Objective To find out the rate of deterioration of systemic lupus erythematosus (SLE) during pregnancy,the incidence of co-existing pregnancy induced hypertension (PIH) and the ways of antepartum treatment.Methods A retrospective analysis of the clinical data was performed in 19 cases of SLE with pregnancy from 1998 to 2003.Results SLE with pregnancy had an acute deterioration rate of 52.6% and incidence of co-existing PIH of 52.6% and 31.6%,which were related to patients'condition and remissions.Conclusion When SLE happens in pregnancy,it is more likely to get worse and complicated with PIH.It is necessary to enhance the antepartum monitoring and treatment for these patients.

Objective To construct two DNA vaccines encoding Gag-Env fusion protein and Tat-Rev-Integrase(C-half)-Vif-Nef fusion protein derived from the first HIV-1 CRF01_AE isolate(AE2f) in Chi-na and to evaluate the immunogenicity in mice. Methods Two DNA vaccines were constructed by inserting the codon optimized and synthesized gag-env fusion gene and tat-rev-integrase(c-half)-vif-nef fusion gene de-rived from AE2f into mammalian expression vector pDRVISV1. 0, the generated DNA vaccines were desig-nated as pSVAE/GE and pSVAE/TRIVN, respectively, and their in vitro expression were determined by Western blot with transfected 293T cells. Mice were i. m. immunized with either pDRVI1.0 as mock control, pSVAE/GE or pSYAE/TRIVN for 4 times at two-week interval. Two weeks following the final im-munization, cellular responses to pool of HIV-1 Env, Gag, Tat, Rev, Intergrase, Vif and Nef peptides were evaluated by ELISPOT assay. Results The construction of DNA vaccine pSVAE/GE and pSVAE/TRIVN was validated by restriction enzyme digestion and bidirectional sequencing. Western blot showed a specific band at molecular mass 220×10~3 in lane of pSVAE/GE transfeeted 293T cell and a specific band at 95×10~3 in the lane of pSVAE/TRIVN. Both DNA vaccines mounted significant specific T cell responses with (3010 ± 566) SFC/10~6 splenocytes for DNA vaccine pSV AE/GE and (948 ± 737) SFC/10~6 spleno-cytes for DNA vaccine pSVAE/TRIVN, whereas the mock control of pDRVISV1.0 only raised marginal T cell responses. Conclusion Both pSVAE/GE and pSVAE/TRIVN were capable of expressing the inserted fusion immunogen genes and able to elicit vigorous cellular immune responses, therefore, these DNA vac-cines are highly immunogenic.

Objective To evaluate the influence of ultrasound-guided transverse abdominis plane (us-TAP) block on intraoperative and postoperative analgesia at different time points in total abdominal hysterectomy.Methods 46 patients undergoing total hysterectomy under general anesthesia were selected,randomly divided into two groups,group A and group B,with 23 cases in each group.Group A received bilateral us-TAP block after induction of general anesthesia and before operation;Group B received bilateral us-TAP block after operation and before anesthesia recovery.In both groups,the anesthesia was adjusted according to the bispect ral index (BIS) and hemodynamics.Sufentanil was used for patient-controlled intravenous analgesia (PCIA) after operation.The mean blood pressure (MBP),heart rate (HR) at T0(preanesthesia),T1 (skin incision),T2 (postoperation),T3 (tracheal extubation),T4 [leave the post anesthesia care unit (PACU)] in both two groups were recorded.The dosage of anesthetics during operation and the recovery time after operation were recorded.Visual analogue scores (VAS) at 2 h,6 h,12 h and 24 h after operation were observed in the resting and coughing state of the patients in the two groups.The total consumption of analgesics 24-h after surgery and the side effects of nausea and vomiting were recorded.Results MAP and HR in group A were significantly lower than that in group B at T1 (P ＜ 0.05),but there was no statistical difference at other time points (P ＜ 0.05).The dose of sufentanil used in group A was less than that in group B (P ＜ 0.05).The recovery time in group A was shorter than that in group B (P ＜ 0.05).At 2 h,6 h,12 h and 24 h post operation,there was no significant difference at rest and coughing VAS between the two groups (P ＜ 0.05).There was no difference in the consumption of analgesics 24 hours after operation between the two groups (P ＜ 0.05).The incidence of postoperative nausea and vomiting in group A was lower than that in group B (P ＜ 0.05).Conclusions In open hysterectomy,although the analgesic effect of us-TAP blockade before and after operation is not significantly different,preoperative TAP blockade under ultrasound can effectively reduce the amount of intraoperative general anesthetics and accelerate the recovery of patients,effectively reducing the incidence of postoperative nausea and vomiting.

