Objective To analyze the levels of IL-35, IL-10 and TGF-β in women with or without pregnancy and to investigate the correlation between IL-35 and recurrent spontaneous abortion.MethodsLevels of IL-35, IL-10 and TGF-β in serum were analyzed by enzyme-linked immunosorbent assay (ELISA) in 120 gravidas with normal pregnancy, 40 gravidas with a history of recurrent spontaneous abortion, 40 healthy postpartum women and 40 healthy non-pregnant women of childbearing age.Single factor logistic regression analysis was used for correlation analysis.Results The level of serum IL-35 in normal pregnancies was significantly higher than that in non-pregnant women [333.6 (59.32, 1 391) pg/ml vs 123.9 (8.763, 471.7) pg/ml, P<0.001].The level of TGF-β increased significantly in the first trimester as compared with that in non-pregnant women [473.4 (398.0, 580.5) pg/ml vs 379.7 (311.0, 441.3) pg/ml, P<0.01].No significant difference in the level of serum IL-10 was observed between gravidas and non-gravidas [8.602 (5.854, 12.89) pg/ml vs 9.339 (5.691, 12.07) pg/ml, P>0.05].The level of serum IL-35 in gravidas with recurrent spontaneous abortion was significantly lower than that in healthy gravidas in their first trimester [220.4 (4.951, 702.0) pg/ml vs 386.5 (64.37, 1 355) pg/ml, P<0.05].Serum IL-35 was negatively correlated with the occurrence of recurrent spontaneous abortion (regression coefficient=-0.003, OR=0.997).Conclusion The level of serum IL-35 increases in healthy gravidas, but decreases in gravidas with recurrent spontaneous abortion.IL-35, rather than IL-10 or TGF-β, is recognized as an active player in maternal-fetal immune tolerance.

Objective To investigate the incidence of thyroid space occupying lesion by ultrasound imaging in patients with breast cancer.Methods From 2009 to 2012,150 patients with breast cancer as experimental group and another 150 patients with breast benign diseases as control group underwent thyroid ultrasound examination.Ultrasound results of the two groups were analyzed to find the differences.Restult More obvious space occupying lesions were found in experimental group than those in control group (P＜0.05).Conclusion The incidence rate of thyroid space occupying lesion in the patients with breast cancer is higher than that in the patients with no breast cancer.

Objective To explore the serum lipids levels in healthy pregnant women,and to establish the reference intervals of serum lipids in middle and late pregnancy.Methods Triglyceride (TG),total cholesterol (TCH),high density lipoprotein (HDL),low density lipoprotein (LDL),apo-lipoprotein-A (APO-A) and apo-lipoprotein-B (APO-B) were measured in 3 200 pregnant women and 3 200 healthy women of childbearing age(the control group) from January 2014 to Febuary 2015 in Obstetrics and Gynecology Hospital of Fudan University.In the healthy pregnant women,serum lipids were measured at 14-20,24-28 and 37-40 gestational weeks,respectively.All the parameters were detected by Hitachi 7180 automatic biochemical analyzer.The test results were calculated and determined by the C28-A3 standard of the National Clinical and Laboratory Standards Institute.And the normal reference intervals of serum lipids in middle and late pregnancy were defined as 2.5％-97.5％.Results (1) The levels of TG,TCH,HDL,LDL,APO-A and APO-B in the control group were 0.8,4.2,1.0,2.7 mmol/L and 1.1,0.8 g/L,respectively.The levels of TG,TCH,HDL,LDL,APO-A and APO-B in middle and late pregnancy were significantly higher than those in the control group (P＜0.05).(2) The serum lipids levels at 14-20,24-28 and 37-40 gestational weeks in healthy pregnant women were compared with the control group as following.The TG levels were 1.9,3.8 and 4.4 folds of the control group;the TCH levels were 1.1,1.5 and 1.5 folds of the control group;the HDL levels were 1.2,1.6 and 1.5 folds of the control group;the LDL levels were 1.1,1.4 and 1.4 folds of the control group;the APO-A levels were 1.3,1.4 and 1.5 folds of the control group;and the APO-B levels were 1.1,1.5 and 1.5 fold of the control group respectively.The TG level was the most increased,and it increased gradually with gestational age (P＜0.01).(3) The median of LDL to HDL cholesterol ratio in the healthy pregnancy group at 14-20,24-28 and 37-40 gestational weeks were 2.7,2.5,2.6,respectively,which were significantly lower than that of the control group (2.8;P＜0.05).(4) Reference intervals of serum lipids at 14-20,24-28 and 37-40 gestational weeks in healthy pregnant women were as following.The TG levels were 0.7-3.9,1.7-6.3 and 1.6-8.1 mmol/L,respectively;the TCH were 3.3-6.9,4.3-8.3,4.3-8.7 mmol/L,respectively;the HDL were 0.8-1.8,1.0-2.1 and 1.0-2.1 mmol/L,respectively;the LDL were 2.1-4.5,2.7-5.1 and 2.6-5.2 mmol/L,respectively;the APO-A were 1.1-1.8,1.2-1.9 and 1.1-2.4 g/L,respectively;and the APO-B were 0.6-1.4,0.9-1.8 and 0.8-2.1 g/L,respectively.The LDL/HDL ratios were 2.3-3.1,2.2-2.9 and 2.1-3.0,respectively.Conclusions Serum lipids increased physiologically with gestational age in middle and late pregnancy.The establishment of reference intervals for serum lipids in pregnancy will help to distinguish abnormal serum lipid levels in middle and late pregnancy.

