Objective　To investigate the effect of placental isoferritin in pathogenesis of preeclampsia and its predictive value. Methods　A prospective double-blinded study was performed. There were 120 initial normal pregnant women at earlier third trimester (from 24 to 34 weeks) in this study. Their plasma placental isoferritin and nitric oxide (NO) metabolites (nitrite/nitrate) (NO2-/NO3-) were examined by enzyme linked immunoabsorbent assay (ELISA) and Griess assay respectively. The outcomes of pregnancies were followed up. Results　In 120 initial normal pregnant women, 19 pregnant women occurred preeclampsia (preeclampsia group), and 101 cases were normal (normal group) at follow up. The levels of plasma placental isoferritin (PLF) were significantly decreased in preeclampsia group (285.31±53.73 mg/L) than that of normal group (699.05±203.03) mg/L, P＜0.01. The levels of plasma NO were significantly increased in preeclampsia group (54.57±32.71 μmol/L) than that of normal group (38.89±30.00) μmol/L, P＜0.05. The significant negative correlation between the plasma placental isoferritin and NO levels was observed（r=0.329，P<0.01）. At the cut point of 400 mg/L PLF level, the sensitivity, specificity, positive predictive value, negative predictive value and Kappa index of PLF level predicting on the outcomes of pregnancy with preeclampsia were 100%, 85.15%, 55.88%, 100%, 0.645. Conclusions　 The decrease of plasma placental isoferritin levels is associated with preeclampsia, and the endothelial cell damage may be one of its mechanism. The PLF may be an earlier predictor of preeclampsia at 24～34 gestational weeks.

BACKGROUND:Screw loosening and shedding may occur after osteoporosis associated with lumbar degenerative disease treated with pedicle screw fixation. Application of pedicle screw enhanced with cured materials can improve the therapeutic effect.
OBJECTIVE:To compare the clinical effect of pedicle screws enhanced with poly(methyl methacrylate) and injectable calcium sulfate cement in the lumbar internal fixation of osteoporosis.
METHODS:Sixty-one patients diagnosed with osteoporosis combined with lumbar spondylolisthesis, lumbar spinal instability, and severe lumbar spinal stenosis were col ected. Al patients were divided into two groups according to the treatment method:poly(methyl methacrylate) bone cement enhanced pedicle screw group and calcium sulfate bone cement enhanced pedicle screw group.
RESULTS AND CONCLUSION:There were no significant differences in the operation time, blood loss, preoperative and postoperative visual analog scale score, Japanese Orthopedic Association scores and the Japanese Orthopedic Association score improvement rate between two groups (P>0.05). The results showed that two patients had bone cement leakage in poly(methyl methacrylate) group which had no neurological symptoms caused by new symptoms during fol ow-up period. The bone mineral density was not improved gradual y in poly(methyl methacrylate) group with fol ow-up time prolonging;however, in calcium sulfate group, the bone mineral density was increased significantly after treatment, and the change of bone mineral density was linearly related with Japanese Orthopaedic Association score improvement rate in calcium sulfate group. No screw loosening, pul ing out or neurological dysfunction occurred in both groups. The results indicate that like poly(methyl methacrylate), balcium sulfate bone cement can increase the stability of pedicle screws.

OBJECTIVETo analyze the literature on power frequency electric field testing data and to propose views and suggestions for current testing.

METHODSThe literature on power frequency electric field testing data published in the previous years was searched to identify 306 articles involving 193 valid testing data. Mann-Whitney test and Wilcoxon W test were used for analyzing the testing data.

RESULTSThe classification of data was carried out according to one quarter of occupational exposure limit (1.25 kV/m), one half of the exposure limit (2.5 kV/m), and the exposure limit (5 kV/m). The structure of testing data showed a significant difference between the non-power facility group and the power facility group (P<0.05).

CONCLUSIONAs occupational hazard factors, the radiation exposure from power frequency electric field is extensive. However, the power frequency electric field testing data in actual workplaces except high-voltage power facilities are far less than the occupational exposure limit with little harmfulness. There is a phenomenon of excessive testing at present.

BACKGROUND: The treatment of multilevel cervical spondylotic myelopathy (MCSM) aims at sustaining the spinal cord compression and restoring the stability of the cervical vertebrae at most.OBJECTIVE: To analyze the clinical characters of anterior cervical discectomy with fusion and expansive open-door laminoplasty for MCSM.METHODS: Sixty-seven patients with MCSM were divided into two groups, and treated with anterior cervical discectomy with fusion (group A) or posterior cervical expansive open-door laminoplasty (group B). All the patients were followed up for 12 months, and the range of motion of cervical vertebrae, cervical curvature index were observed,as well as the Visual Analogue Scale and Japanese Orthopaedic Association scores were condueted. Moreover, the operation time, blood loss and adverse reactions were recorded.RESULTS AND CONCLUSION: (1) The loss of range of motion of the cervical vertebrae in the group B was significantly less than that in the group A (P < 0.05). (2) The cervical curvature index in the group A was significantly improved (P < 0.05), but the index had no significant change in the group B. (3) The axial systems were significantly improved in both groups, especially in the group A (P < 0.05). (4) The neurological function was significantly improved in both groups (P < 0.05), which showed no significant difference between two groups (P > 0.05). (5) The intraoperative blood loss in the group B was significantly more than that in the group A (P < 0.05). (6) The incidence of hoarseness and dysphagia in the group A was 19％. The incidence of wound infection, cerebrospinal fluid leakage and C5 nerve root palsy in the group B was 9％. (7) These results suggest that during choosing an appropriate method for MCSM,surgeons' skills and patients' situation should be considered.