Objective To investigate the value and advantage of ultrasound guided intermuscular groove and suprascapular nerve block combined with general anesthesia in shoulder arthroscopy.Methods 40 American Society of Anesthesiologists (ASA) Ⅰ-Ⅱ patients undergoing elective arthroscopic shoulder surgery were randomly divided into two groups.Patients in group A were treated with general anesthesia,while patients in group B were treated with brachial plexus and suprascapular nerve block combined with general anesthesia.Mean arterial pressure (MAP),heart rate (HR) and visual analogy score (VAS) were measured at preoperative (To),5 min after the beginning of the surgey (T1),30 min after the beginning of the surgey (T2),at the end of the surgery (T3),and 30 min after removing laryngeal mask (T4).Bispectral index (BIS) was recorded at T1 and T2.The operation time,extubation time,dosage of opioids (sufentanyl),dosage of propofol,visual analogue scale (VAS) scores at awake time in post anesthesia care unit (PACU),and 6 h,12 h,24 h after surgery.Results There were no significant differences in the BIS between two groups at T1 and T2 (P ＞ 0.05).Both the MAP and HR had no statistical significance at T0 (P ＞ 0.05).MAP and HR in group B were significantly lower than those in group A from T1 to T4 (P ＜ 0.05).Compared with group A,patients in group B had significantly shorter extubation time (P ＜ 0.05),smaller dosages of sufentanyl and propofol (P ＜ 0.05),lower VAS scores at awake time 6 h and 12 h after surgery (P ＜ 0.05).Conclusions Brachial plexus and suprascapular nerve block combined with general anesthesia can offer better anesthesia status,reduce dosage of opioids and propofol,and can provide effective analgesia in shoulder arthroscopy.

Objective To explore the clinical feasibility of predicting synchronous liver metastases based on MRI radiomics nomogram based on T2WI in rectal cancer. Methods The imaging and clinical data of 261 patients with primary rectal cancer admitted to Zhejiang People′s Hospital from April 2012 to May 2018 were retrospectively analyzed. 101 patients were accompanied by synchronous liver metastasis All cases were divided into training group (n=182) and verification group (n=79). T2WI image of each patient was selected to extract texture features by AK analysis software of GE company. A radiomics signature was constructed after reduction of dimension in training group by the least absolute shrinkage and selection operator (LASSO). Univariate logistic regression was used to select for independent clinical risk factors and multivariate logistic regression along with imaging omics tags were used to construct predictive models and nomogram. ROC was used to assess the accuracy of the nomogram in the training group and to verify them by the validation group. Finally, the clinical efficacy of each patient′s synchronized liver metastasis risk factor was calculated based on the nomogram. Results A total of 328 texture features were extracted from the T2WI. Seven most valuable features were selected after reducing the dimension by LASSO algorithm, including 3 co-occurrence matrices (GLCM) and 4 run-length matrices(RLM). Tumor staging and radiomic signatures were included in the Multifactor logistic regression to build the prediction model and nomogram. The accuracy of predicting SRLM was 0.862 and 0.844 in the training and the verification group, respectively. To evaluate the accuracy of the nomogram, radiomics signature and the tumor staging in all cases were 0.857, 0.832 and 0.663, respectively. There was no significant difference in the number of SRLM cases between the high risk group and the low risk group based on nomogram (P>0.05). Conclusion The radiomics nomogram based on T2WI can be used as a quantitative tool to predict synchronous liver metastases of rectal cancer.

