Objective To explore the characteristics of upper airway obstruction on multi spiral computed tomography(MSCT)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)and their correlation with the disease,as well as to identify key characteristic indicators.Methods Forty-three patients with OSAHS(OSAHS group)and 45 normal controls(control group)were selected.MSCT of the upper airway was performed to analyze the differences in various observation indicators between the two groups,including diameters at levels of upper airway obstruction,soft palate thickness,mandibular plane to hyoid distance(MP-H),oropharyngeal length,air-pharyngeal ratio,and fat infiltration in the tongue base.A multivariate logistic regression model was con-structed to identify the main risk factors,and the receiver operating characteristic(ROC)curve was used to assess the diagnostic per-formance of the model.Results The OSAHS group exhibited smaller diameters at levels of upper airway obstruction and air-pharyn-geal ratio compared to the control group[area:(0.75±0.38)cm2 vs(1.36±0.58)cm2,t=5.855,P＜0.001].Additionally,body mass index(BMI),degree of fat infiltration in the tongue base,soft palate thickness,and MP-H were significantly greater in the OSAHS group than those in the control group(soft palate thickness:t=-6.881,P＜0.001).Multivariate logistic regression analysis revealed that fat infiltration in the tongue base,soft palate thickness,MP-H,and the area of upper airway obstruction were the main risk factors for OSAHS.The area under the curve(AUC)was 0.940[95％confidence interval(CI)0.868-0.979,P＜0.001],indica-ting good diagnostic performance.Conclusion MSCT can effectively evaluate the upper airway obstruction characteristics in patients with OSAHS,with fat infiltration in the tongue base,soft palate thickness,MP-H,and the area of upper airway obstruction as the primary indicators for OSAHS,providing a reference for clinical practice.

Objective To explore the characteristics of upper airway obstruction on multi spiral computed tomography(MSCT)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)and their correlation with the disease,as well as to identify key characteristic indicators.Methods Forty-three patients with OSAHS(OSAHS group)and 45 normal controls(control group)were selected.MSCT of the upper airway was performed to analyze the differences in various observation indicators between the two groups,including diameters at levels of upper airway obstruction,soft palate thickness,mandibular plane to hyoid distance(MP-H),oropharyngeal length,air-pharyngeal ratio,and fat infiltration in the tongue base.A multivariate logistic regression model was con-structed to identify the main risk factors,and the receiver operating characteristic(ROC)curve was used to assess the diagnostic per-formance of the model.Results The OSAHS group exhibited smaller diameters at levels of upper airway obstruction and air-pharyn-geal ratio compared to the control group[area:(0.75±0.38)cm2 vs(1.36±0.58)cm2,t=5.855,P＜0.001].Additionally,body mass index(BMI),degree of fat infiltration in the tongue base,soft palate thickness,and MP-H were significantly greater in the OSAHS group than those in the control group(soft palate thickness:t=-6.881,P＜0.001).Multivariate logistic regression analysis revealed that fat infiltration in the tongue base,soft palate thickness,MP-H,and the area of upper airway obstruction were the main risk factors for OSAHS.The area under the curve(AUC)was 0.940[95％confidence interval(CI)0.868-0.979,P＜0.001],indica-ting good diagnostic performance.Conclusion MSCT can effectively evaluate the upper airway obstruction characteristics in patients with OSAHS,with fat infiltration in the tongue base,soft palate thickness,MP-H,and the area of upper airway obstruction as the primary indicators for OSAHS,providing a reference for clinical practice.

In recent years, with the continuous progress of medical technology, the survival rate of cancer patients after treatment has been continuously improved, and more and more young cancer patients begin to pay attention to the fertility problem after survival. For prepubertal or adolescent cancer patients who require urgent chemoradiotherapy, and for reproductive female patients, ovarian tissue cryopreservation (OTC) follows by transplantation is the only option to preserve their fertility at present. Although the OTC technology has been carried out as a routine clinical project in a few medical institutions in China, it is still in the stage of clinical trial research in majority medical institutions. There are still many technical and ethical challenges in clinical practice of OTC technology. Therefore, this paper discussed the ethical principles that should be followed in clinical practice of human OTC and transplantation, and briefly analyzed the corresponding ethical issues. When implementing this technology, the indications should be followed strictly, the wishes of patients should be respected and true and full informed consent should be obtained while ensuring that the cancer treatment of patients is not delayed. Besides, it is significants to accumulate enough experience for minor patients to fully protect their rights and interests and promote the construction of relevant national laws and regulations.

