Preeclampsia (PE), a multisystem disorder in pregnancy, is one of the leading causes of perinatal morbidity and mortality that poses financial and physical burdens worldwide. Preterm PE with delivery at <37 weeks of gestation is associated with a higher risk of adverse maternal and perinatal outcomes than term PE with delivery at ≥37 weeks of gestation. A myriad of first trimester screening models have been developed to identifying women at risk of preterm PE. In fact, the Fetal Medicine Foundation (FMF) first trimester prediction model has undergone successful internal and external validation. The FMF triple test enables the estimation of patient-specific risks, using Bayes theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor. Establishing a quality control process for regular monitoring and to ensure data standardization, reliability, and accuracy is key to maintaining optimal screening performance. The rate of preterm PE can be reduced by 62% by using the FMF prediction model, followed by the administration of low-dose aspirin. Recent evidence has also demonstrated that metformin has the potential for preventing PE in patients at high-risk of the disorder. In this article, we will summarize the existing literature on the different screening methods, different components of risk assessment, therapeutic interventions, and clinical implementation of the first trimester screening and prevention program for PE with specific considerations for Chinese mainland.

Preeclampsia (PE), a multisystem disorder in pregnancy, is one of the leading causes of perinatal morbidity and mortality that poses financial and physical burdens worldwide. Preterm PE with delivery at <37 weeks of gestation is associated with a higher risk of adverse maternal and perinatal outcomes than term PE with delivery at ≥37 weeks of gestation. A myriad of first trimester screening models have been developed to identifying women at risk of preterm PE. In fact, the Fetal Medicine Foundation (FMF) first trimester prediction model has undergone successful internal and external validation. The FMF triple test enables the estimation of patient-specific risks, using Bayes theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor. Establishing a quality control process for regular monitoring and to ensure data standardization, reliability, and accuracy is key to maintaining optimal screening performance. The rate of preterm PE can be reduced by 62% by using the FMF prediction model, followed by the administration of low-dose aspirin. Recent evidence has also demonstrated that metformin has the potential for preventing PE in patients at high-risk of the disorder. In this article, we will summarize the existing literature on the different screening methods, different components of risk assessment, therapeutic interventions, and clinical implementation of the first trimester screening and prevention program for PE with specific considerations for Chinese mainland.

Objective:To investigate the influence of muscle energy technology (MET) combined with Maitland joint mobilization surgery on the elbow joint flexion function in patients with deep burn of elbow joint.Methods:A retrospective controlled clinical trial was conducted. From January 2020 to January 2022, 53 patients with elbow joint flexion dysfunction after deep burns who met the inclusion criteria were treated in Tongren Hospital of Wuhan University & Wuhan Third Hospital, including 32 males and 21 females, aged (37±12) years. According to the treatment method used, the patients were divided into conventional treatment alone group (15 cases), conventional treatment+joint mobilization surgery group (18 cases), and conventional treatment+joint mobilization surgery+MET group (20 cases). Before treatment and 2 months after treatment, the patient's elbow joint range of motion was measured using a protractor, the Mayo elbow joint function score was used to evaluate elbow joint function, a portable muscle strength tester was used to measure elbow extensor muscle strength, and visual analogue scale was used to evaluate pain degree. Data were statistically analyzed with one-way analysis of variance, least significant difference test, paired sample t test, Kruskal-Wallis H test, Wilcoxon signed rank-sum test, chi-square test, Fisher's exact probability test, and Bonferroni correction. Results:After two months of treatment, the elbow joint range of motion and elbow joint function scores of patients in conventional treatment+joint mobilization surgery group and conventional treatment+joint mobilization surgery+MET group ((103±12)° and 60 (50, 66), (131±14)° and 73 (65, 80)) were significantly larger and higher than those in conventional treatment alone group ((77±15)° and 45 (35, 50), P values all <0.05), respectively. The elbow joint range of motion and elbow joint function scores of patients in conventional treatment+joint mobilization surgery+MET group were significantly larger and higher than those in conventional treatment+joint mobilization surgery group ( P values all <0.05), respectively. After two months of treatment, the elbow extensor muscle strength and pain score of patients in conventional treatment+joint mobilization surgery+MET group were respectively significantly larger and lower than those in conventional treatment alone group and conventional treatment+joint mobilization surgery group ( P values all <0.05). The elbow extensor muscle strength and pain score of patients in conventional treatment+joint mobilization surgery group were similar to those in conventional treatment alone group ( P>0.05). The elbow joint range of motion and elbow extensor muscle strength (with t values of 9.37, 25.54, 28.71, 6.70, 7.20, and 7.01, respectively, P<0.05), elbow joint function scores and pain scores (with Z values of 3.15, 3.63, 3.93, 3.30, 3.52, and 3.84, respectively, P<0.05) of patients in conventional treatment alone group, conventional treatment+joint mobilization surgery group, and conventional treatment+joint mobilization surgery+MET group after two months of treatment were significantly improved compared with those before treatment. Conclusions:The combination of MET and Maitland joint mobilization surgery can effectively improve elbow joint range of motion, elbow joint function, elbow extensor muscle strength, and pain of patients with deep elbow joint burns, therefore it is worthy of promotion.

