Objective To determine the random spot albuminuria to creatinine ratio (ACR) of normal pregnant women , to track the pregnancy outcome , and to discuss the predictive value of ACR in women with hy-pertensive disorders complicating pregnancy (HDCP). Methods Except for 87 pregnant women suffering from HDCP, 2 038 pregnant women were enrolled in this study. ACR, routine examinations of blood and urine, blood biochemical, 24-hr urinary protein were determined. Results ACR, but not 24-hr urinary protein level,was sig-nificantly higher in women with HDCP. There was positive correlation between the ACR and 24-hr urinary protein quantitation. Age, gestational weeks, ACR, red blood cells, fasting plasma glucose, serum creatinine, total pro-tein were the independent risk factors for HDCP. The sensitivity , specificity and optimal cut off value of ACR for predicting HDCP were 0.78, 0.63, 1.46 mg/mmol. Conclusions There was positive correlation between ACR and 24-hr urinary protein quantitation , and ACR provided a more sensitive pathway for early predictionof HDCP.

Objective To evaluate the feasibility of T2 *mapping T2 *value combined with DWI ADC value in quantitative assessment of the activity of sacroiliitis.Methods 30 patients diagnosed with ankylosing spondylitis (AS)were divided into 2 groups as acute group (n=17)and chronic group (n=13)according to the BASDAI scores of the clinical severity of disease.And 20 healthy adults were recruited as control group.All groups were examined by MR with traditional sequence,T2 *mapping and DWI in the sacroiliac joint.The T2 *value and ADC value of the bone marrow edema region and normal region were measured.Furthermore,the imaging data and the clinical scores were statistical analysis and compared among three groups.Results T2 *values and ADC values in acute group of AS patients were higher than chronic group (P<0.05),as well as compared with healthy volunteers (P<0.05).There was no statistically significant difference between the chronic group of AS patients and control group (P>0.05).Positive correlation between ADC value and BASDAI was observed in patients group.Conclusion T2 *mapping combined with DWI imaging in AS is beneficial for early diagnosis and quantitative analysis of the activity of sacroiliitis.

Objective To evaluate the effect of computer-aided design of composite materials with epoxide acrylate maleic (E) and hydroxyapatite (H) in cranioplasty. Methods A total of 45 patients with cranium defects were treated with cranioplasty by using skull bone flaps made of composite materials including epoxide acrylate maleic (E) and hydroxyapatite (H) ,which was designed with computer aid according to individual requirements. The patients were followed up for 6-36 months. Results After cranioplasty with composite EH, there occurred subcutaneous fluid in one patient and mild bone collapse in one. The composite EH showed good histocompatibility, with no infection or rejection. Conclusion During cranioplasty, use of computer-aided design of composite EH takes advantages of good accuracy, short operation time, good biocompatibility and good clinical efficiency.

Objective To discuss improvement effect of butylphthalide soft capsules on cognitive function of patients with cerebral arterial thrombosis in recovery period. Methods A total of 86 cases of patients with cerebral arterial thrombosis in recovery period were divided into observation group and control group at random. The patients in two groups were given the basic medical treatment such like depressurization, glucose-lowering, lipid-regulating, anti-platelet aggregation, cerebral circulation improvement and etc. The patients in observation group were additionally given butylphthalide soft capsules, 0.2 g per time, three times a day, while the patients in control group were additionally given piracetam tablets, 1.2 g per time, three times a day for 14 days. The changes of cognitive function indexes of pa-tients in two groups before and 14 days after the medical treatment were observed, and the curative effect and security evaluation were carried on as well. Results After 14 days’ medical treatment, WMS and MOCA scores of patients in two groups were obviously rose (P<0.05 or P<0.01), and the rising rate of patients in observation group was much high-er than that in control group (P<0.05). Meanwhile, total improvement rate of cognitive function of patients in observa-tion group was 95.35%, much higher than that in control group (79.07%) (χ2=5.11, P<0.05). 8 cases of drug adverse re-action (DAR) of patients in two groups were appeared during the medical treatment, 3 cases in observation group and 5 cases in control group, with light symptom. After comparing the untoward effect of patients in two groups, no statistical differences were appeared (χ2=0.14, P>0.05). Conclusion Butylphthalide soft capsules has favorable improvement effect on the declining of cognitive function of patients with cerebral arterial thrombosis in recovery period, which can en-hance the recovery of cognitive function of patients with favorable security.

Objective :To explore influence of intra—arterial thrombolysis combined hyperbaric oxygen on serum levels of soluble intercellular adhesion molecule—1 (sICAM—1) and calcitonin gene related peptide (CGRP) in patients with severe ischemic stroke .Methods : A total of 96 patients with severe ischemic stroke in our hospital were randomly and equally divided into thrombolysis group and combined treatment group (received intra—arterial thrombolysis +hyperbaric oxygen therapy ).United States National Institutes of Health Stroke score (NIHSS) was used to assess neurological function recovery , and modified Rankin rating score (mRS) was used to assess recovery of clinical symptoms.After two—week treatment ,clinical therapeutic effect etc .were compared between two groups .Results :Compared with thrombolysis group after treatment ,there was significant rise in total effective rate (77.08% vs. 93. 75%, P＝0.021) ;significant reductions in scores of NIHSS [ (8.10 ± 3.45) scores vs .(5.36 ± 2.11) scores] and mRS [ (2.58 ± 0. 80) scores vs .(1.81 ± 0.76) scores] ;significant reduction in serum sICAM—1 level [ (237.31 ± 18. 04) ng／ml vs.(220.25 ± 16.40) ng／ml] ,and significant rise in serum CGRP level [ (27.02 ± 6.06) pg／ml vs. (35.24 ± 6.13) pg／ml] in combined treatment group , P＝0.001 all.There was no significant difference in revascu—larization within two weeks between two groups , P＝0.551. Conclusion : Intra—arterial thrombolysis combined hy—perbaric oxygen possesses significant therapeutic effect on patients with severe ischemic stroke .It can relieve clinical symptoms ,recover cognitive function ,improve revascularization rate in these patients .

