Objective To explore the correlation between serum hypoxia-inducible factor-1α(HIF-1α)levels and cerebral microbleeds(CMBs)and cognitive impairment and to assess the predictive value of HIF-1α for CSVD-related cognitive impairment.Methods A total of 104 patients with CSVD who attended the Department of Neurology,First Affiliated Hospital of Xinxiang Medical University from June 2022 to November 2023 were enrolled.All enrolled patients were subjected to basic statistics,cranial nuclear magnetic resonance examination,cognitive function assessment,and serum HIF-1α test,and the number and location of CMBs were counted.Based on the above data the enrolled patients were grouped.The correlation between HIF-1α and cognitive function and CMBs was studied the influencing factors of CMBs and cognitive impairment were analyzed,and the predictive value of HIF-1α on the occurrence of cognitive impairment was evaluated.Results There were statistically significant differences in HIF-1α levels and cognitive function among different CMBs groups.Serum HIF-1α levels were significantly negatively correlated with overall cognitive function,visuospatial and executive function,attention,and delayed recall,and serum HIF-1α was positively correlated with the number of CMBs.HIF-1α may be a risk factor for CMBs and cognitive impairment associated with CSVD,and serum HIF-1α has potential in predict the cognitive impairment caused by CSVD.Conclusion Serum levels of HIF-1α were associated with the number of CMB and CSVD-related cognitive impairment,and serum levels of HIF-1α may have a predictive value for CSVD-related cognitive impairment.

Objective To explore the correlation between serum hypoxia-inducible factor-1α(HIF-1α)levels and cerebral microbleeds(CMBs)and cognitive impairment and to assess the predictive value of HIF-1α for CSVD-related cognitive impairment.Methods A total of 104 patients with CSVD who attended the Department of Neurology,First Affiliated Hospital of Xinxiang Medical University from June 2022 to November 2023 were enrolled.All enrolled patients were subjected to basic statistics,cranial nuclear magnetic resonance examination,cognitive function assessment,and serum HIF-1α test,and the number and location of CMBs were counted.Based on the above data the enrolled patients were grouped.The correlation between HIF-1α and cognitive function and CMBs was studied the influencing factors of CMBs and cognitive impairment were analyzed,and the predictive value of HIF-1α on the occurrence of cognitive impairment was evaluated.Results There were statistically significant differences in HIF-1α levels and cognitive function among different CMBs groups.Serum HIF-1α levels were significantly negatively correlated with overall cognitive function,visuospatial and executive function,attention,and delayed recall,and serum HIF-1α was positively correlated with the number of CMBs.HIF-1α may be a risk factor for CMBs and cognitive impairment associated with CSVD,and serum HIF-1α has potential in predict the cognitive impairment caused by CSVD.Conclusion Serum levels of HIF-1α were associated with the number of CMB and CSVD-related cognitive impairment,and serum levels of HIF-1α may have a predictive value for CSVD-related cognitive impairment.

Objective:To investigate the relationship between serum glial cell line-derived neurotrophic factor (GDNF) levels and neuroimaging changes and cognitive impairment in patients with cerebral small vascular disease (CSVD).Methods:135 patients with CSVD recruited from the Department of Neurology of the First Affiliated Hospital of Xinxiang Medical University from September 2021 to July 2022 were assessed by cranial multimodal magnetic resonance imaging and Montreal cognitive function assessment (MoCA), and the basic data were analyzed at the same time.The serum GDNF concentration of all patients was detected by enzyme-linked immunosorbent assay (ELISA). According to the median GDNF concentration, the patients were divided into low GDNF group and high GDNF group. The baseline data, MoCA score and imaging markers of the two groups were compared by Mann-Whitney U test, chi-square test, logistic regression, Kruskal-Wallis H test and Jonckheere-Terpstra trend test, and the correlation between serum GDNF level and imaging markers and cognitive function of patients with CSVD was analyzed. Results:The median serum GDNF concentration of all CSVD patients was 16.66 pg/mL. Multivariate logistic regression analysis showed that low serum GDNF level was a risk factor for white matter hyperintensity and total image load in patients with CSVD. Serum GDNF level was a protective factor of cognitive impairment in patients with CSVD in multiple logistic regression analysis. The area under the curve of ROC curve analysis of cognitive impairment after CSVD predicted by serum GDNF level was 0.735, the sensitivity was 66.4%, and the specificity was 71.4%. The level of serum GDNF was positively related with visual space and executive function, attention and computational power, delayed recall and orientation( r=0.267, 0.187, 0.219, 0.215, all P<0.05). Conclusion:The serum GDNF level is related to white matter hyperintensities, total imaging load and cognitive impairment in patients with CSVD. Serum GDNF level may play a predictive role in CSVD and cognitive impairment.