Objective:This study aims to explore the structural characteristics of the abnormal brain cortex in patients with autism by analyzing the neuroanatomical differences between patients with autism and the healthy controls.Methods:This study analyzed the brain imaging data of patients with autism ( n=525) and healthy controls ( n=569) extracted from the database of the Autism Brain Imaging Data Exchange (ABIDE) which collected data from 20 sites around the world. The cerebral cortex thickness was estimated using the FreeSurfer software based on the data of brain structure and was compared between patients with autism and the healthy controls using the t test. At the same time, according to their age, all participants were divided into three groups, which were younger than 12 years old group(150 patients and 151 controls), 12 to 18 years old group (210 patients and 233 controls), and older than 18 years old group (159 patients and 183 controls), and the cortical thickness was compared between patients with autism and healthy controls in different age groups using the t test respectively. Results:Based on the comparison of the thickness of the cerebral cortex between the autism group and the control group, it was found that compared with the control group, patients with autism showed a significant increase in cortical thickness in the occipital face area of both left and right sides of the brain (left side: size=1 043.95 mm 2, Z=4.31, MNI coordinates: x=-13.1, y=-102.4, z=2.4; right side: size=1 364.13 mm 2, Z=5.14, MNI coordinates: x=14.4, y=-101.3, z=3.1) and significant atrophy of cortical thickness at the posterior part of the superior frontal gyrus on the right side of the brain (size=485.86 mm 2, Z=4.71, MNI coordinates: x=6.8, y=-13.1, z=61.6). Comparisons of cerebral cortical thickness in different age groups found that patients younger than 12 years old showed a significant reduction in cortical thickness in the middle and posterior right superior frontal gyrus (right side: size=914.44 mm 2, Z=4.86, MNI coordinates: x=19.7, y=32.4, z=41.1) and inferior temporal gyrus (left side: size=638.16 mm 2, Z=-4.36, MNI coordinates: x=-34.7, y=-32.5, z=-22.8) compared to the healthy controls of the same age. Patients within 12 to 18 years old showed a reduction in the cortical thickness of the posterior upper frontal gyrus and an increase in the occipital facial area compared to the corresponding healthy controls. No significant difference in the thickness of the cortex was found between patients older than 18 years and the healthy controls of the same age. Conclusion:Abnormal cortical thickness in the occipital face area and posterior part of the superior frontal gyrus could be the characteristics of neurodevelopment in patients with autism, especially in younger children with autism.

Objective:The study aims to explore the abnormal characteristics in cerebral cortex among children with different subtypes of attention deficit hyperactivity disorder (ADHD).Methods:Four hundred and twelve samples were obtained from the Healthy Brain Network project of American Child Mind Institute. There were 288 children with ADHD (all subjects: age,M=10.03,SD=3.11; 151 of ADHD-C, 20 of ADHD-H, and 117 of ADHD-I) and 124 healthy controls (age,M=9.98,SD=2.98). Using FreeSurfer software, we processed the brain structure images and obtained the cortical volume, cortical thickness and surface area for each subject. Analysis of Variance (ANOVA) and post hoc comparison analyses were conducted.Results:ANOVA analysis showed significant differences of the cortical volume located in the left superior parietal gyrus ( Z=5.94) and superior temporal gyrus ( Z=5.49) among the 3 subtypes of ADHD children and the healthy controls (Monte Carlo, P<0.05). Compared with the healthy controls, ADHD-H group exhibited an increased cortical volume in the left superior parietal gyrus ( Z=6.79), while the ADHD-I group had a decreased volume in the left superior temporal gyrus ( Z=-5.12) and lateral occipital cortex ( Z=-6.40). ADHD-C group also had a decreased volume in the left lateral occipital cortex ( Z=-3.37). Among 3 subtypes of ADHD patients, both ADHD-I and ADHD-C groups had a smaller volume in the left superior parietal gyrus than that of the ADHD-H group (ADHD-I: Z=-7.33,MNI coordinate:x=-26.8,y=-60.6,z=45.4; ADHD-C: Z=-7.14,MNI coordinate:x=-26.6,y=-60.2,z=45.4). Additionally, there was no statistical difference in cortical volume between the ADHD-I and ADHD-C group (Monte Carlo, P>0.05). Subsequent supplementary analyses showed that the sample size and age had no significant effect on the above results. Moreover, analysis of cortical thickness and the surface area showed that the abnormality of the cortical volume in different ADHD subtypes was mainly determined by the surface area of the cerebral cortex. Conclusion:Cortical measures in the superior parietal gyrus might be the crucial features that distinguishes the different subtypes of ADHD. These results enable us to further explore the neurodevelopmental mechanism of ADHD and guide the precise and specific clinical treatment.

