Objective To investigate the effect of ectopic pregnancy tubal resection or common disease retention on female reproductive endocrine and menstrual traits.Methods 286 patients with ectopic pregnancy lapa-roscopic operation were selected.According to the different treatment methods,the patients were divided into resection group (n =199),retention group 87 cases,in surgical operation on the third day and the thirtieth day and tested for female reproductive hormone (P,LH,FSH,E2 )and human chorionic gonadotropin (hCG).Results Resection group in the third day after surgery of FSH[(8.5 ±4.9)IU /mL]was significantly higher than that of preserving group[(3.9 ± 0.9)IU /mL],with significant difference (t =5.44,P <0.05),the amounts of LH,E2 ,P and HCG were insignificant (t =0.56,1.24,0.82,all P >0.05).30 days after the surgery,there was no significant difference between the two groups in FSH,LH,E2 ,P and HCG (t =0.92,0.77,1.02,0.65,all P >0.05),but at the age of more than 40 years old and bilateral absence of fallopian tube in patients with,menorrhagia and menstrual cycle change obviously,and female ovarian endocrine function to reduce the clinical symptoms.Conclusion Tube resection has some influence on the ovarian function of tubal ectopic pregnancy,especially older,lack of bilateral fallopian tube.

Objective To detect the expression difference of dynactin 2(DCTN2)and cell-cycle-related and expression-elevat-ed protein in tumor(CREPT)in gastric cancer and paracancer tissues,and to explore the relationship between DCTN2 and CREPT ex-pressions and the clinicopathological characteristics and prognosis of gastric cancer patients.Methods A total of 90 patients who received gastric cancer surgery from March 2014 to September 2015 in Affiliated Hospital of Xuzhou Medical University and were confirmed by his-tology were enrolled.The expression levels of DCTN2 and CREPT in gastric cancer tissues and paracancer tissues were detected by immu-nohistochemistry,and the Spearman correlation analysis was used to analyze the relationship between DCTN2 and CREPT in gastric cancer tissues;the relationship between their levels and clinicopathological characteristics were analyzed;Kaplan-Meier and Log-rank analysis were used to analyze the relationship between the expression levels of DCTN2 and CREPT and the overall survival time of gastric cancer patients;univariate and multivariate COX regression analysis were used to analyze the independent risk factors influencing prognosis of gastric cancer patients.Results The expression levels of DCTN2 and CREPT in gastric cancer tissues were significantly higher than that in paracancer tissues,and DCTN2 was positively correlated with CREPT in gastric cancer tissues(P<0.05).The expression levels of DCTN2 and CREPT were correlated with the tumor differentiation,TNM stage,invasion depth,lymph node metastasis(P<0.05),but were not significantly correlated with gender,age and distant metastasis(P>0.05);the results of prognosis analysis showed that the 1-year,3-year and 5-year cumulative survival rate and overall survival rate of gastric cancer patients in the DCTN2high-expression group were significantly lower than those in the DCTN2 low-expression group,and the 5-year cumulative survival rate and overall sur-vival rate of gastric cancer patients in the CREPT high-expression group were significantly lower than those in the CREPT low-expres-sion group(P<0.05).Univariate and multivariate COX regression analysis showed that both DCTN2 and CREPT were independent risk factors on the prognosis of gastric cancer patients.Conclusion DCTN2 and CREPT are highly expressed in gastric cancer tissues and their high expression were closely related to the poor prognosis of gastric cancer patients.DCTN2 and CREPT were expected to be potential markers and new therapeutic targets for gastric cancer diagnosis,and help to judge the prognosis of gastric cancer patients.