In recent years, with the continuous progress of medical technology, the survival rate of cancer patients after treatment has been continuously improved, and more and more young cancer patients begin to pay attention to the fertility problem after survival. For prepubertal or adolescent cancer patients who require urgent chemoradiotherapy, and for reproductive female patients, ovarian tissue cryopreservation (OTC) follows by transplantation is the only option to preserve their fertility at present. Although the OTC technology has been carried out as a routine clinical project in a few medical institutions in China, it is still in the stage of clinical trial research in majority medical institutions. There are still many technical and ethical challenges in clinical practice of OTC technology. Therefore, this paper discussed the ethical principles that should be followed in clinical practice of human OTC and transplantation, and briefly analyzed the corresponding ethical issues. When implementing this technology, the indications should be followed strictly, the wishes of patients should be respected and true and full informed consent should be obtained while ensuring that the cancer treatment of patients is not delayed. Besides, it is significants to accumulate enough experience for minor patients to fully protect their rights and interests and promote the construction of relevant national laws and regulations.

Objective:To explore the difference of embryological and clinical outcomes between the oocytes with indented zona pellucida and normal morphology.Methods:A retrospective cohort study was conducted on 93 cycles treated with intracytoplasmic sperm injection (ICSI) in the Clinical Reproductive Medicine Center of the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019. According to the morphology of oocytes and the methods of fertilization, the cycles were divided into three groups, normal oocytes with traditional ICSI group (group A, n=52), indented zona pellucida oocytes with traditional ICSI group (group B, n=30), and indented zona pellucida oocytes with rescue ICSI group (group C, n=11). Laboratory and clinical results were compared among the three groups. Results:There were no differences in oocytes retrieved rate, normal fertility rate, clinical pregnancy rate and implantation rate among the three groups (all P>0.05). The good-quality embryo rate in groups A [62.50% (250/400)] and B [59.07% (114/193)] was significantly higher than that in group C [40.85% (29/71); P=0.001, P=0.006] and blastocyst formation rate in group A [64.78% (160/247)] was significantly higher than that in group C [37.14% (13/35), P=0.002]. Otherwise, the abortion rate in group A [2.44% (1/41)] was significantly lower than that in groups B and C [21.05% (4/19), P=0.031; 44.44% (4/9), P=0.002] and the cumulative pregnancy rate in group A [82.69% (43/52)] was comparatively higher than that in groups B and C [56.67% (17/30), P=0.009; 45.45% (5/11), P=0.014]. Conclusion:Traditional ICSI insemination of the indented pellucida oocytes showed the similar results of good-quality embryo rate and blastocyst formation rate with that of normal oocytes, but the overall clinical outcome was lower than that of normal oocytes. Abnormal oocytes of zona pellucida should be inseminated by ICSI directly, which can obtain better clinical outcome.

Objective:To explore the difference of embryological and clinical outcomes between the oocytes with indented zona pellucida and normal morphology.Methods:A retrospective cohort study was conducted on 93 cycles treated with intracytoplasmic sperm injection (ICSI) in the Clinical Reproductive Medicine Center of the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019. According to the morphology of oocytes and the methods of fertilization, the cycles were divided into three groups, normal oocytes with traditional ICSI group (group A, n=52), indented zona pellucida oocytes with traditional ICSI group (group B, n=30), and indented zona pellucida oocytes with rescue ICSI group (group C, n=11). Laboratory and clinical results were compared among the three groups. Results:There were no differences in oocytes retrieved rate, normal fertility rate, clinical pregnancy rate and implantation rate among the three groups (all P>0.05). The good-quality embryo rate in groups A [62.50% (250/400)] and B [59.07% (114/193)] was significantly higher than that in group C [40.85% (29/71); P=0.001, P=0.006] and blastocyst formation rate in group A [64.78% (160/247)] was significantly higher than that in group C [37.14% (13/35), P=0.002]. Otherwise, the abortion rate in group A [2.44% (1/41)] was significantly lower than that in groups B and C [21.05% (4/19), P=0.031; 44.44% (4/9), P=0.002] and the cumulative pregnancy rate in group A [82.69% (43/52)] was comparatively higher than that in groups B and C [56.67% (17/30), P=0.009; 45.45% (5/11), P=0.014]. Conclusion:Traditional ICSI insemination of the indented pellucida oocytes showed the similar results of good-quality embryo rate and blastocyst formation rate with that of normal oocytes, but the overall clinical outcome was lower than that of normal oocytes. Abnormal oocytes of zona pellucida should be inseminated by ICSI directly, which can obtain better clinical outcome.

