Objective:To investigate the effect of altitude on the risk of pre-eclampsia (PE).Methods:This cross-sectional study included 19 246 pregnant women who delivered in Gansu Provincial Hospital from January 2016 to December 2020. General clinical data, pregnancy outcomes and neonatal outcomes were collected. The diagnosis of PE was based on the disease diagnosis coding of medical record information system and the Chinese guidelines for the diagnosis and treatment of hypertensive disorders in pregnancy (2020). According to the altitude of residence, the subjects were divided into low altitude group (9 931 cases), middle altitude group (9 068 cases) and high altitude group (247 cases). Univariate and multivariate logistic regression analyses were used to evaluate the relationship between altitude and the risk of PE, after adjusting for confounding factors such as age, ethnicity, mode of conception, gestational diabetes mellitus, and hemoglobin level.Results:(1) Among the 19 246 pregnant women, 752 (3.91%, 752/19 246) were diagnosed with PE. The incidence of PE in the low altitude group, middle altitude group and high altitude group was 2.95% (293/9 931), 4.91% (445/9 068) and 5.67% (14/247), respectively. With the increase of living altitude, the incidence of PE increased significantly ( P<0.001). (2) The results of univariate logistic analysis showed that compared with the low altitude area, the risk of PE in pregnant women living in the middle altitude area and high altitude area increased by 70% ( OR=1.70, 95% CI: 1.46-1.97; P<0.001) and 98% ( OR=1.98, 95% CI: 1.14-3.43; P=0.016). (3) The results of multivariate logistic regression analysis showed that after fully adjusting for confounding factors, the risk of PE increased by 40% for every 500 meters of elevation ( OR=1.40, 95% CI: 1.25-1.57; P<0.001). Compared with those living in low altitude areas, the risk of PE in pregnant women living in middle altitude and high altitude areas increased by 72% ( OR=1.72, 95% CI: 1.47-2.00; P<0.001) and 100% ( OR=2.00, 95% CI: 1.07-3.74; P=0.030). Conclusion:In the high-altitude environment of Gansu Province, the risk of PE gradually increases with the increase of altitude.

Objective:To investigate the effect of altitude on the risk of pre-eclampsia (PE).Methods:This cross-sectional study included 19 246 pregnant women who delivered in Gansu Provincial Hospital from January 2016 to December 2020. General clinical data, pregnancy outcomes and neonatal outcomes were collected. The diagnosis of PE was based on the disease diagnosis coding of medical record information system and the Chinese guidelines for the diagnosis and treatment of hypertensive disorders in pregnancy (2020). According to the altitude of residence, the subjects were divided into low altitude group (9 931 cases), middle altitude group (9 068 cases) and high altitude group (247 cases). Univariate and multivariate logistic regression analyses were used to evaluate the relationship between altitude and the risk of PE, after adjusting for confounding factors such as age, ethnicity, mode of conception, gestational diabetes mellitus, and hemoglobin level.Results:(1) Among the 19 246 pregnant women, 752 (3.91%, 752/19 246) were diagnosed with PE. The incidence of PE in the low altitude group, middle altitude group and high altitude group was 2.95% (293/9 931), 4.91% (445/9 068) and 5.67% (14/247), respectively. With the increase of living altitude, the incidence of PE increased significantly ( P<0.001). (2) The results of univariate logistic analysis showed that compared with the low altitude area, the risk of PE in pregnant women living in the middle altitude area and high altitude area increased by 70% ( OR=1.70, 95% CI: 1.46-1.97; P<0.001) and 98% ( OR=1.98, 95% CI: 1.14-3.43; P=0.016). (3) The results of multivariate logistic regression analysis showed that after fully adjusting for confounding factors, the risk of PE increased by 40% for every 500 meters of elevation ( OR=1.40, 95% CI: 1.25-1.57; P<0.001). Compared with those living in low altitude areas, the risk of PE in pregnant women living in middle altitude and high altitude areas increased by 72% ( OR=1.72, 95% CI: 1.47-2.00; P<0.001) and 100% ( OR=2.00, 95% CI: 1.07-3.74; P=0.030). Conclusion:In the high-altitude environment of Gansu Province, the risk of PE gradually increases with the increase of altitude.

