Objective:To measure the morphological parameters of the fetal vertebral centrum ossification centers (COC) in the second-third trimester using MRI susceptibility weighted imaging (SWI), and to explore the growth and development trajectory of the vertebrae.Methods:Fetus in the second-third trimester with normal vertebrae development were prospectively and continuously included in Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2015 to December 2021, and the SWI scanning of fetal spine was performed. The following morphometric parameters of the C4, T6, L3, S1 vertebrae COC were measured, including sagittal diameter, transverse diameter, height, cross-sectional area and volume. The linear and nonlinear regression analysis was used to derive the best-fit curve for each parameters and gestational age.Results:A total of 112 fetuses were recruited with gestatonal age 21-39 (29.4±3.9) weeks, including 30 cases of C4, 58 cases of T6, 92 cases of L3, 62 cases of S1. Fetal spine in utero with global curvature was kyphosis, presenting two primary curves (thoracic and sacral kyphosis). The morphological parameters sagittal diameter, transverse diameter, height, cross-sectional area and volume of C4 followed the quadratic polynomial rule during 25 to 38 weeks (R 2=0.938, 0.943, 0.952, 0.957, 0.982). During 21 to 38 weeks, the sagittal diameter, transverse diameter and height of the T6 followed the exponential growth pattern (R 2=0.915, 0.923, 0.849) and the growth of the area and volume followed the quadratic polynomial growth pattern (R 2=0.943, 0.961). The L3 followed the quadratic polynomial rule during 21 to 39 weeks (R 2=0.910, 0.916, 0.914, 0.942, 0.948) The sagittal diameter, transverse diameter and height of the S1 followed the linear growth pattern (R 2=0.905, 0.911, 0.922) and the area and volume followed the quadratic polynomial growth pattern (R 2=0.930, 0.964) during 23 to 39 weeks. Conclusions:The growth and development of C4, T6, L3 and S1 COC of fetus in the second-third trimester has a good correlation with gestational age. The growth of fetal vertebral COC in the early stage is slow, but with the growth of gestational age, the growth rate of vertebral bodies accelerates.

Objective:To study the effect of cyclin Y (CCNY) on the lesion degree of patients with liver cancer and its correlation with preoperative and postoperative liver injury.Methods:The clinical data of 60 patients with liver cancer (liver cancer group) and 69 patients with liver cirrhosis (liver cirrhosis group) in Hangzhou Hospital of Zhejiang Medical and Health Group from January 2015 to October 2017 were retrospectively analyzed. In liver cirrhosis group, Child-Pugh liver function grade A was in 33 cases (liver cirrhosis grade A group), grade B was in 21 cases (liver cirrhosis grade B group), grade C was in 15 cases (liver cirrhosis grade C group). The serum total bilirubin (TBIL), alanine aminotransferase (ALT), albumin, cholinesterase, γ-glutamyl transpeptidase (GGT) and total bile acid were detected by automatic biochemical analyzer. The serum CCNY was detected by WB method, and compared with 40 healthy subjects (healthy control group).Results:Compared with those in healthy control group, the albumin and cholinesterase in liver cirrhosis grade A, B and C groups were significantly decreased, the ALT, TBIL, GGT, total bile acid and CCNY were significantly increased, , and the changes were more obvious with the severity of liver disease, and there were statistical differences ( P<0.05). Pearson correlation analysis result showed that the CCNY was positive correlation with TBIL, ALT, total bile acid and GGT in patients with liver cancer ( r = 0.544, 0.612, 0.553 and 0.539; P<0.05), and CCNY was negative correlation with albumin and cholinesterase ( r = - 0.478 and - 0.620, P<0.05). In patients with liver cancer, before operation and 1, 2 and 7 d after operation, the CCNY was 3.01 ± 1.10, 7.24 ± 2.57, 6.29 ± 1.78 and 4.01 ± 1.52, ALT was (98.74 ± 16.79), (430.55 ± 197.62), (255.73 ± 26.77) and (121.89 ± 20.42) U/L, respectively; the CCNY and ALT 1 and 2 d after operation were significantly higher than those before operation, those 2 d after operation were significantly lower than those 1 d after operation, those 7 d after operation were significantly lower than those 2 d after operation, and there were statistical differences ( P<0.05); there were no statistical difference between 7 d after operation and before operation ( P>0.05). The expression of CCNY before operation and 1 d, 2 d, 7 d after operation was positive correlation with ALT in patients with liver cancer ( r = 0.669, 0.821, 0.663 and 0.642; P<0.01). Conclusions:The more severe the degree of liver lesions in patients with liver cancer, the higher the serum CCNY, and the higher the expression of CCNY, the more severe the degree of liver injury in patients with liver cancer due to surgery, which is positively correlated with liver injury indexes.

