Objective To evaluate the risk factors,manifestation and utrasonography examination in the diagnosis of placental abruption.Methods The clinical data of 48 patients with placental abruptiontreated in our hospital from Jan. 1999 to Oct. 2006 were analyzed retrospectively. Results Premature delivery rate was 31.25%,the perinatal death rate was 10.42%,choke of neonaty rate was 16.3%,postpartum haemorrhage rate was 14.6%,uterine upoplexy rate was 4.17%,cesarean section rate was 52.1%,ultrasonography diagnosis rate was 28.6%.Conclusions The earlier diagnosis of placental abruption depends on comprehensive analysis risk factors,clinical symptoms and accessory examination such as ultrasonography.

Objective To study the relativity of pregnancy and idiopathic thrombocytopenic purpura(ITP).Method Thirty two pregnancies with ITP from 2000 to 2005 in our hospital were analyzed retrospectively(A group).Eighty feminine inpatients were selected at random and were compared(to include)forty nomal pregnancy delivery(B group)and forty ITP(C group).Results Compared with B group,the ratio of cesarean section,the occurrence of postpartum hemorrhage and time of hospitalization after postpartum of A group was higher.But the mortality of mother and baby and the ratio of choke of neonaty was not sigrificantly different.compared with C group,the number and width of platelet,functing of cruor,and the occurrence of hemorrhage was clearly differentce.Conclusion We think that ITP could effect the functon of cruor of pregnancy,and aggravate the occurrence of hemorrhage of pregnancy. pregnancy didn't affect the course of ITP.

Objective To investigate the early diagnosis and importance of cesarean section in time.Methods Three cases of AFLP treated in our hospital during the past three years were retrospectively studied with emphasis on symptoms,laboratory findings,maternal complications and the action of well-timed cesarean section.Clinical diagnose was proved by postpartum liver biopsy or autopsy.Results The gestational age at onset of the three multiparae was 35～36 weeks.In the early stage,all cases had malaise,nausea,vomit,loss of appetite and epigastric distress followed by jaundice.Laboratory findings included raised transaminases (≤300IU/L)and total serum bilirubin levels.Neither B ultrasonic nor CT examine found fatty liver.Two of them were received cesarean section after obvious complication,and one died with her baby,the other pulled through MSOF,whose twins died of seriously asphyxia.While the third received cesarean section at early stage and was cured with a healthy baby.Conclusion Increasing awarenessespecially in early piagnosis of AFLP cases and termination pregnancy in time,the prognosis of AFLP is obviously improved.

Objective:To investigate the effects of pre-existing antibody on seroconversion rate after influenza vaccination.Methods:This study recruited 1 900 healthy volunteers to receive influenza split vaccines in Xinjiang Uygur Autonomous region and Yunnan Province from September 2009 to October 2018. Hemagglutinin agglutination inhibition assay was used to detect the titers of specific antibodies in blood samples collected before vaccination and 28 d after vaccination and the effects of pre-existing antibody on the seroconversion to different influenza vaccine components were analyzed.Results:Trend analysis showed that with the increasing titer of pre-existing antibody, the seroconversion rates to A/H1N1, A/H3N2, B/Victoria and B/Yamagata vaccine components were gradually decreased (χ 2=121.76, P<0.001; χ 2=67.58, P<0.001; χ 2=45.25, P<0.001; χ 2=54.55, P<0.001). After adjusting for factors such as region, gender and age, multivariate logistic regression showed that pre-existing antibody titer equal to or higher than 40 was an independent factor that affected the seroconversion to A/H1N1, A/H3N2 and B/Victoria vaccine components, and the adjusted OR (95%CI) values were 2.50(2.00-3.13)、1.64(1.35-2.00) and 2.50(1.79-3.45), respectively. Conclusions:The seroconversion rate to each vaccine component was negatively correlated with the pre-existing antibody titer. The factor that pre-existing antibody titer equal to or higher than 40 was detrimental to the seroconversion to A/H1N1, A/H3N2 and B/Victoria vaccine components, but had no significant influence on B/Yamagata seroconversion.

