Abastract:Objective To validate the performance of six different lipoprotein(a)[Lp(a)]immunoassay detection systems,compare the correlation and consistency of the measurement results of different detection systems,and explore their clinical application in the e-valuation of atherosclerotic cardiovascular disease(AsCVD).Methods A total of 150 AsCVD patients attending Peking Union Medi-cal College Hospital were retrospectively selected as the subjects of study group,and 50 individuals of physical examination during the same period were selected as healthy control group.Lp(a)levels were measured in 200 serum samples using six immunoassay detection systems,including two Lp(a)particle concentration assays in nmol/L(Roche and Mindray Ⅱ),and four Lp(a)mass concentration assays in mg/L(Mindray,MedicalSystem,BSBE,and Sekisui).All assays'precisions were evaluated.The results of each assay sys-tem were compared with the mean value of all the Lp(a)assays.Passing-Bablok regression analysis and Bland-Altman bias plots were used to assess the accuracy of assays,and the consistency between different systems was analyzed using the concordance correlation co-efficient(CCC).In addition,the consistencies of different assays in assessing AsCVD in clinical setting were compared using weighted Kappa statistical method,and the positive rates of Lp(a)particle concentration and mass concentration,as well as the overestimation and underestimation of mass concentration were also assessed for both the study group and the healthy control group.Results The pre-cision of the six Lp(a)assays ranged from 0.6％to 2.1％.Passing-Bablok regression analysis showed that the Spearman correlation co-efficients of the regression equations were all greater than 0.970,and the intercepts and slopes of the regression lines were-43.311 to 39.456 and 0.547 to 5.500,respectively.The Bland-Altman bias plots showed that the percent bias of the six assays compared to the mean value of Lp(a)determination was in the range of-25.939％to 40.205％.The results of the Lp(a)mass concentration detection system showed a positive deviation in Mindray and MedicalSystem,and a negative deviation in BSBE and Sekisui.Compared with the mean value of Lp(a),the results of consistency analysis showed that Roche and Mindray Ⅱ had excellent consistency(CCC:0.992 to 0.993).Mindray,MedicalSystem and BSBE had good consistency(CCC:0.950 to 0.986),and Sekisui showed moderate consistency(CCC:0.935).In descending order,the positivity rates of Lp(a)in the study groups were:MedicalSystem＞BSBE＞Mindray＞Roche=Mindray Ⅱ＞Sekisui.The overall concordances of Mindray,MedicalSystem,BSBE and Sekisui compared to Lp(a)particle concentration assay in different groups were 97.33％,93.33％,97.33％and 98.00％with Kappa values of 0.910,0.798,0.912 and 0.927,respec-tively.Conclusion The two assays for Lp(a)particle concentration have fine correlation and consistency,but there were significant differences between the four assays for Lp(a)mass concentration.Compared to the Lp(a)particle concentration assays,the four assay for Lp(a)mass concentration resulted in overestimation or underestimation of Lp(a)levels in the assessment of AsCVD.Accurate de-termination of Lp(a)concentration should be of great importance in accurately assessing the overall risk of AsCVD in patients.