BACKGROUND:Large numbers of experimental data have confirmed that bone marrow mesenchymal stem cel s have a positive therapeutic effect on cerebral ischemia-reperfusion injury, but there are few reports about intravenous administration of bone marrow mesenchymal stem cel conditioned medium in the treatment of stroke.
OBJECTIVE:To investigate the effects of the conditioned medium of rat bone marrow mesenchymal stem cel s on the recovery of neurological function in rats after cerebral ischemia-reperfusion injury.
METHODS:The bone marrow mesenchymal stem cel s were isolated from rat bone marrow. When cel s at passage 2 or 3 reached 90%confluence, the original culture medium was removed. Then the cel s were cultured in serum-free DMEM for 18 hours. After that, the culture solution was col ected as the conditioned medium of rat bone marrow mesenchymal stem cel s. Adult rats were subjected to 2 hours of right middle cerebral artery occlusion. Ischemia-reperfusion injury rats were randomly assigned to three groups:control group, simple culture medium group and conditioned medium group, and respectively given injection of normal saline, DMEM, conditioned medium (10 mL/kg) via the tail vein at 2, 24, 48 hours after operation.
RESULTS AND CONCLUSION:There was no difference in the behavioral tests among the three groups at postoperative 2 hours (P>0.05). Compared with the control and simple culture medium group, neurological impairment was significantly improved in the conditioned medium group at postoperative 1, 3, 5 days (P<0.05), but there was no significant difference between the control and simple culture medium groups. At postoperative 5 days, brain edema was significantly eased in the conditioned medium group in comparison to the control and simple culture medium groups (P<0.05), and there was also no difference between the latter two groups (P>0.05). These results suggest that rat bone marrow mesenchymal stem cel s-conditioned medium via intravenous administration can significantly ease brain edema and improve the neurologic function after cerebral ischemia-reperfusion injury.

Objective:To investigate the seasonal changes of fasting plasma glucose (FPG) levels in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke who were hospitalized in the Department of Neurology, the Second Hospital of Tianjin Medical University and had fasting blood glucose data from January 1, 2016 to December 31, 2020 were enrolled retrospectively. The general data and FPG results of all patients were collected, and the seasonal changes of various indexes were analyzed. Multiple linear regression analysis was used to determine the influencing factors of FPG.Results:A total of 1 323 patients with acute ischemic stroke who had FPG data were enrolled, of whom 519 patients (39.2%) had diabetes mellitus and 804 (60.8%) had no diabetes mellitus. The baseline National Institutes of Health Stroke Scale score, body mass index, systolic blood pressure, diastolic blood pressure and FPG in the winter group were significantly higher than those in the summer group (all P<0.05). Further subgroup analysis of gender and age showed that the FPG level of elderly patients aged 65-80 years had significant seasonal changes ( P<0.05). Multiple linear regression analysis showed that age, season, body mass index, whether complicated with diabetes mellitus, whether using insulin and/or oral hypoglycemic drugs were the independent influencing factors of FPG levels. Conclusion:The FPG levels in patients with acute ischemic stroke have the characteristics of seasonal fluctuation, which is more obvious in elderly patients aged 65-80 years.

Objective:To investigate the seasonal changes of glycated hemoglobin (HbA1c) in patients with acute ischemic stroke in Tianjin.Methods:Acute ischemic stroke patients with available HbA1c data admitted to the Department of Neurology, the Second Hospital of Tianjin Medical University from January 1, 2011 to December 31, 2020 were enrolled retrospectively. The demographic data, vascular risk factors, baseline clinical data and routine blood test findings were collected. The seasonal changes of various indexes were investigated. Multiple linear stepwise regression analysis was used to determine the influencing factors of HbA1c.Results:A total of 2 721 acute ischemic stroke patients with available HbA1c data were included, of whom 1 779 (65.4%) also had diabetes mellitus, 942 patients (34.6%) did not have diabetes mellitus. The baseline National Institutes of Health Stroke Scale score, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol and uric acid in the winter group were significantly higher than those in the summer group (all P<0.05). HbA1c had seasonal difference in acute ischemic stroke patients without diabetes mellitus ( P<0.05). For acute ischemic stroke patients with diabetes mellitus, HbA1c showed seasonal fluctuations only at HbA1c >7% ( P<0.05). Multiple linear stepwise regression analysis showed that combined with diabetes mellitus, using insulin and/or oral hypoglycemic drugs, fasting blood glucose, uric acid, creatinine and season were the independent infuencing factors of HbA1c. Conclusions:HbA1c in patients with acute ischemic stroke in Tianjin is characterized by seasonal fluctuations, which is high in winter and spring and low in summer and autumn. This difference is related to the level of HbA1c.

