Objective: To revise and evaluate the Chinese version of the FACT-B. Method: The Chinese version of the FACT-B was translated from the original one, after back-translated and culture adaptation, it was applied to 165 patients with breast cancer. Result: The test-retest reliability of five domains, such as physical well-being, social/family well-being, emotional well-being, functional well-being, additional concerns and the overall scale were 0.82～0.89. The internal consistency alpha for the five domains were 0.61～0.84. After admission to hospital 2-4 weeks, the quality of life of patients showed some change in this scale. Conclusion: The Chinese version of the FACT-B has good psychometric quality and can be used to assess the quality of life of Chinese patients with breast cancer.

Objective To explore the different methods of decoloration for immunohistochemical HE slides,and their influence on tissue antigen expression.Methods Antigen retrieval solution (EDTA or citric acid solution) was used in immunohistochemistry to decolor HE slides,and was compared with the method of hydrochloric acid solution decoloration in normal temperature.Results Antigen heat retrieval decolors completely.Compared with other methods,it has shorter decoloration time (1 ～ 2min),more than 90％ of completely decoloration rate,the difference was significant(x2 =27.6,23.9,all P ＜ 0.01).Meanwhile,the method dose not damage slides,and the immunohistoehemical results are exact,without background coloring and unusual coloring,antigen expression rate and intensity are high.Conclusion Antigen heat retrieval decoloration not only simplifies the coloration process,but also protects tissue antigen activity better.It is the preferable method of decoloration and protecting antigen resource,which possesses some practical value in the pathology diagnosis.

Objective To determine the serum levels of miR-16,miR-126 and miR-221 in type 2 diabetes (T2DM)patients with or without microvascular complications,and further evaluate their clinical significance.Methods The serum levels of miR-16,miR-126 and miR-221were examined in 55 T2DM patients,55 T2DM patients with microvascular complications and 5 5 healthy controls using quantitative real-time PCR (qRT-PCR).The levels of fasting blood glucose,triglycerides,choles-terol,high density lipoprotein,low density lipoprotein and others biochemical parameters were determined by biochemical an-alyzer,and the diagnostic usefulness of the three miRNAs for T2DM patients and patients with microvascular complications were assessed by ROC curve analysis and logistic regression analysis.Results Compared with healthy controls [miR-1 6 (14.35±1.00)×10-5 ,miR-126(11.75±1.47)×10-5 and miR-221(32.26±3.98)×10-5 ],the miR-16,miR-126 and miR-221 expression were significantly increased in T2DM patients [miR-16(23.74±2.70)×10-5,miR-126(25.01±4.13)× 10-5 and miR-221(84.76±11.79)×10-5 ]and T2DM patients with microvascular complications [miR-16(43.74±9.61)× 10-5 ,miR-126(17.66±2.20)×10-5 and miR-221(82.52±12.48)×10-5 ].The area under ROC curve (AUCROC)of miR-16,miR-126 and miR-221 for T2DM patients were 0.63 (95%CI 0.53~0.74),0.64 (95%CI 0.54~0.74)and 0.74 (95%CI 0.65~0.83),respectively.For T2DM patients with microvascular complications,the area under ROC curve were 0.75 (95%CI 0.66~0.84),0.62 (95%CI 0.52~0.73)and 0.73 (95%CI 0.64~0.83),respectively.Furthermore,logistic re-gression revealed that the three miRNAs were novel independent risk factors for T2DM and T2DMC.Conclusion The levels of miR-16,miR-126 and miR-221 were significantly increased in the serum of T2DM patients with or without microvascular complications,and can be used as potential non-invasive biomarkers and risk factors for T2DM patients and T2DM patients with microvascular complications.

Objective: To study the effect of different sorts of fertilizer on the content of tanshinone Ⅱ A, the effective element of cultivated Radix Salvia miltiorrhizae. Methods: Fertilize Radix Salvia miltiorrhizae with the several kinds of combination: the oddment cake(round flat cake made of residue of seed after extracting oil form it), pig manure, chicken manure, duck manure, human excrement, plant ashes, dregs of a decoction (residue of Traditional Chinese medicine material after being extracted), phosphoric fertilizer and compound fertilizer; and gather Radix Salvia miltiorrhizae one year later. Determine the content of Tanshinone Ⅱ A in cultivated Radix Salvia miltiorrhizae by HPLC. Results: The contents of Tanshinone Ⅱ A in Radix Salvia miltiorrhizae fertilized by different sorts of fertilizer are of significant difference. Conclusion: Plant ashes, oddment cake and compound fertilizer are good for growing of Radix Salvia miltiorrhizae and raises of the content of Tanshinone Ⅱ A.

