OBJECTIVE To explore the efficacy of platelet-rich plasma （PRP） intrauterine infusion combined with Gushen antai pills in the treatment of recurrent abortion （RSA） and its impacts on endometrial receptivity and hormone levels in patients. METHODS A total of 108 patients with RSA treated in our hospital from January 2021 to January 2024 were selected and evenly divided into control group and study group using the random number table method， with 54 cases in each group. On the basis of conventional treatment， patients in the control group were administered with Gushen antai pills， while patients in the study group received PRP intrauterine infusion combined with Gushen antai pills. The clinical efficacy， TCM syndrome scores before and after treatment， endometrial receptivity [endometrial thickness （EST）， spiral artery resistance index （RI）， and pulsatility index （PI）]， hormone [progesterone （P）， estradiol （E2）， and human chorionic gonadotropin （HCG）] levels， as well as pregnancy outcomes， were compared between the two groups. Additionally， the occurrence of adverse reactions in both groups was recorded. RESULTS The total effective rate （91.44% vs. 81.48%） and infant live birth rate （96.30% vs. 83.33%） of the study group were significantly higher than those of the control group （P＜0.05）. Following treatment， various TCM syndrome scores and total score， spiral artery RI and PI levels in both groups were markedly lower than those in the same groups before treatment， with the study group showing significantly lower levels than the control group（P＜0.05）. Conversely， the P， E2， HCG and EST levels in both groups were significantly higher than those in the same groups before treatment， and the study group exhibited notably higher levels than the control group （P＜0.05）. There was no statistically significant difference in the total incidence of adverse reactions between the two groups （P＞0.05）. CONCLUSIONS PRP intrauterine infusion combined with Gushen antai pills has good clinical efficacy in the treatment of RSA. It can improve TCM syndromes， enhance endometrial receptivity， regulate hormone levels and improve pregnancy outcomes， and it is highly safe.

Objective:To investigate the molecular features of hand, foot and mouth disease (HFMD) caused by coxsackievirus A10 (CVA10) in Qingdao and analyze the clinical features of mild and severe cases.Methods:A total of 6 677 cases of HFMD routinely monitored by Qingdao Women and Children Hospital from 2014 to 2021 were enrolled. Throat swab samples were collected. Clinical data of these cases were retrospectively analyzed. Virus nucleic acid was extracted from the samples and the serotypes of enteroviruses were identified. The VP1 genes of CVA10 strains were amplified and sequenced. A phylogenetic tree based on the VP1 gene sequences was constructed using MEGA7. 0 software. SPSS23.0 software was used for statistical analysis.Results:There were 285 cases positive for CVA10, including 183 males and 102 females, and children under five years old accounted for 89.8%. Most of CVA10 infection occurred between the months of April to September. The count of white blood cells, the percentage of neutrophils, the concentration of hemoglobin, and the levels of aspartate aminotransferase and alanine transaminase were significantly higher in severe patients than in mild patients. Besides, chest radiography and brain CT revealed more abnormalities in severe patients, and the duration of ECG monitoring was longer in them. Compared with mild cases, severe cases developed rash early than fever with rash mostly on buttocks ( P<0.05). Phylogenetic analysis showed that most of the CVA10 strains circulating in Qingdao between 2014 and 2021 belonged to clade Ⅰ, and there were two variations A23V and I283V in the amino acid sequence of clade Ⅰ. Conclusions:This study showed that children of all ages were susceptible to CVA10, especially those under five years old. CVA10 showed complex and diverse epidemic trends in different regions and years.

Objective:To learn about the arsenic status of drinking water in Urumqi City and evaluate its health risk, so as to provide scientific basis for the construction of water improvement projects in Urumqi City.Methods:From 2018 to 2020, 687 water samples were collected at monitoring sites in 7 districts and 1 county of Urumqi City for three consecutive years, and arsenic in drinking water was detected according to "Standard Examination Methods for Drinking Water - Nonmetal Parameters" (GB/T 5750.5-2006), and the arsenic in drinking water was evaluated according to "Standards for Drinking Water" (GB/T 5749-2006). The health risk of arsenic in drinking water in Urumqi City was evaluated by using the health risk assessment model recommended by United States Environmental Protection Agency (USEPA).Results:All of 687 water samples were centralized water supply, the arsenic compliance rates in dry season ( n = 342) and wet season ( n = 345), surface water ( n = 414) and underground water ( n = 273) were 100.0%. In dry season, the carcinogenic risk of arsenic via drinking water was 8.24 × 10 -6/a. In wet season, the carcinogenic risk of arsenic via drinking water was 3.30 × 10 -6/a. Conclusions:Remarkable achievements have been made in the construction of water improvement projects in Urumqi City, and the drinking water arsenic condition is good, the health risk of arsenic via drinking water is small. In the future, we should continue to strengthen the monitoring of drinking water quality, promote the construction of water improvement projects, further improve the drinking water sanitation, and put forward targeted prevention and control measures to ensure drinking water safety.