Objective To compare the effects of different statistical protocols on the results of external quality assessment(EQA)of se-men,and select appropriate statistical protocols for the promotion of EQA of semen.Methods Taking sperm concentration as an ex-ample,the semen EQA data of 20 laboratories in Hunan Province in 2022 were selected,and the advantages and disadvantages of the traditional statistical scheme(TSS),robust statistical scheme(RSS)and traditional statistical scheme after eliminating the"outliers"(TSEOS)combined with robust statistical technology were analyzed and compared.Results The"outliers"could not be excluded from the sperm concentration data of the four groups in the TSS,which led to the difference between TSS and RSS or TSEOS.The num-ber of qualified laboratories for TSS and RSS were 19 vs 16,19 vs 16,19 vs 19,and 19 vs 19,respectively.Conclusion The results of RSS are similar to those of TSEOS.Compared with TSS,RSS do not need to remove outlier data steps,and are more suitable for se-men EQA data analysis with small data volume.

Objective:To study the clinical features of children with Prader-Willi syndrome(PWS).Methods:Eighteen cases of PWS were collected from July 2016 to November 2018 in Shenzhen Maternal and Child Healthcare Hospital, Southern Medical University.The clinical data of children with PWS were analyzed retrospectively.Results:There were 12 males and 6 females in 18 cases with PWS.The diagnosis age ranged from 25 days to 9.5 years old [(3.09±3.02) years old]. Among them, 11 cases were in infancy (≤3 years old) and 7 cases after infancy (>3 years old). The main clinical features of infants with PWS were 11 cases of gonadal dysplasia (100.0%), 11 cases of psychomotor retardation (100.0%), 10 cases of hypotonia (90.1%), 6 cases of feeding difficulty and weak cry (54.5%). After infancy the main clinical features included 7 cases of psychomotor retardation (100.0%), 5 cases of hyperphagia(71.4%), 5 cases of obesity (71.4%), 5 cases of abnormal behavior problems (71.4%) and 4 cases of visual problems (57.1%). The clinical features of all patients throughout the developmental stage were as follows: decreased fetal movement, hypoplasia, neonatal hypotonia, weak cry, feeding difficulty, psychomotor delay, hyperphagia, obesity, abnormal behavior problems, and so on.Conclusions:The clinical features of PWS vary with age.The main clinical features in the infancy are hypotonia, weak cry, difficulty feeding and gonadal dysplasia.After infancy, there are hyperphagia, obesity, behavior and visual problems.And psychomotor retardation is present in the whole developmental stage of children with PWS.Early diagnosis and treatment are important for improving the prognosis of PWS.

