Objective To observe the value of ultrasound microvascular flow imaging(MV-Flow)combined with maternal serum vascular endothelial growth factor(VEGF)expression level for diagnosis of fetal growth restriction(FGR).Methods Totally 87 pregnant women with FGR(FGR group,including 43 cases of gestational week＜28 weeks[＜28 weeks subgroup]and 44 cases of ≥28 weeks[≥28 weeks subgroup])and 112 normal pregnant women with normal fetuses(normal control group,55 with gestational week＜28 weeks[NC 1 subgroup]and 57 with ≥28 weeks[NC 2 subgroup])were prospectively enrolled.MV-Flow technology was used to measure placental microvascular index(MVI),and the placental microvascular circulation was evaluated.The expression level of maternal serum VEGF was detected simultaneously,also of placental maternal surface immediately after delivery.The receiver operating characteristic curves were drawn to explore the value of placental MVI,maternal serum VEGF and the combination of placental MVI,maternal serum VEGF for diagnosing FGR.Results The levels of placental MVI and maternal serum VEGF in 2 subgroups of FGR group were both lower than those in control group(all P＜0.01).Placental VEGF expression level in FGR group was significantly lower than that in control group(P＜0.01).The area under the curve(AUC)of placental MVI,maternal serum VEGF and their combination for diagnosing FGR＜28 weeks was 0.981,0.870 and 0.997,respectively,while for diagnosing FGR≥28 weeks was 0.991,0.867 and 0.993,respectively.AUC of maternal serum VEGF alone for diagnosing in 2 subgroups of FGR were both lower than that of placental MVI and combination of placental MVI and maternal serum VEGF(all P＜0.05),while no significant difference of AUC was found between placental MVI and combination of maternal serum VEGF and placental MVI(both P＞0.05).Conclusion Both placental MVI and maternal serum VEGF level could be used to screen FGR,and the former was more valuable.

Objective:To analyze the mutation types and distribution characteristics of thalassemia gene among high-risk populations in Sanya City, and to evaluate the effectiveness of blood routine screening, in order to provide scientific basis for formulating measures for prevention and control of thalassemia in Sanya City.Methods:Retrospective analysis was used to collect detection results and clinical data from high-risk individuals who completed genetic screening for thalassemia at Sanya Materal and Child Health Hospital from January 2019 to August 2021. Mutation types and distribution characteristics of thalassemia gene were analyzed, and the missed detection rate and sensitivity of blood routine indicators [mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH)] were evaluated based on the results of genetic screening for thalassemia.Results:A total of 5 760 high-risk individuals were included in the screening results of thalassemia genes, and 3 868 samples of thalassemia gene mutations were detected, with a detection rate of 67.15%. Among them, there were 2 979 samples with α-thalassemia genetic mutations, with a detection rate of 51.72%; including 2 966 common genotype samples (99.56%), the main genotype was αα/-α 3.7 (20.14%, 600/2 979); 13 rare genotype samples (0.44%), 4 cases of αα/-- THAI, 3 cases of α CD40(AAG>AA-)α/αα, 2 cases of α PPα/αα, and 1 case of Fusion gene/αα, Fusion gene/α WSα, α WSα/α PPα, and α CD40(AAG>AA-)α/α WSα each. There were 340 samples with β-thalassemia gene mutations, with a detection rate of 5.90%; including 336 common genotype samples (98.82%). The β CD41/42/β N genotype was dominant (57.65%, 196/340); 4 rare genotype samples (1.18%), β CD5(-CT)/β N, β IVS-Ⅱ-2(-T)/β N, β IVS-Ⅱ-761(-T)/β N and β Initiation(ATG>AGG)/β N 1 case each. There were 549 samples of αβ-compound type thalassemia, with a detection rate of 9.53%. The α missing recombination β CD41/42 genotype was dominant (61.02%, 335/549). There were a total of 4 226 samples that could be traced back to MCV and MCH. Among them, 3 007 samples were found to have mutations in thalassemia genes through screening, 2 584 cases were found to have abnormalities in the combination of MCV and MCH indicators, and 423 samples were missed in blood routine screening, with a missed detection rate of 14.07% (423/3 007). The missed samples were mainly α static type, accounting for 89.13% (377/423) of the total missed samples. The screening sensitivity of MCV combined with MCH for α-, β- and αβ-compound type thalassemia was 82.65%, 98.07% and 98.15%, respectively. Conclusion:The types of genetic mutations in thalassemia in Sanya City are complex and diverse, and there are certain omissions in the blood routine screening of MCV combined with MCH.

