Objective To explore the childhood abuse impact on clinical and personality characters among anxiety associated depressive patients.Methods A case-control method was taken among 86 anxiety associated depression patients,36 cases with childhood abuse and controlled with 50 cases without childhood abuse.HAMD,HAMA,CECA-Q,MMPI were used to evaluate the participants,and the scores of the results were compared between the two groups.Results For the HAND,the group with CA were significantly higher than the group without CA(t=7.079,P＜0.05).From the point of factor scores,there was not a significant difference between the two groups among the factors such as anxiety somatization,cognitive impairment,and hopelessness.From the point of view of the total scores of HAMA (t=3.108) and spiritual anxiety (t=4.037),somatic anxiety (t=2.742) the CA group was significantly higher than group without CA(P＜0.05).In the patients with CA the psychoticism(P) (t=2.794) and neuroticism (N) (t=3.217) factors were significantly higher than patients without CA (P＜0.05).MMPI evaluation results showed accept ance T points in addition to lie(L),calibration(K),male woman(Mf),light mania(Ma),the CA group were significantly higher than the group without CA(P＜0.05).T points to compare two groups of MMPI additional factor scale,the adaptation to the society (A),emotional intelligence (EQ),decisionmaking ability (DE),CA group were lower than the group without CA,violence (VL),traffic accident (DR) and addiction(SA) with CA group was higher than the group without CA(P＜0.05).The regression analysis showed that the emotional neglect score and HAMD scores were positively related in the relationship of the childhood abuse and depression.Y =3.729+0.887 X(P=0.000).Sexual abuse score and HAND scores were related,regression analysis showed that the Y =9.799 + 0.655 X (P =0.000).Conclusions The clinical patients with CA have more severe symptoms than the patients without CA.Personality is extraversion more emotionally unstable.Their emotional intelligence and decision-making comprehensive ability is low,and violence tendency is obvious.Emotional neglect and sexual abuse have an important impact in the pathogenesis of the disease.

Objective To investigate the application effect of nasal gastrointestinal double lumen catheter tube placement with air insufflation in mechanically ventilated patients with intra-abdominal hypertension.Methods A total of 20 patients with intra-abdominal hypertension were randomly divided into control group and observation group (n=10 in each group).Patients in control group received indwelling nasogastric tube for decompression and indwelling nasal intestine tube by air insufflation for enteral nutrition support .Patients in observation group received the dual lumen gastrointestinal tube for decompression and enteral nutrition support.The time required for catheterization,changes in intra-abdominal pressure before and after air insufflation,catheter success rate at one attempt,pain scores of patients to catheter operation, duration of decompression,enteral nutrition start time and the duration of mechanical ventilation were compared between two groups.Results The time required for catheterization,catheter air insufflation volume in observation group were significantly lower than those in control group (P <0.01);pain scores of patients to catheter operation were significantly lower in observation group than those in control group (P <0.01);There was no significantly difference in once catheter success rate,changes in intra-abdominal pressure before and after catheterization,abdominal high pressure relief time ,enteral feeding start time, and duration of mechanical ventilation between the two groups (P >0.05 ).Conclusions The technique of air insufflation has higher success rate for Indwelling nasal intestine tube in mechanically ventilated patients with intra-abdominal hypertension,and this method is safe and reliable,dual lumen gastrointestinal tube can improve patients'comfort,shorter catheterization time and reduce catheter air insufflation volume.

Decreasing trend has occurred in incidence of colorectal cancer in developed countries. A shift from left to right in location of colorectal cancer has been recognized,which may be associated with colonoscopy screening,aging population,diet structure modification,increased incidence of cancer and diabe-tes. Factors including sex,race and education may also play a role to some extent. Right-sided intestinal cancers have higher proportion of poor differentiation,terminal stage and mucinous component. Complications and second primary intestinal cancer are more common in right-sided intestinal cancers. Left-sided intestinal cancers tend to be well differentiated and at relatively early stage at diagnosis. With respect to molecular mecha-nism,right-sided cancers are associated with mismatch repair system,while left-sided cancers are related to p53 mutation. Based on the differences in clinicopathology and genetics,it′s implied that left-sided and right-sided intestinal cancers may belong to two different kind of disease. It′s suggested that attentions should be paid differently according to their respective characteristics in clinical practice and trials.