Objective:To evaluate the effect of ultrasound guided modified-subcostal approach to anterior quadratus lumborum block (MSC-AQLB) on postoperative pain relief in open gynecological tumor surgery.Methods:Fifty patients with open gynecological tumor surgery admitted to the Changsha Central Hospital from June 2022 to March 2023 were selected, aged 35-70 years old, with American Society of Anesthesiologist (ASA) grades Ⅰ-Ⅱ. They were randomly divided into two groups using a random number table: an improved subcostal lumbar quadratus anterior block combined with general anesthesia group (MQ group) and a simple general anesthesia group (GA group), with 25 patients in each group. Before induction of general anesthesia, the MQ group received bilateral MSC-AQLB under ultrasound guidance, with 20 ml of 0.4% ropivacaine administered to both sides; The GA group did not receive nerve block. Both groups received intravenous inhalation combined with general anesthesia during the surgery, and both groups received patient-controlled intravenous analgesia (PCIA) with sufentanil after the surgery. The block plane of the MQ group at 5 and 15 minutes after block was recorded, as well as the resting and active (cough) Visual Analogue Scale (VAS) of patients in both groups at extubation (T 1), departure from post anesthesia care unit (PACU) (T 2), postoperative 6 hours (T 3), 12 hours (T 4), 24 hours (T 5), and 48 hours (T 6), the effective and total compressions of the analgesic pump within 48 hours after surgery, the analgesic recovery rate, and postoperative patient satisfaction, the incidence of nausea and vomiting, complications related to nerve block (local anesthetic poisoning, muscle weakness, pneumothorax, bleeding, accidental entry into the abdominal cavity, kidney damage, etc.)were also recorded. Resultsl:The highest and lowest blocking planes of bilateral MSC-AQLB under ultrasound guidance were T 6 and L 1 (at 5 minutes), T 5 and L 2 (at 15 minutes), respectively. The resting and active VAS scores of the MQ group at T 1 to T 6 were significantly lower than those of the GA group (all P<0.05), and the effective press frequency, total press frequency, and analgesic recovery rate of the analgesic pump within 48 hours were significantly lower than those of the GA group (all P<0.05). The postoperative analgesic satisfaction score was higher than that of the GA group ( P<0.05), and the incidence of nausea and vomiting within 48 hours after surgery was significantly lower than that of the GA group ( P<0.05). The MQ group of patients did not experience complications related to nerve block such as kidney injury and muscle weakness. Conclusions:In open gynecological tumor surgery, ultrasound guided MSC-AQLB can effectively reduce postoperative pain scores, reduce the dosage of postoperative analgesics, reduce the incidence of nausea and vomiting, and significantly improve patient satisfaction with pain relief.

Objective To investigate the clinical manifestations and genetic features of children with papillorenal syndrome caused by PAX2 gene mutation.Methods Clinical manifestations,imaging changes and sequencing data were collected and analyzed from a family with papillorenal syndrome who were diagnosed in Wuhan Children's Hospital in February 2018."PAX2","papillorenal syndrome" and "renal coloboma syndrome" were used as key words to search in China National Knowledge Infrastructure,Wangfang Data Knowledge Service Platform,PubMed and Human Gene Mutation Database up to April 2018.Results A ten years old girl was admitted due to "edema and urine output decreased for one week".Lab showed BUN 25.30 mmol/L,Scr 766.5 μmol/L,Urine protein 3.6 g/24 h.Imaging examination showed bilateral vesical and ureter reflux combined with left duplex kidney and duplication of ureter.Developmental dysplasia of the left hip was also found.The father of the patient had been diagnosed with chronic kidney disease for 10 years and on hemodialysis for 6 years.Next generation sequencing revealed that both the father and daughter carried a heterozygous nonsense mutation in the exon3 c.219C ＞ G(p.Y73X) of PAX2.No Chinese literature ever was reported about papillorenal syndrome.Ninety-four articles in English were retrieved and 177 patients with papillorenal syndrome were confirmed by gene analysis with a total of 92 PAX2 variants.Ten nonsense mutations had been reported.Developmental dysplasia of the hip (DDH) never be reported before.Conclusion Papillorenal syndrome caused by PAX2 mutation can mainly manifest as abnormal development of both kidney and optic nerve,which may be accompanied by other systemic abnormalities,it is rarely reported in China.DDH may be a new phenotype of papillorenal syndrome.