Objective: To analyze the ear, nose, and throat exam of some freshmen in the military college entrance examination in Shandong Province in 2020 and to facilitate adolescent targeted health promotion. Methods: The 1 411 freshmen participating in the military college entrance examination in Jinan, Zibo and Weifang of Shandong Province were included. The ear, nose, and throat exam were performed by professionals using electric otoscope, 5 meter whispering test, and front rhinoscope. Results: Nasal septal deviation and hypertrophy of inferior turbinate accounted for the highest proportion. Among 489 cases of nasal septum deviation, the detection rate of Jinan (15.97%) was significantly lower than that of Weifang (43.60%) and Zibo (46.53%) ( χ 2=63.32， P <0.05). For deviation of nasal septum, the detection rate in students with urban residence (31.53%) was significantly lower than that of rural students (39.03%) ( χ 2=4.11， P <0.05). Seventy two cases of inferior turbinate hyperplasia were detected, and the detection rate in Jinan (2.99%) was significantly lower than that in Weifang (6.51%) and Zibo (6.04%) ( χ 2=6.63， P <0.05). The detection rate of tonsil hypertrophy was significantly lower in boys (4.63%), students from urban area (3.94%), compared with that of girls(9.56%) and rural students (6.70%) ( χ 2=5.35，4.86， P <0.05). In pharyngeal examination, tonsil hyperplasia was the most common condition of enlarged tonsils ( n =214), which was significantly higher in Jinan(22.36%) than that of Weifang (11.71 %) and Zibo (10.74%) ( χ 2=22.39， P <0.05), and was significantly lower in boys (14.38%) and rural students (12.40%) than that in girls (22.79%) and urban students (17.24%) ( χ 2=4.70，4.65， P <0.05). Conclusion Nasal septum deviation and tonsil hypertrophy are the most prevalent upper airway diseases among freshmen participating in the military college entrance examination. Prevention and treatment of nasopharynx diseases should be emphasized.

Objective:To explore the relationship between the polymorphisms of SIRT1 and follicle-stimulating hormone receptor (FSHR) gene and ovarian function in women who underwent assisted reproductive technology (ART) and the differences between Mongolian and Han nationalities, so as to provide basis for the individualized treatment of ART assisted pregnancy. Methods:A retrospective cohort study was performed. The clinical data of 204 ART patients who visited the Reproductive Center of the Affiliated Hospital of Inner Mongolia Medical University from September 2019 to September 2021 were collected. There were 53 cases of Mongolian nationality and 151 cases of Han nationality. MassARRAY SNP genotyping technology was used to detect three sites, which were rs2236319 of SIRT1 and rs6165 and rs6166 of FSHR. SIRT1 was divided into three groups: AA group (wild type), AG group (heterozygous type) and GG group (mutant type); FSHR rs6165 was divided into TT group (wild type), AT group (heterozygous type), AA group (mutant type); FSHR rs6166 was divided into NN group (wild type), NS group (heterozygous type) and SS group (mutant type). The differences of genotype frequency and clinical and laboratory data were compared. Results:1) The allele frequencies and genotype frequencies of SIRT1 rs2236319, FSHR rs6165, and rs6166 loci were not statistically different in composition between Mongolian and Han ART female patient groups. There were no significant differences between Mongolian and Han ART women in terms of general clinical data and basal sex hormones and ovarian reserve function (all P>0.05). 2) There was a statistically significant difference in the number of eggs captured at the rs2236319 locus of the SIRT1 gene among the mutant GG group [18.5 (13.0, 32.8)], the AA group [13.0 (7.0, 20.0)] and the AG group [10.0 (5.0, 21.0), P=0.019]. 3) There was a statistically significant difference in the basal FSH levels at the rs6165 locus of the FSHR gene among the AA group [(7.45±2.73) U/L], the TT group [(5.97±2.23) U/L] and the TA group [(6.70±2.04) U/L, P=0.005]. The proportion of ovarian hyporesponsiveness among the AA group [29.6% (8/27)], the TT group [8.5% (8/94)] and the TA group [13.3% (11/83)] was statistically significant ( P=0.017). 4) The difference in basal FSH levels at the rs6166 locus of the FSHR gene among the SS group [(7.48±2.78) U/L], the NN group [(6.08±2.28) U/L] and the NS group [(6.61±1.99) U/L] was statistically significant ( P=0.016). The proportion of ovarian hyporesponsiveness among the SS group [37.0% (10/26)], the NN group [8.5% (8/99)] and the NS group [10.8% (9/79)] was statistically significant ( P=0.001). Conclusion:There were no significant differences between Mongolian and Han ART women in terms of general clinical data, basal sex hormones and ovarian reserve function. The gene polymorphism at rs2236319 of SIRT1 gene is associated with ovarian hyperresponsiveness. FSHR rs6165 and rs6166 gene polymorphisms are associated with ovarian hyporesponsiveness. There was no significant correlation between the three polymorphisms and the clinical pregnancy rate of ART.

