Objective To investigate the possibility of blood flow resistance index (RI),pulse index (PI) plus the risk of malignant index (RMI) in preoperative diagnosis of ovarian neoplasm.Methods Four hundred and sixty-eight women with ovarian tumor,30 years or older,were enrolled in current study from January 2007 to December 2012 in the People's Hospital of Tianjin.Among them,127 were with malignant ovarian tumors and 341 with benign ovarian tumors.They were retrospectively prospective assessed by RI + PI,RMI,and RI + PI combine with RMI.Results The value of RI,PI of malignant ovarian tumors group were lower than those of benign ovarian tumors group ((0.41 ± 0.08) vs (0.68 ± 0.15),t =28.83,P ＜ 0.01 ; (0.82 ± 0.24) vs (1.67 ±0.71),t =22.26,P ＜0.01).RMI of malignant ovarian tumors group was (269.7 ±41.2),higher than that of benign ovarian tumors group(25.6 ± 11.4,t =107.55,P ＜0.01).The indices of RI ＜0.40 and/or PI ＜1.00,RMI ＞ 200 were served as the critical biomarker respectively.Histopathological examination result was conducted and considered as gold standard for identifying patients with ovarian cancer pelvic masses.The sensitivity of RI,PI plus RMI was 92.57％,higher than that used by RI and PI (81.02％) or RMI only (84.21％),and the difference was significant (P ＜ 0.05).The sensitivity,specificity,positive and negative predictive values of the combined index of RI,PI adding to RMI were all higher than 90％.Conclusion The combined index of RI,PI plus RMI was proved to enhance the diagnostic accuracy regarding of the preoperative diagnosis of benign or malignant ovarian tumors.

Objective To compare the effects of autologous blood transfusion and allogenic blood transfusion on the patients undergoing selective operation of intervertebral fusion with cage. Methods Forty patients who underwent selective operation of intervertebral fusion with cage in the De?partment of Orthopedics of our hospital from September 2012 to June 2014 were recruited for the study,including 20 cases that received autologous blood transfusion only(group A)and 20 cases that received allogenic blood transfusion only(group B). Preoperative and postoperative results of blood routine examination,body temperature,postoperative recovery indicators and expense of blood transfusion were compared between the two groups. Results The postoperative erythrocyte and hemoglobin of the patients in group A were significantly higher than those in group B(P<0.05). When the amount of blood used during the operation reaches or exceeds 4 units,the expense of autologous blood transfusion was lower than that of allogenic blood transfusion. Conclusion Autologous blood transfusion contributes to higher levels of postoperative erythrocyte and hemoglo?bin. When a large amount of blood is used during an operation,autotransfusion can help to reduce the expense of blood transfusion.

Objective To investigate the incidence of pleural effusion in acute panereatitis(AP)and the relation between pleural effusion and severity of AP.Methods The medical records of 766 patients with AP were analyzed retrospectively.The incidence of pleural effusion was documented and its relationship with age of onset,sex,Ranson score,CTSI,serum albumin and hospital day was analyzed.Results In the 766 AP patients,there were 129(16.8%)patients had pleural effusion.In 171 SAP patients,there were 91 (15.3%)patients had pleural effusion.In the 595 MAP patients,there were 129(16.8%)patients had pleural effusion.The difference in the incidence of pleural effusion between MAP and SAP patients was statistically significant(P＜0.05).The serum amylase,albumin,Ranson score,CTSI,and hospital day in patients with pleural effusion were(795±1013)U/L,(36±7)g/L,1.12±1.15,4.02±1.16 and(23.4±23.4)d,respectively;while the corresponding values in patients without pleural effusion were(592±856)U/L,(38±6)g/L,0.85±0.98,3.15±16.60 and(17.3±16.6)d,respectively.The difference in Ranson score,serum amylase,CTSI between the two groups was statistically significantly(P＜0.05 or＜0.01＝,the serum level of albumin in patients with pleural effusion was significantly lower than that in patients without pleural effusion(P＜0.01),the hospital day in patients with pleural effusion was significantly longer than that in patients without pleural effusion(P＜0.01).Pleural effusion of both sides was present in 92 patients,while pleural effusion of right side was present in 11 patients,pleural effusion of left side was present in 26 patients;the site of pleural effusion was not associated with the severity of AP,however,patients with pleural effusion of left side tended to have longer hospital day(P＜0.05).Conclusions Patients with pleural effusion during AP were more likely to be complicated with severe conditions,and the presence of pleural effusion may be a good marker for severity evaluation.

