Karyotype analysis has been considered as the key tool for prenatal diagnosis .Although it is cost-effective, it has great challenge to meet the growing demand of efficiency and quality in clinical settings.To improve the effeiciency and detection quality , cytogenomic microarray analysis ( CMA ) is developed, with high detection rate.However, traditional karyotype analysis at different resolution should also be used as the reference for CMA .

Objective To investigate significance of interferon-γ/interleukin-4(IFN-γ/IL-4) and macrophages in uterus in early embryo loss (or resorption), and to elucidate the anti-abortive effect and the immunological modulation at maternal-fetal interface with quercetin and bornvl acetate. Methods Lipopolysaccharide (LPS)(0.10μg/mouse)was injected via tail vein in order to induce abortion in 7-day-gestation mice which received quercetin and bornvl acetate at days 4-7 of gestation. Levels of IFN-γ and IL-4 in uterus lysate supernatant were measured using enzyme-linked immuno-absorbent assay (ELISA), and uterine macrophages of each group ( n =10) were detected by immunohistochemistry. Results The amount of macrophages was much higher in the uteri of LPS-induced abortion mice than that in control mice. The abortion rate of mouse declined to certain level. The therapy of quercetin combined with bornyl acetate reversed LPS-induced abortion. Conclusion The increase of IFN-γ/IL-4 and the amount of macrophages in the LPS-treated mouse uterus is associated with the embryo loss, and quercetin and bornyl acetate have the anti-abortive effect through modulation of maternal-fetal interface immunity balance.

Objective To investigate the relationship between Trp64Arg mutation in β3-adrenerglc receptor (β3-AR) gene and the incidence of metabolic syndrome (MS). Methods A seven-year follow-up study was conducted in 386 simple obese subjects and 175 normal weight subjects in whom geno-typing of Trp64Arg mutation in β3-AR gene was examined in 2000. Results There were no differences between a Trp64Trp homozygote group and a Trp64Arg heterozygote group of whether obese or normal weight subjects with respect to adiposity, blood pressure, lipid profile, fasting blood glucose and fasting insulin in the baseline. The results of follow-up indicated that the incidence of MS in the Trp64Arg heterozygote group was higher than that in the Trp64Trp homozygote group of obese males (54. 76% vs 40. 85% ,P <0. 05) but not in the group of obese females. The incidences of MS both in the Trp64Trp homozygote group and Trp64Arg heterozygote group were higher in obese males than in obese females (40. 85% vs 18. 27% and 54. 76% vs 21.28% ,all P <0. 01 ) . No significant differences were found in incidences of MS both in the Trp64Trp homozygote group and Trp64Arg heterozygote group of normal weight subjects whether the comparison was made between males and females respectively or between males and females. The overall incidence of MS in the obese subjects were significantly increased than that in the normal weight subjects whether there was genevariant or not(31.30% vs 6. 03% and 42. 75% vs 12. 73%, all P <0. 01 ). Logistic analysis showed thatβ3-AR gene variant was associated with increased incidence of MS in males. Conclusion β3-AR gene Trp64Arg mutation is an independent risk factor for the incidence of MS in males.Conclusion β3-AR gene Trp64Arg mutation is an independent risk factor for the incidence of MS in males.

Objective To evaluate the correlation between three-dimensional histogram vascular indexes of ovarian tumors and microvessel density (MVD).Methods Fifty-seven patients with ovarian cystic-solid or solid masses from Beijing Obstetrics and Gynecology Hospital,Capital Medical University were evaluated by three-dimensional (3D) power ultrasound within one week before surgery from January 2008 to December 2009.We captured 3D power imaging in the interested and solid areas of tumors,and used three-dimensional histogram from virtual organ computer-aid analysis (VOCAL) to calculate vascularization index (Ⅵ),flow index (FI) and vascularization-flow index (VFI).After operation the specimens underwent immunohistochemistry staining and MVD and vascular endothelial growth factor (VEGF) were calculated.Two independent-samples t tests were used to compare MVD between ovarian benign and malignant tumors.Rank sum test was used to compare VEGF.Spearman was used to analyze the relationship between 3D PD vascular indices and MVD.Results Sixty-two ovarian masses in 57 patients were confirmed by pathology (5 cases were bilateral tumors),including 22 benign and forty malignant messes (including eight borderline tumors).Fifty-four tumors underwent immunohistochemistry staining.MVD and VEGF were calculated.Both of MVD and VEGF in ovarian malignant tumors were obviously higher than those in benign ones (t=-5.255,Z=-3.868,both P ＜ 0.01).Both of Ⅵ and VFI were positive correlative to MVD (r=0.295,0.280,both P ＜ 0.05).Conclusions There was a positive correlation between vascular indexes and microvessel density.The vascular indexes could reflect the density of angiogenesis in ovarian tumors before surgery,and they could provide valuable information for early-stage diagnosis of ovarian cancer.