Objective:This study aims to explore the structural characteristics of the abnormal brain cortex in patients with autism by analyzing the neuroanatomical differences between patients with autism and the healthy controls.Methods:This study analyzed the brain imaging data of patients with autism ( n=525) and healthy controls ( n=569) extracted from the database of the Autism Brain Imaging Data Exchange (ABIDE) which collected data from 20 sites around the world. The cerebral cortex thickness was estimated using the FreeSurfer software based on the data of brain structure and was compared between patients with autism and the healthy controls using the t test. At the same time, according to their age, all participants were divided into three groups, which were younger than 12 years old group(150 patients and 151 controls), 12 to 18 years old group (210 patients and 233 controls), and older than 18 years old group (159 patients and 183 controls), and the cortical thickness was compared between patients with autism and healthy controls in different age groups using the t test respectively. Results:Based on the comparison of the thickness of the cerebral cortex between the autism group and the control group, it was found that compared with the control group, patients with autism showed a significant increase in cortical thickness in the occipital face area of both left and right sides of the brain (left side: size=1 043.95 mm 2, Z=4.31, MNI coordinates: x=-13.1, y=-102.4, z=2.4; right side: size=1 364.13 mm 2, Z=5.14, MNI coordinates: x=14.4, y=-101.3, z=3.1) and significant atrophy of cortical thickness at the posterior part of the superior frontal gyrus on the right side of the brain (size=485.86 mm 2, Z=4.71, MNI coordinates: x=6.8, y=-13.1, z=61.6). Comparisons of cerebral cortical thickness in different age groups found that patients younger than 12 years old showed a significant reduction in cortical thickness in the middle and posterior right superior frontal gyrus (right side: size=914.44 mm 2, Z=4.86, MNI coordinates: x=19.7, y=32.4, z=41.1) and inferior temporal gyrus (left side: size=638.16 mm 2, Z=-4.36, MNI coordinates: x=-34.7, y=-32.5, z=-22.8) compared to the healthy controls of the same age. Patients within 12 to 18 years old showed a reduction in the cortical thickness of the posterior upper frontal gyrus and an increase in the occipital facial area compared to the corresponding healthy controls. No significant difference in the thickness of the cortex was found between patients older than 18 years and the healthy controls of the same age. Conclusion:Abnormal cortical thickness in the occipital face area and posterior part of the superior frontal gyrus could be the characteristics of neurodevelopment in patients with autism, especially in younger children with autism.

Objective:The study aims to explore the abnormal characteristics in cerebral cortex among children with different subtypes of attention deficit hyperactivity disorder (ADHD).Methods:Four hundred and twelve samples were obtained from the Healthy Brain Network project of American Child Mind Institute. There were 288 children with ADHD (all subjects: age,M=10.03,SD=3.11; 151 of ADHD-C, 20 of ADHD-H, and 117 of ADHD-I) and 124 healthy controls (age,M=9.98,SD=2.98). Using FreeSurfer software, we processed the brain structure images and obtained the cortical volume, cortical thickness and surface area for each subject. Analysis of Variance (ANOVA) and post hoc comparison analyses were conducted.Results:ANOVA analysis showed significant differences of the cortical volume located in the left superior parietal gyrus ( Z=5.94) and superior temporal gyrus ( Z=5.49) among the 3 subtypes of ADHD children and the healthy controls (Monte Carlo, P<0.05). Compared with the healthy controls, ADHD-H group exhibited an increased cortical volume in the left superior parietal gyrus ( Z=6.79), while the ADHD-I group had a decreased volume in the left superior temporal gyrus ( Z=-5.12) and lateral occipital cortex ( Z=-6.40). ADHD-C group also had a decreased volume in the left lateral occipital cortex ( Z=-3.37). Among 3 subtypes of ADHD patients, both ADHD-I and ADHD-C groups had a smaller volume in the left superior parietal gyrus than that of the ADHD-H group (ADHD-I: Z=-7.33,MNI coordinate:x=-26.8,y=-60.6,z=45.4; ADHD-C: Z=-7.14,MNI coordinate:x=-26.6,y=-60.2,z=45.4). Additionally, there was no statistical difference in cortical volume between the ADHD-I and ADHD-C group (Monte Carlo, P>0.05). Subsequent supplementary analyses showed that the sample size and age had no significant effect on the above results. Moreover, analysis of cortical thickness and the surface area showed that the abnormality of the cortical volume in different ADHD subtypes was mainly determined by the surface area of the cerebral cortex. Conclusion:Cortical measures in the superior parietal gyrus might be the crucial features that distinguishes the different subtypes of ADHD. These results enable us to further explore the neurodevelopmental mechanism of ADHD and guide the precise and specific clinical treatment.

