Objective To evaluate the expression of annexin V in maternal blood and placenta,and to explore the relationship between annexin V and preeclampsia(PE). Methods 120 women with PE who delivered babies in the Second Hospital of Hebei Medical University from December 2007 to December 2009 were chosen as study groups. They were classified into four groups: early-onset mild group (n =30),early-onset severe group (n=30), late-onset mild group ( n = 30) and late-onset severe group (n=30). 30women without perinatal complications who accepted elective term cesarean section were chosen as control group. Western blot and immunohistochemistry were used to detect the expression and localization of annexin V in placenta and maternal blood. Flow cytometry was employed to detect the apoptosis of cytotrophoblast.Annexin V mRNA level was determined by reverse transcription (RT)PCR. Prothrombin time (PT),activated partial thromboplastin time (APTT), fibrinogen (FiB), international normalized ratio (INR) were detected in each group. Results (1) The expression of annexin V in placenta and maternal blood were:0.54±0.12 and 0.62±0.17 in early-onset mild group; 0.47±0.15 and 0.56±0.24 in early-onset severe group; 0.74±0.23 and 1.08±0.32 in late-onset mild group; 0.68±0.28 and 0.72±0.21 in late-onset severe group;1.73±0.35 and 1.55±0.27 in control group. They were significantly lower in PE groups than in control group (P＜0.05 ). However, there was no significant difference among PE groups (P＞0. 05). (2) The early apoptosis, late apoptosis percentage of trophoblast cells were: 3. 21%, 0. 86%, in early-onset mild group; 5.32%, 0. 72%, in early-onset severe group; 2. 43%, 0. 63%, in late-onset mild group;4. 28%, 0. 48% in late-onset severe group; 1.05%, 0. 59%, in control group. Early apoptosis percentage in each group of PE was higher than that in control group ( P ＜ 0. 05 ). However, there was no significant difference among PE groups (P＞0.05). (3) The annexin V mRNA levels in placenta were:25.0±3.0 in early-onset mild group; 24. 8 ± 3.0 in early-onset severe group; 25.4 ± 3. 9 in late-onset mildgroup; 25.1±2.7 in late-onset severe group, respectively. All were significantly higher than that in control group (30. 6±3.0, P＜ 0. 05), and no significant difference was found among PE groups (P＞0.05).(4) PT, APTT, FiB, INR levels were: (11.3±2.4), (25.6±2.9) s, (4.6±0.9) g/L and 0.9 ±0.2in early-onset mild group; (12.1±1.9), (27. 2 ±2. 1 ) s, (5.0 ± 1. 0) g/L and 0. 9 ±0. 2 in early-onset severe group; (11.7±2.3), (26.5±2.3)s,(5.0±0.7)g/L and 0.8±0.3 in late-onset mild group;(11.4±2.6), (27.3±3.0) s, (4.3 ±0.8) g/L and 0.8 ±0.3 in late-onset severe group; (12.4±2.7), ( 28.0±1.9) s, (5.1±1.2) g/L and 0.9 ± 0.2 in control group. There was no significant difference among PE groups and control group ( P ＞ 0.05 ). Conclusion The expression changes of annexin V in placenta and maternal blood were observed in patients with PE. This indicated that annexin V played an important role in the pathogenesis and progression of PE by affecting coagulation.

Background and purpose:The mutation of BRCA1 gene is widely acknowledged to be related to the incidence of triple-negative breast cancer (TNBC). The aim of this study was to investigate the association between TNBC and single nucleotide polymorphisms (SNPs) of BRCA1-associated genes. Methods:This study investigated the associations between the BRCA1-A complex genes and risk of developing TNBC in a case-control study of Chinese Han Women population including 414 patients with TNBC and 354 cancer-free controls diagnosed in the Fudan University Shanghai Cancer Center during 2008-2011. This study also detected 37 common variants in Abraxas, BRE, Rap80, NBA1 and BRCC36 genes encoding the BRCA1-A complex and evaluated their genetic susceptibility to the risk of TNBC. An additional cohort with 652 other types of breast cancer (non-TNBC) cases and 890 controls were used to investigate the associations between TNBC-speciifc SNPs genotype and non-TNBCs susceptibility. Results:This study found that rs7250266 in the promoter region of NBA1 confers a decreased risk to TNBC (P<0.01). Compared with CC genotype, women with the GC genotype (OR=0.70, 95%CI:0.51-0.97) and GG genotype (OR=0.48, 95%CI:0.21-1.07) had a lower risk of developing TNBC (P=0.03). In addition, the haplotypes containing two polymorphisms rs7250266 and rs2278256 were associated with a lower chance of TNBC development. In the second part of the study, the result showed that there was no difference in rs7250266 expression between non-TNBC and normal people (0.19 vs 0.18, P=0.85).Conclusion:Genetic variants in NBA1 may be an important genetic determinant of TNBC susceptibility in Chinese women.