Abstract: Objective To investigate the correlation between persistent and non-persistent HPV infection and vaginal microecology and cervical lesions, and to provide the basis for HPV prevention and treatment. Methods In this prospective study, 229 female patients with high-risk type (HR-HPV) were selected for cervical cytology and vaginal microecological examination in the gynecological outpatient department of Baise Maternal and Child Health Hospital from January 2018 to June 2021. The patients were followed up for 1 year to detect persistent HR-HPV infection. The relationship between HR-HPV persistent infection and vaginal microecology and cervical lesions was analyzed using the HPV-negative group as a control. Results Among 229 patients with HR-HPV, there were 109 patients with persistent HR-HPV infection and 120 patients with non-persistent HR-HPV infection in 1-year follow-up, and the incidence of persistent HR-HPV infection was 47.6%. In the HR-HPV persistent and non-persistent infection and HPV-negative groups, the bacterial vaginal incidence was 20.2%, 15.0% and 8.6%, respectively; vulvovaginal candidiasis was 19.3%, 13.3% and 7.9%, respectively; trichomoniasis vaginitis was 12.8%, 9.2% and 4.5%, respectively; mixed infection was 10.1%, 6.7% and 2.7%; H2O2 detection rate was 24.8%, 18.3% and 12.0%,the positive rate of pH value was 52.3%, 40.8% and 36.4%, and microecological normal detection rate was 22.9%, 32.7% and 40.2%, respectively. There were significant differences among the three groups (χ2=10.634, 10.522, 9.010, 9.374, 10.054, 8.268, P<0.01). In the HR-HPV persistent and non-persistent infection groups, the rates of atypical squamous cell detection were 12.8% and 10.0%, and 8.3% and 4.2% for low-grade squamous cell lesions, and 4.6% and 1.7% for high-grade squamous cell carcinoma, 2.8% and 0 for squamous cell carcinoma, respectively. There was no significant difference in the composition of atypical squamous cells between the two groups (χ2=4.358, P>0.05), there were significant differences in the composition of low-grade, high-grade and squamous cell carcinoma (χ2=11.472, 12.685, 11.378, P<0.01). Spearman rank correlation analysis showed that the presence or extent of HPV infection was positively correlated with bacterial vaginosis, vulvovaginal candidiasis, trichomonal vaginitis and mixed infection (P<0.05), positively correlated with H2O2, sialdase, leucocyte esterase,pH positive and positive for all four items (P<0.05), negatively correlated with microecology (P<0.01), positively correlated with low grade, high grade and squamous cell carcinoma (P<0.01), and not significantly correlated with atypical squamous cell carcinoma (P>0.05). Conclusion Persistent cervical HPV infection is an important factor of dysregulation in vaginal microecology and aggravates the degree of dysregulation in vaginal microecology, which is related to the development of cervical lesions.

Objective • To investigate the effect of mammalian target of rapamycin (mTOR) inhibitor rapamycin on acute myeloid leukemia (AML) with DNA methyltransferase 3A (DNMT3A) R882 mutation in mouse model. Methods • AML cell line OCI-AML3 cells with DNMT3A R882 mutation were cultured with the treatment of rapamycin or DMSO, and then these cells were injected into the tail vein of sublethally irradiated NOD/SCID mice, respectively. The disease progression was monitored by blood routine examination and flow cytometry analysis of CD45+, OCI-AML3 cells, in peripheral blood. Survival time was recorded. Samples from bone marrow, spleen and liver were harvested for flow cytometry analysis and pathological examination. Results • The increasing trend of peripheral leukocytes in the rapamycin treated group was obviously slower than that in the DMSO treated group. The proportion of peripheral blood CD45+ cells in the rapamycin treated group was (4.44±2.58)% (1 week after transplantation) and (34.42±13.64)% (2 weeks after transplantation), which were lower than (16.71±8.96)% and (51.55±5.36)% in the DMSO treated group in the same period, respectively. The median survival time of the rapamycin treated group (27 d) was significantly longer than that of the DMSO group (23 d). The ratios of CD45+ cell infiltration in bone marrow, spleen and liver of the rapamycin treated group were all less than 5%, which were significantly lower than those [(51.32±27.81)% in spleen and (50.03±28.74)% in liver] of the DMSO treated group. Compared with the DMSO treated group, the spleen size of the mice was significantly smaller, and the spleen infiltration and structural damage were significantly alleviated in the rapamycin treated group. Conclusion • Rapamycin shows effective inhibition on the progression of AML with DNMT3A R882 mutation in NOD/SCID mouse model.