Objective To investigate the feasibility and effectiveness of ‘ group-head responsibility teaching method' in the physiology experiment teaching.Methods Totally 422 students of clinical medicine major in 2010 grade were randomly divided into two groups:212 students in control and 210 in study group.For students in control group,principles,procedures,items of experiment and computer operation were first taught,then experiment was performed while for those in study group,initial procedures were firstly explained,then the group heads were called together to observe the experiment preformed by teacher,after that the group heads returned to assist other students performing the experiment.Finally,experiment success rates,scores of final-term experiment operation,theoretical exam and report of two groups were compared and analyzed.Meanwhile,questionnaire survey was conducted.Results Success rates were improved significantly in study group than in control group (x2 =37.42,P =0.0000).There were significant differences in operation scores (t =4.3213,P =0.0000),theoretical exam scores (t =6.8744,P =0.0000) and report scores (t =15.298,P =0.0000) between the two groups.Conclusions ‘ Group-head responsibility teaching method' is better than traditional lecture-style teaching method and it can promote comprehensive capabilities of students.

Aim To investigate the effects of isoliquiri-tigenin ( ISL) on anti-angiogenesis both in vitro and in vivo and its mechanisms. Methods We assessed the antiangiogenic activities of ISL on proliferation viabili-ty, migration and tube formation of human microvascu-lar endothelial cell line-1 (HMEC-1) in vitro. The cell proliferation viability was assessed using the Sulforho-damine B ( SRB ) assay. Modified Boyden Transwell chamber assay was done to study the effect of ISL on HMEC-1 cells migration. 2′, 7′-dichlorofluorescein di-acetate ( DCFH-DA) was used to measure the levels of intracellular reactive oxygen species ( ROS ) , which was induced by VEGF. Metalloproteinase-2 ( MMP-2 ) and metalloproteinase-9 ( MMP-9 ) expressions by HMEC-1 cells were assessed through gelatin zymogra-phy assay. HMEC-1 cells cycle was detected by flow cytometry. Moreover, we investigated the in vivo anti-angiogenic activity of ISL on chicken embryos nap al-lantoic membrane model ( CAM ) . Results ISL con-centration-dependently inhibited the growth of HMEC-1 cells as well as SW620 and A549 cells. ISL signifi-cantly and concentration-dependently suppressed the migration activity of HMEC-1 cells. Tube sample struc-ture formation further confirmed the effect of ISL on an-ti-angiogenesis. Moreover, ISL also inhibited intracel-lular ROS level, MMP-2 and MMP-9 expression by HMEC-1 cells. ISL induced endothelial cell apoptosis at a low concentration ( ISL 12 . 5 μmol · L-1 ) and blocked the cells in S phase of mitosis at higher con-centrations ( ISL 25~100 μmol·L-1 ) . Furthermore, ISL distinctly inhibited the angiogenesis of chick em-bryos in vivo. Conclusions ISL has anti-tumor and angiogenesis effects on HMEC-1 cells. The mechanism may be related to intracellular ROS scavenging and ap-optosis induction of HMEC-1 cells.

Objective:To explore the clinical characteristics and treatment of a family with inherited generalized epilepsy with febrile seizures plus (GEFS + ) caused by the KCNT2 gene mutation and review the literature. Methods:Clinical data of a child with GEFS + and his family members who visited Department of Pediatric Neurology, Guangzhou Women and Children′s Medical Center in May 2019 were collected.DNA samples were collected from the peripheral blood of the proband, his parents, his elder brother, and his maternal grandparents, and genetic analysis and verification were performed using the next-generation sequencing technique.Using " KCNT2" as the key word, literature was retrieved from PubMed, China National Knowledge Infrastructure and Wanfang databases (up to August 2019). Results:The proband was a 3-year-old boy who was admitted to Guangzhou Women and Children′s Medical Center because of frequent epileptic seizures in the past 5 months.He presented with a binocular gaze and experienced 3 to 8 times of extremities myoclonic-spastic epileptic attacks every day.He had a history of 3 times of febrile seizures at the age of 2 years old.His seizures were refractory to Sodium valproate, Topiramate, Nitrazepam and Levetiracetam.His elder brother and mother had a history of childhood febrile seizures.Other members in the family had no history of convulsion.Ictal electroencephalogram showed general 1 Hz high voltage spike-slow waves.A heterozygous nonsense mutation of KCNT2 gene c. 574C>T(p.Q192X) that was never reported previously was detected in the proband, his brother, mother and maternal grandmother.Furthermore, no other family members carried the mutation at the c. 574 locus of the KCNT2 gene.No article in Chinese was found, and 2 articles in a language other than Chinese provided the complete data of 3 sporadic cases.Together with 4 cases in the family studied in this article, there were 7 cases and 4 mutation sites in KCNT2 gene.Of these mutations, there were 3 missense mutations and 1 nonsense mutation.Three sporadic patients presented with early infantile epileptic encephalopathy.The family of this study was characterized with febrile seizures and febrile seizures plus. Conclusions:A de novo mutation and phenotype of the KCNT2 gene is found in a family with GEFS + .It would expand the gene mutation spectrum and provide basis for family genetic counseling. KCNT2 mutation induced GEFS + is refractory to antiepileptic drugs.

