Objective To analyze the expression levels of TIPE2 and Ki67 in endometrial carcinoma(EC)and their relationship with clinicopathological parameters and prognosis.Methods Tissue samples and clinical data of 96 patients with EC who underwent surgical resection,120 patients who underwent total hysterec-tomy due to uterine fibroids and 120 patients who underwent total hysterectomy or curettage admitted to our hospital from February 2020 to February 2022 were retrospectively collected as the research objects,which were divided into the EC group,the normal endometrial group and the atypical hyperplasia endometrial group,respectively.All 3 groups were followed up until March 28,2023.Immunohistochemistry was used to detect the expression levels of TIPE2 and Ki67 in tissue samples of the three groups,and to analyze the relationship between the levels of TIPE2 and Ki67 and clinicopathological parameters and prognosis.Receiver operating characteristic curve(ROC)was used to analyze its diagnostic value for poor prognosis.Results The expression levels of TIPE2 and Ki67 in cancer tissues of the EC group were higher than those of the normal endometrial group and the atypical hyperplasia endometrial group,and those of the atypical hyperplasia endometrial group were higher than those of the normal endometrial group(P<0.05).The expression levels of TIPE2 and Ki67 in EC tissues were higher in patients with FIGO stage Ⅲ,lymph node metastasis,postmenopausal status,and ER and PR negative than patients with stageⅡ,no lymph node metastasis,premenopausal status,and ER and PR positive(P<0.05).Moreover,the expres-sion level of Ki67 in EC tissues was higher in p53 positive patients than in p53 negative patients(P<0.05),and there was a positive correlation between the both expression levels of TIPE2 and Ki67 in EC tissues(r=0.569,P<0.05).Compared with the poor prognosis group,the expression levels of TIPE2 and Ki67 in EC tissues in the good prognosis group were downregulated(P<0.05),and the AUC value of the combined detection of TIPE2 and Ki67 expression levels was 0.905,which was significantly higher than that of the single detection(P<0.05),sensitivity was 86.67%and specificity was 87.88%,and the predictive value was higher.Conclusion TIPE2 and Ki67 were highly expressed in EC tissues,and there was a positive correlation between the two,and their high expressions were related to clinicopathological features,and their combined detection had high predictive value for poor prognosis of EC.

Objective To investigate the predictive value of pre-transfer serum fibroblast growth factor 21(FGF-21),anti-Müllerian hormone(AMH),and neuropilin-1(NRP-1)for early pregnancy loss at 6 weeks following in vitro fertilization-embryo transfer(IVF-ET),and to establish an early predictive model based on serum biochemical markers.Methods This prospective study consecutively enrolled 322 women who achieved clinical pregnancy after IVF-ET at our center between September 2022 and September 2024.Participants were randomly divided into a modeling cohort(n=225)and a validation cohort(n=97)at a 7:3 ratio.According to ultrasound findings at 6 weeks of gestation,patients in the modeling cohort were classified into an early pregnancy loss group(n=59)and an ongoing pregnancy group(n=166).Baseline clinical characteristics and pre-transfer serum levels of FGF-21,AMH,and NRP-1 were collected.Multivariate logistic regression was applied to identify inde-pendent risk factors for early pregnancy loss and to construct a predictive model.Model discrimination,calibra-tion,and stability were evaluated using receiver operating characteristic(ROC)curves,the Hosmer-Lemeshow goodness-of-fit test,and bootstrap resampling in both cohorts.Results Univariate analysis revealed that the FSH/LH ratio,antral follicle count,and number of retrieved oocytes were significantly associated with early pregnancy loss(P<0.001).Compared with the ongoing pregnancy group,women with early loss showed significantly elevated pre-transfer serum FGF-21 levels,whereas AMH and NRP-1 levels were markedly reduced(P<0.001).Multivariate logistic regression demonstrated that an FSH/LH ratio<1.8(OR=1.629,P=0.002)and higher FGF-21 levels(OR=1.338,P=0.002)were independent risk factors,while higher AMH(OR=0.741,P=0.010)and NRP-1 levels(OR=0.874,P=0.007)were protective.Stratified analysis indicated that among patients with FSH/LH≥1.8,FGF-21 levels were significantly higher and AMH and NRP-1 levels significantly lower(all P<0.001).Interaction analysis further suggested that the FSH/LH ratio significantly modified the associations between these biomarkers and pregnancy loss risk(P for interaction<0.05).Specifically,in the higher FSH/LH subgroup,the risk effect of FGF-21 was amplified,while the protective effects of AMH and NRP-1 were more pronounced.The combined predictive model achieved C-indices of 0.869(95%CI:0.826～0.926)in the modeling cohort and 0.835(95%CI:0.811～0.907)in the validation cohort.Its AUC for predicting early pregnancy loss was 0.934 in the modeling co-hort and 0.909 in the validation cohort,both significantly outperforming individual markers(AUCs:FGF-21=0.867,AMH=0.881,NRP-1=0.853;Z=2.024,1.831;P<0.001).Decision curve analysis showed that the model provided consistent net clinical benefit across threshold probabilities of 0.1～0.4,underscoring its clinical utility.Conclusions Elevated pre-transfer serum FGF-21 and reduced AMH and NRP-1 levels are strongly associ-ated with early pregnancy loss at 6 weeks after IVF-ET.The predictive model developed in this study demonstrates robust accuracy and stability,offering substantial clinical application value for early risk stratification.