Background C57BL/6(B6) is a kind of routine mouse specie used in experimental autoimmune uveitis (EAU) research.Previous studies showed that the pathogenesis of uveitis related to inflammatory cytokines secreted by different helper T(Th) cells.However,the interaction of different Th cells in EAU is unclear.Objective This study was to investigate the dynamic changes of inflammatory factors in the spleen and serum after immunization in EAU mice.Methods Forty-four SPF B6 mice were immunized by injection of interphotoreceptor retinoid-binding protein (IRBP) and complete Freund adjuvant (CFA) emulsion via caudal vein and footpad.Indirect ophthalmoscope was used to examine the eyes 3 times per week and the inflammatory response was scored based on Thurau's criteria.In the thirty day after injection,20 model eyes were extracted and the sections of eye tissue were prepared for histopathological examination.The spleens of model mice were enucleated before injection and 2,5,10,15,20,25,30 days after injection,and reverse transcriptase PCR (RT-PCR) was used to detect the contents of interleukin-17 (IL-17) mRNA,interferon-γ (IFN-γ) mRNA,tumor necrosis factor-α (TNF-α) mRNA and IL-10 mRNA,and the contents of IL-17,IFN-γ,TNF-α and IL-10 in model serum were assayed by ELISA in 24 model mice.The experimental protocol and use of the animals were approved by Ethic Committee for Care and Use of Laboratory Animals of Shandong University of Traditional Chinese Medicine.Results Mild inflammatory response was seen in 12 days under the indirect ophthalmoscope with the scores of 0.5.The inflammatory scores peaked in 13-15 days with the scores of 1.0 and alleviated after that with the inflammatory scores of 0.5 in 30 days after injection.The histopathological score was consistent with the clinical score in the models on the 30 days.The serum IL-17 content of model mice was (0.98±0.05) ng/L before injection and increased to (51.85 ±2.42) ng/L on the fifth day,and decreased to (4.01±0.06)ng/L on the fifteen day.But,the serum IL-17 level increased to (25.00±0.94)ng/L again on the 25th day,and then lowed to (6.01 ±0.21)ng/L 30 days after injection,showing a significant elevation in comparison with that of before injection (P=0.000).The serum IFN-γ content of the model mice was (1.02±0.09)ng/L before injection and increased to (50.54±0.48) ng/L on the fifth day,and (73.21±0.12) ng/L on the tenth day,and then it declined gradually until (5.15±0.18)ng/L in the 30th day,which was still higher than that of before injection (P=0.000).After injection of IRBP+CFA,the serum TNF-α level upregulated from the second day to fifth day with the peak values (134.25±0.59)ng/L,and declined to valley on 15th day.A repeat elevation of serum TNF-α level was found on the 20th day with the values (60.54±0.62)ng/L and followed by decrease till the 30th day,which was higher than that of before injection (P=0.660).Serum IL-10 was detectable in the tenth day and peaked on the 15th day.Then a slight decrease was seen till the 30th day,compared with before injection(P =0.000).The contents of IL-10 mRNA,IL-17 mRNA,TNF-α mRNA,IFN-γmRNA in mice spleens followed the same pattern with serum levels of their proteins.Conclusions IL-17,IFN-γ,TNF-α and IL-10 are key inflammatory factors of Th1,Th2 and Th17,they present with specific changes during EAU,it confirming that IFN-γ probably play a pathogenic role in EAU,IL-17 and TNF-α levels probably associated with the chronic and recurrent procedure of uveitis,IL-10 plays an inhibit role in EAU.

