in many cells and necrosis was hardly seen. No obvious difference was found between the peripheral area and the core area. At 3 days after TACE, the heterogeneous hypo-intense was observed on DWI images. Many nuclear fragmentation and caryolysis appeared on pathology. Neoplasm necrosis was seen. At 1 week after TACE, the heterogeneous hypo-intense areas became larger. Light microscopy showed incomplete necrosis. There were increased karyopycnosis and nuclear fragmentation. Conclusion: MR perfusion imaging of VX2 liver cancer corresponds well with pathology and can reflect the outcome of liver cancer after TACE.

Objective: To explore the effect of Huangqi-Baoxin decoction combined with conventional western medicine on the cardiac function of the patients with diabetic cardiomyopathy (DCM). Methods: A total of 103 DCM patients who met the inclusion criteria were divided into the control group (51 cases) and the research group (52 cases) by random number table method. The control group was treated with conventional therapy, while the study group was treated with Huangqi-Baoxin decoction on the basis of the control group. Both groups were treated for 3 months. TCM syndromes were scored before and after treatment. The serum GSH-Px, SOD and CRP levels were measured by ELISA. Left ventricular ejection fraction (LVEF) and E/A ratio of early diastolic peak velocity to late diastolic peak velocity (E/A) were measured by echocardiography and then evaluate the clinical efficacy. Results: The total effective rate was 92.3% (48/52) in the study group and 76.5% (39/51) in the control group. There was significant difference between the two groups (χ²=4.922, P=0.027). After treatment, the scores of palpitation, shortness of breath, chest tightness and chest pain, fatigue, hypochondriac mass, spontaneous sweating, edema and total scores in the study group were significantly lower than those in the control group (t values were 10.603, 9.997, 10.546, 10.074, 5.211, 3.981, 6.438, 13.502, P<0.01). After treatment, LVEF (46.03% ± 1.70% vs. 42.33% ± 1.63%, t=11.271) and E/A (1.02 ± 0.17 vs. 0.90 ± 0.16, t=3.796) in the study group were significantly higher than those in the control group (P<0.01). After treatment, the serum GSH-Px and SOD levels in the study group were significantly higher than those in the control group (t values were 7.585, 6.816, P<0.01), and CRP level was significantly lower than the control group (t=10.854, P<0.01). Conclusions The Huangqi-Baoxin decoction combined with routine western medicine therapy can improve the clinical symptoms and cardiac function of DCM patients, reduce oxidative stress injury and inhibit inflammation.

OBJECTIVE: To assess the practical and health economical values of non-invasive prenatal test (NIPT) in Changsha Municipal Public Welfare Program. METHODS: A retrospective analysis was carried out on 149 165 women undergoing NIPT test from April 9, 2018 to December 31, 2019. For pregnant women with high risks, invasive prenatal diagnosis and follow-up of pregnancy outcome were conducted. The cost-benefit of NIPT for Down syndrome was analyzed. RESULTS: NIPT was carried out for 149 165 pregnant women and succeeded in 148 749 cases (99.72%), for which outcome were available in 148 538 (99.86%). 90% of pregnant women from the region accepted the screening with NIPT. 415 (0.27%) were diagnosed as high risk. Among these, 381 (91.81%) accepted amniocentesis, which led to the diagnosis of 212 cases of trisomy 21 (PPV=85.14%), 41 cases with trisomy 18 (PPV=48.81%) and 10 cases with trisomy 13 (PPV=20.83%). The sensitivity and specificity of NIPT for trisomy 21, trisomy 18 and trisomy 13 were (97.70%, 99.98%), (97.62%, 9.97%) and (100%, 99.97%), respectively. In addition, 213 and 30 cases were diagnosed with sex chromosomal aneuploidies (PPV=46.2%) and other autosomal anomalies (PPV=16.57%), respectively. For Down syndrome screening, the cost and benefit of the project was 120.79 million yuan and 1,056.95 million yuan, respectively. The cost-benefit ratio was 1: 8.75, and safety index was 0.0035. CONCLUSION NIPT is a highly accurate screening test for trisomy 21, which was followed by trisomy 18 and sex chromosomal aneuploidies, while it was less accurate for other autosomal aneuploidies. The application of NIPT screening has a high health economical value.
Aneuploidy ; Cost-Benefit Analysis ; Female ; Humans ; Noninvasive Prenatal Testing ; Pregnancy ; Retrospective Studies ; Trisomy 18 Syndrome/genetics*