Objective:To analyze the effect of permissive hypercapnia(PHC) in premature infants with respiratory distress syndrome(RDS).Methods:Seventy preterm infants diagnosed with RDS from July 2019 to September 2020 were enrolled.The preterm infants were divided into PHC group[noninvasive high-frequency ventilation(NHFV)+ PHC, n=34] and non PHC group(NHFV, n=36)after injection of pulmonary surfactant by LISA method.Ventilator parameters, time of ventilation, oxygen therapy, enteral feedingand hospitalization days were compared between the two groups.The incidences of patent ductus arteriosus, intracranial hemorrhage, pneumothorax and ventilator-induced lung injury were recorded. Results:The time of mechanical ventilation, oxygen therapy, age of enteral feeding and hospitalization time in PHC group were less than those in non PHC group( P<0.05). PaO 2 and PaCO 2 of the two groups had no difference before mechanical ventilation treatment( P>0.05), and PaO 2 of the two groups had no difference after 24 hours of treatment( P>0.05). After treatment, PaCO 2 in non PHC group was significantly lower, and there was no significant difference in PHC group( P<0.05). There was no significant difference regarding ventilator parameters MAP and FiO 2 after 24 hours of treatment between the two groups( P>0.05), and the ΔP of PHC group was significantly lower than that of non-PHC group ( P<0.05). The incidence of ventilator-induced lung injury in PHC group was lower than that in non-PHC group( P<0.05). Conclusion:Compared with conventional ventilation therapy, PHC has similar therapeutic effect, but it can shorten the mechanical ventilation time, oxygen therapy time, age of enteral feeding and hospitalization days, and reduce the incidence of ventilator-induced lung injury.

Objective:To summarize the prenatal ultrasound features and prognosis of fetal goiter.Methods:The prenatal ultrasound findings and clinical data of five cases of fetal goiter in the Affiliated Hospital of Qingdao University from August 2018 to October 2022 were retrospectively analyzed regarding the sonographic features, concomitant signs, and prognosis using descriptive statistical method.Results:The five cases were first diagnosed as fetal goiter at 25-35 weeks of gestation, with all of them showing hypoechoic or medium echoic masses in the fetal anterior neck area. One case exhibited a central blood flow signal, early appearance of the distal femoral ossification center, tachycardia, increased cardiothoracic ratio during pregnancy, and developed postnatal hyperthyroidism. Three cases showed peripheral blood flow signals and had postnatal hypothyroidism, one of which had delayed appearance of distal femoral ossification center and increased cardiothoracic ratio. One case showed a peripheral blood flow signal with normal thyroid function after birth. Among the five cases, tracheal compression and polyhydramnios were found in one case; neck hyperextension was found in three cases. After treatment, the size of goiters did not change or shrunk in three cases and increased with the gestations in one case. One case did not receive any prenatal treatment and was born through cesarean section due to late detection and increased cardiothoracic ratio. Two cases underwent cesarean section at 35 gestational weeks, one had full-term cesarean section, and two delivered vaginally at term. Hyperthyroidism in one neonate was caused by excessively elevated maternal thyrotropin receptor antibody. Three cases of hypothyroidism occurred due to maternal antithyroid medication whose thyroid function recovered after supplementation of thyroxine. The thyroid function was normal in the rest of the baby. During the follow-up from 9 months to 4 years and 11 months old, no abnormalities in the intellectual and motor development of the five children were found.Conclusions:Fetal goiter often exhibits hypochoic or medium echoic mass in the anterior neck during prenatal ultrasonography. The fetal thyroid function could be evaluated according to different blood flow patterns and the presence of the ossification center. The prognosis of fetal goiter is good after active prenatal treatment.

