Objective:To investigate the efficacy of phloroglucinol combined with ballon dilation in promoting cervical ripening and shortening labor duration in full-term primiparas and its effects on maternal and neonatal outcomes.Methods:A randomized controlled study was conducted on 60 full-term primiparas who delivered at the First People's Hospital of Longnan from January 2022 to December 2023. The subjects were randomly divided into a control group and an observation group ( n = 30/group) using the random number table method. The control group underwent ballon dilation for cervical ripening, while the observation group received intravenous injection of 80 mg phloroglucinol in addition to ballon dilation. Cervical ripening effect, labor duration, delivery mode, and the incidence of adverse pregnancy outcomes were observed in both groups. Results:The score of cervical ripening in the observation group was significantly higher than that in the control group [(8.31 ± 0.93) vs. (7.83 ± 0.85), t = 2.09, P = 0.041]. The duration of the first stage of labor, the duration of the second stage of labor, and the total duration of labor were (482.7 ± 18.2) minutes, (38.3 ± 10.7) minutes, and (526.6 ± 21.2) minutes, respectively. All these durations were significantly shorter than those in the control group [(521.3 ± 16.4) minutes, (45.7 ± 8.3) minutes, (573.4 ± 18.5) minutes, t = 2.62, 4.32, 12.80, all P<0.05]. The amount of postpartum bleeding in the observation group was significantly lower than that in the control group [(322.5 ± 21.2) mL vs. (341.9 ± 32.5) mL, t = -3.87, P<0.001]. There were no statistically significant differences in the Apgar scores and neonatal behavioral neurological assessment scores between the two groups (both P>0.05). Conclusions:The use of phloroglucinol combined with ballon dilation can effectively promote cervical ripening in full-term primiparas, shorten labor duration, improve induction success rates, and reduce postpartum hemorrhage. Therefore, this combined treatment significantly enhances maternal and neonatal outcomes while demonstrating high safety.

Objective:To study the relationship between serum levels of angiopoietin-2 (Ang-2), insulin-like growth factor 1 (IGF-1), immune factors, and prognosis in patients with uterine fibroids.Methods:A case-control study was conducted involving 93 patients with uterine fibroids who underwent laparoscopic myomectomy at The First People's Hospital of Longnan City between June 2021 and June 2023. These patients constituted the study group. Additionally, 104 healthy women undergoing routine health check-ups during the same period were selected as the control group. Based on the prognosis of the patients in the study group, they were further divided into two subgroups: a good prognosis group ( n = 42) and a poor prognosis group ( n = 46). The correlations among serum levels of Ang-2, IGF-1, immune factors, and prognosis were analyzed in the study group compared to the control group, as well as between the good prognosis and poor prognosis groups. Results:Four cases from the control group and five cases from the study group were excluded from the analysis. In the study group, serum levels of Ang-2 and IGF-1 were found to be (303.18 ± 42.39) mg/L and (1377.11 ± 84.78) mg/L, respectively. Both levels were significantly higher than those in the control group [(231.25 ± 34.18) mg/L, (438.09 ± 52.15) mg/L, t = 12.87, 19.63, both P < 0.001]. Additionally, CD 8+ levels in the study group were higher than those in the control group ( t = -15.79, P < 0.001). Conversely, CD 3+, CD 4+, and CD 4+/CD 8+ levels were lower in the study group compared to the control group ( t = 7.92, 8.41, 5.21, all P < 0.001). In the poor prognosis group, the levels of Ang-2 and IGF-1 were (335.16 ± 42.67) mg/L and (1406.18 ± 83.77) mg/L, respectively, both of which were significantly higher than those in the good prognosis group [(284.63 ± 36.19) mg/L, (434.91 ± 53.28) mg/L, t = 5.96, 64.1, both P < 0.001]. The CD 8+ levels in the poor prognosis group were also higher than those in the good prognosis group ( t = -10.27, P < 0.001), while CD 3+, CD 4+, and CD 4+/CD 8+ levels were lower in the poor prognosis group ( t = 5.31, 7.03, 3.15, all P < 0.001). Correlation analysis revealed that Ang-2 was negatively correlated with CD 3+, CD 4+, and CD 4+/CD 8+ levels ( r = -0.623, -0.578, -0.662). In contrast, Ang-2 was positively correlated with CD 8+ levels, a history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding ( r = 0.593, 0.452, 0.446, 0.419, 0.422). IGF-1 levels were also negatively correlated with CD 3+, CD 4+, and CD 4+/CD 8+ levels ( r = -0.720, -0.751, -0.712), while positively correlated with CD 8+, a history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding ( r = 0.631, 0.503, 0.444, 0.501, 0.451). Furthermore, multivariate logistic regression analysis indicated that a family history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding were all significant risk factors affecting the prognosis of patients with uterine fibroids (all P < 0.05). Conclusions:Patients with uterine fibroids have higher levels of Ang-2, IGF-1 and CD 8+, while the levels of CD 3+, CD 4+, and CD 4+/CD 8+ are lower. Additionally, the expression levels of Ang-2 and IGF-1 are associated with the patients' immune factors and prognosis.