Objective:To evaluate the efficacy and safety of less invasive surfactant administration (LISA) combined with nasal intermittent positive pressure ventilation (NIPPV) in the treatment of infants with respiratory distress syndrome (RDS).Methods:A prospective study was conducted on preterm infants of gestational age ≤34 weeks with RDS who were admitted to the Neonatal Intensive Care Unit of Xuzhou Central Hospital from October 2019 to November 2021. The infants were randomly assigned into the LISA+NIPPV group and the intubation-surfactant-extubation (INSURE) +nasal continuous positive airway pressure (NCPAP) group. In the LISA+NIPPV group, with the support of NIPPV, a Lisa tube was inserted through the vocal cords under direct vision with direct laryngoscope, and then pulmonary surfactant (PS) was infused into the lung. In the INSURE+NCPAP group, the patients were endotracheally intubated and infused with PS into the lung through endotracheal tube, then extubated and continued to receive NCPAP therapy (INSURE). The blood gas analysis at 1 h and 6 h after PS infusion, the adverse reactions during injection, clinical efficacy, bronchopulmonary dysplasia (BPD) and other related complications were compared between the two groups.Results:A total of 112 preterm infants with RDS were enrolled, including 58 in the LISA+NIPPV group and 54 in the INSURE+NCPAP group. The blood oxygen partial pressure (PaO 2) and PaO 2/FiO 2 (P/F) in the LISA+NIPPV group were significantly higher than those in the INSURE+NCPAP group at 1 h and 6 h after PS infusion, while carbon dioxide partial pressure (PaCO 2) were significantly lower than that in the INSURE+NCPAP group, and the differences were statistically significant (all P<0.05). The rate of tracheal intubation within 72 h (15.5% vs. 33.3%), the duration of non-invasive ventilation [ (7.5 ± 4.3) d vs.(9.9 ± 5.5) d ], total oxygen inhaling [ (10.5 ± 3.5) d vs.(13.3 ± 4.1) d ], failure rate of machine withdrawal (8.6% vs. 31.0% ), the times of apnea [7.0 (3.0-21.0) times vs. 15.0 (4.0-28.0) times ] and re-administration of PS (17.2% vs. 33.3%) in the LISA+NIPPV group were significantly lower than those in the INSURE+NCPAP group, and the differences were statistically significant ( P<0.05). The incidence of regurgitation in the LISA+NIPPV group was lower than that in the INSURE+NCPAP group (13.8% vs. 35.2%), and the difference was statistically significant ( P<0.05). There was no significant difference in the time needed for intubation between the two groups ( P>0.05). The occurrence of BPD in the LISA+NIPPV group was significantly lower than that in the INSURE+NCPAP group (10.3% vs. 25.9%), and there was no significant difference in other related complication between the two groups (all P>0.05). Conclusions:LISA combined with NIPPV in the treatment of preterm infants with RDS can effectively improve oxygenation, reduce carbon dioxide retention, reduce the mechanical ventilation rate, shorten the duration of noninvasive mechanical ventilation, and reduce the incidence of BPD.

Objective To assess the clinical efficacy and safety of heated humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (NCPAP) for prevention of extubation failure in preterm infants with respiratory distress syndrome (RDS).Methods From March 2016 to December 2017,75 preterm infants (≤32 weeks gestation) with RDS who needed noninvasive respiratory support after a period of mechanical ventilation with an endotracheal tube in neonatal intensive care unit were studied.They were randomly assigned into the HHHFNC group (38 cases) and the NCPAP group (37 cases) by using a random number table.The main observation was the success rate of removal of the ventilator,duration of noninvasive ventilation time,the total oxygen inhaling time,feeding conditions and incidence of adverse events.Results The baseline demographic characteristics of the two groups were similar in terms of gestational age,birth weight,gender,incidence of cesarean delivery,premature rupture of membranes,administrations of antenatal glucocorticoid prophylaxis,Apgar scores at 1 and 5 minutes (P ＞ 0.05).No significant difference was found in the success rate of removal of the ventilator between HHHFNC group and NCPAP group(94.7 ％ vs.91.9％,P ＞ 0.05).The time of noninvasive ventilation,the total oxygen inhaling time and hospital stay in the NCPAP group were shorter than those in the HHHFNC group,but there were no significant differences between two groups (P ＞ 0.05).The occurrence of abdominal distention (10.5％ vs.27.05％),nasal trauma(5.2％ vs.21.6％),head shaping(0 vs.32.4％) were lower in HHHFNC group than those in NCPAP group (P ＜0.05).The time needed to achieve total enteral nutrition[(10.1 ± 1.2) d vs.(14.1 ± 1.6)d] and the incidence of feeding intolerance (13.1％ vs.29.7％) were reduced in HHHFNC group than those in NCPAP group (P ＜ 0.05).Conclusion As an respiratory support for the treatment of preterm infants with RDS after extubation,HHHFNC has the similar efficacy with NCPAP.However,HHHFNC has lower incidence of nasal trauma,abdominal distension and feeding intolerance,and further clinical research is needed.