Objective To study in the correlation of the laboratory markers of coagulation,fibrinolysis and thrombosis in patients with sepsis and SOFA score,the procalcitonin (PCT) concentration and seven-day survival rate.Methods From February 2017 to March 2018,119 patients with sepsis admitted in ICU and another 119 patients with non-sepsis undergoing selective surgery were enrolled as control in this study.APTT (activated partial thromboplastin time),PT-INR (prothrombin time-international normalized ratio),FIB (fibrinogen),AT-Ⅲ (antithrombin Ⅲ),D-Dimer,FDP (fibrinogen degradation products),sTM (soluble thrombomodulin),TAT (thrombin antithrombin complex),PIC (plasmin-a2 plasminogen inhibitor complex) and t-PAI-C (tissue plasminogen activator and its inhibitor complex),were simultaneously monitored at admission.The correlation between the given laboratory markers mentioned and SOFA score,the PCT concentration and seven-day survival rate were analyzed with the Spearman correlation analysis.Results (① In the patients with sepsis,a positive correlation between SOFA score and sTM,t-PAI-C,TAT respectively was found,and a negative correlation between SOFA score and PLT (platelet count) was observed,and no correlation between SOFA score and PIC was noticed.(②) A positive correlation between PCT and sTM,t-PAI-C respectively was significant,a negative correlation between PCT and PLT was marked,and no correlation between PCT and AT-Ⅲ,TAT,PIC respectively was found.(③) A negative correlation between seven-day survival rate and sTM,t-PAI-C and TAT respectively was obvious,a positive correlation between seven-day survival rate and AT-Ⅲ,PLT respectively was occurred,and no correlation between seven-day survival rate and PIC was determined.Conclusions Soluble thrombomodulin (sTM),thrombin-antithrombin (TAT),antithrombin Ⅲ (AT-Ⅲ) and tissue plasminogen activator inhibitor complex (t-PAI-c) were good clinical monitoring indicators of coagulation disorder in patients with sepsis,which were the representative of the endothelial cell damage with highly activated coagulation,relatively insufficient anti-coagulation function and poor fibrin degradation ability.These were good adjuvants to PLT,INR and APTT for core diagnostic criteria of coagulation disorder in sepsis.

Objective: To observe the clinicopathologic features of oropharyngeal squamous cell carcinoma associated with human papilloma virus (OPSCC-HPV) and discuss the role and value of different in situ hybridization (ISH) detection methods for HPV in pathologic diagnosis. Methods: Fifteen cases of OPSCC-HPV were collected from Department of Pathology, Beijing Tongren Hospital, Capital Medical University from January 2016 to August 2018. These cases were diagnosed in accordance with the WHO classification of head and neck tumors. The histopathologic features and the clinicopathologic data were retrospectively analyzed. Immunohistochemistry (two-step EnVision method) was done to evaluate the expression of p16, Ki-67 and p53. ISH was used to detect HPV DNA (6/11 and 16/18). RNAscope technology was used to evaluate the presence of HPV mRNAs (16 and 18). Results: The mean age for the 15 patients (8 males, 7 females) was 47 years (range from 30 to 69 years). OPSCC-HPV typically presentedat an advanced clinical stage, six patients had cervical lymphadenopathy (large and cystic), seven had tonsillar swelling, one had tumor at base of tongue, and one had odynophagia. Microscopically the tumors exhibited distinctive non-keratinizing squamous cell carcinoma morphology. Cervical nodal metastases were large and cystic, with thickening of lymph node capsules. OPSCC-HPV raised from crypt epithelium and extended beneath the tonsillar surface epithelial lining as nests and lobules, often with central necrosis. Tumor cells displayed a high N: C ratio, and high mitotic and apoptotic rates. Tumor nests are often embedded within lymphoid stroma, and may be infiltrated by lymphoid cells.Fifteen cases (15/15) were strongly positive for p16; Ki-67 index were 60%-90%; they were focally positive or negative for p53. Ten cases (10/10) were negative for HPV 6/11 DNA, and one case(1/10) was focally positive for HPV16/18 DNA. Eleven cases (11/11) were strongly positive for HPV16 mRNA, one case was focally positive for HPV18 mRNA. Conclusions OPSCC-HPV is a pathologically and clinically distinct form of head and neck squamous cell carcinoma. OPSCC-HPV is associated with high-risk HPV (type 16) in all cases. Detection of high-risk HPV16 mRNA by RNAscope is of great significance in the final diagnosis and pathogen identification.

Objective: To study the clinical effect of inhaled nitric oxide(iNO) with mechanical ventilation for the neonates with persistent pulmonary hypertension of newborn(PPHN). Methods: A total of 40 neonates with PPHN poorly responding with routine treatment were treated with iNO therapy.Pulmonary artery pressure, blood gas ion analysis and respiratory function changes were observed at different time points before and after iNO. Results: Treatment with iNO resulted in a rapid decrease in pulmonary artery pressure from(54.95±17.08) mmHg(1 mmHg=0.133 kPa) to(20.40±14.26) mmHg.Oxygenation of 40 cases improved in the first 0.5~1 hour after iNO therapy, the values of mean airway pressure(MAP)declined from(13.98±2.40)cmH₂O(1 cmH₂O=0.098 kPa) to(12.44±2.69)cmH₂O, oxygenation index(OI)decreased from 26.89±18.62 to 13.84±5.52, PaO₂/FiO₂ increased from(60.34±23.49) mmHg to(144.46±23.49) mmHg, and the value of pH increased from 7.31±0.14 to 7.37±0.07.Furthermore, within 48 hours after treatment, PaO₂/FiO₂ and pH increased gradually, while MAP and OI decreased gradually, which all had statistical differences(P<0.01). Conclusion Mechanical ventilation combined with iNO therapy in the treatment of PPHN can rapidly improve the oxygenation status of neonates, reduce pulmonary vascular resistance, and then improve the survival rate and long-term prognosis.