Objective:To explore the effects of platelet parameters, coagulation indexes, platelet and lymphocyte ratio (PLR) values, neutrophil and lymphocyte ratio (NLR) values on coagulation disorders and perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP).Methods:A retrospective analysis of prothrombin time (PT) and activated partial thromboplastin time (activated partial) of 106 ICP patients (ICP group) and 138 normal pregnant women (control group) delivered from Gansu Provincial People's Hospital from January 2017 to December 2018 was performed. Activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet count, mean platelet volume (MPV), platelet distribution red blood cell distribution width (RDW), number of white blood cell (WBC), PLR, NLR, and postpartum hemorrhage and perinatal outcomes were compared between the two groups. Further based on whether serum bile acid (TBA) was ≥40 μmol/L, the patients in ICP group were divided into mild ICP subgroup and severe ICP subgroup, and the changes in the difference indicators were analyzed between the two subgroups.Results:Compared with control group, MPV ( t=4.929, P<0.001), FIB ( t=3.509, P<0.001), D-D ( t=7.834, P<0.001) and NLR ( t=4.098, P<0.001) were significantly increased in ICP group ( P<0.05). Platelet count ( t=4.367, P<0.001) and PLR ( t=2.448, P=0.015) were significantly decreased in ICP pregnant women. The incidence of postpartum hemorrhage ( t=10.003, P<0.001), fetal distress (χ 2=17.194, P<0.001), preterm birth rate (χ 2=13.938, P<0.001) and transfer into neonatal intensive care unit (NICU)(χ 2=29.736, P<0.001) in ICP group was higher than that in control group. Apgar score ( t=3.234, P=0.001) and neonatal birth weight ( t=6.509, P<0.001) in ICP group were lower than those in control group. Further analysis of ICP components for severe ICP and mild ICP revealed significant differences in MPV ( t=2.376, P=0.019), FIB ( t=2.174, P=0.032), D-D ( t=3.074, P=0.003), WBC ( t=2.021, P=0.046), neutrophil count ( t=2.131, P=0.035), NLR ( t=2.864, P=0.005), etc. Postpartum hemorrhage ( t=3.257, P=0.002), the preterm birth rate (χ 2=4.025, P=0.045), birth weight ( t=3.126, P=0.002), and transfer rate to the NICU (χ 2=5.518, P=0.019) were also significantly different between the two groups. Conclusion:ICP pregnant women have abnormal coagulation and fibrinolysis, which may lead to postpartum hemorrhage. The incidence of poor perinatal outcomes is high, which should be highly valued by the clinic. It is of great significance to evaluate the pregnancy outcome of pregnant women with ICP by analyzing the coagulation function and inflammatory markers of ICP pregnant women.

Objective:To explore the effects of platelet parameters, coagulation indexes, platelet and lymphocyte ratio (PLR) values, neutrophil and lymphocyte ratio (NLR) values on coagulation disorders and perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP).Methods:A retrospective analysis of prothrombin time (PT) and activated partial thromboplastin time (activated partial) of 106 ICP patients (ICP group) and 138 normal pregnant women (control group) delivered from Gansu Provincial People's Hospital from January 2017 to December 2018 was performed. Activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet count, mean platelet volume (MPV), platelet distribution red blood cell distribution width (RDW), number of white blood cell (WBC), PLR, NLR, and postpartum hemorrhage and perinatal outcomes were compared between the two groups. Further based on whether serum bile acid (TBA) was ≥40 μmol/L, the patients in ICP group were divided into mild ICP subgroup and severe ICP subgroup, and the changes in the difference indicators were analyzed between the two subgroups.Results:Compared with control group, MPV ( t=4.929, P<0.001), FIB ( t=3.509, P<0.001), D-D ( t=7.834, P<0.001) and NLR ( t=4.098, P<0.001) were significantly increased in ICP group ( P<0.05). Platelet count ( t=4.367, P<0.001) and PLR ( t=2.448, P=0.015) were significantly decreased in ICP pregnant women. The incidence of postpartum hemorrhage ( t=10.003, P<0.001), fetal distress (χ 2=17.194, P<0.001), preterm birth rate (χ 2=13.938, P<0.001) and transfer into neonatal intensive care unit (NICU)(χ 2=29.736, P<0.001) in ICP group was higher than that in control group. Apgar score ( t=3.234, P=0.001) and neonatal birth weight ( t=6.509, P<0.001) in ICP group were lower than those in control group. Further analysis of ICP components for severe ICP and mild ICP revealed significant differences in MPV ( t=2.376, P=0.019), FIB ( t=2.174, P=0.032), D-D ( t=3.074, P=0.003), WBC ( t=2.021, P=0.046), neutrophil count ( t=2.131, P=0.035), NLR ( t=2.864, P=0.005), etc. Postpartum hemorrhage ( t=3.257, P=0.002), the preterm birth rate (χ 2=4.025, P=0.045), birth weight ( t=3.126, P=0.002), and transfer rate to the NICU (χ 2=5.518, P=0.019) were also significantly different between the two groups. Conclusion:ICP pregnant women have abnormal coagulation and fibrinolysis, which may lead to postpartum hemorrhage. The incidence of poor perinatal outcomes is high, which should be highly valued by the clinic. It is of great significance to evaluate the pregnancy outcome of pregnant women with ICP by analyzing the coagulation function and inflammatory markers of ICP pregnant women.