ObjectiveTo summarize the echocardiographic diagnosis, clinical classification and prognosis of different types of fetal congenital cardiac malformation (FCMH).MethodsThe echocardiography sonogram characteristics for 429 cases with FCMH were summarized and analyzed by pathological findings and postnatal following-up.ResultsThe incidence of FCMH was 1.3% (429/33 800). In one hundred and seventy-seven caese of single structure malformation, there were 5 cases of Atrial septal defect and 55 cases of interventricular septal defect (34.5%, 61/177). The others including (116 cases): 10 cases of single atrium and 34 cases of single ventricle, 20 cases of Ebstein’s anomaly, 11 cases of tricuspid atresia and 6 cases of pulmonary atresia with intact ventricular seprum, 20 cases of pulmonary stenosis, 10 cases of coarctation of aortic arch and 4 cases of interruption of aortic arch, 1 case of pulmonary artery sling. In two hundred and thirty-three cases of symphysic teratism, there were 41 cases of double-outllet right or left ventricle (17.5%, 41/233) and Tetralogy of Fallot (40 cases, 17.2%, 40/233). The others (152 cases) including: 16 cases of complete and 18 cases of corrected transposition of great arteries, 38 cases of atrioventricular septal defect, 30 cases of truncus arteriosus persistens, 8 cases of total and 10 cases of partial abnormal pulmonary venous drainage, 14 cases of hypoplastic right heart and 6 cases of left heart syndrome, 9 cases of pulmonary artery atresia with ventricular septal defect, 2 cases of plysplenia and 1 case of plenia syndrome. Nineteen cases of instructure cardiac anomalies including 16 cases of heart tumor and 3 cases of endocardial ifbroelastosis. Nine cases were missed diagnosis and 7 cases were misdiagnosis. A total of 136 cases couldn′t be cured with an unfavorable outcome. Nighty three cases with severe FCMH could be cured. Fifty four cases needed emergent treatment postnatal, and 146 cases with mild abnormality.ConclusionsFetal congenital malformation of heart diagnosed by antenatal echocardiography is valuable for guiding the clinical decision in prevetion and treatment it can also reduce perinatal mortality with congenital malformation of heart.

Objective:To investigate the clinical characteristics and gene variation of asparagine synthase deficiency that is caused by ASNS gene variation. Methods:In Department of Neuroendocrine Pediatrics, Affiliated Hospital of Qingdao University from October 2018 to February 2020, the clinical data of a family of asparagine synthase deficiency were analyzed retrospectively.The pathogenic mutation of the proband was screened by the full exon analysis technique.The pathogenic sites of candidate genes were determined by combining the phenotype of the proband.In the heterotopic spot of the proband, his parents and other family members were verified by Sanger sequencing.Meanwhile, the relevant literature database was consulted, and the reported ASNS mutation related cases were collected and reviewed. Results:The female with proband visited the hospital at the age of 4 months, and she had recurrent convulsions at the age of about 3 months.Physical examination showed that the child suffered from microcephaly, and mental and motor retardation.Meanwhile, video electroencephalogram examination displayed extensive moderate high amplitude spiny slow wave and sharp slow wave.Exon sequencing illustrated that the compound heterozygous variants of ASNS gene were c. 1211G>A (p.R404H) and c. 1643C>T (p.S548F), respectively.c.1211G>A was a known pathogenic variant, and c. 1643C>T was a new variant.The proband′s younger brother visited the hospital at the age of 2 months, developed convulsions at the age of 1 month, and developed mental and motor retardation.Electroencephalogram displayed that bilateral posterior head was dominant, multiple foci and extensive spike wave, and spike slow wave and fast wave were distributed.Sanger sequencing revealed the same ASNS compound heterozygous variants as the proband.Both of them died of status convulsion at the age of 7 months and 6 months, respectively. Conclusions:This study is helpful to further understand the clinical features of the disease and reveal a new pathogenic mutation of ASNS gene, so as to enrich the mutation spectrum of ASNS gene, thus providing important basis for clinical treatment and genetic counseling.