BACKGROUND: At present, most researches on simulated weightlessness are confined to its effect on the artery. Therefore, the effect on the vein needs to be further studied.OBJECTIVE: To probe into the effect of simulated weightlessness on the ultrastructure of rabbit femoral vein and the remodeling of femoral vein.DESIGN: A completely randomized and controlled trial based on experimental animals.SETTING: Department of Aerospace and Aviation Medical Science, Fourth Military Medical University of Chinese PLA.MATERIALS: The experiment was completed in the Department of Aerospace and Aviation Medical Science, Fourth Military Medical University of Chinese PLA from December 2000 to December 2001. Altogether 24healthy male New Zealand rabbits, weighing 2.0-2.5 kg were obtained.INTERVENTIONS: The model of Head-Down Tilt( -20°) (HDT) simulated weightlessness was established in rabbits. A total of 24 healthy male New Zealand rabbits were randomly divided into control group, 10-day simulated weightlessness group and 21-day simulated weightlessness group, with 8rabbits in each group. The ultrastructure of the rabbit femoral vein was observed under transmission electron microscope.MAIN OUTCOME MEASURES: Changes and degeneration of endothelial cell, mitochondrion, internal elastic membrane, and smooth muscle.RESULTS: Cell organelles in endothelial cell of the femoral vein of HDT rabbits decreased, mitochondrion dissolved and disappeared, vacuolar degeneration in endothelial cell increased and phagolysosome in endothelial cell could be found. Internal elastic membrane became thinner and was broken. The smooth muscle layer became thinner and some smooth muscle cells became degenerated. Cell interstitial substance increased. There was significant difference in changes between 21-day and 10-day simulated weightlessness groups.CONCLUSION: The vascular remodeling of femoral vein occurs with atrophic changes during simulated weightlessness. The longer duration of simulated weightlessness is, the more obviously the structure of femoral vein changes.

Objective To discuss the clinical values of transabdominal ultrasonic diagnosis of nontraumatic hiatal gastric hernia of esophagus in middle-aged and elderly people.Methods Thirty-two cases were examined with fasting and filing methods in half-sitting,standing,supine and supine right anterior oblique positions.The findings were contrasted with X-ray barium meal examination,endoscopy and operation.Results Twenty-nine cases were of sliding hiatal gastric hernia of esophagus,3 of impacted hernia.The ultrasonic diagnosis coincidence rate was 100%.The signs and symtoms of acoustic images were widening of esophageal hiatus diaphragmatic muscle(≥1.37 cm),echoes of gastric mucosa were found in superior phrenic hernail sac and inside hernial sac.The display rates were 100%,100%,15.6%respectively.Conclusions The transabdominal ultrasonic diagnosis of nontraumatic hiatal gastric hernia of esophagus in middle-aged and elderly people is brief and accurate.