Objective:To report the clinical and genetic characteristics of a family of creatine transporter deficiency (CRTR-D) caused by SLC6A8 gene mutation.Methods:A patient, who came from Department of Neurology, Shanxi Children′s Hospital in September 2018, with epilepsy and unexplained general developmental retardation, was clinically examined. The medical history of his family was also collected. Genetic detection was performed to analyze their genetic causes.Results:The proband, a three years and three months old boy, was walking unsteadily, unable to speak and having frequent seizures, with increased urine creatine/creatinine ratio and decreased peak of cerebral creatine indicated by magnetic resonance spectrum. The proband′s uncle had the similar symptoms with him. The mother of the proband only showed some learning difficulties, while the father, sister and grandparents of the proband had no symptoms. The proband was found to have TTC deletion mutation of SLC6A8 gene (NM_005629), c. 1222_1224del (p.Phe408del), suggestting the diagnosis of X-linked CRTR-D. The proband′s mother and grandmother had heterozygous mutations. The proband′s uncle carried the same hemizygous mutation, which was not detected in the proband′s father, sister or grandfather.Conclusion:In this family of CRTR-D caused by SLC6A8 gene mutation, two female carriers with the same mutation presented different clinical features, suggesting phenotypic variation, which has a great significance in studying the correlation between genotype and phenotype.

Objective: To acknowledge the availability and rates of annual transition of outcomes during the progression and regression stages of colorectal cancer (CRC) and related diseases, by pooling global follow-up studies on the natural history of CRC. Methods: Till March, 2017, data was collected through systematic literature review over multiple databases, including PubMed, Embase, Cochrane and Chinese Biology Medicine (CBM) disc. Information regarding the characteristics, classification system of health states, related outcomes and incidence rates on CRC or high-risk adenoma for the surveillance cohorts of the studies, were extracted and summarized. Both Meta and sensitivity analyses were performed on those outcomes if they appeared in more than 3 studies, using the random effects model. Annual transition rate with 95%CI was used to estimate each of the outcomes, Quality of the studies was assessed, using the Newcastle-Ottawa Scale. Results: A total of 29 cohort studies were included, with the mean follow-up period as 5.7 years. All studies except one, focused on adenoma-carcinoma pathway and reported the outcome parameters of adenomas by different risk, and some reported the findings on different sizes (n=6) of adenomas. These cohorts were divided into three groups (normal status, with low-risk or high-risk adenoma) according to the status of baseline endoscopic pathologic findings. Their available outcome parameters, corresponding number of involved articles, aggregated sample size and pooled annual transition rates were presented. Six parameters were obtained in the normal cohorts, including those from normal to low-risk adenoma (16 articles, 58 235, 0.030: 0.024-0.037), to high-risk adenoma (17 articles, 62 089, 0.003: 0.002-0.004), to diminutive adenoma (<5 mm, 4 articles, 1 277, 0.021: 0.013-0.029), to small adenoma (6-9 mm, 4 articles, 1 277, 0.006: 0.001-0.010), to large adenoma (≥10 mm, 7 articles, 3 531, 0.002: 0.000-0.003) and to CRC (19 articles, 104 836, 0.000 3: 0.000 2-0.000 5). Three parameters were obtained in low-risk adenoma in cohorts with polypectomy findings, including recurrence (9 articles, 4 788, 0.109: 0.062-0.157) from low-risk adenoma after polypectomy to high-risk adenoma (10 articles, 5 736, 0.009: 0.004-0.013) and to CRC (12 articles, 11 347, 0.000 6: 0.000 4-0.000 8). Three parameters were obtained on high-risk adenoma from cohorts with polypectomy findings, including recurrence (12 articles, 7 030, 0.038: 0.028-0.048) from high-risk adenoma after polypectomy to low-risk adenoma (8 articles, 2 489, 0.133: 0.081-0.185) and CRC (14 articles, 14 899, 0.002: 0.001-0.003). Except for normal to low-risk adenomas, results from the sensitivity analysis for the other parameters showed stable. Of the included studies, two presented incidence rates of CRC in different clinical stages and the another two were focusing on the parameters related to serrated pathway. Conclusions Globally, follow-up studies reported data on natural history of colorectal cancer is of paucity. Compared to the "adenoma-carcinoma" pathway, transition parameters of the serrated lesion pathway are more limited. This Meta-analysis provided convincing evidence for optimizing the strategies regarding follow-up program on the disease, using the baseline endoscopic findings from global CRC Screening Program. These results also offered strong data-related support for Chinese population- specific interventional model on colorectal cancer.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.