ObjectiveTo investigate the regulatory effect and potential mechanisms of isocitrate dehydrogenase 3A （IDH3A） on cardiomyocyte hypertrophy. MethodsThe expression of IDH3A in the myocardium of healthy volunteers （n=10） and patients with heart failure （HF） （n=10）， and in the myocardium of mice subjected to transverse aortic constriction （TAC） surgery and sham operation， as well as in phenylephrine （PE）-induced neonatal rat ventricular cardiomyocytes （NRVCs）， was assessed by real-time quantitative polymerase chain reaction （RT-qPCR） and Western blot assay. The effect of adenovirus-mediated overexpression of IDH3A on the expression of hypertrophy-related genes in PE-induced NRVCs was also evaluated. The effect of IDH3A on NRVCs area was examined by phalloidin staining assay. A mutant of IDH3A with abolished enzymatic activity， IDH3A_D208A， was generated through site-directed mutagenesis. The impact of this IDH3A mutant on the hypertrophic phenotype， ATP and ROS levels in NRVCs was evaluated to investigate whether the regulatory role of IDH3A in cardiomyocyte hypertrophy was dependent on its enzymatic activity. The effect of exogenous α-ketoglutaric acid （AKG） on cardiomyocyte hypertrophy was also detected by Western blot and phalloidin staining assay， respectively. ResultsIDH3A was significantly decreased in the myocardium of HF patients， in the myocardium of TAC-operated mice， and in PE-induced NRVCs （P = 0.005 2，P = 0.026 6，P = 0.041 3 and P = 0.006 6， respectively）. Overexpression of IDH3A markedly suppressed the expression of hypertrophy-related genes and the increase of cell size of PE-induced NRVCs （P < 0.000 1， P = 0.000 1 and P = 0.000 2， respectively）. The ATP and ROS analysis indicated that IDH3A inhibited the increases of ATP and ROS levels in PE-induced NRVCs （P = 0.001 2 and P<0.000 1， respectively）， whereas the enzymatically inactive IDH3A mutant lacked this effect. Exogenous AKG provision could， but overexpression of IDH3A mutant failed to suppress PE-induced NRVCs hypertrophy. ConclusionIDH3A inhibits cardiomyocyte hypertrophy via elevating AKG level， providing scientific evidence for study on IDH3A-based treatment of cardiac hypertrophy.

Objective To investigate the clinical efficacy of Xinxuetong Oral Liquid in the treatment of patients with acute coronary syndrome(ACS).Methods A total of 80 patients with ACS of blood stasis syndrome who were hospitalized in Shunde Hospital of Guangzhou University of Chinese Medicine from January 2023 to September 2023 were randomly divided into the treatment group and control group according to random number table method,40 patients in each group.The patients in the two groups were given conventional western medicine treatment including lifestyle guidance,percutaneous coronary intervention(PCI),and conventional western medicine therapy.Additionally,the treatment group was treated with Xinxuetong Oral Liquid.The course of treatment for the two groups covered eight weeks.Before and after treatment the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome score,blood stasis syndrome score,angina pectoris score,blood lipid indicators,carotid ultrasonography indicators,echocardiography indicators,and serum levels of trimethylamine-N-oxide(TMAO),nitric oxide(NO),endothelin 1(ET-1),interleukin 8(IL-8),serine/threonine-protein kinase 1(AKT-1),and vascular endothelial growth factor A(VEGF-A).After treatment,the efficacy on TCM syndrome efficacy and the safety of the regimen in the two groups were evaluated.Results(1)During the trial,there were two cases of loss to follow-up and one case of withdrawal due to pneumonia,and eventually a total of 77 patients completed the full course of treatment,among which 39 patients were in the treatment group and 38 patients were in the control group.(2)After eight weeks of treatment,the total effective rate of the treatment group was 89.74％(35/39),and that of the control group was 63.16％(24/38).The intergroup comparison(tested by chi-square test)showed that the effective rate of TCM syndrome efficacy in the treatment group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the scores of TCM symptoms such as chest pain,chest distress,symptom aggravation at night,and palpitation in the two groups,as well as the score of gloomy complexion in the treatment group,were significantly decreased compared with those before treatment(P＜0.05 or P＜0.01),and the decrease of scores of chest distress,symptom aggravation at night,and palpitation in the treatment group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(4)After treatment,the blood stasis syndrome score and angina pectoris symptom score of the two groups of patients were significantly decreased compared with those before treatment(P＜0.01),and the decrease in the treatment group was significantly superior to that in the control group(P＜0.01).(5)After treatment,the serum TMAO,ET-1,IL-8,AKT-1,and VEGF-A levels in the two groups were significantly decreased compared with those before treatment(P＜0.01),and the serum NO level was significantly increased compared with that before treatment(P＜0.01).The decrease of serum TMAO,ET-1,IL-8,and AKT-1,VEGF-A levels and the increase of serum NO level in the treatment group were significantly superior to those of the control group(P＜0.05 or P＜0.01).(6)After treatment,the total cholesterol(TCHO)and low-density lipoprotein cholesterol(LDL-C)levels of the two groups(P＜0.01)and the triglyceride(TG)level of the treatment group(P＜0.05)were decreased significantly compared with those before treatment,while the high-density lipoprotein cholesterol(HDL-C)level of the treatment group was increased significantly compared with that before treatment(P＜0.01).No obvious changes of TG and HDL-C levels before and after treatment were shown in the control group(P＞0.05).The comparison of blood lipid indicators after treatment between groups showed that there were no statistically significant differences(P＞0.05).