Objective To investigate the effect of open surgical drainage approach for the treatment of walled-off pancreatic necrosis ( WOPN) in severe acute pancreatitis. Methods Clinical data of 154 WOPN patients admitted in the First Affiliated Hospital of Xinjiang Medical University from January 2005 to October 2016 were retrospectively analyzed. Traditional open debridement necrosectomy was performed in 83 patients from January 2005 to October 2012 ( debridement group) , and small abdominal incision with low-position open surgical drainage was performed in 71 patients from October 2012 to October 2016 ( drainage group ) . The clinical outcomes of two groups were analyzed and compared. Results 43 cases (51. 8％) in debridement group had postoperative intraperitoneal reinfection, while there were only 13 cases with postoperative intraperitoneal reinfection (18. 3％) in drainage group;18 cases (21. 7％) in debridement group had surgery-related digestive tract fistula, while there were only 4 cases with surgery-related digestive tract fistula (5. 6％) in drainage group; the differences were statistically significant (χ2 = 18. 55, P=0. 001; χ2 = 11. 35, P=0. 002). 15 patients (18. 1％) in debridement group and only 2 patients (2. 8％) in drainage group died. The mortality in drainage group were obviously lower than that in debridement group, and the difference was statistically significant (χ2 = 9. 07, P<0. 05 ). 62 cases ( 74. 7％) in debridement group and 55 cases (77. 5％) in drainage group were cured directly, respectively. No significant difference was found between two groups. However, 3 cases (3. 6％) in debridement group and 12 cases (16. 9％) in drainage group were cured by the way of small intestinal fistula in the late stage of intubation, and the latter was higher than the former with statistically significant(χ2 =5. 989,P=0. 014). Conclusions Compared with open debridement necrosectomy, the abdominal infection rate, digestive tract fistula rate and mortality of open surgical drainage were all significantly reduced , which may be a better treatment for WOPN.

Objective To evaluate the clinico-pathologic presentations and prognosis in the very elderly patients undergoing renal biopsy.Methods The patients who underwent renal biopsy in Nephrology Center of the First Affiliated Hospital of Zhengzhou University were screened from May 2012 to March 2016.All patients were divided into observation group (aged ≥80 years) and control group (aged 65-70 years).The clinico-pathological classifications and prognosis were compared between the two groups.Results Primary glomerulopathy was the most frequent pathologic diagnosis in observation and control groups[20(60.6％) and 64(64.0％),respectively,P=0.726].Among primary glomerulopathy,membranous nephropathy was the most frequent histopathological type[10(50.0％) and 40 (62.5％)] in observation and control groups,respectively,(P =0.320).Among secondary glomerulopathy,the number of patients in observation group were 10 cases (30.3％) and were 13 cases (13.0％) in control group (t=5.194,P＜0.05),with no significant differences between the two groups in amyloid degeneration,ANCA-associated vasculitis,HBV-associated Glomerulonephritis,and nephritis of Schonlein-Henoch purpura.In the very elderly patients with nephrotic syndrome,glomerular minimal change was the most common histological type [7 (30.4％)],followed by membranous nephropathy[6 (26.1％)].Furthermore,there were no side effects of perinephric hematoma,gross hematuria,arteriovenous fistula or other complications.Conclusions The pathological types distribution of patients aged ≥ 80 versus 65-70 years is different.And the renal biopsy is relatively safe and has an important role for the very elderly patients.