Data based on the antiviral-resistant phenotyping characteristics of 884 influenza B viruses circulating in mainland China from October 2013 to March 2014 were analyzed to assess the susceptibility of influenza B viruses to neuraminidase inhibitors. All 884 viruses were sensitive to oseltamivir; two viruses (0.23%) had reduced sensitivity to zanamivir and all other viruses were sensitive to zanamivir. Among the 38 viruses with a B/Victoria lineage, B/Shandong-Kuiwen/1195/2014 exhibited a half-maximal inhibitory concentration (IC50) for zanamivir that was elevated by 5. 12-fold (1.78 nM) compared with neuraminidase inhibitors sensitive to the reference virus (0.34 nM), suggesting that it exhibited reduced inhibition by zanamivir. D35G, N59D and S402T (39, 64 and 399 with N2 number) amino-acid substitutions in the NA gene were detected with no previously reported antiviral-resistant substitutions. Among viruses with the 846 B/Yamagata lineage, B/Hunan-Lingling/350/2013 exhibited a 7.99-fold elevated IC50 for zanamivir (2.72 nM) compared with neuraminidase inhibitors sensitive to the reference virus (0.34 nM), suggesting that it exhibited reduced inhibition by zanamivir. D197N (N2 number), a previously reported antiviral resistant-related amino-acid substitution in the NA gene, was detected in B/Hunan-Lingling/350/2013. These data suggest that recently circulating influenza B viruses in mainland China have retained susceptibility to neuraminidase inhibitors.
Amino Acid Substitution ; Antiviral Agents ; pharmacology ; China ; epidemiology ; Drug Resistance, Viral ; Enzyme Inhibitors ; pharmacology ; Humans ; Influenza B virus ; drug effects ; enzymology ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; virology ; Microbial Sensitivity Tests ; Neuraminidase ; antagonists & inhibitors ; genetics ; metabolism ; Viral Proteins ; antagonists & inhibitors ; genetics ; metabolism

OBJECTIVE: To report the experience in the diagn osis and treatment of post-traumatic pseudoaneurysms and arteriovenous fistulas. METHODS: A series of 30 patients (11 women and 19 men) with pos ttraumatic pseudoaneurysms were reviewed retrospectively. Among them 7 patients (5 women and 2 men) were associated with arteriovenous fistula. RESULTS: The causes included sharp penetrating trauma (18 cases ), blunt trauma (6 cases) and iatrogenic arterial injury (6 cases). The main cli nical manifestations consisted of local pulsatile mass (26 cases), vascular brui ts (19 cases), thrill (13 cases), ischemia of distal limb (9 cases), neuropathy (5 cases) and pseudoaneurysm rupture (2 cases). All patients underwent surgery. The operations included: ligation of the vessels (12 cases), surgical resection and primary suture repair of the vascular defect or anastomosis (11 cases), vasc ular reconstruction with autogenous saphenous vein (3 cases) and synthetic vascu lar graft (4 cases). CONCLUSIONS: Because of the imminent clinical course, early op eration is usually indicated. The operative treatment is effective and safe for most of the patients with post-traumatic pseudoaneurysms and arteriovenous fist ulas.

Objective To analyze the phenotypic characteristics of antiviral-resistant influenza B viruses circulating in mainland China and to analyze the susceptibility of influenza B viruses to neuraminidase inhibitors ( NAIs) . Methods Antiviral-resistant phenotyping test was performed to analyze the NAI suscep-tibility of 1 386 influenza B viruses isolated in mainland China from April 2014 to March 2015, including the test of susceptibility to oseltamivir and zanamivir. Results All of the 94 B-Victoria lineage viruses were sensitive to oseltamivir and zanamivir. Of all 1 292 B-Yamagata lineage viruses tested, 1 virus showed re-duced sensitivity to oseltamivir with NA gene containing I221T amino acid mutation, 10 viruses showed re-duced sensitivity to zanamivir with 4 having D197N amino acid mutation in NA gene, 3 viruses showed re-duced sensitivity to both oseltamivir and zanamivir with NA gene possessing D197N amino acid mutation and 1 virus carrying the A245T amino acid mutation in NA gene showed reduced sensitivity to oseltamivir and highly reduced sensitivity to zanamivir. Conclusion The majority of influenza B viruses circulating in main-land China during 2014 to 2015 were sensitive to NAIs, which indicated that NAIs could be used continually for clinical treatment of patients with influenza. Sustained monitoring of antiviral susceptibility of influenza B viruses should be emphasized for timely detection of antiviral resistant viruses and more attention should be paid to the D197N mutations in NA gene of influenza B viruses.