Objective:To establish a method for quality evaluation of Myristica fragrans Houtt. Methods:The common peak was determined with Dehydroisoeugenol as the reference peak, and the HPLC fingerprint of Myristica fragrans was established; then the common peaks were analyzed by High Resolution Liquid Chromatography-mass Spectrometry (HPLC-MS). The chemical components of the common peaks were identified through the calculation and data retrieval of the primary and secondary mass spectra of the characteristic peaks. Results:The HPLC fingerprint of Myristica fragrans was established, and the similarity degree of the 10 batches of samples was above 0.9 and 11 common peaks were established. According to the results of HPLC-MS, the components of 11 common peaks were identified as follow: Methyl eugenol (peak 1), Licarin A (peak 2), Myristol (peak 3), OdoratisolA (peak 4), 2-(3,4-Dimethoxyphenyl) butynoic acid (peak 5), Malabaricon D (peak 6), 5'-Methoxydehydroisoeugenol (peak 7), Dehydroisoeugenol (peak 8), Malabaricone C (peak 9), 4-Methoxy-6-{(2S,3S)-7-methoxy-3-methyl-5-[(1E)-1-propen-1-yl]-2,3-dihydro-1- benzofuran-2-yl}-1,3-benzodioxole (peak 10) and Licarin B (peak 11). Conclusions:The quality of Myristica fragrans could be evaluate with HPLC fingerprint method. HPLC-MS was used to analyze the chemical composition of complex components, which will provide reference for the identification and analysis of chemical components of the extracts and preparations of Traditional Chinese Medicine.

Objective: To explore the risk factors of predicting white matter hyperintensities progression based on radiomics of MRI of whole-brain white matter. Methods: The imaging and clinical data of 152 patients with white matter hyperintensities admitted to Zhejiang People′s Hospital from March 2014 to October 2018 were retrospectively analyzed. The whole brain white matter on baseline T₁WI images of each patient were segmented by SPM12 software package, and images of white matter were imported into AK software for texture feature extraction and dimensionality reduction. At last, least absolute shrinkage and selection operator(LASSO) was used to calculate the score of radiomics signature of each patient. According to the improved Fazekas scale, patients with WMH progression were divided into three groups: any white matter hyperintensities (AWMH), periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH). Statistical differences of clinical factors and radiomics signature between WMH progression subgroups and non-progression subgroups were compared with independent sample t test or Mann-Whitney U test, and Univariate logistic regression was used to select independent clinical risk factors and multivariate logistic regression along with imaging omics tags were used to construct predictive models, which was evaluated by ROC curve. And the correlation between the clinical indicators of independent risk factors and the texture feature of radiomics signature was analyzed. Results: The efficacy of the model for the detection for AWMH progression, PWMH progression and DWMH progression was 0.818,0.778 and 0.824, respectively. Age is an independent risk factor for AWMH progression and DWMH progression[OR(95%CI), 4.776(2.152-10.601) vs. 3.851(1.101-8.245); P<0.05]. BMI is an independent risk factor for DWMH[OR(95%CI), 3.004(1.204-7.370); P<0.05], and hyperlipidemia is an independent risk factor for AWMH and PWMH[OR(95%CI), 4.062(1.834-8.998) vs. 3.549(1.666-7.563); P<0.05]. In AWMH subgroup, Surface Area was negatively correlated with age and low density lipoprotein(LDL) (r=-0.401, -0.312), and Inverse Difference Moment_ALLDirection_offset 1_SD was negatively correlated with age(r=-0.412). In PWMH subgroup, Compactness 1 was negatively correlated with LDL(r=-0.198), and Inverse Difference Moment_angle 0_offset 7 was positively correlated with LDL(r=0.252). In DWMH subgroup, LongRunEmphasis_ALLDirection_offset 7 was negatively correlated with age(r=-0.322), and GLCMEntropy_angle0_offset 4 was negatively correlated with age(r=-0.278). GLCMEntropy_AllDirection_offset4 was negatively correlated with body mass index(r=-0.514). Conclusion Radiomics based on whole-brain white matter MR imaging can predict WMH progression and identify the risk factors in high-risk populations, thus providing early additional information to conventional magnetic resonance imaging to predict WMH progression.