Objective:To investigate the related factors that affect the timing and prognosis of early tracheostomy in patients with multiple rib fractures.Methods:A retrospective case series study was conducted on medical data of 222 patients with multiple rib fractures who underwent tracheostomy in Affiliated Hospital of Yangzhou University from February 2013 to October 2019，including 160 males and 66 females，with the age of 18 to 85 years ［（49.5 ± 16.3）years］. According to the practice management guidelines for tracheostomy timing and the use of propensity score matching technology，there were 118 patients with tracheostomy within 7 days of tracheal intubation （early group） and 104 patients with tracheostomy after 7 days of tracheal intubation （late group） before matching，and there were 87 patients in early group and 87 patients in late group after matching. Data were compared between groups including the gender，age，underlying disease，injury severity score （ISS），Glasgow coma score （GCS），number of fractured ribs，total number of rib fractures （NTRF），first rib fracture，flail chest，traumatic brain injury，combined injuries （spine，maxillofacial，sternum），acute respiratory distress syndrome （ARDS），volume fraction of pulmonary contusion（VPC），blood lactic acid （within 24 hours of admission），hemothorax，pneumothorax，mechanical ventilation time，duration of tracheostomy，time from tracheal intubation to incision，length of hospital stay，length of stay in ICU，closed thoracic drainage，number of fiberoptic bronchoscopy，multi-drug resistant bacteria infection，ventilator-associated pneumonia，antibiotic use time，duration of sedative and analgesic drugs used and 28-day mortality. The multivariate Logistic regression analysis was used to predict independent risk factors for early tracheostomy. The Pearson method was used to compare the relationship between multiple factors. The receiver operating characteristic （ROC） curve was used to predict indicators that affect the prognosis of patients with early tracheostomy，and calculate the best cut-off value. The Kaplan-Meier single factor and COX multivariate survival were used to analyze the relevant factors affecting the 28-day mortality of patients.Results:（1） In early group，the NTRF，ARDS and VPC were higher than those in late group，and the time from tracheal intubation to incision and 28-day mortality rate were lower than those in late group （ P < 0.05），while the two groups showed no significant differences in the gender，age，underlying diseases and ISS （ P > 0.05）. （2） The multivariate Logistic regression analysis showed that there was statistical significance in NTRF （ OR = 1.775，95% CI 1.439-2.188），ARDS（ OR = 3.740，95% CI 1.441-9.711），VPC （ OR = 1.087，95% CI 1.052-1.124） （ P < 0.05）； the Pearson method analysis showed a significant correlation between VPC and NTRF （ r = 0.369， P < 0.05） and a low degree of correlation between ARDS and VPC （ r = 0.179， P < 0.05），but there was no significant correlation between ARDS and NTRF （ r = 0.132， P > 0.05）. （3） The ROC curve analysis showed that the area under the curve （AUC） of the VPC and NTRF ［AUC = 0.832 （95% CI 0.770-0.893），AUC = 0.804 （95% CI 0.740-0.868）］ were significantly higher than those of the number of rib fractures ［AUC = 0.437（95% CI 0.352-0.523），GCS ［AUC = 0.519 （95% CI 0.432-0.605）］ and ISS ［AUC = 0.484 （95% CI 0.398-0.571）］ （ P < 0.05）. After calculating the Yorden index，the best cut-off value for VPC was 23.9，and the best cut-off value for NTRF was 8.5. （4） The Kaplan-Meier single factor and multivariate COX model survival analysis showed that the 28-day survival ratio of patients with early tracheostomy was significantly better than that of late tracheostomy （ P < 0.05）. Conclusions:The NTRF，ADRS and VPC are independent risk factors for the timing and prognosis of early tracheostomy. There is a significant correlation between VPC and NTRF. The VPC ≥ 23.9% and or NTRF ≥ 8.5 can be used to predict early tracheostomy in patients with multiple rib fractures. Early tracheostomy may benefit the 28-day survival of patients with multiple rib fractures.