Objective:To investigate the efficacy of phloroglucinol combined with ballon dilation in promoting cervical ripening and shortening labor duration in full-term primiparas and its effects on maternal and neonatal outcomes.Methods:A randomized controlled study was conducted on 60 full-term primiparas who delivered at the First People's Hospital of Longnan from January 2022 to December 2023. The subjects were randomly divided into a control group and an observation group ( n = 30/group) using the random number table method. The control group underwent ballon dilation for cervical ripening, while the observation group received intravenous injection of 80 mg phloroglucinol in addition to ballon dilation. Cervical ripening effect, labor duration, delivery mode, and the incidence of adverse pregnancy outcomes were observed in both groups. Results:The score of cervical ripening in the observation group was significantly higher than that in the control group [(8.31 ± 0.93) vs. (7.83 ± 0.85), t = 2.09, P = 0.041]. The duration of the first stage of labor, the duration of the second stage of labor, and the total duration of labor were (482.7 ± 18.2) minutes, (38.3 ± 10.7) minutes, and (526.6 ± 21.2) minutes, respectively. All these durations were significantly shorter than those in the control group [(521.3 ± 16.4) minutes, (45.7 ± 8.3) minutes, (573.4 ± 18.5) minutes, t = 2.62, 4.32, 12.80, all P<0.05]. The amount of postpartum bleeding in the observation group was significantly lower than that in the control group [(322.5 ± 21.2) mL vs. (341.9 ± 32.5) mL, t = -3.87, P<0.001]. There were no statistically significant differences in the Apgar scores and neonatal behavioral neurological assessment scores between the two groups (both P>0.05). Conclusions:The use of phloroglucinol combined with ballon dilation can effectively promote cervical ripening in full-term primiparas, shorten labor duration, improve induction success rates, and reduce postpartum hemorrhage. Therefore, this combined treatment significantly enhances maternal and neonatal outcomes while demonstrating high safety.

Objective:To study the relationship between serum levels of angiopoietin-2 (Ang-2), insulin-like growth factor 1 (IGF-1), immune factors, and prognosis in patients with uterine fibroids.Methods:A case-control study was conducted involving 93 patients with uterine fibroids who underwent laparoscopic myomectomy at The First People's Hospital of Longnan City between June 2021 and June 2023. These patients constituted the study group. Additionally, 104 healthy women undergoing routine health check-ups during the same period were selected as the control group. Based on the prognosis of the patients in the study group, they were further divided into two subgroups: a good prognosis group ( n = 42) and a poor prognosis group ( n = 46). The correlations among serum levels of Ang-2, IGF-1, immune factors, and prognosis were analyzed in the study group compared to the control group, as well as between the good prognosis and poor prognosis groups. Results:Four cases from the control group and five cases from the study group were excluded from the analysis. In the study group, serum levels of Ang-2 and IGF-1 were found to be (303.18 ± 42.39) mg/L and (1377.11 ± 84.78) mg/L, respectively. Both levels were significantly higher than those in the control group [(231.25 ± 34.18) mg/L, (438.09 ± 52.15) mg/L, t = 12.87, 19.63, both P < 0.001]. Additionally, CD 8+ levels in the study group were higher than those in the control group ( t = -15.79, P < 0.001). Conversely, CD 3+, CD 4+, and CD 4+/CD 8+ levels were lower in the study group compared to the control group ( t = 7.92, 8.41, 5.21, all P < 0.001). In the poor prognosis group, the levels of Ang-2 and IGF-1 were (335.16 ± 42.67) mg/L and (1406.18 ± 83.77) mg/L, respectively, both of which were significantly higher than those in the good prognosis group [(284.63 ± 36.19) mg/L, (434.91 ± 53.28) mg/L, t = 5.96, 64.1, both P < 0.001]. The CD 8+ levels in the poor prognosis group were also higher than those in the good prognosis group ( t = -10.27, P < 0.001), while CD 3+, CD 4+, and CD 4+/CD 8+ levels were lower in the poor prognosis group ( t = 5.31, 7.03, 3.15, all P < 0.001). Correlation analysis revealed that Ang-2 was negatively correlated with CD 3+, CD 4+, and CD 4+/CD 8+ levels ( r = -0.623, -0.578, -0.662). In contrast, Ang-2 was positively correlated with CD 8+ levels, a history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding ( r = 0.593, 0.452, 0.446, 0.419, 0.422). IGF-1 levels were also negatively correlated with CD 3+, CD 4+, and CD 4+/CD 8+ levels ( r = -0.720, -0.751, -0.712), while positively correlated with CD 8+, a history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding ( r = 0.631, 0.503, 0.444, 0.501, 0.451). Furthermore, multivariate logistic regression analysis indicated that a family history of uterine fibroids, the number of fibroids, a history of miscarriage, and the duration of breastfeeding were all significant risk factors affecting the prognosis of patients with uterine fibroids (all P < 0.05). Conclusions:Patients with uterine fibroids have higher levels of Ang-2, IGF-1 and CD 8+, while the levels of CD 3+, CD 4+, and CD 4+/CD 8+ are lower. Additionally, the expression levels of Ang-2 and IGF-1 are associated with the patients' immune factors and prognosis.

