Objective To explore the relationship between serum levels of anterior gradient 2(AGR2)and trimethylamine N-oxide(TMAO)and gut microbiota in children with inflammatory bowel disease(IBD).Methods A total of 145 IBD children were selected as the observation group,and children were divided into the ulcerative colitis group(64 cases)and the Crohn's disease group(81 cases)according to the disease type.Meanwhile,140 healthy children underwent physical examination in our hospital were included as the control group.Serum AGR2 and TMAO levels were detected by enzyme-linked immunosorbent assay(ELISA).The disease activity of ulcerative colitis and Crohn's disease were evaluated using the modified Mayo score and the Crohn's Disease Activity Index(CDAI)score,and patients were divided into the active group(75 cases)and the remission group(70 cases)according to the disease activity.Fecal samples were collected for identification and count of intestinal flora.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum AGR2 and TMAO levels in ulcerative colitis and Crohn's disease.The correlation between serum AGR2 and TMAO levels and intestinal flora was analyzed by Pearson test.Logistic regression was used to analyze the relationship between serum AGR2 and TMAO levels and the disease stage of children with IBD.Results The serum AGR2 level was lower in the ulcerative colitis group and the Crohn's disease group than that in the control group,and the serum TMAO level was higher than that in the control group(P＜0.05).The areas under the curve(AUC)of serum AGR2 and TMAO levels were 0.835,0.836 and 0.896 for diagnosis of ulcerative colitis alone and 0.859,0.864 and 0.964 for diagnosis of Crohn's disease.The serum AGR2 level and numbers of lactobacillus and bifidobacterium were significantly lower in the active group than those in the remission group,and the serum TMAO level and numbers of Escherichia coli,enterococcus,Helicobacter pylori and streptococcus were significantly higher in the active group than those in the remission group(P＜0.05).Serum AGR2 levels in IBD children were positively correlated with numbers of lactobacillus and bifidobacterium,and negatively correlated with numbers of Escherichia coli,Enterococcus,Helicobacter pylori and streptococcus(P＜0.05).Serum TMAO level was negatively correlated with numbers of lactobacillus and bifidobacterium,and positively correlated with numbers of Escherichia coli,Enterococcus,Helicobacter pylori and streptococcus(P＜0.05).The decreased serum AGR2 level and the increased TMAO level were risk factors for the disease progression to active stage in children with IBD(P＜0.05).Conclusion The combination of serum AGR2 and TMAO can effectively diagnose ulcerative colitis and Crohn's disease,and it is more valuable in the diagnosis of Crohn's disease.Abnormal expression of both may participate in the progression of IBD disease by affecting changes in gut microbiota structure.

Objective To explore the relationship between serum levels of anterior gradient 2(AGR2)and trimethylamine N-oxide(TMAO)and gut microbiota in children with inflammatory bowel disease(IBD).Methods A total of 145 IBD children were selected as the observation group,and children were divided into the ulcerative colitis group(64 cases)and the Crohn's disease group(81 cases)according to the disease type.Meanwhile,140 healthy children underwent physical examination in our hospital were included as the control group.Serum AGR2 and TMAO levels were detected by enzyme-linked immunosorbent assay(ELISA).The disease activity of ulcerative colitis and Crohn's disease were evaluated using the modified Mayo score and the Crohn's Disease Activity Index(CDAI)score,and patients were divided into the active group(75 cases)and the remission group(70 cases)according to the disease activity.Fecal samples were collected for identification and count of intestinal flora.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum AGR2 and TMAO levels in ulcerative colitis and Crohn's disease.The correlation between serum AGR2 and TMAO levels and intestinal flora was analyzed by Pearson test.Logistic regression was used to analyze the relationship between serum AGR2 and TMAO levels and the disease stage of children with IBD.Results The serum AGR2 level was lower in the ulcerative colitis group and the Crohn's disease group than that in the control group,and the serum TMAO level was higher than that in the control group(P＜0.05).The areas under the curve(AUC)of serum AGR2 and TMAO levels were 0.835,0.836 and 0.896 for diagnosis of ulcerative colitis alone and 0.859,0.864 and 0.964 for diagnosis of Crohn's disease.The serum AGR2 level and numbers of lactobacillus and bifidobacterium were significantly lower in the active group than those in the remission group,and the serum TMAO level and numbers of Escherichia coli,enterococcus,Helicobacter pylori and streptococcus were significantly higher in the active group than those in the remission group(P＜0.05).Serum AGR2 levels in IBD children were positively correlated with numbers of lactobacillus and bifidobacterium,and negatively correlated with numbers of Escherichia coli,Enterococcus,Helicobacter pylori and streptococcus(P＜0.05).Serum TMAO level was negatively correlated with numbers of lactobacillus and bifidobacterium,and positively correlated with numbers of Escherichia coli,Enterococcus,Helicobacter pylori and streptococcus(P＜0.05).The decreased serum AGR2 level and the increased TMAO level were risk factors for the disease progression to active stage in children with IBD(P＜0.05).Conclusion The combination of serum AGR2 and TMAO can effectively diagnose ulcerative colitis and Crohn's disease,and it is more valuable in the diagnosis of Crohn's disease.Abnormal expression of both may participate in the progression of IBD disease by affecting changes in gut microbiota structure.

