Objective: To explore the association between thyroid hormones and visceral fat area(VFA) in the patients with type 2 diabetes. Methods: A total of 729 patients with type 2 diabetes, who joined National Metabolic Management Center(MMC) through Ningbo First Hospital from March, 2018 to July, 2019, were enrolled in this study. Blood tests were taken to assess their thyroid hormones and biochemical indexes. VFA and subcutaneous fat area(SFA) were obtained through bioelectrical impedance analysis. Statistics were later analyzed by Spearman correlation analysis and multivariate linear regression. Results: Spearman correlation analysis showed that VFA were positively correlated with T₃、FT₃(r=0.225 and 0.211, P<0.01), and VFA were inversely correlated with FT₄(r=-0.112, P<0.01). No correlation was found between VFA and either of T₄ or TSH(P>0.05). Multivariate linear regression analysis indicated that VFA was independently correlated with FT₄ and FT₃(P<0.01). An increment of 1 pmol/L in FT₄ was associated with 1.759 cm² increase in VFA, and increment of 1 pmol/L in FT₃ was associated with 3.256 cm² decrease in VFA. Conclusion VFA in patients with type 2 diabetes are correlated with FT₃ and FT₄.

Objective To investigate the value of abdominal aortic balloon combined homeostasis in the cesarean section with invasive completeplacenta previa. Methods Data of 47 cases of completeplacenta previa with placenta accrete from March 2007 to August 2018 were analyzed retrospectively. Seventeen cases (study group) were treated with abdominal aortic balloon combined homeostasis before cesarean, and 30 cases (control group) did not receive balloon occlusion. The operation time, intra-operative blood loss, intra-operative blood transfusion volume, disseminated or diffuse intravascular coagulation (DIC) rate, hysterectomy rate and post operative complications, time of postoperative hospital stay were compared. Also, the blood coagulation parameters 24 h after operation, including activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer werecompared between the two groups. Results Significant difference was observed in the blood loss [1 000 (800—2 000) ml vs. 2 200 (1 000-4 100) ml, Z=-2.272, P=0.023] and blood transfusion volume [400 (0-2 450) ml vs. 2 460 (200-4 460) ml, Z =- 2.02, P = 0.03], 16 cases of the study group still bled after releasing the balloon.Fifteen cases of them received uterine artery ligation. Bleeding stopped after uterine balloon compression in 1 case. Eleven cases of the 15 cases received uterine balloon compression at the same time. One case of 28 weeks gestation underwent subtotal hysterectomy due to hemorrhagic shock combined with DIC caused by placenta accretion of the bladder. While in control group, 7 cases underwent total hysterectomy because hemorrhagic shock combined with DIC and 3 cases underwent subtotal hysterectomy due to heavy bleeding, and there was statistical significance between two groups [1/17 vs. 33.3%(10/30), P=0.039]. Conclusions Temporary balloon occlusion of the abdominal aorta combined with conventional homeostasis can reduce blood loss, blood transfusion and hysterectomy rate in the cesarean section complicated with invasive complete placenta previa.

Objective To study the expression of CD62P and carbohydrate antigen 153 (CA153) in peripheral blood of patients with breast cancer, and to explore the value of CD62P and CA153 in the di-agnosis of breast cancer. Methods The CD62P ratio in peripheral blood of 60 patients with breast cancer ( breast cancer group) , 52 patients with breast fibroma ( fibroma group) and 25 healthy volunteers ( control group) was detected by flow cytometry ( FCM) . The serum CA153 level was detected by electro chemilumi-nescence ( ECLIA) , and the relationship between their expression levels and clinicopathological factors of breast cancer patients was analyzed. The sensitivity and specificity of serum CD62P, CA153 and their com-bination in the diagnosis of breast cancer were analyzed by receiver operating characteristic ( ROC) curve. Results ⑴ The expression levels of CD62P and CA153 in breast cancer group were significantly higher than those in fibroma group and control group (P<0. 05), but with no significant difference between fibro-ma group and control group (P>0. 05). ⑵The expression levels of CA153 and CD62P in peripheral blood of breast cancer group were correlated with clinical stage and lymphatic metastasis (all P<0. 05), and the expression levels of CA153 and CD62P were positively correlated (r=0. 514, P<0. 05). ⑶The sensitivity and specificity of combined detection of CD62P and CA153 for breast cancer were higher than those of single detection. Conclusions CD62P is highly expressed in peripheral blood of patients with breast cancer, which may be a new marker for the diagnosis of breast cancer.