Objective:To investigate the relationship between rs5896 polymorphism of prothrombin gene and renal calculi in the elderly patients.Methods:Ninety elderly patients with kidney stones admitted to Hangzhou Hospital of Zhejiang Medical and Health Group from January 2014 to December 2016 were selected as observation group, and another 80 healthy people during the same period were selected as control group.The prothrombin gene rs5896 polymorphism was detected by RT-PCR, and the differences between the two groups were compared.Results:The T frequency of rs5896 allele in the observation group (64.44%) was higher than that in the control group (46.25%) (χ 2=5.687), and the TT genotype (54.44%) was higher than that in the control group (38.75%) (χ 2=4.187, P<0.05). TT genotype (77.78%) at rs5896 locus was more than single stone (38.89%), and CC genotype (16.67%) was less than single stone (37.04%) (χ 2=13.171, 4.363, all P<0.05). The serum uric acid level of TT type[(434.21±78.13)μmol/L] was higher than that of CC+ CT type[(245.73±54.20)μmol/L] ( t=13.038, P<0.05). The serum creatinine, calcium, phosphorus and potassium levels of different genotypes had not statistically significant differents (all P>0.05). The urine level of uric acid in TT-type [(415.32±56.63)μmol/L] was higher than that in CC+ CT type [(267.31±67.18)μmol/L] ( t=11.343, P<0.05), but there were no statistically significant differences in the changes of calcium, phosphorus and potassium in different genotypes of urine (all P>0.05). Conclusion:The T gene frequency of prothrombin gene rs5896 is higher and TT genotype frequency is higher in elderly patients with renal calculi.It is suggested that T gene may be a susceptible gene and that this site may lead to renal calculi through uric acid metabolic disorder, which is worthy of clinical reference.

Objective: To establish the loop-mediated isothermal amplification (LAMP) method for detection of variola virus. Methods: One set of primers were designed for recognizing 5 distinct sequences on variola virus-specific gene HA. To optimize the reaction temperature and primers screening, and the sensitivity and specificity of this method for variola virus (VARV) detection were evaluated. Results: Rapid detection of variola virus by LAMP assay was completed within 60 min at 63 ℃. The sensitivity of LAMP with detection limits of 1 pg/μl was 10 times higher than that of PCR, that is, the LAMP sensitivity was 3.37×10⁵ copies/μl, and the PCR sensitivity was 3.37×10⁶ copies/μl. and the result of 2 kinds of other virus were negative, showing that it had a good specificity. Conclusions The method reported here demonstrates a potential and valuable means for detection of VARV. The LAMP assay is suitable for wide-area sample screening and on-site detection of variola virus in grassroots units, for on-site and primary quarantine, medical units for rapid diagnosis.

Objective To understand the comparability of the detection results of four items (ALT ,AST , GGT ,ALP) of liver enzymology in 11 clinical laboratories in Xinjiang Production and Construction Corps (XPCC) and offer reference for improving mutual recognition of the results .Methods Eleven clinical labora-tories of XPCC organized the result comparability tests of 4 items of liver enzymology twice in 2017 ,and the samples with 5 batches were completed in each comparability test .One set of detection system in each labora-tory was used as comparability system according to comparability scheme .The detection results were analyzed through Robust Z Score and the evaluation criterion was :|Z|≤2 "satisfied";2< |Z|<3"warning";|Z|≥3 "not satisfied".Results The detection results of all 10 batch samples in 4 clinical laboratories showed |Z|≤2 in 2 comparability tests .In the first comparability test ,the detection results of 5 batch samples for 4 items were |Z|≤2 in 5 laboratories .In the second comparability test ,the detection results of 5 batch samples for 4 i-tems were |Z|≤2 in 8 laboratories ,but the ALT results of 5 batch samples in 1 laboratory showed positive deviation(Z≥3)and the GGT results of 5 batch samples in the other laboratory showed negative deviation (Z≤ -3) .Conclusion The 11 clinical laboratories in XPCC should continuously improve quality management system and make sure that the mutual recognition of the detection results of 4 items of liver enzymology is effective .