Objective To investigate the value of early quantified analysis of perinatal white matter injury by cranial ultrasound gray scale measurement. MethodsThe cranial ultrasound exam was performed in 152 newborns with different gestational age0 early after their birth. These newborns were divided into two groups: 104 newborns diagnosed as white matter injury within 7 days after birth were taken as patient group; while 48 newborns who were not were taken as control group. The gray scale values in the trigone of lateral ventricle of white matter were analyzed by medical image analysis system. The newborns in patient group accepted cranial ultrasound exam at one month after birth, the grey scale value and cyst in the white matter were recorded. Three to six months old, the cranial ultrasound exam was repeated to record the change of white matter volume, morphology of lateral ventricle and change of the cysts. When they were 1.5 to 2 years old, the neurological function were quantitatively evaluated with Gesell score, and the results were classified as normal and abnormal.The relationships between gray scale value and neuro-developmental outcome were analyzed with receiver operating characteristic curve.Results During neonatal period, the average gray scale values in severely injured group was 131.72±2.40, higher than that of mildly injured group (116.61±2.48), and which in mildly injury group was higher than that in control group (100.50±1.66) (q=4. 521 and 4. 492, P＜0. 05). It was showed by receiver operating characteristic curve that gray scale value ＞114.37 could help to diagnose white matter injury, with the sensitivity of 0. 721 and the specificity of 0. 854; gray scale value ＞119.80 could help to diagnose severe white matter injury,with the sensitivity of 0. 716 and the specificity of 0. 776.As the gray scale value increased, the incidence of white matter volume decreased and the enlargement of lateral ventricle in the later period of injury increased. Patients with gray scale value ＞ 130 tended to suffer from leucomalacia. During neonatal period, the incidence of abnormal neurodevelopment before 2 years old was 5.0％ in patients with gray scale value ＜ 110, while it was 27.8 ％ in the patients with gray scale value between 110 and 120, 47.8％ in the patients with gray scale value ＞ 120.Conclusions Quantified analysis of ultrasound gray scale value might be promising in early diagnosis of perinatal white matter injury through early judgement of the outcomes of white matter injury and forward neurodevelopment.

Objective:To detect pathogenic mutation in a Chinese family affected with isolated bilateral microtia.Methods:During 2022 June to December, one Chinese Han family with non-syndromic bilateral microtia was recruited at the First Hospital of Shanxi Medical University. The clinical data and peripheral blood samples were collected from the family members. Whole genome sequencing (WGS) was performed in the proband to screen all candidate variants. Quantitative PCR was applied to identify the candidate copy number variation (CNV) among the proband, the unaffected wife and the affected son to demonstrate the association between candidate variant and phenotype.Results:The patients in the family had non-syndromic bilateral concha-type microtia. WGS detected the duplication in the intergenic region of HMX1 and CPZ gene in the proband, which involved the evolutionarily conserved region (ECR). Both the proband and his affected son carried the CNV, while his unaffected wife did not have this variation.Conclusion:Duplications involving the long range HMX1 enhancer ECR are associated with the bilateral concha-type microtia in this family.

Objective:To detect pathogenic mutation in a Chinese family affected with isolated bilateral microtia.Methods:During 2022 June to December, one Chinese Han family with non-syndromic bilateral microtia was recruited at the First Hospital of Shanxi Medical University. The clinical data and peripheral blood samples were collected from the family members. Whole genome sequencing (WGS) was performed in the proband to screen all candidate variants. Quantitative PCR was applied to identify the candidate copy number variation (CNV) among the proband, the unaffected wife and the affected son to demonstrate the association between candidate variant and phenotype.Results:The patients in the family had non-syndromic bilateral concha-type microtia. WGS detected the duplication in the intergenic region of HMX1 and CPZ gene in the proband, which involved the evolutionarily conserved region (ECR). Both the proband and his affected son carried the CNV, while his unaffected wife did not have this variation.Conclusion:Duplications involving the long range HMX1 enhancer ECR are associated with the bilateral concha-type microtia in this family.

The wind, phlegm, and blood stasis are important pathogenic factors of cough variant asthma in children, and they are also the pathological products in the occurrence and development of this disease. They have typical pathogenic characteristics. The main pathogenesis characteristics of cough caused by wind, phlegm and blood stasis are as follows that external wind attacks the lungs and induces internal wind, phlegm and dampness accumulates in the lungs, and the lungs fail to declare and descend, and blood stasis obstructs the collaterals and stagnation of Qi. The wind, phlegm, and blood stasis have their own pathogenic characteristics, and their cough-causing also have their own pathogenic characteristics and clinical characteristics. Based on the characteristics of wind, phlegm, and blood stasis, the application of medicine based on the differentiation of symptoms and signs can effectively prevent and treat this disease, and provide theoretical basis and treatment ideas for the treatment of cough variant asthma in children with Chinese medicine.