Objective To establish a method to simultaneously determine syringing and isofraxidin by HPLC;To investigate the features of percutaneous absorption in vitro of Jiegugao blended and pasted by white vinegar, honey and vaseline; To discuss the mechanism of commonly used ointment matrices in Tujia Minority. Methods Rat abdomen skin in vitro was as transdermal barrier;the modified Franz diffusion pool was used to simulate human skin medication; the content of syringin and isoprofen was determined by HPLC; the percutaneous absorption equation was established and the related parameters, such as cumulative permeation rate and permeation rate, were calculated. Results When using Syncronis C18 (250 mm × 4.6 mm, 5 μm) as chromatographic column, acetonitrile-0.1%phosphoric acid as mobile phase, 1.0 mL/min as perfusion speed and 265 nm as determine wavelength, regression equation of syringingwas A=10 686.454 6C+1565.778 8 (r=1.000 0), regression equation of isofraxidin was A=12 297.305 4C-5913.729 9 (r=0.999 9). Cumulative permeation quantity of syringing in Jiegugao blended and pasted by white vinegar, honey, vaseline and blank were 7.549 2, 4.580 3, 3.890 8 and 5.378 4 μg?cm-2?h-1 respectively and permeation rate were 25.66%, 16.11%, 13.73% and 18.78%. Meanwhile, cumulative permeation quantity of isofraxidin were 2.536 9, 1.941 8, 1.178 2 and 2.293 6 μg?cm-2?h-1 respectively and permeation rate were 47.04%, 35.06%, 22.11%and 41.11%. Conclusion Using white vinegar as the ointment matrix can promote the percutaneous absorption of effective composition in Jiegugao blended. However, it will retard the percutaneous absorption of effective composition in Jiegugao when using honey and vaseline as the ointment matrices, but honey and vaseline can be used as a slow-release matrix.

Objective This study aimed to explore the prognostic value of 18F-FDG PET/CT Metabolic and Heterogeneity Parameters Combined with Clinical Features Before Definitive Chemoradiotherapy(D-CRT)in predicting the prognosis of esophageal squamous cell carcinoma(ESCC)Patients.Methods A retrospective analysis was conducted on clinical data from 106 patients with ESCC who received D-CRT at the first affiliated Hospital of University of Science and Technology of China between January 2017 and December 2021.All patients underwent 18F-FDG PET/CT examination before the treatment.The primary tumor′s metabolic and heterogeneity parameters were obtained through data processing.All patients were followed up for overall survival.The Kaplan-Meier method and Cox proportional hazards models were used to analyze the association between clinical features,tumor metabo-lism and heterogeneity parameters and patient prognosis.Results The 1-and 1.5-year overall survival rates of all patients were 77.4%and 51.9%.The median survival time was 20 months.Univariate analysis showed that N stage,M stage,metabolic tumor volume,total lesion glycolysis,heterogeneity index-2(HI-2),and coefficient of variation with a threshold of 40%maximum standard uptake value(CV40%)were correlated with the prognosis of ESCC(all P<0.05).Multivariate analysis showed that N stage and CV40%were independent predictors of prognosis in patients with ESCC(P = 0.039 and P<0.001,respectively).Conclusion N stage and tumor metabolic heterogeneity parameter CV40%,which offering a degree of predictive value,are closely related to the prognosis of patients with ESCC treated with D-CRT.

Objective To explore the polymorphism and distribution of apolipoprotein E(ApoE)gene in patients with hyperlipidemia.Methods A total of 370 hyperlipidemia patients diagnosed at Hangzhou Ninth People's Hospital from October 2023 to June 2024 were selected.Gene polymorphism was detected in the blood samples of the patients using fluorescence polymerase chain reaction,and the distribution of gene polymorphism among different genders and age groups within this population was compared.Results ①The polymorphism distribution of the two genetic loci(ApoE 388T＞C and ApoE 526C＞T)in the studied sample population conforms to Hardy-Weinberg equilibrium,indicating that it is representative of the population;②Among the 370 patients,the distribution of the ApoE gene was as follows:E3/E3(66.49％),E3/E4(20.27％),E2/E3(8.65％),E2/E4(1.89％),E2/E2(1.35％),and E4/E4(1.35％).The proportion of the patient population carrying the E4 allele was about 1.88 times higher than that of those carrying the E2 allele;③The distribution differences of ApoE gene polymorphism were not related to the patients'gender and age(P＞0.05).Conclusion The distribution of ApoE gene polymorphism among hyperlipidemia patients at a hospital in Hangzhou is uneven and is not related to gender or age groups.Therefore,it is recommended to prioritize the detection of ApoE gene in patients before using statin medications to assess treatment effectiveness.