Objective:To explore the difference of high-risk factors between early-onset and late-onset pre-eclampsia, and to further understand high-risk factors of pre-eclampsia.Methods:Clinical data of pre-eclampsia pregnant women in 160 medical institutions in China in 2018 were retrospectively analyzed, including 8 031 cases of early-onset pre-eclampsia and 12 969 cases of late-onset pre-eclampsia. The proportion of high-risk factors, different body mass index (BMI) and age stratification between early-onset group and late-onset group were compared.Results:(1) Univariate analysis of high-risk factors: the proportions of high-risk factors in early-onset group and late-onset group were compared, and the differences were statistically significant (all P<0.05). Among them, the proportions of primipara and multiple pregnancy in early-onset group were lower than those in late-onset group, while the proportions of pregnant women with advanced age, irregular antenatal examination, obesity, family history of hypertension, pre-eclampsia, diabetes, kidney diseases, immune system diseases and assisted reproductive technology were higher than those in late-onset group. (2) Hierarchical analysis of BMI: the proportion of pregnant women with BMI≥24 kg/m 2 in early-onset group [48.2% (2 828/5 872) vs 45.5% (4 177/9 181), respectively; P=0.001] and the proportion of pregnant women with BMI ≥28 kg/m 2 in early-onset group [19.5% (1 143/5 872) vs 18.0% (1 656/9 181), respectively; P=0.028] were significantly higher than those in late-onset group. (3) Age stratification analysis: the proportion of pregnant women aged 35-39 years in the early-onset group [21.8% (1 748/8 023) vs 17.5% (2 110/12 068), respectively; P<0.01], the proportion of pregnant women 40-44 years old [6.8% (544/8 023) vs 5.4% (648/12 068), respectively; P<0.01], and the proportion of pregnant women ≥45 years old [0.7% (58/8 023) vs 0.5% (57/12 068), respectively; P=0.021] were significantly higher than those in the late-onset group. (4) Multivariate analysis: advanced age (≥35 years old), multiple pregnancy, irregular antenatal examination or transfer from other hospitals, family history of hypertension (including paternal, maternal and parental lines), previous history of pre-eclampsia, kidney diseases, immune system diseases (systemic lupus erythematosus, antiphospholipid antibody syndrome) and assisted reproductive technology pregnancy were the risk factors affecting the severity of pre-eclampsia (all P<0.05). Conclusion:Pregnant women with high risk factors such as age ≥35 years old, BMI ≥24 kg/m 2 before pregnancy, family history of hypertension, history of pre-eclampsia, chronic kidney diseases, immune diseases (mainly including systemic lupus erythematosus and antiphospholipid syndrome) and assisted reproductive technology are more likely to have early-onset pre-eclampsia.