Objective·To explore the association between high myopia and life quality among children.Methods·Cross-sectional study method was adopted in this study.Highly myopic children aged 4-10 from 16 districts in Shanghai were enrolled through Shanghai Child and Adolescent Large-scale Eye Study-High Myopia Registration Study.Baseline data for spherical equivalent after cycloplegia and questionnaire data in 2020 were collected.Emmetropic children aged 4-10 from 16 kindergartens and elementary schools in Jing'an District and Pudong New Area were enrolled.The uncorrected visual acuity,corrected visual acuity and spherical equivalent without cycloplegia were measured through myopia screening in schools,and the questionnaire on quality of life was filled out.Quality of life was measured by the Strengths and Difficulties Questionnaire(SDQ)and EuroQol Five Dimensions Questionnaire Visual Analogue Scale(EQ-VAS).After describing and testing the differences in variable distributions between the highly myopic children group and the emmetropic children group,the differences in life quality between the two groups,and the association between spherical equivalent and life quality scores of the highly myopic children were examined by a linear regression model.Results·A total of 193 children with high myopia and 209 children with emmetropia were enrolled.There were statistically significant differences in age[(9.58±0.94)years vs(7.63±1.50)years,P＜0.001]and gender distribution(46.6％males vs 62.7％males,P=0.00l)between the highly myopic children and emmetropic children.After adjusting for age and gender,it was found that there was no statistically significant difference in SDQ score between the highly myopic children and emmetropic children(β=0.313,95％CI-0.723-1.349,P=0.553),but the EQ-VAS score in the highly myopic children was lower than that in the emmetropic children(β=-3.805,95％CI-6.593--1.017,P=0.008).There was no significant relationship between spherical equivalent and SDQ score(β=0.297,95％CI-0.035-0.628,P=0.079)and EQ-VAS score(β=0.579,95％CI-0.330-1.489,P=0.21 1)in the highly myopic children.Conclusion·In children with high myopia,self-evaluated overall health status reflected by EQ-VAS score is poorer compared with that in children with emmetropia.However,the EQ-VAS score is not associated with the degree of high myopia.

Objective: To investigate the difference of clinical characteristics of recurrent spontaneous abortion (RSA) in patients with losses after spontaneous gestation and after in vitro fertilization and embryo transfer ( IVFET) ． Methods : 237 patients diagnosed with RSA were divided into spontaneous gestation group ( n = 185) and IVF group (n = 52) according to their previous modes of fertilization．The clinical characteristics of the two groups were analyzed. Results: Compared with the spontaneous gestation group，the age of the first pregnancy and the age at the time of RSA in the IVF group were statistically greater than those in the natural pregnancy group ( P < 0. 05 ) ．The number of biochemical pregnancies in IVF group was statistically higher than that in spontaneous gestation group，and the number of spontaneous abortions in IVF group was statistically lower than that in spontaneous gestation group (P＜0. 001) ．The proportion of patients with irregular menstruation in IVF group was statistically higher than that in spontaneous gestation group ( P ＜ 0. 05 ) ． The serum activated partial prothrombin time (APTT) ，R , K，high density lipoprotein cholesterol (HDL-C) ，thyrotropin (TSH) and homocysteine ( HCY) in IVF group were statistically lower than those in spontaneous gestation group，and the Angel，Ma，low density lipoprotein cholesterol (LDL-C) and body mass index (BMI) in IVF group were statistically higher than those in spontaneous gestation group (P＜0. 05) ．In the comparison of etiological composition between the two groups，the proportion of anatomical factors in IVF group was statistically higher than that in spontaneous gestation group (P < 0. 05) ． Conclusion The abortion risk factors in RSA patients after IVF-ET is more serious than that in RSA patients after natural pregnancy．It is suggested to further improve and implement the pre-pregnancy examination and education of infertile patients during IVF-ET treatment，so as to reduce the risk of RSA and obtain a better pregnancy outcome.