Objective To investigate the prevalence,clinical classification,treatment and prognosis of neonatal hyperphenylalaninemia(HPA) in Xuzhou area,China.Methods Infants born between July 1,2003 and July 1,2015 in Xuzhou area were investigated.Heel blood samples of neonates were collected at 72 hours after birth,and the concentration of blood phenylalanine(Phe) was determined by fluorescent quantitative method in Xuzhou Maternity and Child Health Care Station Neonatal Disease Screening Center.Differential diagnosis was performed in all 265 cases diagnosed as HPA by urinary pterin analysis and dihydropteridine reductase activity determination.The blood Phe concentration and mental development were followed up regularly in infants with HPA.Mutations of phenylalanine hydroxylase (PAH) gene were analyzed by gene sequencing.The relationship between blood Phe concentration and mental development was analyzed by Bivariate correlation analysis.Results (1) The prevalence of HPA in neonates in Xuzhou was 1/4 635.Among the 265 confirmed HPA cases,260 cases(98.11％) had PAH deficiency,including 90(33.96％) classical phenylketonuria(PKU),84(31.70％) mild PKU and 86(32.45％) mild HPA.The other five patients(1.89％) diagnosed with tetrahydrobiopterin (BH4) deficiency all had 6-pyruvoyl tetrahydropteim synthase(PTPS) deficiency.(2) Among the 265 HPA cases,26 cases refused any treatment,including five cases of PTPS deficiency and 21 cases of PKU.Of the five patients with PTPS deficiency,two died and the other three had normal mental and physical development.Twenty-one PKU patients who refused treatment had mental retardation of various degrees.Among 153 PKU patients who received medical treatment,three died and 12 were lost to follow-up.(3) For 138 PKU patients who received dietary treatment and follow-up,the ages at the last visit were two months to 12 years,116 of them had normal mental development,the remaining 22 patients had mental retardation,and a negative correlation was observed between mental development and the average Phe concentration.(4) Thirty-five patients with PAH deficiency underwent gene sequencing,and 22 kinds of mutations of PAH gene were detected.Conclusions The prevalence of HPA in Xuzhou area is higher than the average national level.With early diagnosis and standard treatment,most of PKU neonates can have normal mental development.Phe level control is an important factor for mental development.

Objective To understand demonstration methods and ultrasonographic features of left and right atrial appendages in normal fetuses.Methods 200 consecutive normal fetuses during gestation age 19-28 weeks from November 2011 through April 2012 entered the study.Ultrasonographic features and the demonstrated rates of atrial appendages at different incidence angle of ultrasonography and different gestational weeks were recorded and calculated,respectively.Results Atrial appendages of normal fetuses can be demonstrated on atrial appendages plane,which was little lower the view of parasternal great artery short axis.The display rate of left,right and left-right atrial appendages was 92％,68％,65.5％,respectively.When ultrasound beam entranced into chest from the right side,the display rate of left-right atrial appendages was highest(94.3％).The best time to observe atrial appendages was 22 to 24 week of pregnancy.The majority of left atrial appendages were fingerlike hook shapes,with narrower bases and longer bodys,and the endocardial surfaces were relatively smooth.Sometimes with incisures on external edges.Whereas the majority of right atrial appendages were obtuse-angled triangle shapes,with broad bases and shallower bodys.On endocardial surface the pectinate muscles were often seen,which looked like serrated echoes,sometimes prominent taenia sagittalis were noted in right atrial appendages.Conclusions Atrial appendages of normal fetuses can be demonstrated using two-dimensional ultrasonography on atrial appendages plane.The demonstrated rates of atrial appendages were different according to different incidence angle of ultrasonography and gestational weeks.There were some differences in ultrasonographic features between left and right atrial appendages,which is very helpful in determinating atrial situs.