OBJECTIVE To analyze the levels of NOD like receptor thermal protein domain associated protein 3(NLRP3),nuclear factor κB(NF-κB)and Caspase-1 in peripheral blood mononuclear cells in patients with recur-rent spontaneous abortion(RSA)and reproductive tract infection(RTI),and the relationship between above inde-xes and pregnancy outcome.METHODS A total of 136 patients with RSA and RTI who were admitted to Nanyang First People's Hospital from Mar.2021 to Apr.2024 were selected as the study group,70 patients with RSA but without RTI during the same period were selected as the control group,and those patients with RSA and RTI who were pregnant again were divided into the continued pregnancy group and the abortion group based on their preg-nancy outcomes.The levels of NLRP,NF-κB and caspase-1 in peripheral blood mononuclear cells were compared between the study group and the control group,Multivariate logistic regression analysis was used to identify risk factors for adverse pregnancy outcomes in patients with RSA and RTI.Receiver's operating characteristic(ROC)curves were used to evaluate the value of NLRP,NF-κB,and Caspase-1 in peripheral blood mononuclear cells in predicting pregnancy outcomes of patients with RSA and RTI.RESULTS The levels of NLRP,NF-κB and caspase-1 in the study group were(1.93±0.49),(1.82±0.41)and(2.23±0.41)respectively,which were higher than those in the control group(P＜0.05).The proportion of abortion in the study group was 39.79％,which was higher than that in the control group(P=0.036).Pre-pregnancy body mass index(BMI)and the levels of glycated hemoglobin,triacylglycerol,NLRP,NF-κB and Caspase-1 in the abortion group were higher than those in the continued pregnancy group.Multivariate logistic regression analysis showed that NLRP3(OR=4.721,95％CI:1.336-16.680,P=0.016),NF-κB(OR=4.669,95％CI:1.495-14.58,P=0.008),caspase-1(OR=4.358,95％CI:1.260-15.070,P=0.023)and pre-pregnancy BMI(OR=2.927,95％CI:1.280-6.693,P=0.011)were risk factors affecting pregnancy outcomes of patients with RSA and RTI(P＜0.05).ROC curves indicated that the area under the curve(AUC)of NLRP,NF-κB and Caspase-1 for pregnancy outcome in patients with RSA combined with RTI was 0.846,0.885 and 0.938.CONCLUSION The NLRP,NF-κB and Caspase-1 in peripheral blood mononuclear cells is highly expressed in patients with RSA and RTI,and the high expression of the above indicators is closely related to the adverse pregnancy of patients,which can be used as a predictor of pregnancy outcomes in patients with RSA and RTI.