Scar contracture after burn on the back of hand can easily lead to the limitation of flexion function of fingers, which seriously affects daily life activities. Generally, comprehensive rehabilitation treatment is adopted for scar contracture on the back of hand, among which wearing braces is an effective treatment method. However, some braces will limit the normal finger joints or must wait until all the affected fingers heal before they can be worn, and the wearing operation is quite complicated. In order to solve these problems, the author designed and made a finger flexion band, which was used to stretch the patients with limited flexion of finger caused by scar contracture after burn on the back of hand, and achieved good therapeutic effect. According to the measured hand size, the finger flexion band is cut and spliced from the fabric commonly used in daily life. The finger flexion band is designed with finger sleeve, which will not limit the normal finger joints, can interfere with the healed finger in advance, fix the corresponding fingers better, and improve the treatment comfort, especially for children who do not cooperate with the braces wearing. This finger flexion band is simple to make, cheap, convenient to use, and suitable for clinical promotion.

Objective To study the expression and biological functions of RN181 in SMMC7721 cells,the retroviral vector was constructed.Methods Gene cloning techniques were used to construct pRetrox-TRE3G/RN1S1 recombinant vector.The regulating plasmid pRetroX-TRE3G/RN181 or the response plasmid of pRetroX-Tet3G were respectively cotansfected into GP2-293 cells with Envelope Vector plasmid to package retrovirus after routine identification.Both viruses co-infected target cells SMCC7721,and then were selected by G418 to obtain stable cell lines.The stable cell lines were induced by doxycycline (DOX),and then verified by RT-PCR and Western blotting.CCK-8 was used to evaluate the effect of RN181 on growth of SMMC7721 cells.Results We constructed the recombinant plasmid.Stable recombinant plasmid were verified by screening.And there were significant differences of RN181 between the induced and uninduced cell lines through RT-PCR and Western blot.Conclusions We have successfully constructed the inducible stable RN181 expression SMCC7721 cell,which can be used as an effective cell model to study the biological functions of RN181.We found RN181 could suppress the proliferation and invasion in SMMC7721 cells in vitro.

Objective To study the clinical results of patients with gallbladder stones and common bile duct stones treated either by laparoscopic cholecystectomy followed by endoscopic sphincterotomy (EST + LC) or laparoscopic cholecystectomy + common bile duct exploration (LC + LCBDE) in the elderly patients.Methods A retrospective study was conducted on 96 patients who had common bile duct and gallbladder stones treated from January 2012 to January 2016.The patients were divided into the control group and the observation group.46 patients were in the observation group who underwent LC three days after EST,while the remaining patients were in the control group who underwent LC and LCBDE.The serum amylase levels before LC,operation time,intraoperation bleeding volume,postoperative time to first flatus,total hospitalization stay and total hospitalization costs and incidences of postoperative complication were compared.Results The total operation time was (95.0 ±7.0) minutes and (125.0 ± 18.0) minutes,respectively,(P＜0.05).The total costs in the two group were (39515.0 ±4 135.0) yuan and (28287.0 ± 2 254.0) yuan (P ＜ 0.05),respectively.Postoperative complications were observed in 5 (6.1％) and 10 (13.2％) patients (P ＜ 0.05),respectively.The preoperative serum amylase levels were (97.6 ± 48.5) IU/L and (131.4 ± 68.7) IU/L,respectively.The blood loss was (35.7 ± 8.5) ml and (31.8 ± 7.3) ml,respectively.The postoperative time to first flatus was (1.7 ± 0.5) days and (1.9 ± 0.4) days,respectively.The total hospitalization stay was (16.3 ±2.8) days and (15.2 ±3.7) days.There were no significantly differences (P ＞ 0.05).Conclusions LC carried out on day 3 after EST to treat elderly patients with cholecystolithiasis and choledocholithiasis was safe and efficacious and the treatment had the advantages of minimal trauma,short operative time,rapid recovery and low complication rates.This should be recommended in clinical practice.