Alzheimer's disease(AD)is the most common neurodegenerative disease,typically affecting individuals aged 65 and older.Mild cognitive impairment is generally regarded as a precursor stage of AD.The underlying molecular and cellular processes of AD can be visualized in vivo using PET/CT technology.Multi-modal imaging based on Aβ PET,tau PET,and FDG PET within the ATN framework can effectively characterize the core neuropathological features of AD.Many novel PET tracers have recently been developed and applied to deeply probe the pathophysiological dysfunction and internal environmental alterations in AD.Therefore,this review will summarize the recent advances of amyloid,tau protein,FDG,and neuroinflammatory PET probes in AD research within the ATN framework.

Objective:To investigate the clinical application value of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area.Methods:Twenty-six patients who underwent laparoscopic cholecystectomy based on the concept of enhancing recovery after surgery using the LEER model in People's Hospital of Jinkouhe District of Leshan from January to October 2021 were included in the observation group. An additional 20 patients who concurrently underwent laparoscopic cholecystectomy and conventional intervention were included in the control group. Clinical efficacy, postoperative complications and postoperative pain were compared between the two groups.Results:Postoperative fasting time, length of hospital stay, and total hospital days in the observation group were 6 (6, 6) hours, 2 (2, 3) days and 4 (4, 6) days respectively, which were significantly shorter than 24 (24, 36) hours, 5 (5, 6) days, 7 (7, 9) days in the control group ( H = 351.00, 407.50, 458.00, all P < 0.05). Hospitalization cost in the observation group was 5 454.58 (5 014.11, 6 016.58) yuan, which was significantly lower than 6 611.91 (6 192.68, 7 841.73) yuan in the control group ( H = 420.00, P < 0.05). There were no significant differences in operative time and postoperative complications between the two groups (both P > 0.05). At postoperative 6 hours, Visual Analogue Scale score in the observation group was 3 (3, 4) points, and patients with mild pain accounted for 73.07% (19/26). At postoperative 24 hours, Visual Analogue Scale score in the observation group was 2 (2, 3) points, and patients with mild pain accounted for 92.31% (24/26). Overall pain was well controlled after surgery. Patient satisfaction rate in the observation was 96.15% (25/26). All patients recovered and were discharged. Conclusion:Application of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area can promote postoperative recovery, contribute to changing the theory of diagnosis and treatment, and improve overall medical quality. The enhanced recovery after surgery protocol using the LEER model has a good application value.

Objective:To determine whether the blood urea nitrogen to serum albumin (B/A) ratio was a useful prognostic factor of mortality in the patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB).Methods:Totally 1 120 patients with acute upper gastrointestinal bleeding (VUGIB) admitted to the Emergency Department from January 2019 to December 2021 were prospectively and continuously collected and 449 eligible patients with acute non-varicose upper gastrointestinal tract were finally enrolled. The clinical data, laboratory tests and endoscopic results of the patients were recorded, and the data from the 30-day survival group and the non-survival group were compared and analyzed.Results:Significant differences were observed in age, mean arterial pressure, pulse rate, albumin levels, total protein levels, blood urea nitrogen levels, glucose, Glasgow-Blatchford score (GBS), Rockall, and AIMS65 scores between the survival and non-survival groups (all P <0.05). The B/A ratio in the non-survival group was significantly higher than that in the survival group [(24.9 ± 16.4) vs. (9.0 ± 8.6) mg/g, P<0.001]. Receiver operating characteristic (ROC) curve showed that the best cutoff value of B/A ratio for predicting 30-day death was 32.08 mg/g, with a sensitivity of 0.776 and specificity of 0.823. There was a significant difference in the 30-day Kaplan-Meier survival curve between patients with B/A ratio ≥32.08 mg/g and those with B/A ratio <32.08 mg/g (Log Rank 32.229, P<0.001). Multivariate logistic regression analysis revealed that the B/A ratio (≥32.08 mg/g) was associated with 30-day mortality ( OR=4.87, 95% CI: 1.94-6.85, P<0.001). Area under the ROC curve (AUC) for B/A ratio, GBS, Rockall and AIMS65 scores for predicting 30-day mortality were 0.855 (95% CI: 0.807-0.902), 0.849 (95% CI: 0.796-0.901), 0.657 (95% CI: 0.576-0.737), and 0.828 (95% CI: 0.774-0.883), respectively. Conclusions:The B/A ratio is a simple but potentially useful prognostic factor of mortality in the ANVUGIB patients.