OBJECTIVE To analyze the levels of NOD like receptor thermal protein domain associated protein 3(NLRP3),nuclear factor κB(NF-κB)and Caspase-1 in peripheral blood mononuclear cells in patients with recur-rent spontaneous abortion(RSA)and reproductive tract infection(RTI),and the relationship between above inde-xes and pregnancy outcome.METHODS A total of 136 patients with RSA and RTI who were admitted to Nanyang First People's Hospital from Mar.2021 to Apr.2024 were selected as the study group,70 patients with RSA but without RTI during the same period were selected as the control group,and those patients with RSA and RTI who were pregnant again were divided into the continued pregnancy group and the abortion group based on their preg-nancy outcomes.The levels of NLRP,NF-κB and caspase-1 in peripheral blood mononuclear cells were compared between the study group and the control group,Multivariate logistic regression analysis was used to identify risk factors for adverse pregnancy outcomes in patients with RSA and RTI.Receiver's operating characteristic(ROC)curves were used to evaluate the value of NLRP,NF-κB,and Caspase-1 in peripheral blood mononuclear cells in predicting pregnancy outcomes of patients with RSA and RTI.RESULTS The levels of NLRP,NF-κB and caspase-1 in the study group were(1.93±0.49),(1.82±0.41)and(2.23±0.41)respectively,which were higher than those in the control group(P＜0.05).The proportion of abortion in the study group was 39.79％,which was higher than that in the control group(P=0.036).Pre-pregnancy body mass index(BMI)and the levels of glycated hemoglobin,triacylglycerol,NLRP,NF-κB and Caspase-1 in the abortion group were higher than those in the continued pregnancy group.Multivariate logistic regression analysis showed that NLRP3(OR=4.721,95％CI:1.336-16.680,P=0.016),NF-κB(OR=4.669,95％CI:1.495-14.58,P=0.008),caspase-1(OR=4.358,95％CI:1.260-15.070,P=0.023)and pre-pregnancy BMI(OR=2.927,95％CI:1.280-6.693,P=0.011)were risk factors affecting pregnancy outcomes of patients with RSA and RTI(P＜0.05).ROC curves indicated that the area under the curve(AUC)of NLRP,NF-κB and Caspase-1 for pregnancy outcome in patients with RSA combined with RTI was 0.846,0.885 and 0.938.CONCLUSION The NLRP,NF-κB and Caspase-1 in peripheral blood mononuclear cells is highly expressed in patients with RSA and RTI,and the high expression of the above indicators is closely related to the adverse pregnancy of patients,which can be used as a predictor of pregnancy outcomes in patients with RSA and RTI.

Objective To investigate the predictive value of pre-transfer serum fibroblast growth factor 21(FGF-21),anti-Müllerian hormone(AMH),and neuropilin-1(NRP-1)for early pregnancy loss at 6 weeks following in vitro fertilization-embryo transfer(IVF-ET),and to establish an early predictive model based on serum biochemical markers.Methods This prospective study consecutively enrolled 322 women who achieved clinical pregnancy after IVF-ET at our center between September 2022 and September 2024.Participants were randomly divided into a modeling cohort(n=225)and a validation cohort(n=97)at a 7:3 ratio.According to ultrasound findings at 6 weeks of gestation,patients in the modeling cohort were classified into an early pregnancy loss group(n=59)and an ongoing pregnancy group(n=166).Baseline clinical characteristics and pre-transfer serum levels of FGF-21,AMH,and NRP-1 were collected.Multivariate logistic regression was applied to identify inde-pendent risk factors for early pregnancy loss and to construct a predictive model.Model discrimination,calibra-tion,and stability were evaluated using receiver operating characteristic(ROC)curves,the Hosmer-Lemeshow goodness-of-fit test,and bootstrap resampling in both cohorts.Results Univariate analysis revealed that the FSH/LH ratio,antral follicle count,and number of retrieved oocytes were significantly associated with early pregnancy loss(P<0.001).Compared with the ongoing pregnancy group,women with early loss showed significantly elevated pre-transfer serum FGF-21 levels,whereas AMH and NRP-1 levels were markedly reduced(P<0.001).Multivariate logistic regression demonstrated that an FSH/LH ratio<1.8(OR=1.629,P=0.002)and higher FGF-21 levels(OR=1.338,P=0.002)were independent risk factors,while higher AMH(OR=0.741,P=0.010)and NRP-1 levels(OR=0.874,P=0.007)were protective.Stratified analysis indicated that among patients with FSH/LH≥1.8,FGF-21 levels were significantly higher and AMH and NRP-1 levels significantly lower(all P<0.001).Interaction analysis further suggested that the FSH/LH ratio significantly modified the associations between these biomarkers and pregnancy loss risk(P for interaction<0.05).Specifically,in the higher FSH/LH subgroup,the risk effect of FGF-21 was amplified,while the protective effects of AMH and NRP-1 were more pronounced.The combined predictive model achieved C-indices of 0.869(95%CI:0.826～0.926)in the modeling cohort and 0.835(95%CI:0.811～0.907)in the validation cohort.Its AUC for predicting early pregnancy loss was 0.934 in the modeling co-hort and 0.909 in the validation cohort,both significantly outperforming individual markers(AUCs:FGF-21=0.867,AMH=0.881,NRP-1=0.853;Z=2.024,1.831;P<0.001).Decision curve analysis showed that the model provided consistent net clinical benefit across threshold probabilities of 0.1～0.4,underscoring its clinical utility.Conclusions Elevated pre-transfer serum FGF-21 and reduced AMH and NRP-1 levels are strongly associ-ated with early pregnancy loss at 6 weeks after IVF-ET.The predictive model developed in this study demonstrates robust accuracy and stability,offering substantial clinical application value for early risk stratification.