Abastract:Objective To validate the performance of six different lipoprotein(a)[Lp(a)]immunoassay detection systems,compare the correlation and consistency of the measurement results of different detection systems,and explore their clinical application in the e-valuation of atherosclerotic cardiovascular disease(AsCVD).Methods A total of 150 AsCVD patients attending Peking Union Medi-cal College Hospital were retrospectively selected as the subjects of study group,and 50 individuals of physical examination during the same period were selected as healthy control group.Lp(a)levels were measured in 200 serum samples using six immunoassay detection systems,including two Lp(a)particle concentration assays in nmol/L(Roche and Mindray Ⅱ),and four Lp(a)mass concentration assays in mg/L(Mindray,MedicalSystem,BSBE,and Sekisui).All assays'precisions were evaluated.The results of each assay sys-tem were compared with the mean value of all the Lp(a)assays.Passing-Bablok regression analysis and Bland-Altman bias plots were used to assess the accuracy of assays,and the consistency between different systems was analyzed using the concordance correlation co-efficient(CCC).In addition,the consistencies of different assays in assessing AsCVD in clinical setting were compared using weighted Kappa statistical method,and the positive rates of Lp(a)particle concentration and mass concentration,as well as the overestimation and underestimation of mass concentration were also assessed for both the study group and the healthy control group.Results The pre-cision of the six Lp(a)assays ranged from 0.6％to 2.1％.Passing-Bablok regression analysis showed that the Spearman correlation co-efficients of the regression equations were all greater than 0.970,and the intercepts and slopes of the regression lines were-43.311 to 39.456 and 0.547 to 5.500,respectively.The Bland-Altman bias plots showed that the percent bias of the six assays compared to the mean value of Lp(a)determination was in the range of-25.939％to 40.205％.The results of the Lp(a)mass concentration detection system showed a positive deviation in Mindray and MedicalSystem,and a negative deviation in BSBE and Sekisui.Compared with the mean value of Lp(a),the results of consistency analysis showed that Roche and Mindray Ⅱ had excellent consistency(CCC:0.992 to 0.993).Mindray,MedicalSystem and BSBE had good consistency(CCC:0.950 to 0.986),and Sekisui showed moderate consistency(CCC:0.935).In descending order,the positivity rates of Lp(a)in the study groups were:MedicalSystem＞BSBE＞Mindray＞Roche=Mindray Ⅱ＞Sekisui.The overall concordances of Mindray,MedicalSystem,BSBE and Sekisui compared to Lp(a)particle concentration assay in different groups were 97.33％,93.33％,97.33％and 98.00％with Kappa values of 0.910,0.798,0.912 and 0.927,respec-tively.Conclusion The two assays for Lp(a)particle concentration have fine correlation and consistency,but there were significant differences between the four assays for Lp(a)mass concentration.Compared to the Lp(a)particle concentration assays,the four assay for Lp(a)mass concentration resulted in overestimation or underestimation of Lp(a)levels in the assessment of AsCVD.Accurate de-termination of Lp(a)concentration should be of great importance in accurately assessing the overall risk of AsCVD in patients.

BACKGROUND:Laser therapy is a non-invasive and painless treatment that is considered to be an effective method suitable for the treatment of osteoarthritis due to its simplicity and non-invasive nature.Currently,the mechanism of action of laser therapy is unclear and the results of studies on its clinical application are controversial. OBJECTIVE:To review and summarize the latest research progress of laser therapy on chondrocytes,animal experiments and clinical efficacy,and to explore the possible mechanism of laser-mediated multi-pathway biological effects,so as to provide a theoretical basis for further research on the laser treatment of osteoarthritis of the knee joint. METHODS:A literature search was performed in CNKI,WanFang Data,VIP and PubMed databases for relevant literature published from 2018 to 2023,with"laser therapy,low level laser therapy,high level laser therapy,photobiomodulation,knee osteoarthritis,chondrocytes"as the search terms in Chinese and English,respectively.Together with 14 articles searched manually,70 articles were finally included for review. RESULTS AND CONCLUSION:Laser therapy in the treatment of knee osteoarthritis is mainly categorized into two types:low-level laser therapy and high-level laser therapy.Differences in laser parameters and treatment protocols have a direct impact on laser efficacy.When appropriate parameters are used,low-level lasers show positive effects in cellular experiments,animal models,and clinical efficacy.High-level lasers have been less studied in the treatment of knee osteoarthritis,but some preliminary clinical studies have shown positive results.Cell experiments have shown that low-level laser promotes chondrocyte proliferation and cartilage matrix synthesis,thereby reducing inflammatory response.Animal experiments have shown that low-level laser can reduce the release of pro-inflammatory factors,promote cartilage matrix synthesis,inhibit matrix degradation,and effectively improve the repair process of cartilage tissue.Low-level laser is also able to reduce oxidative stress damage and relieve pain in knee osteoarthritis.In clinical trials,both low-and high-level laser can reduce patients'pain and improve functional activities.The combination of laser therapy and exercise therapy modalities may improve the therapeutic effect.Lasers may affect intracellular signaling and cellular functions through photobiological or thermodynamic effects.This provides direct evidence that laser promotes articular cartilage regeneration.

