Objective To investigate the pathogenesis role of aquaporin 3 and aquaporin 9 in idiopathic polyhydramnios by detecting their expression and distribution in fetal membranes and placenta.Methods Twenty-one of term pregnancy women with idiopathic polyhydramnios were enrolled as patient group matched with 30 women with normal term pregnancy as control group.The expression and localization of aquaporin 3 and aquaporin 9 in fetal membranes and placenta were detected by real-time polymerase chain reaction and streptavidin peroxidase immunohistochemiscal staining.Results (1)The mRNA expressions of aquaporin 3 and aquaporin 9 were detected in amnion,chorion and placental tissue in both patient group and control group.Both aquaporin 3 and aquaporin 9 were demonstrated positive staining in the amnion epithelia,chorion cytotrophoblasts and placental trophoblast.(2)The ratio of aquaporin 3 and aquaporin 9 mRNA expressions in amnion in patient group comparing to those in control group were 5.00 and 3.25,while in chorion they were 2.03 and 2.08.When compared with those in amnion and chorion of control group,there was a significant difference(P<0.01).However,the relative change fold of aquaporin 3 and aquaporin 9 in placental trophoblast in patient group were decreased in comparison of those in control group,which also showed statistical difference(P<0.01).(3)The expression of aquaporin 3 and aquaporin 9 protein in anmion were 7.5 ±2. 0 and 11.1 ± 1.8 in patient group, while they were 5.3 ± 1. 6 and 5.6 ± 2. 3 in control group. In chorion, the expression of aquaporin 3 and aquaporin 9 protein was 7.5±2. 0 and 10. 0 ±1.6 in patient group, respectively, while in control group, they were 5.4 ±2.2 and 5.6±2. 1. When compared with those proteins in control group, it exhibited statistical difference (P<0.05). However, in placental trophoblast of patient greup,the expression of aquaporin 3 and aquaporin 9 protein were 3.5±1.4and 4. 0±2. 5, respectively, which were significantly decreased than 5.6±1. 3 and 7. 1±2. 9 in control group(P< 0. 05). Conclusions The alterations of aquaporin 3 and aquaporin 9 expressions in fetal membrane and placenta might be an adaptive response to idiopathic polyhydramnios. Further investigation should be needed to clarify the regulatory mechanism of aquaporin 3 and aquaporin 9 expressions.

Objective To find the optimal route of eontralateral C7 nerve transfer for brachial plexus avulsion injuries through autopsy. Methods The bilateral brachial plexus were exposed on 30 sides of 15 cadaverie specimens of adult. The C7 nerve root was sectioned at the junction site of trunk and division, and then dissected proximally to the foramina. The max length of anterior and posterior division of C7 was measured. The distance between the roof of C7 and the upper trunk and the lower trunk at the affected side through vertebral body route, prespinal route and a subcutaneous tunnel on the anterior surface of the neck was measured. Results The max length of anterior and posterior division of C7 was (7.67±1.06) cm and (7.79±1.36) cm respectively. The distance between the roof of C7 and the upper trunk at the affected side through vertebral body route, prespinal route and a subcutaneous tunnel on the anterior surface of the neck was (6.97±0.56) cm and (10.04±0.94) cm and (16.56±1.24) cm respectively, there were statistical significance among them (P < 0.01). The distance between the roof of C7 and the lower trunk at the affected side through vertebral body route and prespinal route and a subcutaneous tunnel on the anterior surface of the neck was (6.82±0.92) cm、(9.91±0. 83) cm and (17.64±0.97) cm, with a significant difference (P<0.01). Conclusion The best way of contralateral C7 nerve transfer for the treatment of brachial plexus injury was through the vertebral body route from the point of anatomy.

AIM:To explore the effect of FOXQ1 gene silencing on angiogenesis and proliferation ability of co-lon cancer cells induced by Sonic hedgehog (Shh).METHODS:Lentivirus expressing different FOXQ1-shRNA or nega-tive cantrol (NC)-shRNA was used to infect the SW480 cells.The best silencing condition was screened and used in the following experiments .The SW480 cells were divided into interfered group ( FOXQ1-shRNA) and control group ( NC-shR-NA) .The MTT assay was used to observe the doubling time and cell activity .Tube formation assay was performed to detect the ability of angiogenesis.Meanwhile, the expression of vascular endothelial growth factor (VEGF)-A, matrix metallopro-teinase ( MMP) 2 and cyclin D1 at mRNA and protein levels was determined by real-time PCR and Western blot .After in-duction of the cells by recombinant Shh proteins , the changes of angiogenesis and proliferation ability in each group were detected.At the same time, the transformation of related gene was examined .RESULTS:Compared with control group , the angiogenic ability in interfered group was decreased , and no obvious difference of proliferation ability was observed .The expression of VEGF-A and MMP2 was declined significantly , and the expression of cyclin D 1 was not obviously changed . Recombinant Shh proteins improved the expression of FOXQ1 gene.Compared with NC-shRNA group, after induction, the angiogenic ability of FOXQ1-shRNA group was decreased , and the proliferation ability was not obviously changed .CON-CLUSION:FOXQ1 gene mediates the angiogenic ability but does not affect the proliferation ability of SW 480 cells.Mean-while, it may be regulated by shh pathway .