Objective:To investigate the effect of jugular tubercle thickness on pathogenesis of hemifacial spasm (HFS) and its curative efficacy by microvascular decompression (MVD).Methods:One hundred and thirty-five HFS patients accepted MVD in our hospital from June 2017 to May 2018 were enrolled in this study. The thickness of the jugular tubercle was measured on preoperative magnetic resonance imaging (MRI) with steady state acquisition (FIESTA) sequence. The differences of jugular tubercle thickness and arterial flow rate from the jugular tubercle to the brainstem between the healthy side and symptomatic side in these patients were compared. These patients were divided into immediate symptom-relief group ( n=112) and symptom residual group ( n=23) according to the symptom relief one d after MVD; the difference of jugular tubercle thickness between the two groups were compared. Results:No significant difference in the jugular tubercle thickness was noted between the healthy side and the symptomatic side in all 135 patients ( t=0.787, P=0.432). The arterial flow rate from the jugular tubercle to the brainstem in the symptomatic side (95.6%) was significantly higher than that in the healthy side (57.0%, P<0.05). The jugular tubercle thickness in the symptomatic residual group ([5.13±2.19] mm) was significantly higher than that in the immediate symptom-relief group ([4.03±1.16] mm, t=2.114, P=0.0396). Conclusion:The thickness of jugular tubercle is not associated with HFS onset, but may affect the immediate outcome of MVD.

Objective To explore the main problems of ultrasonic quality management in Qinghai Province.Methods The ultrasound departments of 19 tertiary hospitals and 51 secondary hospitals in Qinghai Province were investigated.The x2 test was carried out to analyze the setting of departments,subspecialty,instrument status,ultrasonic quality control,workload,and personnel specialty and educational composition ratio.Results There was a statistically significant difference between tertiary and secondary hospitals in department settings,sub-specialty,instrument status,ultrasound quality control,workload,personnel specialty,and personnel qualifications (x2=30.49,38.208,36.87,7.913,28.518,7.111 and 322.363,respectively,P ＜ 0.01 for all).Conclusions The above-mentioned observation indexes are better in the 19 tertiary hospitals than in the 51 secondary hospitals in Qinghai Province.Strengthening construction from these aspects and improving ultrasound quality control management play an important role in improving the level of ultrasound diagnosis and promoting the homogeneity of ultrasound diagnosis.

Purpose To investigate the clinicopathologic characteristics, differential diagnosis, treatment and prognosis of differentia-ted-type vulvar intraepithelial neoplasia ( dVIN) . Methods Clinicopathologic findings and immunophenotypes of 6 cases diagnosed as“dVIN” were retrospectively analyzed, and the relevant literatures were also reviewed. Results 6 patients were all female ranged 53~80 years old with mean age of 62 years old. Clinical aspects included leukoplakia vulvar, pruitis, irritation, pain, ulcer and so on. The histopathological features were hyperplasia of basal and parabasal layer with elongation and anastomosing reteridges. Cells were marked atypia with obvious nucleoli, atypical mitosis, and dyskeratosis. In the middle and surface layer, cells were well differentiated with pronounced intercellular bridges, and eosinophilic cytoplasm, hyperkeratosis and parakeratosis. Oedema and band of infiltration of chronic inflammatory cells of subepidermal could been seen. Immuohistochemistry showed the expression rates of p53 and p16 in totally 6 cases were 83. 3% (5/6), 0 (0/6), respectively. The Ki-67 index was more than 90% in basal and parabasal cells. Four patients were followed up ( mean follow-up 17 months, range 6~36 months) , one patient died at 9 months later after surgery, another patient recurred at 6 months later after surgery, both of the 2 cases were all with invasive lesions after resection, and the rest two cases had no recur in 18 months and 36 months after surgery, respectively. Conclusion dVIN is a high grade squamous intraepithelial lesions of vulvar with low incidence rate, but had more risk of progression. p53, p16 and Ki-67 stain were useful in the diagnosis of dVIN.

Objective To investigate the correlation between antiphospholipid antibody syndrome and the early onset of preeclampsia. Methods From May 2010 to July 2013, one hundred and threecases in-patient treatment of the early onset preeclampsia were enrolled in this study. The maternal serum anticardiolipin antibodies(ACA)and anti-β2-glycoproteinⅠantibody (Aβ2-GPⅠ) were detected by ELISA method. 58 cases of pregnant women were randomly divided into the routine treatment group (30 cases) and the anticoagulant therapy group (28 cases). Results ACA positive predictive value of the early onset preeclampsia value was 3.9%. No significant difference was found in the prolonged anticoagulation of early onset preeclampsia time between the control group and the treatment group. Conclusion ACA may not be used to predict the early onset preeclampsia. Anticoagulation therapy can′t extend the early onset preeclampsia time and improve the outcome of pregnancy.