Objective Mild hypothermia (MHT) can effectively protect the brain in traumatic brain injury (TBI). This study was to investigate the effects of MHT on the calmodulin (CAM) expression and brain edema in the rat model of TBI. Methods Ninety adult SD rats were randomly divided into a sham operation, a normal temperature and an MHT group of equal number. Immediately after TBI, the rats of the MHT group maintained at a rectal temperature of (32 ± 0.5) °C for 6 hours. Modified neurological severity scores (mNSS) were obtained from 6 rats in each group at 1, 3, 5 and 7 days after modeling, and the rest of the animals subjected to brain MRI at 6, 12, 24 and 48 hours and then killed for determination of the CAM gene transcription and protein expression in the brain tissue by real-time PCR, immunohistochemistry and Western blot. Results The mNSSs were significantly higher in the MHT and normal temperature groups than in the sham operation control (P < 0.05) at all time points, neurological severity markedly decreased in the MHT group compared with the normal temperature group (P < 0.05). At 6, 12, 24 and 48 hours, the expression of CAM mRNA was remarkably down-regulated in the MHT group (1.83 ± 0.19, 1.72 ± 0.12, 1.59 ± 0.06 and 1.60 ± 0.07) in comparison with the normal temperature group (2.76 ± 0.25, 2.49 ± 0.18, 2.04 ± 0.14 and 1.65 ± 0.09) (P < 0.05), even lower in the MHT than in the normal temperature group (P < 0.05), but higher in both of the two groups than in the sham operation group (P < 0.05). At 6, 12, 24 and 48 hours, the volume of brain edema was significantly reduced in the MHT group ([32.14 ± 4.52], [36.52 ± 4.10], [42.10 ± 4.38] and [46.25 ± 5.02] mm³) as compared with the normal temperature group ([48.56 ± 5.35], [53.13 ± 6.31], [59.23 ± 6.82] and [62.35 ± 7.25] mm³) (P < 0.05). Conclusion Mild hypothermia can improve the neurological function and reduce the CAM expression and brain edema in the brain tissue of rats with traumatic brain injury, which may be related to the neuroprotective effect of mild hypothermia.

To analyze the antigenic and genetic characteristics of the influenza A (H3N2) virus in mainland China during the surveillance year of 2013-2014, the antigenic characteristics of H3N2 virus were analyzed using reference ferret anti-sera. The nucleotide sequences of the viruses were determined by Sanger dideoxy sequencing, phylogenetic trees were constructed with the neighbor-joining method, and the genetic characteristics of the viruses were determined in comparison to current vaccine strains. The results showed that most of the H3N2 viruses were antigenically closely related to the A/Victoria/361/2011 vaccine strain cell-propagated prototype virus (99.6%). Using the A/Texas/50/2012 egg isolate as the reference antigen, 15.1% of the viruses were found to be closely antigenically related to it, while 11.9% of strains were closely antigenically related to the egg-propagated epidemic strain, A/Shanghai-Changning/1507/2012. Phylogenetic analysis of HA genes indicated that the A(H3N2) viruses in this surveillance year were in the same clade, but no drug resistant mutation was identified in the NA genes. During the 2013-2014 influenza surveillance year, no significant genetic change was detected in either the HA or NA genes of the A(H3N2) viruses, while significant mutations were found in egg isolates resulting from their adaptation during propagation in eggs. The antigenic and genetic changes should be investigated in a timely manner to enable the selection of an appropriate vaccine strain in China.
Animals ; Antigenic Variation ; Base Sequence ; Chick Embryo ; China ; Genetic Variation ; Hemagglutinin Glycoproteins, Influenza Virus ; genetics ; immunology ; Humans ; Influenza A Virus, H3N2 Subtype ; genetics ; immunology ; isolation & purification ; Influenza, Human ; virology ; Molecular Sequence Data ; Mutation ; Phylogeny