Hyperkalemia is one of the common ion metabolism disorders in clinical practice. Hyperkalemia is defined as serum potassium higher than 5.0 mmol/L according to the guidelines at home and abroad. Acute severe hyperkalemia can cause serious consequences, such as flaccid paralysis, fatal arrhythmia, and even cardiac arrest. The use of renin-angiotensin- aldosterone system inhibitors, β-blockers and diuretics, low-sodium and high-potassium diets, and the presence of related comorbidities increase the occurrence of hyperkalemia. Hyperkalemia risk exist in all clinical departments, but there is a lack of a standardization in the management of multi- department cooperation in hospital. Therefore, a number of domestic nephrology and cardiology department experts have discussed a management model for multi-department cooperation in hyperkalemia, formulating the management standard on hospital evaluation, early warning, diagnosis and treatment, and process. This can promote each department to more effectively participate in nosocomial hyperkalemia diagnosis and treatment, as well as the long-term management of chronic hyperkalemia, improving the quality of hyperkalemia management in hospital.

OBJECTIVE: To explore the genetic basis for fetus with bilateral lateral ventriculomegaly. METHODS: Fetus umbilical cord blood and peripheral blood samples of its parents were collected. The fetus was subjected to chromosomal karyotyping, whilst the fetus and its parents were subjected to array comparative genomic hybridization (aCGH). The candidate copy number variation (CNV) were verified by qPCR, Application goldeneye DNA identification system was used to confirm the parental relationship. RESULTS: The fetus was found to have a normal karyotype. aCGH analysis indicated that it has carried a 1.16 Mb deletion at 17p13.3, which partially overlapped with the critical region of Miller-Dieker syndrome (MDS), in addition with a 1.33 Mb deletion at 17p12 region, which is associated with hereditary stress-susceptible peripheral neuropathy (HNPP). Its mother was also found to harbor the 1.33 Mb deletion at 17p12. qPCR analysis confirmed that the expression levels of genes from the 17p13.3 and 17p12 regions were about the half of that in the normal control, as well as the maternal peripheral blood sample. Parental relationship was confirmed between the fetus and its parents. Following genetic counseling, the parents has chosen to continue with the pregnancy. CONCLUSION The fetus was diagnosed with Miller-Dieker syndrome due to the de novo deletion at 17p13.3. Ventriculomegaly may be an important indicator for prenatal ultrasonography in fetuses with MDS.
Pregnancy ; Female ; Humans ; Classical Lissencephalies and Subcortical Band Heterotopias ; Comparative Genomic Hybridization ; DNA Copy Number Variations ; Fetus ; Hydrocephalus ; Prenatal Diagnosis ; Chromosome Deletion

