Genetic factors are the important reasons for birth defects.Among genetic factors,chromosome abnormality is the most common.Prenatal diagnosis can effectively avoid fetus of abnormal chromosome being born.Noninvasive prenatal diagnosis has more advantage than invasive prenatal diagnosis,such as non-invasive,painless and safe.It is bound to become the main method of prenatal diagnosis.However,non-invasive prenatal diagnosis is still in its infancy stage and the accuracy and sensitivity of detection are pending and need further clinical validation.This article will present a variety of non-invasive prenatal diagnostic methods using cell-free fetal DNA (RNA) and their advantages and disadvantages will be discussed.

Objective: To investigate the association between the polymorphism of HLA-A, HLA-B genes and pre-eclampsia. Methods: HLA-A, HLA-B genotyping was performed by polymerase chain reaction sequence-specific primer (PCR-SSP) in 119 preeclampsia patients, 117 normal pregnant women and their neonates. Results: The study showed that 16 HLA-A and 39 HLA-B alleles were obtained in pre-eclamptic patients and normal pregnant women. 15 HLA-A and 37 HLA-B alleles were obtained in their neonates. No significant difference was found in maternal or neonatal HLA-A, HLA-B alleles be-tween pre-eclampsia group and control group (Pc>0. 05). The frequencies of HLA-A11, HLA-A24,HLA-B13, HLA-B14, HLA-B15, HLA-B52 maternal/fetus genetic assoications were significantly different between pre-eclampsia group and control group (P<0. 05). Conclusion: Some HLA-A, HLA-B maternal/fetus special bindings may be associated with the susceptibility or protective of pre-eclampsia.

Objective Tongue shape and motion is one of the important references for tongue diagnosis.However, current tongue image objectification of tongue diagnosis cannot express the characteristics of tongue.Methods In order to increase shape and dynamic information about the tongue, the methods of key frame selection and linear interpolation were used to tongue 3D dynamic visualization reconstruction model on the basis of 3D static visual model.For the convenient use of the tongue 3D dynamic visualization model, this paper put forward a model of 3D dynamic visualization interaction system which was realized based on DirectX.Results The 3D dynamic visualization model not only had a static visual model of texture and depth information, but also could intuitively describe the tongue motion.Conclusions It provides a method for the auxiliary tongue diagnosis of traditional Chinese medicine (TCM).

Objective To investigate the clinical value of serum procalcitonin (PCT) in diagnosis of urinary tract infection(UTI) in elderly patients.Methods 114 elderly patients with UTI in the department of infectious diseases of a hospital from January 2013 to December 2014 were analyzed retrospectively, clinical data of patients with abnormal and normal serum PCT were compared, PCT levels in patients with positive and negative blood cultures were compared, PCT receiver operating characteristic (ROC) curve for the diagnosis of bacteremia were drawn.Results Among 114 elderly patients with UTI, 46 were with abnormal PCT, 68 were with normal PCT.In abnormal PCT group, the proportions of patients with highest body temperature within 24 hours of admission, white blood cell count, neutrophil granulocyte percentage, C-reactive protein (CRP), blood urea nitrogen(BUN), creatinine(Cr), and urinary tract obstructive disease were all higher than those with normal PCT (all P<0.05).Among 42 patients with blood culture, PCT level in positive blood culture group(n=12) was higher than negative blood culture group(n=30)(1.93 [0.57-8.32] μg/L vs 0.36[0.15-1.01]μg/L, P=0.028).The area under the ROC curve (AUC) of the patients with bacteremia diagnosed by PCT was 0.72(95%CI:0.54-0.90),at the optimal value of 0.52 g/L, sensitivity, specificity, positive predictive value, and negative predictive value were 83.3%, 63.3%, 47.6%, and 90.5% respectively.Conclusion Serum PCT level can well reflect the severity of elderly patients with UTI, and is of great value in early diagnosis of bacteremia in elderly patients with UTI.

Objective To investigate serum interferon-inducible protein 16 (IFI16) level in the patients with preeclampsia (PE) and its correlation with PE pathogenesis.Methods Forty-five PE pregnant women in the Third Affiliated Hospital of Zhengzhou University from August 2015 to March 2016 were selected as the PE group and contemporaneous 30 healthy pregnant women undergoing the routine pregnant examination were selected as the control group.The biochemical indexes of serum urea,uric acid,creatinine,etc.were detected by using the automatic biochemical analyzer.The serum levels of IFI16 and ET-1 were measured by ELISA.Then the correlations between serum IFI16 level with these detected indicators were analyzed.The receiver operating characteristic (ROC) curve analysis was performed to evaluate the value of serum IFI16 for predicting PE disease.Results The serum IFI16 and ET-1 levels in the PE group were significantly higher than those in the control group (P<0.01).Furthermore the serum IFI16 level in severe PE was significantly higher than that in mild PE (P<0.01).Serum IFI16 level in PE was positively correlated with systolic blood pressure,diastolic blood pressure,24-h urine protein quantitation and serum ET-1 level,and negatively correlated with serum albumin.Serum IFI16 levels 14.47 ng/mL and 17.09 ng/mL as the critical values for predicting preeclampsia and discriminating between mild preeclampsia and severe preeclampsia has a higher sensitivity and specificity.Conclusion The high level of serum IFI16 in pregnant women has a certain correlation with PE pathogenesis and may be a novel biomarker for predicting PE occurrence.