Objective:To study the effects of hypertensive disorders of pregnancy (HDP) on the birth weight (BW) differences in twins.Method:From January 2011 to January 2020, twins delivered in our hospital were retrospectively analyzed. The twins born to HDP mothers were the HDP group and those born to healthy mothers were the control group. The maternal and neonatal data of the two groups were collected and the effects of HDP on the BW differences were analyzed.Result:The age of the mothers, the proportion of mothers of older ages and more-than-once delivery in HDP group (418 cases) were significantly higher than the control group (499 cases) [(31.4±5.3) years vs. (30.4±3.8) years, 26.6% (111/418) vs. 12.6% (63/499), 20.6% (86/418) vs. (15.0% (75/499)] ( P<0.05). The gestational age (GA) of newborns in the HDP group (836 cases) was significantly lower than the control group (998 cases) [(35.1±2.2) weeks vs. (36.7±1.2)]( P<0.05). The proportion of twins with GA <34 weeks in the HDP groups was significantly higher than the control group [24.2% (101/418) vs. 3.8% (19/499)] ( P<0.05). Cesarean section was the main delivery mode in both groups. The BW differences of the twins in the HDP group were larger than the control group [22.4% (9.1%, 31.9%) vs. 13.1% (5.8%, 19.6%)]. Significantly more twins in the HDP group showed ≥30% BW difference than the control group [28.7% (120/418) vs. 3.8% (19/499)] ( P<0.05). The incidences of BW discordant in twins (BWDT) in the HDP group was significantly higher than the control group [BWDT≥15%:61.5% (257/418) vs. 38.3% (191/499), BWDT≥20%: 51.4% (215/418) vs. 25.3% (126/499)] ( P<0.05).Among twins with GA of 34~37 weeks, the BW of the bigger infants and the smaller infants in the HDP group were all lower than the control group and the percentage of BW difference was significantly higher than the control group ( P<0.05). Conclusion:HDP may influence the intrauterine growth of the twins, aggravate the BW differences and increase the incidences of BWDT. It is necessary to make better prenatal management of HDP and closely monitor the intrauterine growth of the fetuses.

Objective: To compare the differences and similarities in emotional and behavioral problems among children with developmental dyslexia (DD), attention deficit hyperactivity disorder (ADHD) or both, aiming to provide basis for targeted intervention. Methods: Strengths and Difficulties Questionnaire (SDQ) was used to investigate emotional and behavioral problems among four groups of children (DD=32, ADHD=32, DD+ADHD=14, TD=32). Hierarchical regression analysis was recruited to investigate the associations of emotional and behavioral problems with spelling impairment or ADHD symptoms. Results: Except for peer problems, emotional and behavioral problems varied in the four groups [prosocial DD: (641±2.75), ADHD: (5.53±2.49), combined: (7.07±2.37), control: (7.72±2.19), F=4.42, P<0.05; emotional problems DD: (1.81±1.94), ADHD: (3.66±1.66), combined: (3.21±2.33), control: (2.03±1.99), F=6.36， P<0.05; conduct problems DD: (2.31±1.23), ADHD: (3.66±1.77), combined: (2.64±1.98), control: (1.97±1.31), F=7.24, P<0.05; difficulties score DD: (6.94±2.96), ADHD: (10.28±3.90), combined: (9.07±3.17), control: (6.06±3.94), F=8.82, P<0.05 ], most serious in ADHD group. In addition, children in DD group scored higher than those in normal group in terms of prosocial behavior. Children in the combined group showed higher total scores of peer problems and difficult score than those in the normal group. Emotional symptoms were more serious among children in combined group than those in the DD group. Compared with the combined group, behavioral problems in ADHD group were more common. Hierarchical regression analysis indicated that occurrence of emotional and behavioral problems in combined group was mostly mediated by hyperactivity symptoms. Conclusion Compared with DD group, children with ADHD combined or not combined with DD show more emotional and behavioral problems. Emotional and behavioral problems are notably observed among those with hyperactivity symptoms than DD.