Objective To investigate the effect of Aidi injection combined with chemotherapy on CD+4CDhi25CDlow127regulatory T (Treg) cells in peripheral blood of advanced non-small-cell lung cancer (NSCLC).Methods Sixty patients with advanced NSCLC were randomly divided into the study group (treated with Aidi injection combined with chemotherapy) and the control group (treated with chemotherapy).The levels of CD+4CDhi25CDlow127Treg cells were detected by flow cytometry (FCM), and TGF-β1 and IL-10 levels were determined by enzyme linked immunosorbent assay (ELISA) before and after chemotherapy. A group consisted of 20 healthy persons was set up meanwhile.Results There was a significantly higher percentage of CD+4CDhi25CDlow127Treg cells in patients with NSCLC (5.77±1.50) % than that(3.84±0.96) % of healthy volunteers (P=0.000).The IL-10 and TGF-β1 levels[(24.09±6.74), (197.76±43.76) ng/ml]in the serum of patients with NSCLC were also significantly higher than that[(19.39±5.73), (141.13±32.17) ng/ml]of healthy volunteers (P =0.006,P =0.002). In control group, levels of CD+4CDhi25CDlow127 Treg cells were obviously lower than that before chemotherapy (P =0.048).Levels of TGF-β1 and IL-10[(22.25±6.79), (184.85±49.11) ng/ml]were slightly decreased, which showed no significant difference contrast to pretherapy[(24.37±8.10), (197.16±44.57) ng/ml](P =0.276, P =0.314).In study group, levels of CD+4CDhi25CDlow127Treg cells and TGF-β1, IL-10[(4.36±1.19) %,(20.16±4.73), (165.42±39.57) ng/ml]were obviously lower than that before chemotherapy[(5.78±1.50) %,(23.81±5.15), (198.35±43.68) ng/ml](P=0.000, P=0.003, P =0.006).Conclusion The CD+4CDhi25CDlow127 Treg cells in the peripheral blood of advanced NSCLC patients is significantly increased. Aidi injection combined with chemotherapy can obviously reduce the level of CD+4CDhi25CDlow127 Treg cells in patients with advanced NSCLC, and the combined therapy could improve the immune function of patients.

Objective To analyse the dysfunction of immunity and clinical significance in patients with cardiac cancer.Methods The level of CD4+ CD25hi CD127low Treg cells were detected by flow cytometry (FCM),and serum IL-10 and TGF-β1 levels were determined by enzyme linked immunosorbent assay (ELISA) kit in 56 patients with cardiac cancer.15 healthy volunteers were tested as normal controls.The clinical data of each patient were collected and analyzed. Results There was a significantly higher percentage of CD4+ CD25hi CD127low Treg cells in patients with cardiac cancer (5.73±1.56)% than that (4.45±1.06)% of healthy volunteers (P<0.01).The IL-10 and TGF-β1 levels in the serum of patients with cardiac cancer were also significantly higher than that of healthy volunteers (P<0.05).There was a positive correlation between levels of IL-10.TGF-β1 and the levels of CD4+ CD25hi CD127low Treg cells.The number of CD4+ CD25hi CD127low regulatory T cells in the peripheral blood of cardiac cancer patients were significantly correlated with clinical stages and metastasis lymph node.Conclusion The CD4+ CD25hi CD127low Treg cells in the peripheral blood of cardiac cancer patients is significantly increased in comparison with that in healthy volunteers,and was also correlated with different stages.The abnormal levels of CD4+ CD25hi CD127low Treg cells may be related to tumor progression in patients with cardiac cancer.

Objective To investigate the effect of 1,6-diphosphate(FDP)on neonatal hypoxic-ischemic encephalopathy(HIE)combined with myocardial damage.Methods 62 cases of HIE in newborn with myocardial damage were randomly divided into two groups:32 cases of the treatment group and 30 cases of the control group.Control group were giren conventional treatment and the treatment group were giren FDP 250mg /(kg?d)by intravenous drip for 10 days for 1 course of treatment.Each case was tested serum creatine kinase(CK)and isoenzyme(CK-MB)within hospitalization 12 hours and after treatment.The two groups were observed with clinical symptoms and signs disappeared,the ECG changes and CK,CK-MB changes.Results Clinical signs and symptoms of treatment group disappeared soon,and serum CK,CK-MB returned to normal rate is high compared with the control group significantly.Conclusion Exogenous FDP has a certain therapeutic effect on moderate to severe HIE with myocardial damage,contributes to recovery of heart and brain function.