Objective To investigate the value of elasticity score and elasticity strain ratio (SR) in predicting the central lymph nodes metastasis of papillary thyroid microcarcinoma (PTMC). Methods This study conducted a retrospective analysis of ultrasonography ifndings of 236 thyroid lesions from 208 patients. All of them underwent surgery in Ruijin Hospital of Shanghai Jiao Tong University from June 2012 to March 2013. Totally 82 PTMC from 82 patients were included in this study. Among them 12 patients with 12 PTMC had central lymph nodes metastasis. The elasticity score and SR were compared between metastasis and non-metastasis groups, and the receiver operating characteristic (ROC) curve of SR was calculated. Results The differences of PTMC elasticity score between two groups showed no statistical signiifcance (χ2=5.00, P=0.08). The average SR of the group with central lymph nodes metastasis is 2.44±0.61, which is higher than the group without lymph nodes metastasis whose average SR is 1.67±0.42. Differences are statistically signiifcant (t=5.5, P=0.00). The area under curve of SR-ROC curve was 0.847. Using 2.01 as cutoff of SR, the sensitivity, speciifcity, accuracy of predicting central lymph nodes metastasis was 83.3%, 81.4%, 78.6%respectively. Conclusion The SR but not elasticity score could be a meaningful indicator for predicting lymph nodes metastasis.

Objective To construct extravillous trophoblast(EVCT) tissue microarray and detect the expression of phosphorylated signal transducer and activator of transcription 3 (pStat3) in EVCT and to explore the role of Stat3 signal transduction pathway in the pathogenesis of preeclampsia.Methods Placentas of 80 pregnant women with preeclampsia and 58 normal pregnant women hospitalized in the Third Affiliated Hospital of Zhengzhou University from December 12,2007 to December 31,2010 were recruited for constructing EVCT tissue microarray.Vimentin,cytokeratin and human leukocyte antigen-G were used to verify EVCT tissue microarray immunohistochemically.The difference of pStat3 expression was detected between preeclampsia patients and normal pregnant women by immunohistochemical staining.Rank sum test,Kruskai-Wallis H test,t-test and Chisquare test were used for statistical analysis.Results Placental tissues from 57 preeclampsia patients (109 tissue cores) and 31 normal pregnant women (65 tissue cores) were suitable for constructing EVCT tissue microarray.The target tissue was positive for both cytokeratin and human leukocyte antigen-G staining and negative for vimentin,which was in accordance with the characters of EVCT tissue.Totally 86.4％(76/88) samples retained the target EVCT tissues,which meant EVCT tissue microarray was constructed successfully.The expression of pStat3 was significantly decreased in EVCT of preeclampsia patients (51.1％,24/47),the early onset (50.0％,19/38) and severe preeclampsia patients(52.3％,23/44) as compared to normal pregnant women (72.4％,21/29) (U=492.00,473.00 and 401.00,P＜0.05 respectively).Conclusions EVCT tissue microarray has been successfully constructed,and could be used to detect pStat3 expression.pStat3 signal transduction pathway may be involved in the development of preeclampsia.

ObjectiveTo evaluate the association between Pro12Ala polymorphism in peroxisome proliferator activated receptorγ2 (PPARγ2) gene and gestational diabetes mellitus(GDM).Methods Publications on genetic association studies of PPARγ2 and GDM were searched using the PubMed database, The HuGE Navigator, China National Knowledge Infrastructure (CNKI), Wanfang database and VIP Science from the inception of the databases to December 1, 2014. Two reviewers independently selected literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the data using the Newcastle-Ottawa Scale (NOS) standard. Meta-analysis was performed using RevMan 5.3 software.ResultsOverall, 13 eligible articles were identified, including seven in English and six in Chinese, with a total of 2 787 GDM cases and 5 408 healthy controls. Quality assessment showed that the quality of the 13 articles was all good, with NOS≥5. (1) Pro12Ala polymorphism in PPARγ2 (allele Ala or genotype Ala/Ala or Pro/Ala) was shown to be highly associated with GDM occurrence on general evaluation, with anOR(95%CI) of 0.74(0.60-0.93) in the allele model and 0.79(0.65-0.96) in the dominant genetic model (P<0.05, respectively). (2) Pro12Ala polymorphism in PPARγ2 was shown to be highly associated with GDM occurrence in Asians in a stratification analysis of ethnicity in the populations included in the studies, with anOR(95%CI) of 0.61(0.48-0.79) in the allele model and 0.64(0.50-0.82) in the dominant genetic model (P<0.01, respectively). No correlation was found between the Pro12Ala polymorphism in PPARγ2 and GDM in the Caucasian population. (3) A meta-analysis of six Chinese studies showed that the Pro12Ala polymorphism in PPARγ2 was associated with the risk of GDM in the Chinese population, with anOR(95%CI) of 0.52 (0.36-0.73) in the allele model and 0.55(0.39-0.80) in the dominant genetic model (P<0.01, respectively). (4) No significant association was observed in the TaqMan allelic discrimination assay with anOR(95%CI) of 0.96(0.83-1.10) in the allele model and 0.95(0.81-1.11) in the dominant genetic model (P>0.05, respectively), although there was still a significant correlation in polymerase chain reaction-restriction fragment length polymorphism with anOR(95%CI) of 0.58(0.43-0.79) in the allele model and 0.62(0.45-0.85) in the dominant genetic model (P<0.01, respectively).ConclusionsThe Ala allele and the Ala/Ala or Pro/Ala genotypes of the Pro12Ala polymorphism in PPARγ2 can decrease the risk of GDM. However, there are differences in the results which are affected by the genotype analysis method or races.