Objective To investigate the relationship between brain white matter volume (WMV) and cognitive function (CF) in childhood and adolescence-onset schizophrenia (CAOS).Methods Forty childhood and adolescence-onset first-episode schizophrenia patients (case group) and thirty-nine healthy volunteers (control group) were selected.All subjects underwent a 3.0 T magnetic resonance imaging(MRI) scans for data acquisition.The Chinese version of MATRICS consensus cognitive battery(MCCB) was used to assess the cognitive function.The psychiatric symptoms of schizophrenia were assessed with the positive and negative syndrome scale (PANSS).And t test was applied to compare whether there were differences in WMV,CF between the two groups.Pearson correlation analysis was used to analyze whether the differences were related with cognitive function and mental symptoms.Results Compared with healthy controls,the case group exhibited WMV deficits in the region of left frontal lobe (LFL) (MNI:x =-27,y =12,z =21),right side limbic lobe (RSLL) (MNI:x =18,y =-9,z =39) and left cingulate gyrus (LCG) (MNI:x =-21,y =-18,z=45) (P＜0.05).The WMV of LFL was negatively related with the total score (r=-0.344,P＜0.05) and the WMV of LCG was negatively related with the positive symptoms score (r=-0.326,P＜0.05) and total score (r=-0.348,P＜0.05) of the PANSS.Besides,compared with the controls,the patients showed significant increase in the scores of Trail Making Test (t =3.56,P＜ 0.01),while significant decrease in the scores of the HVLT-R and BVMT-R(t=-5.67,-8.66,P＜0.05).The WMV of RSLL was positively correlated with verbal fluency test in the case group (r=0.40,P＜0.05).Conclusion CAOS patients exist multiple reduced WMV and cognitive impairment,suggesting the importance of the WMV abnormalities in the pathophysiological mechanism of cognitive impairment.

Objective:To investigate the relationships of rs4658971 polymorphism of disrupted-in-schizophrinia-1 ( DISC1) gene with schizophrenia in children and adolescents and with the brain structure of such patients. Methods:(1) A total of 577 children and adolescents with schizophrenia were recruited from the Inpatient Department of the Second Affiliated Hospital of Xinxiang Medical University from October 2010 to December 2018, and 516 healthy children were selected as the control group.The rs4658971 polymorphism of DISC1 gene was detected by restriction fragment length polymorphism (PCR-RFLP). The differences of DISC1 genotype and allele frequencies between schizophrenia patients and healthy children were compared by Chi-square test.(2)One hundred and eighteen patients with the first-episode schizophrenia whose illness duration was no more than 12 months and 101 healthy children and adolescents were detected by 3.0T magnetic resonance imaging (MRI). The craniocerebral structures of patients with different DISC1 genotypes were analyzed by covariance with age as the covariant. Results:(1) The rs4658971 genotype frequencies(TT 6.6% vs.5.2%, TC 37.4% vs.38.4%, CC 56.0% vs.56.4%, χ2=0.91, P=0.63) and allele frequencies(C 74.70% vs.75.58%, T 25.30% vs.24.42%, χ2=0.23, P=0.63) of DISC1 gene in children and adolescents with schizophrenia were not significantly different from those in the healthy children.(2) Compared with the control group, the transverse diameter of the third ventricle was significantly enlarged in children and adolescent with schizophrenia [(4.68±1.41) mm vs.(4.06±1.36) mm, F=8.534, P=0.004], while the distance between the anterior feet of the lateral ventricle, the width of the caudate nucleus head and the thickness of the hippocampus were significantly reduced [(30.69±2.51) mm vs.(32.02±2.41) mm, (8.17±1.01) mm vs.(9.22±1.14) mm, (8.93±0.97) mm vs.(9.93±1.14) mm], and the differences were statistically significant( F=15.435, 40.201, 44.650, all P<0.001). The covariance analysis (with age as the covariant) showed that there was significant difference in the width of the caudate nucleus head between patients with CC genotype and those with CT+ TT genotype[(8.73±0.85) mm vs.(7.39±0.61) mm, F=41.376, P<0.001]. Conclusions:There are multiple brain structural changes in children and adolescents with first-episode schizophrenia.T allele carriers of DISC1 gene rs4658971 locus may be related to the reduced width of the caudate nucleus head in patients.

