OBJECTIVES: The diagnostic value of ultrasonographic quantitative indicators of umbilical cord coiling, such as the umbilical coiling index (UCI) and pitch value, in identifying hypercoiling and predicting adverse pregnancy outcomes remains controversial. This study aims to evaluate the predictive value of UCI, pitch value, and the cerebroplacental ratio in pregnancies complicated by umbilical cord hypercoiling. METHODS: Pregnant women with densely coiled umbilical cords identified by routine obstetric ultrasound at Changsha Maternal and Child Health Hospital between November 2022 and November 2024 were enrolled. Complete clinical data, including UCI, pitch value, and cerebroplacental ratio (CPR), were collected. Pregnancy outcome scores were calculated, and newborns were categorized into the normal outcome group (n=177) and adverse outcome group (n=85), with the latter further subdivided into mild (n=51), moderate (n=19), and severe (n=15) subgroups. Differences in baseline data, UCI, pitch value, and incidence of CRP<1 were compared between groups and among subgroups. Correlations between UCI, pitch value, and adverse pregnancy outcomes were analyzed. Receiver operating characteristic (ROC) curve were used to assess the predictive performance of UCI, pitch value, CPR<1, and their combinations. RESULTS: Compared with the normal outcome group, the adverse outcome group had higher age, parity, parity, incidence of CPR<1, and UCI, while gestational age at delivery and pitch values were lower (all P<0.05). The incidence of obesity, gestational diabetes mellitus, and hypertensive disorders of pregnancy did not differ significantly between the 2 groups (all P>0.05). The normal outcome group showed lower UCI and higher pitch values than all 3 adverse outcome subgroups (all P<0.05), while differences among the 3 adverse subgroups were not significant (all P>0.05). UCI was positively correlated with adverse pregnancy outcomes (r_s=0.350, P<0.05), whereas pitch value was negatively correlated (r_s=-0.286, P<0.05). ROC curve analysis showed that the area under the curve (AUC) values for predicting adverse outcomes were 0.837 for UCI, 0.886 for pitch value, and 0.610 for CPR<1, with sensitivities of 77.6%, 82.4%, and 27.1% and specificities of 78.5%, 83.6%, and 94.9%, respectively. The combined UCI+CPR<1 and pitch value+CPR<1 models yielded AUCs of 0.841 and 0.886, with sensitivities of 78.8% and 81.2% and specificities of 78.5% and 84.2%, respectively. No significant differences were found between the AUCs of UCI and pitch value (P>0.05), but both outperformed CPR<1 alone (both P<0.001). The combined models showed no significant improvement over UCI or pitch value alone (both P>0.05), though both were superior to CPR<1 alone (both P<0.001). CONCLUSIONS Most umbilical cord hypercoiling cases had favorable outcomes, with UCI, pitch value, CPR<1 and their combinations demonstrating significant predictive value for adverse pregnancy outcomes.
Humans ; Female ; Pregnancy ; Pregnancy Outcome ; Adult ; Ultrasonography, Prenatal/methods* ; Umbilical Cord/diagnostic imaging* ; Hemodynamics ; Predictive Value of Tests ; Infant, Newborn ; ROC Curve

Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

Objective:To explore the protective effect of miR-346 up-regulated by crocin on myocardial ischemia reperfusion injury in rats.Methods:The rat model of myocardial ischemia reperfusion was constructed by open-chest ligation of the left anterior descending coronary artery followed by reperfusion. Fifty male SD rats were randomly divided into the sham operation group, model group, crocin group, miR-346 negative control (miR-NC) group, and miR-346 inhibitor group with 10 rats in each group. Rats in the sham operation group were only received thoracotomy without ligation. Rats in the miR-NC group and miR-346 inhibitor group were injected with miR-NC or miR-346 inhibitor through the tail vein 48 h prior to ligation of the left anterior descending coronary artery ligation. The crocetin reagent for gastric lavage was prepared by dissolving 8 mg of crocetin in 100 ml of physiological saline. Rats in the crocetin group, miR-NC group, and miR-346 inhibitor group were gavaged with crocetin reagent at 80 mg/kg. Rats in the sham operation group and model group were gavaged with saline at 5 ml/kg. The crocetin reagent and saline were gavaged once a day for 15 days. Serum levels of creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH) were detected by enzyme-linked immunosorbent assay (ELISA). The miR-346 expression level was detected by real-time fluorescence quantitative PCR (qRT-PCR). The pathological changes in cardiac muscle tissues were detected by HE staining. Cardiomyocyte apoptosis rate was detected by TUNEL staining. The expression levels of apoptosis-related proteins were detected by Western Blot.Results:Compared with the sham operation group, the serum levels of CK-MB and LDH, pathological scores, cardiomyocyte apoptosis rate and expression of cleaved cysteinyl aspartate specific proteinase-3 (cleaved Caspase-3) and B-cell lymphoma-2 (Bcl-2)-associated X protein (Bax) were increased in the model group (all P < 0.05), and the miR-346 expression level and Bcl-2 levels in myocardial tissues were decreased (all P < 0.05). Compared with the model group, serum CK-MB and LDH levels, pathological scores, cardiomyocyte apoptosis rate, and cleaved Caspase-3 and Bax expression levels were decreased in the crocin group (all P < 0.05), and miR-346 expression level and Bcl-2 levels in the myocardial tissues were increased (all P < 0.05). Compared with the miR-NC group, the serum levels of CK-MB, LDH, pathological scores, cardiomyocyte apoptosis rate, and cleaved Caspase-3 and Bax expression levels were decreased in the miR-346 inhibitor group (all P < 0.05), and miR-346 expression level and Bcl-2 level were increased in myocardial tissues (all P < 0.05). Conclusions:Crocin can reduce myocardial tissue injury and attenuate cardiomyocyte apoptosis in myocardial ischemia-reperfusion rats by up-regulating miR-346.

ObjectiveTo investigate the infestation and disposal of bedbugs in Shanghai， and provide scientific evidence for comprehensive prevention and control of bedbugs. MethodsA questionnaire survey was conducted in the pest control operations （PCOs） of Shanghai Association for Health Promotion to investigate the infestation and disposal of bedbugs. The questionnaire included basic information of the unit， bedbug disposal experience， type of environment of bedbug infestation， main disposal site， main treatment method， main drug and formulation， and evaluation of the disposal. Chi-square test was used for comparison between groups. ResultsOf the 116 PCOs， 78 （67.24%） had conducted bedbug disposal， and 29.49% had conducted the disposal no less than 5 times in the past three years. The main types of environment of bedbug infestation were dormitories （46.96%）， hotels （18.78%）， and households （20.44%）. Additionally， bedbug infestation was found in nursing homes， prisons and detention centers， and transport vehicles. Bed frame/bed board/mattress （32.42%） was the main site of bedbug infestation， followed by mat （19.63%）. Chemical spraying was the most common method for bedbug disposal （98.72%）， followed by high-temperature steam （11.54%）. The main drug used in chemical spraying were pyrethroids （69.23%）， nicotinoids （60.26%） and organophosphorus （42.31%）， for which the main formulation were suspended insecticides （55.13%）， followed by wettable powders （43.59%） and emulsifiers （43.59%）. Furthermore， 89.74% of the PCOs performed the assessment after disposal， in which the control effect was generally satisfactory. ConclusionBedbug infestation is relatively common in Shanghai. Dormitories， hotels and households are places where bedbug infestation is more likely to occur. Bed frame， bed board and mattress are the most vulnerable sites to bedbug infestation. Combination of physical and chemical methods should be used for disposal of bedbug infestation.

Objective:To evaluate the clinical efficacy and safety of compound acid combined with Chinese medicinal liniment pourmask in the treatment of pigmentation after acne.Methods:From October 2020 to October 2021, the Department of Dermatology, the First Affiliated Hospital of Anhui College of Traditional Chinese Medicine divided 96 patients with pigmentation after acne inflammation, 34 males, 62 females, aged 18-53 (27.4±7.3) years, into a joint group (compound acid combined with Chinese medicinal liniment pourmask, n=32), compound acid group ( n=32) and Chinese medicinal liniment pourmask group ( n=32). Compound acid was used once every 2 weeks, Chinese medicinal liniment pourmask twice a week, a total of 8 weeks. The clinical efficacy of 2 weeks and 4 weeks after treatment was different from that before treatment ( P<0.05). The pigmentation degree score and the total efficacy of each group were assessed at 2 weeks and 4 weeks after the end of treatment. The occurrence of adverse reactions in each group during the treatment cycle was also recorded. Results:After 2 weeks and 4 weeks of follow-up after the course of treatment, the pigmentation score of the three groups of patients decreased, and the difference was statistically significant ( P<0.05). The total effective rates of the combined group were 68.75% (22/32) and 96.88% (31/32) at 2 and 4 weeks after treatment respectively, both were higher than that of the compound acid group and Chinese medicinal liniment pourmask group ( P<0.05). There was no significant difference in total effective rate between compound acid group and Chinese medicinal liniment pourmask group ( P>0.05). Conclusions:The efficacy of compound acid combined with Chinese medicinal liniment pourmask group in the treatment of pigmentation after acne is remarkable and the safety is good, and therefore it is worth promoting.