OBJECTIVE: To assess the value of BACs-on-Beads (BoBs) technique for the detection of chromosomal abnormalities in abortus tissues from recurrent pregnancy loss. METHODS: A total of 109 abortus samples were collected and analyzed with the BoBs technique. The incidence and types of chromosomal abnormalities for different age groups and gestational weeks were compared. RESULTS: The BoBs assay has succeeded in all cases, with an incidence for chromosomal abnormalities reaching 62.39% (68/109). The major findings included trisomy 16 (12/68), trisomy 22 (9/68), trisomy 13 (9/68) and trisomy 21 (8/68). The abnormal rate was significantly higher in those above 35-year-old compared with that of the <35-year-old group (P<0.05). More aberrations were found among abortus tissues derived from 42-70 days of pregnancy albeit with no statistical significance (P>0.05). The aberration rates were similar for samples derived from second, third and fourth time abortions (P>0.05). CONCLUSION BoBs technique can detect chromosomal aberrations in miscarriages and may be routinely used for the analysis of early spontaneous abortions.
Abortion, Habitual ; Abortion, Spontaneous ; Adult ; Chromosome Disorders ; Down Syndrome ; Female ; Humans ; Karyotyping ; Pregnancy ; Prenatal Diagnosis

ObjectiveTo investigate the migration of bone marrow stem cells (BMSCs) to the liver and liver repair in mice with acute liver injury treated with BMSC transplantation through four approaches. MethodsMale BALB/c mice were divided into groups A, B, C, D, E, and F, with 10 mice in each group. Groups A, B, C, and D were treated by transplantation, group E was used as the donor of BMSCs, and group F was used as the model of acute liver injury. CCL4/2-AFF was used to establish the model of acute liver injury. Mouse BMSCs were isolated, labeled with the red fluorescent dye PKH26, and then transplanted into the mice with acute liver injury through the portal vein (group A), the tail vein (group B), the abdominal cavity (group C), and the spleen (group D). The mice were sacrificed 2 weeks later. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin (Alb) were measured. The pathology of liver tissue was observed to evaluate the migration of BMSCs to the liver and the degree of liver repair. The mice in group F were sacrificed on day 8 to measure the levels of ALT, AST, and Alb. The t test was used for comparison of continuous data between two groups, and one-way analysis of variance was used for comparison of continuous data between multiple groups. ResultsIn groups A, B, C, and D, transplanted BMSCs migrated to the liver under a microscope, and newly formed hepatocytes were observed on pathological images. There were significant differences in the levels of ALT, AST, and Alb between groups A, B, C, and D and group F (ALT: t=2.372, 2.473, 2.354, and 2.383, all P＜0.05; AST: t=2.534, 2.423, 2.437, and 2.643, all P＜0.05; Alb: t=2.336, 2.243, 2.373, and 2.352, all P＜0.05). ConclusionBMSCs can promote repair of the liver in mice with acute liver injury, and the degree of liver repair is not related to the transplantation approach.

Objective To investigate the effect of the humanized care on the blood glucose, blood lipid and diabetic ketoacidosis control of type 1 diabetes patients outside the hospital. Methods Fifty type 1 diabetes patients were enrolled in this study, aged from 18 to 30 years old, outside the hospital. The duration of this study was from Mar 2009 to Jan 2016.The clinical and laboratory data of patients,including HbA1c,LDL-C,HDL-C,TG and diabetic ketoacidosis were collected and analyzed. Results About 60.0% and 80.0% of type 1 diabetes pa-tients achieved the goals of contorlling glycemia (HbA1c < 6.5%) and dyslipidemia (LDL-C < 2.6 mmol/L) respec-tively, after receiving the humanized care outside the hospital, while only 32.0% and 22.0% of type 1 diabetes pa-tients achieved these goals before.Moreover,after receiving the humanized care outside the hospital,only 16.0% of type 1 diabetes patients suffered from diabetic ketoacidosis which was 40.0% before.Conclusions The humanized care outside the hospital can help patients to acheive the goals of contorlling glycemia and dyslipidemia among the type 1 diabetes.Besides,it contributes to reduce the incidence rate of the diabetic ketoacidosis.