Objective:To evaluate the efficacy and safety of less invasive surfactant administration (LISA) combined with caffeine citrate in the treatment of respiratory distress syndrome (RDS) in preterm infants receiving continuous positive airway pressure (NCPAP) ventilation.Methods:From August 2019 to April 2021, a total of 112 preterm infants with RDS (26 weeks≤gestational age ≤32 weeks) who were hospitalized in the Neonatal Intensive Care Unit of Xuzhou Central Hospital, were chosen as research subjects. The patients were randomly divided into the LISA combined treatment group ( n=58) and the INSURE group ( n=54). In the LISA combined treatment group, a LISA tube was inserted through the vocal cords under direct vision with a direct laryngoscope and then infused with pulmonary surfactant (PS) into the lung when NCPAP ventilation was applied, and caffeine citrate was given intravenously. In the INSURE group, the patients were endotracheally intubated and infused with PS into the lung through an endotracheal tube, and then extubated and put on NCPAP again. The following indicators were examined: the general clinical data, results of blood gas analysis at 1 h and 6 h after infusion of PS into the lung, clinical efficacy and related complications. Results:①No significant differences were found between the two groups in the general clinical data (all P>0.05).Intra-group comparison within LISA combined treatment group or INSURE group showed that partial pressure of arterial carbon dioxide (PaCO 2), partial pressure of arterial oxygen (PaO 2) of blood gas analysis and PaO 2/fraction of inspired oxygen (P/F) at 1 h and 6 h after infused PS into the lung were all improved compared to those of before treatment, and the differences were statistically significant (all P<0.05). The PaO 2 and P/F in the LISA combined treatment group at 1 h and 6 h after breath support therapy were higher than those in the INSURE group, while PaCO 2 was lower than that in the INSURE group, and the differences were statistically significant (all P<0.05). The duration of noninvasive ventilation, total oxygen inhalation, re-administration of PS, failure rate of machine withdrawal, the rate of tracheal intubation within 72 h and the times of apnea in the LISA combined treatment group were significantly shorter, or lower, or less than those in the INSURE group [3.0 (1.0, 18.0) d vs. 7.5 (2.0, 22.0) d, 5.5 (3.0, 21.0) d vs. 10.5 (4.0, 28.0) d, 9 (15.5%) vs. 17 (31.5%), 6 (10.3%) vs. 14 (25.9%), 5 (8.6%) vs. 12 (22.2%), 5.0 (3.0, 21.0) times vs. 15.0 (4.0, 28.0) times], and the differences were all statistically significant (all P<0.05). The incidence of bronchopulmonary dysplasia in the LISA combined treatment group was less than that in the INSURE group [(5 (8.6%) vs. 13 (24.1%)], and the difference was statistically significant ( P<0.05). There was no significant difference between the two groups in other complications( P>0.05). Conclusions:Compared with INSURE, the LISA technique combined with caffeine citrate can effectively improve oxygenation, reduce the mechanical ventilation rate, shorten the duration of noninvasive mechanical ventilation, and reduce the incidence of BPD in the treatment of premature infants with RDS at the gestational age of 26-32 weeks.