Objective To analyze the expression levels of TIPE2 and Ki67 in endometrial carcinoma(EC)and their relationship with clinicopathological parameters and prognosis.Methods Tissue samples and clinical data of 96 patients with EC who underwent surgical resection,120 patients who underwent total hysterec-tomy due to uterine fibroids and 120 patients who underwent total hysterectomy or curettage admitted to our hospital from February 2020 to February 2022 were retrospectively collected as the research objects,which were divided into the EC group,the normal endometrial group and the atypical hyperplasia endometrial group,respectively.All 3 groups were followed up until March 28,2023.Immunohistochemistry was used to detect the expression levels of TIPE2 and Ki67 in tissue samples of the three groups,and to analyze the relationship between the levels of TIPE2 and Ki67 and clinicopathological parameters and prognosis.Receiver operating characteristic curve(ROC)was used to analyze its diagnostic value for poor prognosis.Results The expression levels of TIPE2 and Ki67 in cancer tissues of the EC group were higher than those of the normal endometrial group and the atypical hyperplasia endometrial group,and those of the atypical hyperplasia endometrial group were higher than those of the normal endometrial group(P<0.05).The expression levels of TIPE2 and Ki67 in EC tissues were higher in patients with FIGO stage Ⅲ,lymph node metastasis,postmenopausal status,and ER and PR negative than patients with stageⅡ,no lymph node metastasis,premenopausal status,and ER and PR positive(P<0.05).Moreover,the expres-sion level of Ki67 in EC tissues was higher in p53 positive patients than in p53 negative patients(P<0.05),and there was a positive correlation between the both expression levels of TIPE2 and Ki67 in EC tissues(r=0.569,P<0.05).Compared with the poor prognosis group,the expression levels of TIPE2 and Ki67 in EC tissues in the good prognosis group were downregulated(P<0.05),and the AUC value of the combined detection of TIPE2 and Ki67 expression levels was 0.905,which was significantly higher than that of the single detection(P<0.05),sensitivity was 86.67%and specificity was 87.88%,and the predictive value was higher.Conclusion TIPE2 and Ki67 were highly expressed in EC tissues,and there was a positive correlation between the two,and their high expressions were related to clinicopathological features,and their combined detection had high predictive value for poor prognosis of EC.

Objective:To investigate the characteristics of resting energy expenditure (REE) in children with cerebral palsy (CP) graded with different levels of Gross Motor Function Classification System (GMFCS), and to evaluate the accuracy and association of commonly used REE prediction formulas in children with CP.Methods:It was a retrospective study involving 36 children with CP aged 24-144 months who visited the Third Affiliated Hospital of Zhengzhou University between September 2021 and August 2022.REE was measured by the indirect calorimetry.Based on the GMFCS, children with CP were divided into grade Ⅰ-Ⅱ group (20 cases), grade Ⅲ group (6 cases) and grade Ⅳ-Ⅴ group(10 cases). During the same period, 11 age-matched healthy children were included in control group.The measured REE (MREE) between children with CP and healthy controls was compared.Predicted REE (PREE) calculated by the Harris-Benedict, WHO, Schofield-W, Schofield-WH and Oxford prediction formulas were compared with MREE in children for their consistency and correlation.Independent samples were analyzed using t-test or Mann- Whitney U test, and categorical data were analyzed using Chi- square test.Using paired t-test and Pearson linear correlation analysis to analyze the correlation between MREE and PREE.The accuracy of PREE values calculated by different formulas was assessed using the root mean square error. Results:The MREE in control group and children with CP were (952.18±270.56) kcal/d and (801.81±201.89) kcal/d, respectively.There was no significant difference in the MREE between grade Ⅰ-Ⅱ group versus control group[(868.30±194.81) kcal/d vs.(952.18±270.56) kcal/d, P>0.05], and grade Ⅲ group versus control group [(813.17±192.48) kcal/d vs.(952.18±270.56) kcal/d, P>0.05]. The MREE was significantly lower in grade Ⅳ-Ⅴ group than that of control group [666.00(513.50, 775.50) kcal/d vs.(952.18±270.56) kcal/d, P=0.011]. There were no significant difference between MREE and PREEs calculated by Harris-Benedict, WHO, Schofield-W, Schofield-WH, and Oxford (all P>0.05). The correct classification fraction calculated by the 5 formulas were 33.3%, 47.2%, 41.7%, 47.2%, and 41.7%, respectively.The r values of the consistency of PREE calculated by the 5 formulas were 0.585, 0.700, 0.703, 0.712, and 0.701, respectively.The Blande-Altman Limits of Agreement were (-297.77, 359.22), (-245.60, 326.94), (-250.62, 316.05), (-242.22, 177.36) and (-241.28, 325.81), respectively.The clinically acceptable range was -80.18 to 80.18 kcal/d.The root mean square error were 168.09 kcal/d, 149.64 kcal/d, 146.24 kcal/d, 144.23 kcal/d and 148.77 kcal/d, respectively. Conclusions:The MREE values decreased significantly in children with CP classified as CMFCS grade Ⅳ and Ⅴ.When REE cannot be regularly monitored by indirect calorimetry to develop nutritional support programs, children with CP may be prioritized to estimate REE using the prediction formula of Schofield-WH.

