Objective: To analyze the association between intraoperative blood transfusion and adverse perinatal outcomes(a composite of maternal death, hepatic encephalopathy, etc) in patients with acute fatty liver of pregnancy (AFLP), identify independent risk factors for these outcomes, and develop and validate a risk prediction model for early identification of high-risk patients. Methods: Clinical data of 56 AFLP patients admitted to our hospital from January 2008 to January 2025 were retrospectively analyzed. The chi-square test was used to compare the incidence of adverse perinatal outcomes between the transfusion group and the non-transfusion group. Univariate and multivariate Firth-penalized logistic regression analyses were performed to identify independent predictors of adverse outcomes. Based on the identified independent risk factors, a combined prediction model was developed. Internal validation was performed using the Bootstrap method (1 000 resamplings) to assess the model′s generalizability. Model performance was evaluated using receiver operating characteristic(ROC) curves and calibration curves. Finally, a nomogram for predicting adverse perinatal outcomes in AFLP was constructed. Results: Overall, 57.1%(32/56) of the patients received blood product transfusion during the termination of pregnancy. Multivariate Firth-penalized logistic regression analysis showed that, given the limited sample size, intraoperative blood transfusion had no independent statistical effect on adverse outcomes (OR=0.812, 95%CI:0.133-3.698, P=0.797). Mediation analysis also revealed no significant indirect effect. The independent risk factors were decreased preoperative fibrinogen (OR=14.062, 95%CI:2.389-126.656, P=0.003), pregnancy with infection (OR= 4.536, 95%CI:1.143-22.107, P=0.031), and cesarean section (OR=8.691, 95%CI:1.321-90.081, P=0.023). The combined prediction model achieved an AUC of 0.881 (95% CI:0.793-0.969, P<0.001), indicating good discrimination. At the optimal cut-off value, the sensitivity was 65.6%, specificity 95.8%, positive predictive value 95.5%, and negative predictive value 67.6%. Internal validation by the Bootstrap method showed that the predictive model had good discrimination and no obvious overfitting. The calibration curve demonstrated that the model′s predicted risk was consistent with the actual observed risk. Based on this, an AFLP perinatal adverse outcome nomogram model was constructed. Conclusion: Under the limited sample size of this study, no independent statistical effect of intraoperative blood product infusion on adverse perinatal outcomes in AFLP patients was detected. A multivariate Firth-penalized logistic regression model incorporating decreased preoperative fibrinogen, pregnancy with infection, and cesarean delivery demonstrated good discrimination and calibration. The derived nomogram may serve as an exploratory tool for early risk stratification and proactive intervention.

Objective To investigate the relationship between the onset of cerebral infarction in anterior and posterior circulation and the "three high" risk factors in Guangzhou communities. Methods From Jan. 2014 to Jan.2016,367 patients from Guangzhou communities were diagnosed with new cerebral infarction by head diffu-sion weighted imaging(DWI).The data were divided into two groups of anterior and posterior circulation,and uni-variate and multivariate methods were used to analyze the relationship between the "three high" and other risk factors and the onset of cerebral infarction in anterior and posterior circulation.The data of anterior circulation cere-bral infarction were further divided into two subgroups of lacunar and non-lacunar infarction,and the same statisti-cal methods were employed to analyze differences of risk factors between the two subgroups. Results The frequen-cies of hypertension(P = 0.040)and large atherosclerotic infarction(P = 0.012)were significantly higher,and the serum high-density lipoprotein(HDL)level(P = 0.045)was significantly lower in posterior circulation than those in anterior circulation,respectively;and the onset of posterior circulation cerebral infarction was more associ-ated with the incidence of hypertension(OR = 1.767,P = 0.035)and the decrease of HDL(OR = 0.380,P =0.021). In anterior circulation,the levels of systolic blood pressure(SBP)(P = 0.011)and diastolic blood pres-sure(DBP)(P=0.000),as well as the frequency of large atherosclerotic infarction(P=0.000)in non-lacunar infarction subgroup were significantly higher than those in lacunar infarction subgroup respectively,and the onset of non-lacunar infarction was more closely related to increased SBP levels(OR=1.045,P=0.001). Conclusions Among the"three high"risk factors,the onset of posterior circulation cerebral infarction is more closely related to the incidence of hypertension and the decrease of HDL.In anterior circulation,and the onset of non-lacunar infarc-tion is more closely related to the increased levels of DBP and SBP,especially to the elevated levels of SBP.

[Objective]To repair segmental bone defect with the composite of deproteinised cancellous bone,bone morphogenetic protein(BMP) and fibrin.[Method] Bone defects were created in 36 New Zealand rabbits on the bilateral radii and treated with three kinds of implantations:A,composite of deproteinised cancellous bone,BMP and fibrin;B,of deproteinised cancellous bone;C,blank control.The defects were observed by entgenography,optical microscopy,and electron-microscopy at 2,4,8,12,16 weeks.[Result] The defects treated with A implantation regenerated much more new bone and bridged earlier than the defects treated with B implantation and got completely repaired 16 weeks after operation.The defects with B and C implantation couldn't get osseous tissue healing.[Conclusion]The composite of deproteinised cancellous bone,bone morphogenetic protein(BMP) and fibrin can be effectively used to repair segmental bone defect.

Objective To investigate the regulation of gene variation and explore the tumor associated suppressor genes on chromosome 9 during the developing of cervical squamous cell carcinoma. Methods Microdissection, PCR, electrophoresis and radiograph were selected to detect the LOH in 46 cases cervical squamous cell carcinoma with high-grade squamous dysplasia and normal tissue. The changes of LOH at chromosome 9 total seven microsatellite markers and relationship between LOH rate and clinical parameters were analysed. Results Total frequency of LOH in CIN (Ⅱ,Ⅲ) was 16 % and in cervical squamous cell carcinoma was 25 %. In the former, LOH at marker D9S171(30 %), D9S162(23 %), D9S43(20 %), D9S303(17 %), D9S753(12 %), D9S242(11 %) were found, whereas D9S1748 LOH was not detected in high-grade dysplasia. In the latter, LOH at marker D9S171(41 %), D9S43(33 %), D9S162(31 %), D9S242(24 %), D9S303(17 %), D9S753(17 %), D9S1748 13 % were found. In addition, LOH was found in high-grade dysplasia in three cases but not in cervical squamous cell carcinoma. Conclusions The study in seven microsatellite markers showed that from normal squamous tissue to dysplasia to cervical squamous cell carcinoma were accompanied with accumulation of gene errors. The p15 gene inactivation had a high relationship with the occur of cervical squamous cell carcinoma. Tumor suppressor genes associated with cervical squamous cell carcinoma may exist near or at D9S43, D9S162, D9S242. Some cases showed that high-grade dysplasia and cervical squamous cell carcinoma may came from different independent clone which provide some clue for multiple foci carcinoma at genetic level.