Objective To explore the relationship between soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK),high-sensitivity C-reactive protein(hs-CRP)levels and the occurrence of major adverse cardiovascular events(MACE)in the short term after discharge in patients with acute myocardial infarction(AMI),and to construct a risk prediction model.Methods A total of 135 patients with AMI admitted to Nanyang Second General Hospital from October 2019 to October 2022 were selected as the research subjects.They were followed up for 6 months after discharge,and the occurrence of MACE was recorded.Patients with MACE were included in the MACE group,and the patients without MACE were included in the non-MACE group.The serum levels of sTWEAK and hs-CRP,as well as clinical data such as age,gender,body mass index(BMI),smoking history,drinking history,anemia,diabetes history,hypertension history,hyperlipidemia history,stroke history,old myocardial infarction,anterior wall infarction,Killip heart function classification,coronary artery lesion number,coronary artery Gensini score,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ),white blood cell count,serum creatine kinase isoenzyme(CK-MB)level,serum cardiac troponin T(cTnT)level,and the time from onset to reperfusion were compared between the two groups.The risk factors for short-term MACE after discharge of AMI patients were analyzed by using a logistic regression model.Based on the logistic regression analysis results,a model for predicting the risk of short-term MACE after discharge of AMI patients was established,and its prediction efficiency and calibration capability were evaluated by using the receiver operating characteristic(ROC)curve and calibration curve.Results The incidence rate of MACE within 6 months after discharge in AMI patients was 27.73％(33/135).The proportion of patients over 60 years old,proportion of patients with smoking history,percentage of coronary artery lesions in two or more branches,APACHE Ⅱ score,and serum cTnT,sTWEAK and hs-CRP levels in the MACE group were significantly higher than those in the non-MACE group(P＜0.05).There were no statistically significant differences in gender distribution,BMI,drinking history,anemia,diabetes history,hypertension history,hyperlipidemia history,stroke history,old myocardial infarction,atrial fibrillation,anterior wall infarction,Killip heart function classification,time from onset to reperfusion,coronary artery Gensini score,white blood cell count,and serum CK-MB level between the MACE group and the non-MACE group(P＞0.05).Logistic regression model analysis showed that age over 60 years old,coronary artery lesions in two or more branches,high APACHE Ⅱ score,high serum cTnT level,high serum sTWEAK level,and high serum hs-CRP level were risk factors for the occurrence of short-term MACE after discharge of AMI patients(P＜0.05).A risk prediction model for MACE occurrence after discharge of AMI patients was constructed based on age,number of coronary artery branches with lesions,APACHE Ⅱ score,serum cTnT level,serum sTWEAK level,and serum hs-CRP level.The area under the curve of this model for predicting MACE was 0.860(95％confidence interval:0.784-0.916),with a sensitivity of 84.85％(95％confidence interval:68.100-94.900)and a specificity of 83.72％(95％confidence interval:74.200-90.800).The Hosmer-Lemeshow goodness-of-fit test showed there was no statistically significant difference between the predicted probability of short-term MACE occurrence after discharge of AMI patients and the actual probability(x2=5.541,P＞0.05).Conclusion High levels of serum sTWEAK and hs-CRP are risk factors for the occurrence of MACE after discharge in AMI patients.The risk prediction model constructed based on these two indicators has good performance for predicting MACE and can provide a reference for clinical guidance on the management and treatment of AMI patients after discharge.