Objective:To compare and analyze the clinical characteristics between acute fatty liver of pregnancy (AFLP) and the hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome.Methods:This is a retrospective cohort study. The clinical data of 13 cases with AFLP and 34 cases with HELLP syndrome were collected from three tertiary referral centers in Yunnan (the First Affiliated Hospital of Kunming Medical University, the Second Affiliated Hospital of Kunming Medical University, and Yan'an Hospital of Kunming City) from January 2016 to December 2021. The patients were diagnosed to AFLP and HELLP syndrome according to the Swansea criteria and the Tennessee classification system. The general characteristics, clinical features, laboratory results within 24 hours after admission, complications, maternal and neonatal outcomes were compared to analysis the differences between the two groups.Results:① Maternal characteristics: compared with HELLP syndrome group, AFLP group had lower body mass index (BMI) and blood pressure at admission (both P < 0.01). ②Clinical features: the most common symptoms in AFLP patients were skin jaundice, abdominal pain, nausea and vomiting, edema. The main manifestations of patients with HELLP syndrome were albuminuria, hypertension, edema, headache. Some patients had multiple symptoms concurrently. ③ Laboratory results: compared with HELLP syndrome group, the levels of platelet count (PLT), total bilirubin (TBil), direct bilirubin (DBil), γ-glutamyl transferase (γ-GGT), alkaline phosphatase (ALP), total bile acid (TBA), serum creatinine (SCr) and international standardized ratio (INR) in AFLP group were significantly increased within 24 hours after admission [PLT (×10 9/L): 107.69±51.13 vs.76.71±43.25, TBil (μmol/L): 121.60 (83.20, 170.00) vs.15.25 (7.22, 29.05), DBil (μmol/L): 86.50 (58.60, 104.00) vs. 4.30 (2.22, 10.10), γ-GGT (U/L): 87.00 (37.00, 127.00) vs. 41.00 (19.00, 64.42), ALP (U/L): 199.10 (109.00, 349.20) vs. 125.50 (90.50, 155.25), TBA (μmol/L): 51.50 (16.20, 117.40) vs. 4.15 (2.02, 6.95), SCr (μmol/L): 155.80 (129.00, 237.00) vs. 79.00 (65.43, 113.70), INR: 1.28 (1.17, 1.63) vs. 0.94 (0.88, 1.08), all P < 0.05], prothrombin time (PT) was significantly prolonged [seconds: 16.10 (14.50, 19.20) vs. 12.40 (11.43, 13.40), P < 0.05]. The level of blood glucose (GLU), fibrinogen (FIB) and the activity of antithrombin Ⅲ (ATⅢ) decreased significantly [GLU (mmol/L): 5.18±1.33 vs. 6.33±1.19, FIB (g/L): 1.96±1.46 vs. 3.81±1.58, ATⅢ (%): 40.61±25.84 vs. 66.39±24.11, all P < 0.05]; ④ Complications: compared with HELLP syndrome group, the incidence of patients with hypoglycemia [30.77% (4/13) vs. 0% (0/34)], acute liver failure [53.85% (7/13) vs. 5.88% (2/34)], acute renal insufficiency [69.23% (9/13) vs. 8.82% (3/34)], coagulopathy [76.92% (10/13) vs. 38.24% (13/34)], disseminated intravascular coagulation (DIC) [53.85% (7/13) vs. 5.88% (2/34)], and multiple organ dysfunction syndrome (MODS) [53.85% (7/13) vs. 5.88% (2/34)] were significantly higher in AFLP group (all P < 0.05). ⑤ Maternal and neonatal outcome: all patients delivered after admission. The total length of hospital and intensive care unit stay were significantly longer in the AFLP group than in the HELLP syndrome group [days: 17.00 (11.00, 25.00) vs. 9.00 (7.00, 12.00), 12.00 (4.00, 22.00) vs. 3.91 (0, 7.00), both P < 0.01]. Two AFLP patients died, including one due to intracranial venous thrombosis and one due to multiple organ failure and cardiopulmonary arrest. There were no deaths in the HELLP syndrome group. Conclusions:There are significant differences in maternal characteristics, laboratory results and complications between AFLP and HELLP syndrome. TBil, γ-GGT, SCr, FIB, INR and ATⅢ activity may help to distinguish the two diseases.