Objective To compare the surgical effect of gasless endoscopic thyroidectomy and CO2- insufflation endoscopic thyroidectomy, and evaluate the safety and applicability of gasless endoscopic thyroidectomy. Methods A prospective randomized controlled study was carried out.Sixty patients who were scheduled for bilateral thyroid surgery under endoscope were divided into 2 groups by sortition method: gasless group (30 patients, treated with gasless endoscopic thyroidectomy) and CO2-insufflation group (30 patients, treated with CO2-insufflation endoscopic thyroidectomy). The data of arterial partial pressure of carbon dioxide (PaCO2) and pH value before operation and 60 min after operation were detected. The operation time, intraoperative bleeding, time of putting the drain, hospitalization time after operation and postoperative complications were recorded. Results All the 60 patients completed endoscopic surgery,and no case was converted to the conventional procedure.There were no statistical differences in PaCO2and pH value before operation between 2 groups(P>0.05).The PaCO260 min after beginning of operation in gasless group was significantly lower than that in CO2-insufflation group:(36.43 ± 1.98)mmHg(1 mmHg=0.133 kPa)vs.(37.93 ± 3.27)mmHg,the pH value 60 min after beginning of operation was significantly higher than that in CO2-insufflation group:7.42 ± 0.02 vs. 7.37 ± 0.01, and there were statistical differences (P<0.05 or <0.01). There were no statistical difference in operation time, intraoperative bleeding, time of putting the drain, hospitalization time after operation and incidence of hoarseness between 2 groups (P>0.05). There were no complications related with trachea, parathyroid gland and superior laryngeal nerve in 2 groups. The incidence of CO2retention related complications in gasless group was significantly lower than that in CO2-insufflation group: 6.7% (2/30) vs. 43.3% (13/30), and there was statistical difference (P<0.01). Conclusions The modified spring suspension gasless endoscopic thyroidectomy not only acquires the equivalent surgical effect and indication,compared with the CO2-insufflation endoscopic surgery,but also is safer and has lower incidence rate of CO2retention related complications.

Objective To investigate the significance of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in serum and cerebrospinal fluid for evaluation of severe hand ,foot ,and mouth disease (HFMD) complicated with neurogenic pulmonary edema (NPE).Methods A total of 140 patients diagnosed with HFMD in Henan Children′s Hospital were enrolled and divided into three groups including mild group ,severe HFMD group without NPE ,severe HFMD group with NPE .These severe HFMD patients were also divided into survival group and death group according to the 28-day prognosis .Meanwhile ,50 age-matched healthy children were selected as controls .Serum MMP-9 and TIMP-1 levels were measured in all enrolled children .At the same time ,MMP-9 ,TIMP-1 and ratio of MMP-9／TIMP-1 in cerebrospinal fluid were measured in the severe HFMD group with and without NPE .Quantitative data were compared using one-way analysis of variance , and means comparisons between samples were conducted using LSD-t test .Results Among 140 children with HFMD ,66 were in mild group ,42 in severe HFMD without NPE group ,and 32 in severe HFMD with NPE group .And 50 healthy children were in control group .After 28 days ,14 cases died in severe HFMD groups .MMP-9 , TIMP-1 and MMP-9／TIMP-1 in serum of severe HFMD group with NPE increased significantly greater than those in the other three groups (F＝269 .356 ,121 .301 and 101 .502 ,respectively ,all P ＜0 .05). MMP-9 ,TIMP-1 and MMP-9／TIMP-1 in cerebrospinal fluid of severe HFMD group with NPE were (57 .24 ± 8 .92) μg／L ,(35 .26 ± 8 .14) μg／L and (1 .66 ± 0 .23) μg／L ,respectively ,while those in cerebrospinal fluid of severe HFMD group without NPE were (30 .57 ± 3 .89) μg／L ,(26 .25 ± 0 .32) μg／L and (1 .17 ± 0 .61) μg／L ,respectively .The differences between the two groups were all statistically significant (t＝62 .485 ,37 .680 and 169 .387 ,respectively ,all P＜0 .01).MMP-9 ,TIMP-1 and MMP-9／TIMP-1 in serum and cerebrospinal fluid of death group increased significantly greater than those in survival group ,the difference were statistically significant (all P＜0 .01).The maximum area under curve (AUC) was reached when the MMP9／TIMP-1 ratio in cerebrospinal fluid was 0 .890 (95% CI :0 .801 －0 .978).Conclusions MMP-9 and TIMP-1 may be involved in the pathogenesis of HFMD complicated with NPE .The detection of MMP-9 and TIMP-1 levels may be beneficial for the early diagnosis of severe HFMD with NPE .The imbalance of MMP-9／TIMP-1 ratio can be used as one of the predictors of severe HFMD combined with NPE.