Reproductive health is a basic element of human health and an important pillar of social sustainable development. Based on the 2030 sustainable development goal, a global perspective should be given to the broader relationship between human beings and the earth and the natural ecological environment. The purpose of reproductive health is not only to reduce the death rate and improve the quality and the rate of the birth, but also to promote the sustainable development of human beings, resources, and environment. This paper systematically discussed the development of reproductive health theory and the current situation of global reproductive health, in order to clarify the important status and role of reproductive health in the national health and to promote the high-quality development of maternal and child health.

Objective:To explore the relationship between the polymorphisms of SIRT1 and follicle-stimulating hormone receptor (FSHR) gene and ovarian function in women who underwent assisted reproductive technology (ART) and the differences between Mongolian and Han nationalities, so as to provide basis for the individualized treatment of ART assisted pregnancy. Methods:A retrospective cohort study was performed. The clinical data of 204 ART patients who visited the Reproductive Center of the Affiliated Hospital of Inner Mongolia Medical University from September 2019 to September 2021 were collected. There were 53 cases of Mongolian nationality and 151 cases of Han nationality. MassARRAY SNP genotyping technology was used to detect three sites, which were rs2236319 of SIRT1 and rs6165 and rs6166 of FSHR. SIRT1 was divided into three groups: AA group (wild type), AG group (heterozygous type) and GG group (mutant type); FSHR rs6165 was divided into TT group (wild type), AT group (heterozygous type), AA group (mutant type); FSHR rs6166 was divided into NN group (wild type), NS group (heterozygous type) and SS group (mutant type). The differences of genotype frequency and clinical and laboratory data were compared. Results:1) The allele frequencies and genotype frequencies of SIRT1 rs2236319, FSHR rs6165, and rs6166 loci were not statistically different in composition between Mongolian and Han ART female patient groups. There were no significant differences between Mongolian and Han ART women in terms of general clinical data and basal sex hormones and ovarian reserve function (all P>0.05). 2) There was a statistically significant difference in the number of eggs captured at the rs2236319 locus of the SIRT1 gene among the mutant GG group [18.5 (13.0, 32.8)], the AA group [13.0 (7.0, 20.0)] and the AG group [10.0 (5.0, 21.0), P=0.019]. 3) There was a statistically significant difference in the basal FSH levels at the rs6165 locus of the FSHR gene among the AA group [(7.45±2.73) U/L], the TT group [(5.97±2.23) U/L] and the TA group [(6.70±2.04) U/L, P=0.005]. The proportion of ovarian hyporesponsiveness among the AA group [29.6% (8/27)], the TT group [8.5% (8/94)] and the TA group [13.3% (11/83)] was statistically significant ( P=0.017). 4) The difference in basal FSH levels at the rs6166 locus of the FSHR gene among the SS group [(7.48±2.78) U/L], the NN group [(6.08±2.28) U/L] and the NS group [(6.61±1.99) U/L] was statistically significant ( P=0.016). The proportion of ovarian hyporesponsiveness among the SS group [37.0% (10/26)], the NN group [8.5% (8/99)] and the NS group [10.8% (9/79)] was statistically significant ( P=0.001). Conclusion:There were no significant differences between Mongolian and Han ART women in terms of general clinical data, basal sex hormones and ovarian reserve function. The gene polymorphism at rs2236319 of SIRT1 gene is associated with ovarian hyperresponsiveness. FSHR rs6165 and rs6166 gene polymorphisms are associated with ovarian hyporesponsiveness. There was no significant correlation between the three polymorphisms and the clinical pregnancy rate of ART.