Objective To evaluate the effect of wound experts′ intervention on the primary caregivers′ behavior of caring patients with pressure ulcers. Methods According to the principle of convenience sampling, 200 cases of patients with out-hospital pressure ulcers were collected in the hospital emergency department between December 2013 and December 2015. Each 100 cases were randomly divided into the intervention group and the control group according to odd even packet. Primary family caregivers in the intervention group were implemented the additional behavioral intervention by professional wound experts on the basis of the conventional education, while the control group only with conventional education. Primary caregivers′behavior score in the intervention group were compared in 1 month and 2 months. And the differences of recovery rate and incidence of pressure ulcers were compared between intervention group and control group. Results The recovery rate of pressure ulcers in intervention group was 59% (59/100) ,which was significantly higher than 32% (32/100) of the control group (χ2=14.690, P=0.000), and the incidence of pressure ulcers rate was 24% (24/100) in intervention group which was significantly lower than 39%(39/100) in the control group (χ2=5.214,P=0.022). Primary caregivers′behavior scores in the intervention group were (48.27±6.12) points after 1 month and (46.18± 4.44) points after 2 months, while those in the control group were (44.15 ± 4.33) points and (43.33 ± 5.67) points, respectively, and the difference of behavior scores in different time-points were statistically significant (F=18.93, P < 0.01). Moreover, the difference of behavior scores was also statistically significant between intervention group and control group (F=5.512, P < 0.05). Conclusions Wound experts′ intervention on home primary caregivers can effectively help improve caregivers′ behavior, promote the healing of pressure ulcers, and reduce the occurrence of complications.

Beginning with the principle of justice, this article analyzed the reasons of medical disputes due to the lack of the principle of justice from four aspects including patients, social media, medical institutions, and medical staff. Corresponding countermeasures were put forward based on the causes of the disputes: fostering cor-rect consciousness of medical treatment, persisting on objective propaganda and creating a favorable environment, strengthening the construction of medical ethics and increasing health investment, strengthening the professional competency education for medical staff, and setting up medical dispute mediation organizations dominated by the third party.

Objective To probe into clinical application value of tetramethylpyrazine injection as an adjuvant of 1,6-diphosphate in the treatment of neonatal hypoxic-ischemic encephalopathy.Methods From January 2012 to December 2012,98 neonatal hypoxic-ischemic encephalopathy children patients were selected in the Second Affiliated Hospital of Shenyang Medical College.The children patients were divided into observation group and control group randomly.There were 49 cases in each group.Both two groups adopted 1 ,6 diphosphate - fructose,and the observation group adopted ligustrazine injection on the basis of control group.The clinical treatment and prognosis of the children patients in two groups were compared and analyzed.Results The rates of significant efficiency and total efficiency were 67.35%and 93.88%in observation group,which were higher than those in control group (51.02%,71.43%),and there were statistically significant (P <0.05 );compared with control group,the NBNA scores of observation group were improved significantly after 3rd,7th and 14th days treatment,and there were statistically significant (P<0.05);compared with control group,the ratio of cerebral palsy,epilepsy,mental retardation and death in observation group showed different degree of reduction,but there were no statistically significant.Conclusion The effect of tetramethylpyrazine injection adjuvant 1 ,6-diphosphate in treatment of neonatal hypoxic-ischemic encephalopathy was effective and significant.It has positive role in promoting the improvement and upgrading of the clinical efficacy and prognosis.

Objective] To summarize professor Shen Hong's clinical experience in treating chronic atrophic gastritis. [Method] By following the teacher clinic and sorting out the related medical materials, the author summarizes professor Shen Hong's academic experience of treatment of chronic atrophic gastritis, and for proven cases. [Result] Professor Shen Hong thinks that the essence of pathogenesis is the weakness of the spleen and stomach. Qi stagnation, damp stagnation and blood stasis are common pathological factors. The characteristic of the disease is deficiency in origin and excess in superficiality. The location of disease is in stomach, relating to liver and spleen. The principle of treatment should be strengthening the spleen and stomach. It is also very important to treat accompanying symptoms and balance property of Chinese medicines. Prof. Shen emphasizes the combination of disease and syndrome differentiation and the integration of TCM and western medicine. He attaches much weight to diet and psychotherapy. The medication is concise and the prescription changes flexibly with the permitted addition and subtraction. The clinical curative effect is satisfactory. [Conclusion] Professor Shen Hong 's experience is effective and worthy of inheritance and promotion.

Effects of antineoplastic agents on endocrine system are common, but it is difficult to identify since clinical complaints are subtle, and even more difficult to relate a particular chemotherapeutic regimen to the induced endocrine disturb. This review was organized according to the pattern of endocrine system diseases induced by antineoplastic agents, such as disorders of glucose metabolism, free water clearance, mineral metabolism, lipid metabolism and GH secretion and growth, metabolic bone diseases, adrenal dysfunction, thyroid disorders and reproductive dysfunction. Early detection and treatment of endocrine deficiency may have a significant impact on the quality and duration of life in a cancer survivor.