Objective To evaluate and compare the efficacy of holmium laser enucleation of the prostate(HoLEP) and plasmakineticenucleation of the prostate(PKEP) for treating benign prostatic hyperplasia (BPH).Methods A total of 86 cases of BPH were selected from the Shandong Energy Zibo Mining Group Co.Ltd Central Hospital from January 2013 to June 2014.The patients received either HoLEP (40 cases) or PKEP(46 cases) treatment.Clinical data including postvoid residual volume (PVR),international prostate symptom score(IPSS),quality-of-life score(QOL score),maximum urinary flow rate (MFR) were evaluated before and 3 months after operation.Blood loss in operation,operation time,weight of resected prostate tissue,bladder irrigation time,catheterization time and length of hospital stay were also collected from the perioperative period.Results Three months after surgery,PVR,IPSS,QOL and MFR were all significantly improved in both HoLEP and PKEP groups compared with the data before operation (P =0.000),while there was no significant difference between the two groups(P＞0.05).Patients from the HoLEP group showed markedly lower values of bone loss in operation than that of PKEP group((69.5±23.6) ml vs.(87.5±38.0) ml,P=0.011).There were no significant differences in terms of other indexes (P＞ 0.05).Conclusion HoLEP and PKEP have similar efficiency in treating BPH,while HoLEP is suggested superior in regard of bone loss.

Neuropsychonical development problems usually occurred on preterm infants. As a predicted factor for neuropsychonical obstacle of preterm infant,attachment will help to find the behavior problem early.Parent's characters, preterm infant's nerve development and family environment influenced attachment quality through different array modes. Preterm tended to cause parents especially mother's rearing anxious.Their feelings and attitudes changed and attachment quality was influenced immediately. The preterm infant' s neuropsychonical development caused the change of their parents' reaction to them, then attachment quality was influenced. When family environment was harmonious with pretenn infant's development and parent's raring action,safe attachment was easy to come into being. Above all,it is necessary to evaluate attachment quality of preterm infants early. So we can find neuropsychonical development problems early and resolve the problems timely.Then we can reduce neuropsychonical development problems and develop preterm infant's quality of life.

Objective:To screen autism children by Chinese edition infant and early children social development screening test and to evaluate the diagnostic value.Methods:From October 2006 to May 2007,843 normal children from 3 children health care clinics(N=564) and 9 kindergartens(N=331) were selected and assessed with the Chinese Edition Infant and Early Children Social Development Screening Test.The 95% reference range was made.From February to June 2007,in the third affiliation hospital of Sun yet-san university,170 children who were diagnosed as autism and 391 normal children were selected to draw ROC curve to evaluate the checklist's screening ability.Results:(1) The total scores of the scale were increased with the age of subjects(F=643.83,P<0.001).(2) The areas below ROC curve of whole checklist corresponding three age period were 0.969,0.988 and 0.994.The scores of whole checklist were 52.5,54.5 and 63.5,when the screening ability was best. Conclusion:The diagnostic value of the checklist for autism children is so good that it is useful for clinical evaluation on the social cognitive development of young children between 0.5～3.5 years.

The article explored the cause of recovery failure by adopting advanced simu-lation system(ECS) in the teaching of ‘recoveing of neonatal asphyxia’and put forward some improvement methods and counter measures.Marking full use of the advantages of ECS,designing the training course with specifit roles and objectives,paying attention to the guidance of organiza-tion and exchange as well as the training of cooperative team are the key to improve the skills of neonatal asphyxia recovery in obstetrical pediatric and the teaching quality.