Reproductive health is a basic element of human health and an important pillar of social sustainable development. Based on the 2030 sustainable development goal, a global perspective should be given to the broader relationship between human beings and the earth and the natural ecological environment. The purpose of reproductive health is not only to reduce the death rate and improve the quality and the rate of the birth, but also to promote the sustainable development of human beings, resources, and environment. This paper systematically discussed the development of reproductive health theory and the current situation of global reproductive health, in order to clarify the important status and role of reproductive health in the national health and to promote the high-quality development of maternal and child health.

Objective:To investigate the correlation of PELP1/MNAR expression with expressions of estrogen receptor (ER), Ki-67, human epidermal growth factor receptor 2 (HER2) and PIK3CA gene mutation.Methods:A total of 80 paraffin-embedded tissue specimens of primary invasive breast cancer patients in the Fifth People's Hospital of Datong in Shanxi Province from January 2008 to December 2018 were collected. The expression of PELP1/MNAR was examined by immunohistochemistry EliVision tow-step method. The polymerase chain reaction (PCR)-Sanger sequencing method was used to detect the mutation of PIK3CA gene. The expressions of PELP1/MNAR among patients with different expression status of ER, Ki-67, HER2 and with or without PIK3CA gene mutation were compared, and the correlations between each index and the expression of PELP1/MNAR were analyzed.Results:The high expression rates of PELP1/MNAR protein in patients with ER-positive [86.1% (31/36) vs. 59.1% (26/44)], Ki-67 high expression [100.0% (13/13) vs. 65.7% (44/67)], HER2-positive [81.0% (34/42) vs. 60.5% (23/38)] were high, and the differences were statistically significant (all P<0.05). There was no significant difference in the high expression rate of PELP1/MNAR protein between patients with mutant and wild-type PIK3CA [60.0% (12/20) vs. 75.0% (45/60), P = 0.199]. The expression of PELP1/MNAR was negatively correlated with the expression level of ER ( r = -0.195, P < 0.05), positively correlated with the expression level of Ki-67 ( r = 0.198, P < 0.05), positively correlated with the expression level of HER2 ( r = 0.225, P < 0.05), and negatively correlated with lymph node metastasis ( r = -0.269, P < 0.05). Conclusions:The expression of PELP1/MNAR in invasive breast cancer is negatively correlated with the expression level of ER, and positively correlated with the expression level of Ki-67 and HER2. There is no correlation between PELP1/MNAR expression and PIK3CA gene mutation, and the two may play their own role in the PI3K-AKT-mTOR regulatory pathway of breast cancer.

Guided by the development of new medical science proposed by Ministry of Education and the "Education and Training Plan for Excellent Doctors 2.0", shifted from treatment-oriented to whole life-health cycle, we have explored curriculum ideological and political education in metabolic-related curriculum chain. Firstly, we constructed a core teaching team and had the training of curriculum ideological and political education. The top-level design was made with the integration of moral education into medical education. Secondly, the syllabus was comprehensively revised, containing the connotation of "morality education". The elements relevant to curriculum ideological and political education hidden behind professional courses were excavated. Finally, the mixed teaching mode of online combining with offline was carried out. Metabolism-related curriculum chain, focused on "metabolism, diabetes, obesity and patient education", formed a progressive link from basic medical science to practice to clinical, strengthening the "prevention, treatment and health care" based "one health" philosophy and giving full play to the implicit curriculum ideological and political education hidden behind professional courses. Our practice shows that the implementation of curriculum ideological and political education in metabolism-related curriculum has been accepted by students, and curriculum ideological and political education has been become part of professional courses. The "gene chimera" mode for curriculum ideological and political education incorporation into professional courses needs to be infiltrated imperceptibly, and the effect will be visualized in the future.