Objective:To study the efficacy and safety of less invasive surfactant administration (LISA) combined with bi-level positive airway pressure (BiPAP) ventilation in premature infants with respiratory distress syndrome (RDS).Methods:Premature infants with RDS at gestational age of 26~32 weeks in the NICU of our hospital from January 2020 to October 2021 were enrolled in this randomized controlled trial. They were randomly assigned to the LISA+BiPAP group or the intubation-surfactant-extubation (INSURE) + nasal continuous positive airway pressure (NCPAP) group, and given the corresponding treatment according to the group. The blood gas analysis at 1 h and 6 h after intratracheal instillation of pulmonary surfactant (PS), medication, noninvasive respiratory support time, total oxygen use time, weaning failure rate and endotracheal intubation rate within 72 h after PS administration were compared between the two groups, as well as the incidence of bronchopulmonary dysplasia (BPD).Results:A total of 86 preterm infants with RDS were enrolled in the study, including 44 in the LISA+BiPAP group and 42 in the INSURE+NCPAP group. Arterial partial pressure of oxygen in the LISA+BiPAP group at 1 h and 6 h after intratracheal instillation of PS were higher than those in the INSURE+NCPAP group, while PaCO 2 and oxygenation index (OI) were lower than those in the INSURE+NCPAP group, and the differences were statistically significant (all P<0.05). The duration of noninvasive respiratory support time [(12.2±8.7) d vs. (16.0 ±7.6) d], total oxygen use time [(16.6 ±8.3) d vs. (20.3±7.4) d], length of hospitalization[(22.6±10.3) d vs. (27.1±12.6) d], weaning failure rate [(11.4% (5/44) vs. 31.0% (13/42)], endotracheal intubation rate within 72 h after PS administration [11.4% (5/44) vs. 28.6% (12/42)], and re-administration of PS [18.2% (8/44) vs. 38.1% (16/42)] in the LISA+BiPAP group were lower than those in the INSURE+NCPAP group, and the differences were statistically significant ( P<0.05). The time needed for intubation and the incidence of regurgitation in the LISA+BiPAP group were lower than those in the INSURE+NCPAP group, and the differences were statistically significant ( P<0.05). The incidence of BPD in the LISA+BiPAP group was lower than those in the INSURE+NCPAP group [11.4% (5/44) vs. 31.0% (13/42)] ( P<0.05), the difference was also statistically significant ( P<0.05). There was no significant difference in the incidence of other complications between the two groups ( P>0.05). Conclusions:LISA combined with BiPAP can effectively improve oxygenation, reduce the mechanical ventilation rate, shorten the duration of non-invasive respiratory support, and reduce the incidence of BPD in the treatment of premature infants with RDS at the gestational age of 26~32 weeks.

This article has analyzed the source and clinical significance of statement of "if keeping health, Zusanli (ST36) frequently being given moxibustion" based on philology and medical principles.The statement was recorded in Suosuilu (Trivial Details of Traditional Chinese Medicine) written in early Southern Song Dynasty, which was originally designed for preventing and curing wind diseases.The moxibustion on ST36 is to diffuse and unblock qi and blood of zang-fu organs, but is not to give festering moxibustion.If the statement is explained as repeated festering moxibustion, Yubaizhuang moxibution recorded in Beijiqianjinyaofang (Essential Prescriptions Worth a Thousand Gold for Emergencies) and Bao moxibution recorded in Zhenjiuzishengjing (Classic of Nourishing Life with Acupuncture and Moxibustion) used only in the condition of excessive yang deficiency will be misunderstood.Acupressure, frottage and foot bath can be selected in ST36 healthcare.Considering safety, some mild moxibustion therapies are recommended, such as suspended moxibustion and sandwiched moxibustion, in patients with obvious cold symptoms.

No ancient records of bigu(abstinence from grains)for life nurturing in healthy people have been identified although it was originally a taoist asceticism for pursuing immortality.The TCM classics of Huangdi Neijing and Nanjing have shown that healthy person with bigu would die of losing spirit after sev-en days.Bigu and life nurturing have been divided into different chapters to show the difference in the ancient medical books.The taoist doctors oppose bigu on account of early death and malady.Shiqi Bigu (eating qi with abstinence from grains)lacks theoretical evidence and no success cases could be verified."Bloating without appetite"originally refers to the symptom(anorexia)of spleen deficiency pattern.This term is used in Taoist practice to denote willpower of"eliminating desire"(zhinian)in taoist cultivation. Without precise fabrication,bigu prescriptions tend to consist of 80%sweet-flavored ingredients or grain and tonic herbs,which may be the actual cause of bloating and anorexia with safety concern.Bigu seems to have deviated from the ancient rule of TCM"well-balanced diet with the grains, meats, fruits and vegetables for health",and also violated the principle of"food variety with grain dominant"diet in mod-ern nutrition.There is no rationality to include bigu into the life nurturing methods or therapies of tradi-tional Chinese medicine.