Objective To estimate cervical stiffness during late pregnancy with virtual touch tissue quantification technique(VTQ) and investigate the value of predicting the outcome of labor induction. Methods Cervical length in pregnancy women at 35 -41 weeks′gestation was measured through perineum ultrasound examination before labor induction,and then VTQ was applied to measure shear wave velocity (SWV)values in region of interest(ROI),the maximum,minimum and average of SWV values were obtained from multiple SWV measurement under the VTQ mode. The outcomes of labor induction were tracked and Bishop scores were recorded,vaginal delivery and cesarean delivery groups were compared using Student′s t-test for continuous variables. ROC curve was plotted to analyze the correlation between parameters and the outcome of labor induction and to determine the most accurate SWV value and cut-off value for diagnosis.Univariate and multivariate logistic regression analysis were used to determine which of the following parameters were significant predictors of the outcome of labor induction. Results The SWV mix,SWV max and SWV mean of vaginal delivery and cesarean section were (0.92 ± 0.13)m/s,(1.37 ± 0.14)m/s,(1.13 ± 0.10)m/s and (1.03 ± 0.13)m/s,(1.74 ± 0.42)m/s,(1.36 ± 0.11)m/s,respectively, there were significant differences between vaginal delivery and cesarean section(all P < 0.05).Based on ROC curve analysis,the SWV mean value in cervix was the best value for predicting the outcome of labor induction.The cut-off value of SWV mean value was 1.23 m/s,the sensitivity,specificity and Youden index were 93.8%,83.4%,0.77,respectively.The SWV value and cervical length were closely correlated to the outcome of labor induction,especially the SWV value according to multivariate logistic analysis. Conclusions VTQ can assess the cervical stiffness with SWV values during pregnancy,and it may have an application value of predicting the outcome of labor induction.

Objective: To study the correlation between the level of serum Chitinase-3-like protein 1 (CHI3L1) and the significant liver fibrosis and liver cirrhosis in patients with chronic liver disease, and to evaluate its diagnostic value. Methods: 165 patients with chronic liver disease were selected, liver histopathological examination was performed to detect serum CHI3L1 concentration. Four indexes of hepatic fibrosis (type III procollagen, collagen IV, laminin, hyaluronic acid), aspartate aminotransferase/platelet ratio index (APRI) and FIB-4 (fibrosis- 4) scores were based on the pathological findings of liver biopsy and compared the advantages and disadvantages of serum CHI3L1 with other methods for the diagnosis of hepatic fibrosis and liver cirrhosis. A multivariate regression analysis model was created, and receiver operating characteristic curve was analyzed. Results: The level of serum CHI3L1 increased with increase of fibrosis stage and was highest in liver cirrhosis stage. In the period of S0 to 1, the levels of S2 to 3 and S4 were 62.82 (41.40 ~ 87.20), 70.94 (48.47 to 122.60) and 141.06 (78.18 ~ 197.40), and there were statistically significant differences between the groups (P < 0.001). The area under the curve for the diagnosis of significant liver fibrosis was 0.68 (0.60 to 0.77), and 0.74 (0.65 to 0.83) for cirrhosis in CHI3L1. Multivariate regression analysis showed that CHI3L1 was an independent predictor of significant fibrosis and cirrhosis. The combined diagnostic model based on CHI3L1, collagen IV and FIB-4 scores further improved the diagnostic value. The area under the curve for the diagnosis of significant fibrosis and cirrhosis was 0.79 (0.72 to 0.86) and 0.80 (0.73 to 0.87), respectively. Conclusion CHI3L1 has a good diagnostic value in patients with chronic liver disease with significant fibrosis and liver cirrhosis. The diagnostic model in combination with other markers like Collagen IV and FIB-4 scores could further improve the diagnostic value and is worthy of further study.