AlM:To evaluate the long-term efficiency and safety of overnight orthokeratology in myopia correction and control in adolescents.METHODS: Sixty-five myopia adolescents treated in our hospital from August 2011 to February 2012 were retrospectively analyzed and followed up to 2a. Among them, 35 cases ( 67 eyes ) wearing overnight orthokeatology were included as trial group, and 30 cases ( 60 eyes ) wearing spectacles were included as control group. The trial group were divided into 2 subgroup according the myopic grading in the initial visit:subgroup A(35 eyes,≤-3. 00D), B subgroup (32 eyes,>-3. 00D and ≤-6. 00D). ln the trial group, slit lamp, visual acuity, refraction, intraocular pressure, corneal tomography were collected before wearing overnight orthokeratology, 1d, 1wk, 1month, 3mo, and every 6mo after wearing overnight orthokeratology , with axial length, corneal thickness, anterior chamber depth, corneal endothelial cell count, abjective refraction and tear film were also collected before and 2a after wearing overnight orthokeratology. ln the control group, slit lamp, visual acuity, refraction and intraocular pressure were collected before wearing and 2a after wearing spectacles. Paired t test were used to compare the intragroup difference. One-way analysis of variance ( ANOVA) was used to compare the differences among the groups. P<0. 05 was considered statistically significant.RESULTS: The uncorrected visual acuity of the trial group was improved obviously after wearing Orthokeratology Lens 1d, the visual acuity of a group patients improved more significantly. The corneal curvature ( including vertical curvature and horizontal curvature ) of the trial group became more flat after wearing Orthokeratology Lens 2a and stopped 2 wk; The length of ocular axis was also increased, the growth rate of B group (0.33±0.31)mm was lower than that of group A (0. 43±0. 25)mm; Subjective refraction of myopia was increased 0.68±0.49D than wearing Orthokeratology Lens before, but compared with the growth (2. 08 ± 0. 57) D of the control, the effect of myopia control was more obviously. Grade of dry eye was more severely than that of wearing Orthokeratology Lens before, but there was no significant difference between groups A and B. Compared with wearing Orthokeratology Lens before, corneal thickness, anterior chamber depth, corneal endothelial cell number and the intraocular pressure were all no significant differences between the trial and control group.CONCLUSlON: Orthokeratology is a safe and effective method for the correction of myopia, and long-term use of Orthokeratology Lens can effectively control the development of myopia. Controlling of moderate myopia is more effective than that of low myopia.

Objective To observe the relation between functions of vessels of lower extremities and TCM syndromes differentiation in diabetes patients. Methods Totally 168 diabetics of Type II were differentiated into 5 syndromes, i.e. 29 cases of yin deficiency with excessive heat, 41 cases of qi and yin deficiency, 30 cases of yin and yang deficiency, 37 cases of blood stasis in channels, and 31 cases of damp heat affecting the spleen, and 26 healthy people were involved in the control group. The peripheral vessel diagnostic system was adopted to get the toe photoplethysmogram (PPG) and ankle brachial index (ABI) to observe the blood perfusion of limb terminals and the functional state of lower limb arteries. The relation between function of vessels of lower extremities and TCM syndrome was analyzed. Results All the diabetic groups were related with the arterial blood supply of toe terminals. Diabetes was the main risk factor in affecting the terminal blood supply (P

Objective: To investigate the proportion of high-risk population for cardiovascular diseases (CVD) among residents at ages of 35 to 79 in Nanjing City, and establish a prediction model of high-risk population for CVD. Methods: Residents at ages of 35 to 79 years were selected from Nanjing City using a multi-stage stratified cluster random sampling method from 2020 to 2021. Participants' demographic information, characteristics of lifestyle and blood biochemical index were collected using questionnaire surveys, physical examination and laboratory testing. The high-risk population for CVD were determined according to the Chinese Guidelines for Cardiovascular Disease Risk Assessment and Management, and the Chinese Guidelines for the Prevention and Treatment of Adult Dyslipidemia (2016 Revision). Predictive factors for high-risk population for CVD were screened using a multivariable logistic regression model. A nomogram was established and verified with receiver operation characteristic (ROC) curve. Hosmer-Lemeshow goodness of fit test was used to evaluate the fitting effect and Bootstrap method was used for internal verification. Results: A total of 38 428 individuals were surveyed, including 17 970 males (46.76%) and 20 458 females (53.24%), and 25 714 individuals aged 35 to 59 years. There were 8 905 high-risk population for CVD, with a detection rate of 23.17%. Multivariable logistic regression analysis identified 9 factors affecting high-risk population for CVD. A prediction model was established for ln[P/(1-P)]=-7.305+2.107×age-0.366×gender+0.299×marital status-0.297×educational level+0.631×body mass index+0.013×sleep duration+0.096×edible salt intake+0.444×smoke-0.069×alcohol consumption. The area under ROC curve was 0.799 (95%CI: 0.794-0.805), the sensitivity and specificity were 0.731 and 0.753, indicating good differentiation. The nomogram based on the above factors indicated good calibration and stability. Conclusion The nomogram constructed by age, gender, marital status, educational level, body mass index, sleep duration, edible salt intake, smoking and alcohol consumption can be used to predict high-risk population for CVD.