OBJECTIVE: To explore the genetic etiology of two patients with developmental delay and intellectual disability. METHODS: Two children who were respectively admitted to Henan Provincial People's Hospital on August 29, 2021 and August 5, 2019 were selected as the study subjects. Clinical data were collected, and array comparative genomic hybridization (aCGH) was carried out on the children and their parents for the detection of chromosomal microduplication/microdeletions. RESULTS: Patient 1 was a 2-year-and-10-month female and patient 2 was a 3-year-old female. Both children had featured developmental delay, intellectual disability, and abnormal findings on cranial MRI. aCGH revealed that patient 1 has harbored arr[hg19] 6q14.2q15(84621837_90815662)×1, a 6.19 Mb deletion at 6q14.2q15, which encompassed ZNF292, the pathogenic gene for Autosomal dominant intellectual developmental disorder 64. Patient 2 has harbored arr[hg19] 22q13.31q13.33(46294326_51178264)×1, a 4.88 Mb deletion at 22q13.31q13.33 encompassing the SHANK3 gene, haploinsufficiency of which can lead to Phelan-McDermid syndrome. Both deletions were classified as pathogenic CNVs based on the guidelines of American College of Medical Genetics and Genomics (ACMG) and were not found in their parents. CONCLUSION The 6q14.2q15 deletion and 22q13-31q13.33 deletion probably underlay the developmental delay and intellectual disability in the two children, respectively. Haploinsufficiency of the ZNF292 gene may account for the key clinical features of the 6q14.2q15 deletion.
Humans ; Child ; Female ; Child, Preschool ; Intellectual Disability/genetics* ; Comparative Genomic Hybridization ; Chromosome Disorders/genetics* ; Chromosome Deletion ; Magnetic Resonance Imaging ; Chromosomes, Human, Pair 22 ; Developmental Disabilities/genetics* ; Carrier Proteins/genetics* ; Nerve Tissue Proteins/genetics*

Objectives:To investigate the clinical value of endoscopy and mucosal histology for digestive tract diseases in infants.Methods:Clinical data of 357 infants who underwent 422 gastrointestinal endoscopies from January 2010 to December 2021 were collected. The indications, endoscopic manifestations, histological features of mucosa and diagnosis were analyzed.Results:A total of 159 gastroscopies and 263 colonoscopies were performed. Diarrhea (185 cases), bloody stool (178 cases) and vomiting (46 cases) were common symptoms. Endoscopy showed manifestations including non-specific inflammatory changes (265 cases), ulcer-like changes (72 cases), and normal mucusa (48 cases). A total of 373 biopsies were performed, including 260 cases of abnormal mucosal histology, 109 cases of normal mucosal histology, and 4 cases of too small biopsy specimens for analysis. Diagnoses were 208 cases of anaphylactic disease, 45 cases of inflammatory bowel disease, 15 cases of variation of structure, 10 cases of intestinal lymphangiectasis, 2 cases of autoimmune enteropathy, and 1 case of celiac disease. There was only 1 colonic perforation complicating endoscopy in terms of endoscopic complication.Conclusions:It is safe and effective to perform endoscopy standardly for digestive tract diseases in infants. Endoscopy with biopsies is a greatly informative test for diagnosis in infants.

Objective To observe the clinical effect of Yi'naokang Capsules combined with Donepezil Hydrochloride Tablets in treating post-stroke cognitive impairment(PSCI).Methods 110 patients who met the diagnostic criteria of PSCI in the outpatient department were included.According to the random number table method,the patients were divided into trial group and control group,with 55 cases in each group.Patients in control group were treated with routine western medicine,including the treatment of Donepezil Hydrochloride Tablets and secondary prevention of stroke such as lowering blood pressure,lowering blood lipid,lowering blood glucose and anti-platelet aggregation.The trial group was treated with Yi'naokang Capsules on the basis of the treatment in control group,and both groups were treated for 6 months.Before and after 6 months of treatment,the cognitive function of patients was evaluated by the Montreal Cognitive Assessment(MoCA)scale.The activity of daily living(ADL)scale was used to evaluate the ability of daily living,and the severity of cerebral white matter lesions was evaluated by Fazekas scale,and the adverse reactions were also observed.Results After 6 months of treatment,the total score of the MoCA,the scores of visual space and executive function,attention,delayed recall and the ADL of the two groups were all improved(P＜0.05),and the improvement degree of the trial group was better than that of the control group(P＜0.05).The Fazekas score of the trial group after treatment was no significant difference when compared with that before treatment(P＞0.05),but it increased in the control group after treatment(P＜0.05),and the effect of delaying white matter lesion in the trial group was better than that in the control group(P＜0.05).Conclusion Yi'naokang Capsules combined with Donepezil Hydrochloride Tablets are superior to Donepezil alone in the treatment of PSCI,which can safely and effectively improve the cognitive function and daily living ability of patients,as well as prolong the progress of white matter lesions.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.