(7)After treatment,the carotid ultrasonography indicators of carotid intima-media thickness(IMT)and Crouse score of the carotid plaque in the two groups were significantly improved compared with those before treatment(P＜0.01).However,there was no statistical significance in the comparison of the two indicators between the two groups after treatment(P＞0.05).(8)The observation of echocardiography indicators showed that only the post-treatment left ventricular diameter(LVd)of the treatment group was significantly larger than that before treatment(P＜0.05),while no obvious changes of the other echocardiography indicators before and after treatment were shown in the two groups(P＞0.05).The comparison between the groups after treatment also showed no statistically significant differences(P＞0.05).(9)During the treatment,no serious drug-induced adverse reactions or drug-related severe cardiovascular events and complications occurred in the two groups.Conclusion The combination of Xinxuetong Oral Liquid with conventional western medicine treatment exerts certain efficacy and safety on improving the clinical symptoms of patients with ACS of blood stasis syndrome,and its therapeutic mechanism may be related to the improvement of blood lipid levels,inflammatory response,and TMAO level.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To analyze the genetic evolution characteristics of hemagglutinin (HA) and neuraminidase (NA) of influenza B virus in Tongling during 2019-2022 surveillance years.Methods:Twenty-two strains of Victoria influenza B virus isolated from our laboratory during 2019-2022 were selected for whole genome sequencing. The sequence comparison and phylogenetic analysis were conducted by using bioinformatic analysis software.Results:During 2019-2022, seasonal influenza in Tongling City was predominantly caused by influenza B Victoria lineage viruses, which fell within the V1A.3 branch. Among these, 14 strains isolated in the 2021-2022 season were further classified into the V1A.3a.2 sub-branch. Compared with vaccine strains, multiple amino acid mutation sites were detected in both HA and NA proteins of the 22 influenza B Victoria lineage viruses. Notably, all four major antigenic sites (120-loop, 150-loop, 160-helix, and 190-helix regions) in the HA protein exhibited variations. Although no mutations were detected at resistance sites on the NA protein, a change occurred in the glycosylation site at position 197 NETQ in the HA protein.Conclusions:The main amino acid sites of the HA protein of the influenza B Victoria lineage viruses in Tongling City from 2019 to 2022 have undergone significant variation, which may lead to antigenic drift. Therefore, it is essential to strengthen the monitoring of influenza virus mutations.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.

Objective:To investigate the high risk factors,diagnostic accuracy of ultrasonography and pregnan-cy outcomes of umbilical cord wrapped around the neck for≥4 loops.Methods:The clinical data of 64 pregnant women with umbilical cord around the neck for≥4 loops(the group with umbilical cord around the neck≥4 loops)in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2011 to February 2024 were retrospectively analyzed.At the same time,80 cases with umbilical cord around the neck for 1-2 loops(the group with umbilical cord around the neck 1-2 loops)were randomly selected as the controls.General information,clinical manifestations,ultrasound diagnosis and other data of the two groups were collected.The risk factors of umbilical cord around the neck≥4 loops and diagnostic accuracy of ultrasonography were ana-lyzed with univariate and multivariate Logistic regression analysis,and the pregnancy outcomes were compared between the two groups.Results:①The incidence of pregnancy,abortion,delivery and history of cesarean sec-tion were lower in the group with umbilical cord around the neck ≥4 loops than those in the group with umbilical cord around the neck 1-2 loops.The incidence of consciously abnormal fetal movement,abnormal umbilical ar-tery systolic/diastolic(S/D)ratio,abnormal fetal heart rate monitoring(NST)and fetal distress were higher in the group with umbilical cord around the neck≥4 loops than those in the group with umbilical cord around the neck 1-2 loops,and the differences were statistically significant(P＜0.05).②Multivariate Logistic regression analysis showed that polyhydramnios and excessively long cord were independent risk factors for umbilical cord around the neck≥4 loops(OR＞1,P＜0.05).③When the time between ultrasound diagnosis and the operation was 2 days,the consistency rate between ultrasound diagnosis of umbilical cord around the neck≥4 loops and intrao-perative diagnosis was the highest,and the difference was statistically significant with＞3 days(46.2％vs.6.30％,P＜0.05).Compared with umbilical cord around the neck 3 loops,ultrasound diagnosis of umbilical cord loops around the neck at 4 or 5 loops had a higher consistency rate with intraoperative diagnosis,and the differ-ence was statistically significant(P＜0.05).④The incidence of premature delivery,neonatal asphyxia and admis-sion to neonatology in the group with umbilical cord around the neck ≥4 loops were higher than those in the group with umbilical cord around the neck 1-2 loops,and the difference was statistically significant(P＜0.05);and the gestational week and birth weight of newborns were significantly lower(P＜0.05).Conclusions:Polyhydramnios and excessively long cord are high risk factors for umbilical cord around the neck≥4 loops.The closer the ultra-sound diagnosis is to the time before cesarean section and the more times the umbilical cord is around the neck in ultrasonic diagnosis,the higher the diagnostic accuracy.Fetal outcomes with umbilical cord around the neck≥4 loops are worse.