Objective:To explore the feasibility and preliminary effectiveness of case-based learning (CBL) teaching based on network resources in standardized residency training for nuclear medicine.Methods:Open network resources of CBL curriculum (13 sessions in total) were used to perform the collective teaching of 21 residents who received training in our professional base, with a total of 61 person-times. The residents received the test on objective questions before class, immediately after class, and at 1 week after class (7-10 days) to assess the learning effect of residents at these time points, and an evaluation form of teaching effectiveness was used after each class to assess the teaching effect. SPSS 23.0 was used to perform a one-way analysis of variance.Results:As for the test score of objective questions, there were 61 valid scores before class, 61 valid scores immediately after class, and 51 valid scores at 1 week after class (7-10 days), with a mean score of (49.43±13.37), (84.43±14.44), and (80.88±10.04), respectively (with 100 points as the total score), which showed a significant difference ( F=105.80, P<0.01). As for the evaluation of teaching effectiveness, a total of 61 valid forms were received, and the results of "very satisfied, satisfied, fairly good, and dissatisfied" accounted for 34.4% (21/61), 52.5% (32/61), 9.84% (6/61), and 3.28% (2/61), respectively, with an overall satisfaction rate (very satisfied+satisfied) of 86.9% (53/61). Conclusion:It is feasible and effective to make full use of network resources to carry out CBL teaching in standardized residency training for nuclear medicine, which has achieved a good preliminary effect.

Patients with non-small cell lung cancer (NSCLC) are treated in a variety of ways. In addition to radiotherapy, chemotherapy and targeted therapy, breakthroughs have been made in immune checkpoint inhibitors, in particular, programmed cell death 1 (PD-1) and its ligand (PD-L1) inhibitors have achieved survival benefits for NSCLC patients, and some of them have been approved as first-line drugs by the US Food and Drug Administration. Currently, commonly used PD-L1 inhibitors are atezolizumab, durvalumab and avelumab. Combination therapies include combination with chemotherapy, anti-vascular endothelial growth factor drugs, molecular targeted therapy and immunotherapy.

Objective:To investigate the efficacy and safety of plasma exchange(PE) in the treatment of autoimmune hemolytic anemia in children.Methods:The data from 8 hospitals in China during November 2014 to April 2017 were collected, and the clinical characteristics of PE in children with AHA were analyzed retrospectively.Results:A total of 21 children with AHA were included in the study, including 17 cases from PICU and 4 cases from pediatric kidney ward, with 11 boys and 10 girls, and the median age was 3.64(0.25, 11.10)years old, and median hospital stay was 12(4, 45)days.There were 15 cases(71.4%) with infection, 2 cases(9.5%)with autoimmune diseases, 4 cases(19.0%) with unknown.Consciousness disturbance occurred in 4 patients before replacement and recovered to normal after PE.The volume of blood decreased in two cases(9.5%) and completely relieved.There were 20 cases of anemia (95.2%), 15 cases were normal after PE, and 5 cases were improved.Jaundice occurred in 18 cases (85.7%), 12 cases were normal after PE, 6 cases were improved.Hepatosplenomegaly was found in 11 cases, 10 cases were normal after PE, 1 case was improved.After PE, the hemoglobin and red blood cell count increased, while the total bilirubin, indirect bilirubin, urea nitrogen and lactate dehydrogenase decreased, there were significant differences between pre-and post-replacement ( P<0.05). Only 1 case had allergic reaction, which was improved after symptomatic treatment, and PE was continued.After PE, 2 cases (9.5%) had complete remission, 16 cases (76.2%) had partial remission and 3 cases (14.3%) had been discharged. Conclusion:PE therapy can obviously improve the clinical symptoms and laboratory indexes of children with AHA who have failed to respond to conservative treatment.It can be used as a treatment measure for children with severe AHA and has a good safety.