Objective:To construct a real-time monitoring system based on computer vision for monitoring withdrawal speed of colonoscopy and to validate its feasibility and performance.Methods:A total of 35 938 images and 63 videos of colonoscopy were collected in endoscopic database of Renmin Hospital of Wuhan University from May to October 2018. The images were divided into two datasets, one dataset included in vitro, in vivo and unqualified colonoscopy images, and another dataset included ileocecal and non-cecal area images. And then 3 594 and 2 000 images were selected respectively from the two datasets for testing the deep learning model, and the remaining images were used to train the model. Three colonoscopy videos were selected to evaluate the feasibility of real-time monitoring system, and 60 colonoscopy videos were used to evaluate its performance.Results:The accuracy rate of the deep learning model for classification for in vitro, in vivo, and unqualified colonoscopy images was 90.79% (897/988), 99.92% (1 300/1 301), and 99.08% (1 293/1 305), respectively, and the overall accuracy rate was 97.11% (3 490/3 594). The accuracy rate of identifying ileocecal and non-cecal area was 96.70% (967/1 000) and 94.90% (949/1 000), respectively, and the overall accuracy rate was 95.80% (1 916/2 000). In terms of feasibility evaluation, 3 colonoscopy videos data showed a linear relationship between the retraction speed and the image processing interval, which indicated that the real-time monitoring system automatically monitored the retraction speed during the colonoscopy withdrawal process. In terms of performance evaluation, the real-time monitoring system correctly predicted entry time and withdrawal time of all 60 examinations, and the results showed that the withdrawal speed and withdrawal time was significantly negative-related ( R=-0.661, P<0.001). The 95% confidence interval of withdrawal speed for the colonoscopy with withdrawal time of less than 5 min, 5-6 min, and more than 6 min was 43.90-49.74, 40.19-45.43, and 34.89-39.11 respectively. Therefore, 39.11 was set as the safe withdrawal speed and 45.43 as the alarm withdrawal speed. Conclusion:The real-time monitoring system we constructed can be used to monitor real-time withdrawal speed of colonoscopy and improve the quality of endoscopy.

Objective:To establish a deep convolutional neural network (DCNN) model based on YOLO and ResNet algorithm for automatic detection of colorectal polyps and to test its function.Methods:Colonoscopy images and videos collected from the database of Digestive Endoscopy Center of Renmin Hospital of Wuhan University from January 2018 to March 2019 were divided into three databases (database 1, 3, 4). The public database CVC-ClinicDB (composed of 612 polyp images extracted from 29 colonoscopy videos provided by Barcelona Hospital, Spain) was used as the database 2. Database 1 (4 700 colonoscopy images from January 2018 to November 2018, including 3 700 intestinal polyp images and 1 000 non-polyp images) was used for establishing training and verifying the DCNN model. Database 2 (CVC-ClinicDB) and database 3 (720 colonoscopy images from January 2019 to March 2019, including 320 intestinal polyp images and 400 non-polyp images) were used for testing the DCNN model on image detection. Database 4 (15 colonoscopy videos in December 2019, containing 33 polyps) was used for testing the DCNN model on video detection. The sensitivity, specificity, accuracy and false positive rate of the DCNN model for detecting intestinal polyps were calculated.Results:The sensitivity of the DCNN model for detecting intestinal polyps in database 2 was 93.19% (602/646). In database 3, the DCNN model showed the accuracy of 95.00% (684/720), sensitivity of 98.13% (314/320), specificity of 92.50% (370/400), and false positive rate of 7.50% (30/400) for detecting intestinal polyps. In database 4, the DCNN model achieved a per-polyp-sensitivity of 100.00% (33/33), a per-image-accuracy of 96.29% (133 840/138 998), a per-image-sensitivity of 90.24% (4 066/4 506), a per-image-specificity of 96.49% (129 774/134 492), and a per-image-false positive rate of 3.51% (4 718/134 492).Conclusion:The DCNN model constructed in the study has a high sensitivity and specificity for automatic detection of colorectal polyps both in the colonoscopy images and videos, has a low false positive rate in the videos, and has the potential to assist endoscopists in diagnosis of colorectal polyps.