Objective:To analyze the clinical outcome of vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) in infertile patients with polycystic ovary syndrome (PCOS) combined with insulin resistance (IR) .Methods:A total of 257 PCOS infertile patients undergoing IVF/ICSI-ET from Jan. 2018 to Dec. 2020 were included and retrospectively analyzed. The patients were divided into IR group (HOMA-IR≥2.5, 130 cases) and non-IR group (HOMA-IR<2.5, 127 cases) according to the level (median 2.5) of homeostasis model assessment of insulin resistance index (HOMA-IR) . The levels of basic sex hormones [follicular stimulating hormone (FSH) , luteinizing hormone (LH) , estradiol (E2) , testosterone (T) , progestational hormone (P) , anti-mullerian hormone (AMH) ] and numbers of basic sinus follicles, levels of blood glucose and insulin at 30min, 60min and 120min after glucose administration and fasting and proconceptive pregnancy outcome indicators[gonadotropin (Gn) use time and dose, number of eggs obtained, fertilization rate, high-quality embryonic rate, occurrence rate of ovarian hyperstimulation syndrome (OHSS) , implantation rate, clinical pregnancy rate, biochemical pregnancy rate, abortion rate, live birth rate and pregnancy complications] were compared between the two groups. The influencing factors of clinical outcomes were analyzed by Logistic regression.Results:The levels of basic LH [ (8.86±1.60) mIU/ml vs (6.54±1.12) mIU/ml], T[ (63.20±7.47) ng/dl vs (52.11±5.69) ng/dl] in IR group was significantly higher than those in non-IR group ( P<0.05) . At different time-point, the levels of blood glucose and insulin in IR group were significantly higher than those in non-IR group ( P<0.05) . The Gn dose [ (1947.35±129.13) IU vs (1522.70±88.41) IU] and abortion rate [32.69% (17/52) vs 13.70% (10/73) ] in IR group was significantly higher than those in non-IR group ( P<0.05) , and the clinical pregnancy rate [40.00% (52/130) vs 57.48% (73/127) ] and live birth rate [51.92% (27/52) vs 72.60% (53/73) ] was significantly lower than those in non-IR group ( P<0.05) . Logistic regression analysis showed that age, BMI, basic LH, basic T and HOMA-IR was independent risk factors for clinical outcome of IVF/ICSI-ET in infertility patients with PCOS ( P<0.05) , and basic AMH and Gn dose were protective factors for clinical outcome ( P<0.05) . Conclusion:IR negatively affects the clinical outcome of IVF/ICSI-ET in infertile patients with PCOS, HOMA-IR is a risk factor for clinical outcomes, and IR should be evaluated in time for infertile patients with PCOS.

Objective:To investigate the molecular mechanism of the disease based on the clinical characterization and genetic mutation analysis in a family with intellectual disability.Methods:The proband with intellectual disability was diagnosed at Luohe Central Hospital in December 2019. Peripheral blood samples were collected from four family members. Whole exome sequencing (WES) was used to screen the pathological mutations. Then the PCR and Sanger sequencing were used to verify the selected mutations and combine the relevant database to analyze variation loci.Results:We infer that the ARX c.1162 A>G was co-segregated with the phenotype of the family based on the results of WES. The results of sanger sequencing and WES are consistent. The mother of the proband is the carrier of the mutation. There is no mutation frequency reported in the healthy population. The mutation of the ARX c.1162A>G is harmful inferred by a variety of bioinformatics software. Combined with the phenotypic analysis of OMIM database, we infer the phenotype caused by the mutation is consistent with the patients in the family.Conclusion:The mutation of the ARX c.1162 A>G may be the cause of the intellectual disability in the family affected. And the variant has not been reported in China.

Objective To investigate the effect of preoperative percutaneous dilatational trache-otomy (PDT)in oral and maxillofacial surgery anesthesia versus traditional surgical tracheotomy (ST).Methods General data,vital signs,operation time,anesthetics,the amount of bleeding and complications during the procedure were analyzed after reviewing the clinical data of 124 cases under-going radical correction of oral and maxillofacial tumor plus flap transferring and repairing and trache-otomy during May 2013 to May 201 5.Results A total of 124 cases were divided into two groups:PDT group (group P,n =41)and ST group (group S,n =83).There was no significant difference of general data between the two groups.The incision length and operation time were significantly shorter and the amount of bleeding was remarkably lower in group P than those in group S (P <0.05),while the incidence of complications was not significantly different between the two groups.Conclusion PDT has more advantages over traditional ST and is a better airway approach in oral and maxillofacial surgery.