ObjectiveTo investigate the resistance to beta-cypermethrin in Aedes albopictus in Xuhui District， Shanghai， China， and determine the effects of insecticide components， concentration and distance on eliminating resistant population of Aedes albopictus in ultra-low volume （ULV） spray， which would provide scientific evidence for effective mosquito control strategy and rational use of beta-cypermethrin. MethodsLarval impregnation method recommended by the World Health Organization was used to determine the drug resistance in Aedes albopictus larvae to calculate the median lethal concentration （LC₅₀） of insecticides to Aedes albopictus larvae. The resistance to insecticides in female adults of Aedes albopictus was measured by the adult mosquito contact tube method recommended by the World Health Organization， and the 24-hour mortality （%） of female mosquitoes caused by insecticides was measured. Then the 24-hour mortality （%） of resistant female adults of Aedes albopictus due to beta cypermethrin monotherapy and compound agents was calculated by ULV spray. ResultIn 2016， 2017， 2019 and 2021， the resistance ratio in Aedes albopictus larvae to beta-cypermethrin was 9.22， 68.22， 37.33 and 59.22， respectively. In 2021， the 24-hour mortality of Aedes albopictus female adults was 62.07%. ULV sprayer experiments were performed using 4.5% beta-cypermethrin （single dose） and 12.0% beta-cypermethrin-chlorpyrifos （compound dose）. The 24-hour mortality increased with the concentration of the insecticides. The overall mortality caused by compound was higher than that by single dose. The mortality were 24.24%， 31.60% and 97.83% at the concentrations of 0.045 0%， 0.067 5% and 0.090 0% for single dose， respectively， and 58.87%， 61.62% and 90.00% at the concentrations of 0.12%， 0.18% and 0.24% for compound dose， respectively. There was no significant difference in mortality when spraying distance was 10 m， 30 m and 50 m. ConclusionAedes albopictus in Xuhui District is developed varying resistance to beta-cypermethrin. It warrants to strengthen the monitoring on insecticide resistance to formulate scientific and reasonable strategy for insecticide use. and reduce the resistance level of the Aedes albopictus to beta-cypermethrin. Compound dose is recommended to improve the effect. In addition， comprehensive treatment may be adopted to reduce the resistance.

Objective:To explore the effect of the angle between sagittal part of left portal vein and ductus venous(AsLPVDV), and the diameter of ductus venous(DDV) on the success rate of umbilical venous catheterization (UVC) in neonates.Methods:This was a retrospective study including 80 neonates requireing UVC in Gansu Provincial Women and Child-care Hospital from April 2020 to January 2021. According to the results of UVC, they were grouped into the success group(successful insertion of catheter, n=76) and failure group(failed to insert, n=4), or one-time success group (successful after first insertion attempt, n=43) and non-one-time success group(successful after several attempts or failed to insert, n=37). The AsLPVDV and the DDV were measured before UVC by bedside ultrasound. For those with obstruction of catheterization were guided by pressing the abdomen in right side recumbent position under real-time ultrasound monitoring. The success rate of UVC and the differences of AsLPVDV and DDV among different groups were compared. Chi-square test, t test, or U test were adopted for the comparison among groups. Receiver operating characteristic (ROC) curve was used to evaluate the sensitivity and specificity of the AsLPVDV and the DDV in predicting the one-time success of UVC. Results:The total success rate of UVC was 95%(76/80) and the one-time success rate was 53.8%(43/80). A larger AsLPVDV and DDV were observed in the success group compared with the failure group [(142.2±8.3)° vs (133.6±3.2)°, (3.0±0.4) vs(1.8±0.4) mm, t=6.284 and 2.064, both P<0.05] as well as in one-time success group compared with the non-one-time success group [(147.5±6.2)° vs (135.2±4.7)°, (3.1±0.3) vs (2.8±0.6) mm, t=9.956 and 2.939, both P<0.05]. Area under the curve of AsLPVDV and DDV in predicting one-time success of UVC were 0.944(95% CI:0.869-0.983) and 0.811 (95% CI:0.708-0.890), respectively. The cut-off value was 140.4° for AsLPVDV and 2.9 mm for DDV, with the sensitivity of 93.0% and 90.7%, and specificity of 91.9% and 64.9%, respectively. Conclusions:The success rate of UVC is related to AsLPVDV and DDV. AsLPVDV is of high value in predicting the one-time success of UVC.