Objective: To explore the clinical features, the serotype distribution and drug resistance of the isolates in patient with invasive pneumococcal disease (IPD). Methods: By retrieving the laboratory information system in 18 children′s hospitals from 2012 to 2017, the children with IPD were enrolled. Streptococcus pneumoniae (Spn) must be isolated from the sterile sites (blood, cerebrospinal fluid, hydrothorax and joint effusion etc.). The clinical characteristics, serotype, drug resistance, treatment and prognosis were reviewed and analyzed. According to the telephone follow up results, the patients were divided into death group and recovered group. The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis. Results: There were 1 138 children with IPD, including 684 male and 454 female. The proportion of male to female was 1.5∶1. The age ranged from one day to 16 years. The median age was 1 year 3 month. The majority was under 5 years of age (89.3%, n= 1 016), especially under 2 years of age (61.9%, n=704). In all cases, 88.2% (n=1 004) were community acquired infection. The infections included meningitis (n=446, 39.2%), pneumonia with bacteremia (n=339, 29.8%), and bacteremia without focus (n=232, 20.4%). Underlying diseases were found in 242 cases (21.3%). Co-infections were determined in 62 cases (5.4%) with mycoplasma, 27 cases (2.4%) with adenovirus and 34 cases with influenza virus (3.0%). The penicillin insensitivity (PNSP) rates in meningitis and non-meningitis isolates were 69.5% (276/397) and 35.9% (221/615), respectively. There were 81 strains serotyped, in which 93.8% (76/81) were covered by 13-valent protein-polysaccharide conjugate vaccine (PCV13). In the 965 patients who were followed up by phone call, 156 cases (16.2%) were confirmed dead. The independent risk factors for the death were under 2 years of age (OR=2.143, 95%CI 1.284-3.577, P=0.004), meningitis (OR=3.066, 95%CI 1.852-5.074, P<0.01), underlying disease (OR=4.801, 95%CI 2.953-7.804, P<0.01), septic shock(OR=3.542, 95%CI 1.829-6.859, P<0.01), disseminated intravascular coagulation (DIC) (OR=4.150, 95%CI 1.468-11.733, P=0.007), multiple organ failure (OR=12.693, 95%CI 6.623-24.325, P<0.01) and complications of central nervous system (OR=1.975, 95%CI 1.144-3.410, P=0.015). Conclusions Most children with IPD were under 5 years of age, having underlying diseases and acquired the infection in community. The independent risk factors for death were under two years old, meningitis, underlying diseases and multiple organ failure. The problem of drug resistance was severe. The universal immunization of PCV13 would be effective to prevent IPD in Chinese children.

AIM To prepare D-α-tocopherol polyethylene glycol 1000 succinate (TPGS)-modified artesunate liposomes and to investigate the in vitro anti-tumor activity.METHODS The liposomes prepared by thin-film dispersion method were characterized by transmission electron microscopy and particle size analyzer,and the encapsulation efficiency was determined by ultrafiltration centrifugation.The liposomes' cytotoxicity to human hepatoma HepG2 cells was evaluated by MTT method.RESULTS The average particle size,PDI,Zeta potential,encapsulation efficiency,drug loading of the liposomes were 126.7 nm,0.182,-10.1 mV,78.8％ and 18.38％,respectively.The liposomes displayed a significant inhibition on HepG2 cells with the IC50 value of 0.034 μmol/mL.CONCLUSION Compared with non-TPGS-modified artesunate liposomes,the TPGS-modified artesunate liposomes prepared by this method afford smaller vesicle size,better stability and higher encapsulation efficiency with stronger in vitro anti-tumor activity.