Objective:To observe the clinical effects of dexmedetomidine(DDM)under monitored anesthesia care(MAC)in oral and maxillofacial patients undergoing percutaneous dilatational tracheostomy(PDT).Methods:38 patients with oral and maxillofa-cial tumor undergoing PDT before surgery were randomly assigned into 2 groups(n =19).Patients in group D received a single-dose DDMof 0.5 μg/kg infused for 10 min;those in group Mreceived 2 mg of midazolam and 1 μg/kg of fentanil.Then all patients were given local anesthesia followed by PDT.MAP,HR and SpO2 were monitored before (T0 )and after drug administration (T1 ),at T2 (skin incision)and T3 (insert dilation catheter).Ramsay scorce,bucking,respiration depression and adverse cardiovascular reaction were recorded.All patients were followed up 24 h postoperatively for the observation of adverse recall of PDT.Results:Compared with T0 ,at T1 ,T2 MAP and HR in group D were lower,but MAP and HR at T3 in group Mwere higher(P <0.05).At T1 ,T2 and T3 ,MAP and HR in group D were significantly lower than those in group M(P <0.05).During operation,the incidence of bucking and respiration depression in group D was lower than that in group M(P <0.05).Conclusion:During PDT operation under MAC,a single-dose dexmedetomidine is effective in stablizing hemodynamics,reducing bucking and respiration depression.

Compared with the transgenic approach, transient assays provide a convenient alternative to analyze gene expression. To analyze the relationship between miRNAs and their target genes, a rice protoplast system to detect target gene activity was established. The MIRNA and GFP-fused target sequence (or GFP-fused mutated sequence as a non-target control) were constructed into the same plasmid, and then delivered into rice protoplasts. The GFP expression level decreased significantly when the protoplasts were transfected with the plasmid containing GFP-fused target compared to that of the plasmid with non-target sequence either by fluorescence microscopy or qRT-PCR method. Two microRNA genes, osaMIR156 and osaMIR397, and their target sequences were used to prove the feasibility of the rice protoplast transient assay system. This method will facilitate large-scale screening of rice miRNA target in vivo, and may be suitable for functional analysis of miRNAs of other monocot plants that might share the evolutionarily conserved small RNA processing system with rice.
Gene Targeting ; Green Fluorescent Proteins ; genetics ; MicroRNAs ; genetics ; Oryza ; genetics ; Plasmids ; Protoplasts ; metabolism ; RNA, Plant ; genetics ; Transfection

Objective To assess the feasibility,safety and efficacy of endoscopic papillectomy (EP) for tumors at the ampulla of Vater (AV).Methods A total of 15 patients with tumor at AV that were indicated for EP were included in this prospective study.Their clinical profiles,procedural parameters and outcome were evaluated.Results All patients underwent EP procedure successfully.Four patients who were diagnosed as having chronic inflammation in the reference endoscopy were confirmed as having adenoma after EP.Out of the 11 patients who were previously diagnosed as andenoma on biopsy,2 of low differentiated adenocarcinoma,1 of well differentiated adenocarcinoma and 1 malignant transformation were pathologically confirmed after EP.Stents were implanted in 8 patients with dilated pancreatic and/or common bile duct.Except for 2 cases of melena and 2 transient elevated level of blood amylase after EP,no other major complications occurred.Three patients,including 1 case of low-differentiated adenocarcinoma,1 case of malignant transformation and 1 case of lesion residual,were referred to surgery,another patient with low-differentiated adenocarcinoma declined any additional intervention because of old age.In the remaining 11 cases ( 11/15,73.3％ ) including one well differentiated adenocarcinoma,no recurrence was observed during a follow-up period of 23.4 (5 to 47) months.Conclusion EP is a minimal invasive,safe and effective treatment for tumors at AV,which also can provide an accurate staging of the lesion.

OBJECTIVETo investigate the changes in hemodynamics and depth of anesthesia under monitored anesthesia care (MAC) in patients undergoing percutaneous dilatational tracheostomy (PDT).

METHODSForty-six patients with oral cancer were divided into two groups with 23 cases each: Local anesthesia group (group L) and MAC group (group M). Local and intratracheal surface anesthesia were performed with 2% lidocaine in group L. Midazolam, propofol and fentanyl were added to group M after local and intratracheal surface anesthesia, then PDT was carried out. During the induction, observer's assessment of alertness/sedation(OAA/S) scale was used to assess the depth of sedation. Mean arterial blood pressure (MAP), heart rate (HR), state entropy (SE) and response entropy (RE) were recorded before anesthesia (basal value, T1), after local anesthesia (T2), after intravenous administration/before incision (T3), during incision (T4), during dilating with stretching pliers (T5) and endotracheal intubation (T6). A postoperative follow-up was taken in group M.

RESULTSMAP and HR increased significantly at T4-T6 in group L and decreased at T3 (P < 0.05) with no change at T4-T6 in group M compared with those in T1. MAP and HR at T3-T6 in group M were obviously lower than those in group L. SE and RE at T3-T6 in group M were obviously lower than those at T1 or in group L (P < 0.01) and decreased significantly with the reduction of OAA/S scale (P < 0.05) during the induction. Intraoperative awareness in group M was not found through postoperative follow-up.

CONCLUSIONPatients undergoing PDT under MAC has more comfortability, more stable hemodynamics and no memory, so MAC is a better anesthesia for PDT than local anesthesia.