Platelets and neutrophils are now considered the key factor to thrombus initiation and progression .The present article describes the latest discovery of neutrophil extracellular trapping network (NETs) in thrombogenesis and unknown field to be explore ,including biological process of NET formation (NETosis) ,and how extracellular release of DNA and histone of NETs help coagulation and platelet aggregation .Cell biology of NETosis is still ac‐tively characterized ,which may provide new specific inhibition therapy insights .

Objective: To explore the safety and effectiveness of a novel percutaneous self-expanding forceful reduction screw system in the treatment of thoracolumbar fracture with severe vertebral height loss. Methods: Thirty-eight patients of thoracolumbar fracture with more than 50%vertebral height loss were treated with the novel percutaneous self-expanding forceful reduction screw between March 2014 and June 2015. The screw system is a single plane screw with a reduction angle of 0,3,6,9 degrees. During the operation, the fracture vertebral body was automatically restored during the locking process of the top cap. All the patients were single vertebral fractures. Percutaneous screw fixation and reduction was used in the operation. Two groups of screws were used to fix the two adjacent vertebrae of the injured vertebra and to restore the injured vertebral body, without fusion treatment. The vertebral body index (VBI), height of the anterior margin of fractured vertebra (HAMFV), vertebral body angle (VBA), bisegmental Cobb angle (BCA), visual analog scale (VAS) and Oswestry disability index (ODI) of the patients before and after operation, 6 months after operation, and at the end of the follow-up were compared. The scoring results were compared using a t test. Results: The operation was completed successfully in 38 cases. A total of 152 screws were placed. The accuracy rate of CT evaluation was 98.7%. The average operation time was 90.7±21.9 min, and the average intraoperative bleeding amount was 89.2±31.9 ml. The patients' preoperative VBI, HAMFV, VBA, BCA, VAS and ODI scores were 0.38±0.07, 0.38±0.06, 25.45°±4.54°, 18.66°±8.57°, 7.76±1.02, and 44.58%±2.33%, respectively. The postoperative measurements were 0.93±0.03, 0.95±0.02, 3.71°± 1.35°, 5.84°±6.80 °, 4.29±1.16 and 24.37%±1.88%. At the last follow-up, the measurements were 0.92±0.03, 0.94±0.02, 3.89° ±1.31°,6.05°±7.00°, 1.71±0.65 and 5.95%±2.67%. There was significant difference between the preoperative and postoperative data, as well as the preoperative and the last follow-up data (P<0.05). Conclusion In the treatment of thoracolumbar fractures with severe loss of vertebral height, the novel percutaneous self-expanding forceful reduction screw system has achieved satisfactory vertebral height restoration and kyphosis correction.

Histones can be released into the extracellular space,and lead to lethal sepsis, ischemia reperfusion injury, trauma, pancreatitis, coagulation and thrombosis.In addition, the increase of serum histone is related to the pathological and pathophysiological process of autoimmune diseases, nervous system diseases and tumors.Therefore, extracellular histone can be used as biomarkers and therapeutic targets for a variety of human diseases.

Objective To analyze the tendency and influential factors and relationship for behavior problem among 3 to 6 years old preschool children.Methods By a prospective study,the questionnaire survey was carried out in 551 parents of 3 to 6 years old children from kindergarten in Guangzhou,including General Situation Questionnaire,the Strengths and Difficulties Questionnaire(parent version) and 3-7 years old children Behavioral Style Questionnaire.The data were collected at baseline and 1 year follow-up,and were analyzed by the prospective study method.Results Baseline survey 733 valid questionnaires,551 questionnaires were followed up (follow-up rate was 75.2％),the effective questionnaires were 526 (effective rate was 95.5％).The detection rate of behavior problem reduced by age (t =1.975,P =0.049),especially in the kind problem of conduct (t =2.888,P =0.004),friendship (t =2.572,P =0.010) and prosocial behavior(t =-3.329,P =0.001).In the mean time,the degree of cutting down in girls was more obvious than in boys (t =2.359,P =0.019).The influential factors include mother'age,parental education level,structure of family and children' temperament.Children's gender and whether the only child has no significant effect on behavior problems,and the family income only affects the change of behavior problems.Conclusions The detection rate of behavior problem reduce by age and influenced by many factors.Intervention measures must be synthetically considered various related factors.