Objective:To evaluate the deformity changes in the treatment of congenital clubfoot in infants by ultrasound, and to explore its clinical application value.Methods:Seventeen infants with congenital clubfoot treated in the Department of Pediatric Orthopaedics of the Third Affiliated Hospital of Zhengzhou University from March 2020 to June 2021 and 27 normal infants in the same period were selected. The distance between medial malleolus and scaphoids (MM-N distance) of all feet was measured by ultrasound. The distance from the tangent line of the lateral edge of calcaneus to the midpoint of the lateral edge of the chondroid bone (C-C distance), medial soft tissue thickness and tibial calcaneal angle were measured by ultrasound. The data before, after treatment and during follow-up were statistically analyzed.Results:A total of 88 feet of 44 infants were evaluated. The mean number of cast was 4.7±1.1, the follow-up time was (96.9±59.3)days. The MM-N distance, C-C distance and posterior tibial calcaneal angle in the clubfoot group were improved after treatment and at the last follow-up, and the differences were statistically significant (all P<0.01). During the treatment, 1 case had false correction, and 2 cases recurred in the last follow-up. Conclusions:Ultrasound can clearly display the medial, dorsal, lateral and posterior articular structures of normal and clubfoot, and can observe the deformity changes of clubfoot during the correction process, which can provide guidance for the clinical treatment of clubfoot.

Objective:To observe the clinical efficacy and side effects of injecting different doses of botulinum toxin type A (BTX-A) into children with spastic cerebral palsy (CP) and tiptoe deformity.Methods:A total of 107 children with tiptoe deformity resulting from CP were divided into group A ( n=35), group B ( n=36) and group C ( n=36) using a random number table. Group A received 3u/kg injections of BTX-A, group B received 4u/kg injections and group C received 5u/kg. The injections were guided by color Doppler ultrasound and followed by 4 courses of rehabilitation therapy. Before and 1, 3 and 6 months after the treatment, the modified Tardieu scale (MTS) was used to assess gastrocnemius spasms, while sections D and E of gross motor function scale 88 (GMFM-88) and the pediatric balance scale (PBS) were used to evaluate motor functioning and balance. Any side effects were also observed. Results:After the treatment, improvement was observed in all of the measurements, though there were no significant differences in the degree of improvement nor in the incidence of side effects among the three groups.Conclusions:There is no significant difference in clinical efficacy or side effects involved in using different doses of BTX-A to treat tiptoe deformity in children with spastic cerebral palsy. The recommended dosage is therefore 3u/kg.

Objective:To observe the clinical efficacy and any side effects of using ultrasound-guided injection of botulinum toxin A in treating juvenile sialorrhoea.Methods:Forty children with sialorrhoea were randomly divided into group A and group B, each of 20. Under the guidance of color Doppler ultrasound, botulinum toxin type A (BoNT-A) was injected into the children′s 2 parotid glands and their submandibular glands. Each parotid gland was injected with 20u of BoNT-A, while 10u was injected into the submandibular gland in group A and 20u was injected in group B. Before and 2, 8 and 12 weeks after the injections, the children′s sialorrhoea was evaluated using teacher drooling sizing (TDS), the drooling quotient and the Saxon test (ST). Any side-effects were also observed.Results:There was no significant difference in the average TDS score, drooling quotient or ST score between the two groups before the intervention. After the intervention all of those measurements had decreased significantly, but there were still no significant differences between the two groups in any measurement at any time point.Conclusions:Botulinum toxin type A injection under the guidance of ultrasound is accurate and safe. The injection of 10u is sufficient to relieve children′s sialorrhoea without serious side effects.