Objective To investigate the occurrence of deep venous thrombosis (DVT) in the perioperative period of patients with fracture distal to the knee,so that clinicians have a better understanding of the occurrence of DVT in the perioperative period of the fracture distal to the knee.Methods A retrospective analysis of the clinical data of 365 patients with distal knee fractures who underwent surgery in the Department of Orthopaedics Trauma,Xi'an Jiaotong University Medical College Red Cross Hospital from June 2014 to March 2018 was conducted.There were 213 males and 152 females,aged (45.05 ± 15.24) years,with an age range of 17-83 years.Classification of fracture sites:177 cases of tibiofibular shaft fracture,130 cases of ankle fracture,and 58 cases of foot fracture.According to whether thrombosis occurred or not,the patients were divided into thrombotic group and non-thrombotic group before and after operation.There were 66 patients with thrombosis before operation,299 patients without thrombosis before operation,88 patients with thrombosis after operation,and 277 patients without thrombosis after operation.The incidence of thrombosis and the location of the thrombus were recorded.The sex,age,fracture site,ASA score,operation time,the time from injury to admission,the time from injury to surgery,intraoperative tourniquet time,intraoperative blood transfusion volume,intraoperative blood loss,intraoperative transfusion volume,hemoglobin volume at admission and 1 day after operation,D-dimer level at admission and 1 day after operation,multiple injuries,chronic hepatitis and medical diseases were analyzed.The measuremernt data of normal distribution and homogeneity of variance were expressed as mean ± standard deviation (Mean ± SD),the t test was used for comparison between two groups.The comparison of count data was performed by x2 test or Fisher exact probability method,and multivariate logistic regression analysis was performed on the risk factors affecting the occurrence of DVT in both lower extremities.Results The preoperative DVT rate was 18.1％ (66/365).In patients with thrombosis,distal thrombosis accounted for 93.94％ (62/66),and mixed thrombosis accounted for 6.06％ (4/66).The incidence of postoperative DVT was 24.1％ (88/365).In patients with thrombosis,distal thrombosis accounted for 94.32％ (83/88),proximal thrombosis accounted for 1.14％ (1/88),and mixed thrombus accounted for 4.55％ (4/88).Fracture site,ASA score,operation time,intraoperative tourniquet time,intraoperative blood transfusion volume,intraoperative blood loss,intraoperative transfusion volume were not statistically significant(P ＞0.05).Age ≥ 40 years (OR =2.691,95％ CI:1.422-5.093,P =0.002),the time from injury to admission ＞ 3 days (OR =1.927,95 ％ CI:1.072-3.463,P =0.028)were independent risk factors for DVT formation in fracture distal to the knee before operation.Age ≥ 40 years (OR =3.925,95 ％ CI:2.161-7.129,P =0.000),the time from injury to surgery ＞ 5 days (OR =1.835,95 ％ CI:1.080-3.119,P =0.025),D-dimer level at 1 day after operation (OR =1.191,95％ CI:1.096-1.293,P =0.000),combined with multiple injuries (OR =1.981,95％ CI:1.006-3.902,P =0.048),combined with coronary atherosclerotic heart disease (OR =2.692,95％ CI:1.112-6.517,P =0.028) were independent risk factor for DVT formation after operation for fracture distal to the knee.Conclusions The occurrence of DVT before and after the fracture of the knee is mainly caused by distal thrombosis,and proximal thrombosis also occurs.Those patients aged≥40 years,combined with multiple injuries and coronary heart disease,should focus on preventing the occurrence of DVT.After the injury,the patient is immediately admitted to the hospital for DVT screening,and when the general condition allowed,shortening the preoperative waiting time can reduce the occurrence of DVT.

Objective:To evaluate the predictive value of mechanical power (MP) on the risk of in-hospital mortality in critical ill patients in emergency department.Methods:A total of 105 critical ill patients with invasive mechanical ventilation in the Department of Emergency of Second Affiliated Hospital of Guangzhou Medical University between December 1, 2017 and October 31, 2020 were retrospectively analyzed. Based on the clinical prognosis, the patients were divided into the in-hospital survival group (80 patients) and the in-hospital death group (25 patients). The clinical data and ventilator parameters were recorded, and the MP of the two groups was calculated in order to assess the predictive efficacy of MP on in-hospital death.Results:Compared to the in-hospital death group, the oxygenation index PaO 2/FiO 2 was significantly higher (271 mmHg vs. 217 mmHg, P=0.020) and blood lactate (1.59 mmol/L vs. 2.56 mmol/L, P<0.001) and procalcitonin (0.31 ng/mL vs. 3.55 ng/mL, P=0.028), minute ventilation (7.03 L/min vs.8.32 mmol/L, P=0.013), MP (14.37 J/min vs. 16.12 J/min, P=0.041), SOFA score (5 vs. 8, P=0.001) and APACHE II score (16 vs. 22, P=0.041) were significantly lower in the in-hospital survival group. Multivariate Logistic regression analysis showed that PaO 2/FiO 2( OR=1.015, P=0.044), MP ( OR=1.813, P=0.039) and SOFA score( OR=2.651, P=0.010) were independent risk factors for predicting hospital mortality in patients with mechanical ventilation. The areas under the ROC curves (AUC) were 0.62, 0.63 and 0.75, respectively. Moreover, the MP combined with SOFA score for predicting in-hospital death was significantly higher than that of MP alone (0.77 vs. 0.63, P<0.05). Conclusions:MP is associated with in-hospital death in patients with invasive mechanical ventilation in emergency department. MP combined with SOFA score can enhance its predictive efficacy