Objective To understand the prevalence rate and related factors of chronic kidney disease (CKD) among elderly people aged more than 65 years old in the 66th regiment of the fourth division of A Crops in Xinjiang .Methods A total of 2 030 elderly people aged more than 65 years old in the 66th regiment of the fourth division of XPCC were distributed in 6 communities . Totally 334 permanent residents aged more than 65 years old were chosen from 2 communities by the stratified random sampling method .The renal injury indicators and related factors were detected .Results Among 329 residents with intact data ,after the age correction ,the prevalence rate of albuminuria ,hematuria and renal function decrease were 22 .2% ,14 .2% ,4 .9% ,respectively .The prevalence rate of CKD in this group was 32 .8% ,CKD stage 1―3 were dominated .The awareness rate was 15 .1% .The multiva‐riate Logistic regression analysis showed that gender and hypertension were independently associated with CKD .Conclusion The prevalence rate of CKD among elderly people aged over 65 years old in the 66th regiment of the fourth division of this Crops is high‐er .The related factors are gender and hypertension .

Objective To verify the clinical applicability of the published standard intervals of routine clinical chemistry (WS/T404 .1‐2012 ,WS/T404 .2‐2012) based on the health examination results of Han and Uygur populations in Urumqi .Methods This was a retrospective study .The results of serum TP ,ALB ,ALT ,AST ,ALP ,GGT from healthy examination individuals of Han and Uygur populations (from 2013 August to 2015 January) were collected and the healthy cases (age range:20 -79 years old) were chosen to calculate the 2 .5% and 97 .5% percentiles ,excluding the significant abnormal results according to the Medical Deciding Level 2 recommended by Staland .The percents of health cases not falling in the published standard interval were calculated to meet the judgment criterion of verification (<10% ) .Results The test of normality revealed that the Han and Uygur's results of all veri‐fied items were skewed distributions .The 2 .5% and 97 .5% percentiles of the results of two populations were as follows ,TP(Han 65 -81 g/L ;Uygur 64-81 g/L) ,ALB(Han 41-53 g/L ;Uygur 40-52 g/L) ,ALT(Han:male 9-51 U/L and female 7-42 U/L ;Uygur:male 9-53 U/L and female 6-43 U/L) ,AST(Han:male 14-42 U/L and female 12-37 U/L ,Uygur:male 12-42 U/L and female 12-38 U/L) ,ALP(Han:male 45-119 U/L ;Uygur:male 47-122 U/L) ,ALP(female 20-49 years old:Han 35-95 U/L and Uygur 40-104 U/L) ,ALP(female 50-79 years old:Han 43-131 U/L and Uygur 51-132 U/L) ,GGT(Han:male 11-71 U/L and female 8-54 U/L ;Uygur :male 11 -73 U/L and female 7 -55 U/L ) .The percents of AST results for Han's male , Uygur's male and Uygur's female not falling in the published standard reference interval were slightly over 10% ,but AST results o‐ver 10% were mainly under the lower limit of the published standard reference interval .The health case percents for the other veri‐fied items of Han and Uygur populations not falling in the published standard reference interval were under 10% .Conclusion The published standard reference intervals of routine clinical chemistry (WS/T404 .1‐2012 ,WS/T404 .2‐2012) are applicable in our la‐boratory for the detection of Han and Uygur population .

Objective To improve the study on chronic obstructive pulmonary disease (COPD) basicknowledge, and the ability of COPD research and design, organization, implementation andmanagement. Methods Clinical research led stu-dents to participate in the COPD, found the problem from clinical,research students went to COPD, literature, grouping the recent 15 years , the discussion of the COPD design experimental study , lipopolysaccharide ( LPS ) rat model of COPDinduced with smoke, explore the love Luo Ning on the treatment of cough with dyspneaeffect COPD and its mech-anism, integration of traditional Chinese and Western medicineknowledge module to the pathogenesis of COPD, as the core of the problem of the cause. Results 5 graduate students completed COPD in the etiology, pathogenesis andmech-anism of Kechuanning love Luo, master and technology related research methods. Conclusion PBL teaching method helps to promote the quality of postgraduate education,PBL teaching was worth to promoted.