According to 'National Standard of Undergraduate Teaching Quality for Nursing Science', the mode of community nursing practice was explored and implemented by the School of Nursing in Tianjin Medical University. Focus on competency, the syllabus of community nursing practice was revised. Optimizing the management system of community nursing practice, developing the team of high-quality teachers, building standardized community nursing practice bases, and improving the evaluation system of community nursing practice aimed to enhance comprehensive quality of nursing undergraduates and the quality of community nursing practice. Within the concept of "big health", our school is exploring the new mode of combining community nursing practice with health management-oriented nursing personnel training, which lays an important foundation for training applied nursing talents to meet the needs on development of community health services.

Objective To investigate the detection and significance of anti-Müllerian hormone (AMH) and inhibin B (INHB) in patients with polycystic ovary syndrome (PCOS). Methods This study randomly selected 240 PCOS patients from January to October 2018 in Obstetrics and Gynecology Hospital of Fudan University, and 240 healthy women who were admitted to the physical examination center of Obstetrics and Gynecology Hospital of Fudan University as control group during the same period. Retrospective study was adopted. Serum samples of patients were collected and the serum estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), sex hormone binding globulin (SHBG), AMH and INHB were detected. The data were analyzed by single sample Kolmogorov-Smimov test, independent sample T test and logistic regression analysis. Results The detection values of AMH, INHB, E2, LH, FSH, T, SHBG and INHB/AMH in PCOS group were (8.55±3.17) ng/ml, (101.7±15.2) pg/ml, (63± 50) pg/ml, (13.0±5.8) mIU/ml, (6.5±1.5) mIU/ml, (0.68±0.23) ng/ml, (62±52) nmol/ml and (24.03±26.35) respectively. In the control group, the detection values of AMH, INHB, E2, LH, FSH, T, SHBG, INHB and AMH were (4.34±2.07) ng/ml, (83.3±7.7) pg/ml, (66±25) pg/ml, (7.1±3.7) mIU/ml, (7.2±1.9) mIU/ml, (0.40± 0.11) ng/ml, (67±37) nmol/ml and (42.83±62.22). The detection values of AMH, INHB, LH, T and SHBG in PCOS group were higher than those in control group (the t values were 9.843, 7.373, 9.021, 9.349 and 3.867), and the difference was statistically significant (P<0.05). The detection values of E2 and FSH in PCOS group were lower than those in control group(the t values were 0.762 and -1.342), with no significant difference (P>0.05). The INHB/AMH value was lower than that in control group(the t value was -2.332), and the difference was statistically significant(P<0.05). The area under the curve of AMH, INHB and AMH+INHB in the diagnosis of PCOS was 0.762, 0.677 and 0.789, respectively. The cut-off value of AMH in predicting polycystic ovary syndrome was 6.96 ng/mL, the sensitivity was 61.0％, and the specificity was 82.1％. The cut-off value of INHB in predicting polycystic ovary syndrome was 94.9 pg/mL, with a sensitivity of 59.0％ and a specificity of 74.1％. The sensitivity and specificity of combined detection of AMH and INHB in predicting polycystic ovary syndrome were 83.6％ and 60.6％. The positive rates of ultrasound, T, AMH and INHB in PCOS group were 51.25％, 61.25％, 69.58％ and 66.25％, respectively. Conclusion The combined detection of AMH and INHB may improve the sensitivity and specificity of PCOS diagnosis, and its serum level is stable.