Objective:To determine the risk factors of extubation failure and its effect on the prognosis of patients who had successfully passed a spontaneous breathing trial (SBT).Methods:The clinical data of patients with mechanical ventilation more than 24 hours who passed SBT admitted to department of intensive care unit (ICU) of First Hospital of Qinhuangdao from November 2018 to November 2019 were retrospectively analyzed. According to the outcome of weaning within 48 hours after weaning, patients were divided into weaning success group and weaning failure group. The baseline data, the presence of basic cardiopulmonary diseases, B-type natriuretic peptide (BNP), fluid balance, albumin and hemoglobin within 24 hours before weaning, the time of mechanical ventilation before weaning, rapid shallow breathing index (RSBI) during SBT, oxygenation index, cough peak flow at the end of SBT, and prognostic indicators were collected. The outcome of weaning was taken as the dependent variable, and the observation factors were taken as the independent variable for univariate analysis. The factors with statistical significance in univariate analysis were analyzed by binary Logistic regression to determine the influencing factors of weaning failure.Results:Of the 204 patients, 167 (81.9%) were successfully weaned, and 37 (18.1%) failed. Compared with the weaning success group, the total duration of mechanical ventilation and the length of ICU stay in the weaning failure group were significantly longer [days: 13.0 (7.5, 23.5) vs. 5.0 (3.0, 8.0), 17.0 (12.5, 31.0) vs. 10.0 (6.0, 15.0), both P < 0.01], and the tracheotomy rate and mortality were significantly higher (32.4% vs. 0%, 51.4% vs. 0%, both P < 0.01). Univariate analysis showed that there were significant differences in age, proportion of patients with cardiopulmonary diseases, BNP and cough peak flow between weaning failure group and weaning success group [age (years old): 70.65±15.78 vs. 62.69±15.82, cardiopulmonary diseases: 62.2% vs. 24.6%, BNP (ng/L): 416.87 (32.70, 1 225.80) vs. 45.36 (10.00, 273.60), cough peak flow (L/min): 59.89±9.06 vs. 83.84±16.52, all P < 0.01]. However, there were no significant differences in gender, acute physiology and chronic health evaluationⅡ (APACHEⅡ) at admission, mechanical ventilation time before weaning, albumin, hemoglobin, oxygenation index, RSBI and fluid balance 24 hours before weaning between weaning failure group and weaning success group [male: 51.4% vs. 68.3%, APACHEⅡ: 16.70±6.65 vs. 15.67±6.28, mechanical ventilation time before weaning (days): 6.0 (2.5, 11.0) vs. 5.0 (3.0, 8.0), albumin (g/L): 27.78±4.15 vs. 27.76±4.46, hemoglobin (g/L): 102.43±15.80 vs. 100.61±17.19, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 359.33±79.83 vs. 365.75±78.23, RSBI (times·L -1·min -1): 50.73±24.97 vs. 46.76±15.53, positive fluid balance: 70.3% vs. 69.5%, all P > 0.05]. The results of binary Logistic regression analysis showed that age ≥ 75 years old [odds ratio ( OR) = 3.099, 95% confidence interval (95% CI) was 1.003-9.574, P = 0.049], presence of cardiopulmonary diseases ( OR = 3.599, 95% CI was 1.126-11.498, P = 0.031), BNP within 24 hours before weaning ( OR = 1.002, 95% CI was 1.000-1.003, P = 0.005) were the risk factors of extubation failure, while cough peak flow at the end of SBT was the protective factor ( OR = 0.869, 95% CI was 0.823-0.917, P = 0.000). Conclusions:For patients who had successfully passed SBT, age ≥ 75 years old, the presence of cardiopulmonary diseases and an increased level of BNP within 24 hours were the risk factors of extubation failure. In addition, the higher the cough peak flow at the end of SBT, the lower the risk of weaning failure will be.