Objective:To investigate the clinical value of Octreotide plus Ulinastatin in the treatment of severe acute pancreatitis(SAP)in elderly patients.Methods:From May 2016 to February 2019, 124 elderly SAP patients admitted to the gastroenterology department of our hospital were enrolled and divided into the combination therapy group and the control group, with 62 patients in each group.The combination therapy group was treated with Octreotide and Ulinastatin, while the control group was treated with Octreotide alone.Serum leukocyte count, C-reactive protein(CRP), interleukin(IL)-6, tumor necrosis factor(TNF)-α and amylase levels were monitored before and 1, 3, 5, 7 and 14 days after treatment by automated biochemical analysis and enzyme-linked immunosorbent assays.The pain grade scale, APACHE-Ⅱ score and efficacy evaluation were analyzed for the two groups 7 days after treatment.The time to oral refeeding and length of hospitalization were compared between the two groups, and related complications during the treatment were recorded.Complications and the recurrence of pancreatitis within 1 year were followed up in both groups.Results:There was no statistically significant difference in serum white blood cell count, CRP, amylase, IL-6 and TNF-α levels between the two groups before treatment(all P>0.05). Serum white blood cell count, CRP and TNF-α levels had significant differences( t=3.735, 2.851 and -2.147, P=0.036, 0.029 and 0.043)and serum amylase and IL-6 levels had no significant difference( P>0.05)between the two groups 3 days after treatment.All the above parameters had significant differences between the two groups 7 days after treatment( t=3.624, 2.918, -2.166, 2.684 and -2.593, P=0.023, 0.011, <0.001, 0.015 and <0.001). Serum amylase, IL-6 and TNF-α levels had significant differences( t=-3.515, 4.627 and -3.189, all P<0.001)and serum white blood cell count and CRP had no significant difference(all P>0.05)between the two groups 14 days after treatment.There were significant differences in visual analogue scale(VAS)and APACHE-Ⅱ score between the two groups 7 days after treatment( t=-2.346 and -3.245, P=0.021 and 0.002). On the 7th day after treatment, the effectiveness rate was 79.0%(49/62)in the combination therapy group and 61.3%(38/62)in the control group, with a significant difference between the two groups( χ2=4.661, P=0.031). Compared with the control group, time to oral refeeding and hospitalization length were shorter in the combination therapy group than in the control group(6.72±1.87 d vs.7.65±1.69 d, 11.23±2.98 d vs.13.85±3.42 d, t=-2.868 and -4.565, both P<0.05). There were significant differences in the incidences of infectious pancreatic necrosis, gastrointestinal adverse reactions and organ failure between the combination therapy group and the control group(11.3% or 7/62 vs.25.8% or 16/62, 43.5% or 27/62 vs.21.0% or 13/62, 1.6% or 1/62 vs.11.3% or 7/62, χ2=4.324, 7.233 and 4.810, P=0.038, 0.007 and 0.028). There were significant differences in mean length of time without complications and recurrence between the combined group and the control group(10.25±3.26 months vs.8.72±3.73 months, 10.69±2.51 months vs.9.62±2.92 months, Log Rank χ2=7.463 and 4.589, P=0.006 and 0.032). Conclusions:Octreotide combined with Ulinastatin can effectively alleviate local symptoms, slow clinical progression, reduce the risk of complications, decrease the recurrence rate and promote early recovery in elderly SAP patients.

Objective To investigate the effects of hypoxia on the expression of Stat3 and p-Stat3 ,and assessed the apoptosis ability of JAR cells in vitro .Methods JAR cells were cultured under hypoxic conditions .Western blot were used to determine the protein expression of Stat3 and p-Stat3 .Cellular apoptosis was monitored by flow cytometry analysis .Results Abnormal morpholo-gy changes in trophoblast cells under low oxygen conditions .After 48 h hypoxic treatment ,the protein of Stat3 and p-Stat3 were significantly decreased(P< 0 .05) ;however ,the level of apoptosis was significantly increased (P < 0 .05) .Conclusion Stat3 and p-Stat3 protein levels were decreased under hypoxia circumstance ,while the cell apoptosis ability was increased in JAR cells .