Objective To investigate the clinical significance of Epstein-Barr virus EBV DNA in children with Epstein-Barr virus infection realated diseases.Methods A retrospective cohort study was performed.Totally 222 blood samples were collected from children who were diagnosed as EBV infection in Shandong Provincial Hospital from June 2012 to August 2013.Fluorescent quantitative PCR( FQ-PCR) was used to analyze the EBV DNA in peripheral blood lymphocytes.ELISA was used to analyze the four EBV serology antibodies in the serum.Two groups of tested results were compared.Heart, hepatic impairment and renal function were analyzed through detecting AST, ALT, BUN, CREA, CK, CKMB.The results were grouped by EBV DNA copy number, and then non-parametric test together with correlation analysis was performed using SPSS21.0 analytics software.Results The positive rate of EBV-CA IgM and EBV DNA was 51.35%(114/222) and 72.97% (162/222) respectively, χ2 =24.01, P<0.001.The EBV DNA copy number was significant difference (χ2 =11.79,P<0.05) in children at different stages of infection ( no previous infection:6.30 ×103 -1.20 ×104 copies/ml;early infection:5.56 ×103 -3.92 ×106 copies/ml;acute infection:6.58 ×103 -1.73 ×106 copies /ml;chronic infection or recurrent infection:8.92 ×103 -2.34 ×104 copies/ml;late infection or recovery:5.20 ×103 -1.12 ×107 copies/ml;past infection:5.46 × 103 -1.33 ×104 copies/ml).Each biochemical targets were divided into five groups by EBV DNA copy number (Ⅰ>1 ×106 copies/ml,Ⅱ1 ×105 -1 ×106 copies/ml, Ⅲ1 ×104 -1 ×105 copies/ml, Ⅳ5 × 103 -1 ×104 copies/ml, Ⅴ<5 ×103 copies/ml), and ALT(χ2 =10.14,P<0.05), BUN(χ2 =18.17, P<0.05), CK(χ2 =13.09,P<0.05), CKMB(χ2 =17.93,P<0.01) had a statistically significant difference between each group.Well, the log value of EBV DNA copy number had a positive correlation relationship with AST(r=0.357,P=0.001), ALT(r=0.376,P=0.001), BUN(r=0.329,P=0.000), CK(r=0.235,P=0.035).Conclusions Detection of EBV DNA can be used for the early diagnosis and assessment of process of the EBV infection related disease in children.The detection of liver, kidney function and myocardial enzymes can be used for evaluating the severity of EBV infection.

Caudal type homeobox transcription factor 2 (CDX2) is an enteric-specific nuclear transcription factor, which is mainly expressed in the small intestine and colorectum and not expressed in normal gastric mucosa. CDX2 is involved in the occurrence, development, invasion and metastasis of gastrointestinal tumors, and its expression state is related to the clinicopathological characteristics and prognosis of patients with gastrointestinal tumors. It is expected to provide a new idea for the diagnosis and treatment of gastrointestinal tumors by further studying the mechanism of CDX2 involvement in tumor genesis and development and its relationship with clinicopathological features and prognosis.

To investigate the distribution and diagnostic value of serum anti-Müllerian hormone (AMH) in healthy women of childbearing age, women with polycystic ovary syndrome (PCOS), ovarian dysfunction (DOR) and premature ovarian failure (POF). This study retrospectively selected female patients of childbearing age who were treated in the affiliated Obstetrics and Gynecology Hospital of Fudan University from January to December 2019. According to different clinical manifestations, they were divided into 133 cases in PCOS group, 120 cases in DOR group and 134 cases in POF group. 125 healthy women in the same period were selected as the control group. The values of serum AMH, estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T) were measured in the four groups. Single sample Kolmogorov-Smirnov test, one-way ANOVA, independent sample t-test, Kruskal-Wallis H test, Mann-Whitney U test, logistic regression analysis and ROC curve were used for comparative analysis. The serum AMH levels of PCOS group, DOR group, POF group and control group were 9.10 (6.67, 11.49) ng/ml, 0.11 (0.05, 0.29) ng/ml, 0.03 (0.02, 0.06) ng/ml and 2.99 (1.57, 4.98) ng/ml, respectively [ M(Q1,Q3)], the differences were statistically significant ( P<0.001). The basal endocrine levels including E2, FSH, LH and T also had significant differences between groups ( P<0.001). The results of multiple comparisons showed that there were significant differences in AMH and LH between DOR, POF and PCOS groups and the control group. The T level of PCOS group was significantly higher than that of the control group, the E2, LH and T levels of DOR group were significantly higher than that of the control group, and the FSH level of POF group was significantly higher than that of the control group ( P<0.05). The area under the curve (AUC) of AMH and AMH+LH in the diagnosis of PCOS were 0.905 and 0.922, the sensitivity was 82.7% and 85.0%, and the specificity was 88.0% and 88.8%. The AUC of DOR was 0.861 and 0.971, the sensitivity was 89.0% and 92.5%, and the specificity was 63.0% and 92.0%. The AUC of POF was 0.950 and 0.998, the sensitivity was 98.3% and 99.2%, and the specificity was 75.9% and 97.0%, respectively. The AUC of AMH and AMH+LH combined indexes in the differential diagnosis of DOR and POF were 0.768 and 0.937, the sensitivity was 70.3% and 95.5%, and the specificity was 73.9% and 80.8%.