Objective To analyze the effect of Compacept on different types of diabetic macular edema(DME)classified by optical coherence tomography(OCT).Methods Clinical data of 89 DME patients who were admitted to Leshan People's Hospital from September 2021 to September 2022 were collected.There were 32 patients with diffuse macular edema(DRT group),31 patients with cystic macular edema(CME group),and 26 patients with serous retinal detachment(SRD group).All patients were treated with intravitreal injection of Compaercept.The best corrected visual acuity(BCVA),central foveal thickness(CFT),and ellipsoid band integrity were compared among groups after treatment.The correlation between the logarithm of the minimum angle of resolution(logMAR)BCVA grade and ellipsoid band integrity was analyzed.Results LogMAR BCVA and CFT were significantly decreased in all patients at 1,3 and 6 months after treatment;logMAR BCVA in the DRT group was lower than that in the CME group and SRD group at 1,3 and 6 months after treatment,while CFT in the SRD group was higher than that in the DRT group and CME group(all P<0.05).The number of eyes with improved vision was as follows:DRT group>CME group>SRD group,and the average frequency of injection was as follows:DRT group

Objective To investigate iodine nutritional status of key population in Puhui Town,Korla Xinjiang.Methods In 2018,totally 29 samples of factory water,peripheral water and self-prepared well water from centralized water supply in Puhui Town were collected,and urine samples,salt samples and blood samples were collected from 200 children aged 8 to 10 years old and 100 women of childbearing age (including pregnant women)in Puhui Town.Arsenic-cerium catalytic spectrophotometric method was used for determination of iodine in water and urine;the salt iodine was determined using direct titration and the thyroid was examined by ultrasound.The assessment was conducted according to the standard of "Delineation of Water-source Areas and Endemic Areas of High Iodine Goiter" (GB/T 19380-2016).Results In this survey,the median of water iodine in Puhui town (n =29)was 76.1 μg/L,and the median of salt iodine (n =175) was 27.76 mg/kg;the rate of iodized salt was 98.29％ (172/175);the consumption rate of qualified iodized salt was 96.00％ (168/175);the medians of urinary iodine of children aged 8 to 10 years old (n =208),women of childbearing age (n =73),and pregnant women (n =25) were 292.47,248.23,and 246.36 μg/L,respectively.The thyroid enlargement rate was 1.9％ (4/208) in children aged 8-10 years old,no swelling of women of childbearing age and pregnant women.Conclusions Iodine nutrition of pregnant women is in an appropriate state;both the children aged 8 to 10 years old and the women of childbearing aged are in excess of the appropriate level;goiter rate is lower in children.According to the national standards,Puhui Town does not belong to waterborne high iodine area.

Objective To understand the levels of water fluoride,tea fluorosis and the severity of drinking tea type of endemic fluorosis in Xinjiang from 2014 to 2016,and to provide a basis for making prevention and control measures.Methods In 2014-2016,a cross-sectional study was conducted to select six counties with serious fluorosis in Xinjiang as monitor counties,one diseased township was selected from five directions including east,south,west,north and center in each county,one village was selected in each township,and 10 families were selected to investigate the situation of brick tea drinking.Drinking water and brick tea samples were collected for detection of fluorine content,and epidemiological methods were used to analyze the prevalence of dental fluorosis and skeletal fluorosis.Results In 2014-2016,resident population per capita brick tea consumptions were 3.9-4.4 kg,per capita brick tea fluorine intakes were 4.6-6.1 mg,and the mean of tea fluorine was 433.1,385.2,432.7 mg/kg,respectively,the differences were not statistically significant (F =0.33,P ＞ 0.05);the means of water fluorine were 0.06-1.26 mg/L,and they were 0.38,0.37,0.33 mg/L,respectively,the differences were not statistically significant (F =2.64,P ＞ 0.05).The survey results showed that dental fluorosis of children aged 8-12 was 243 in three years,with a detection rate of 4.47％ (243/5 442) and the range of 0.08-0.14,which was negative.The skeletal fluorosis of adults aged 36-45 was 25 in 2015,with a detection rate of 2.75％ (25/910).Conclusions The fluorine content of some tea in drinking tea type of endemic fluorosis areas in Xinjiang is high,and the fluorine content of some water samples has exceed the standard of drinking water type disease area (1.2 mg/L).The prevalences of dental fluorosis and skeletal fluorosis are acceptable;it is recommended to maintain the previous prevention and control policies and to further monitor the tea market.

Objective To investigate the effect of hydrochloric acid (HCl) stimulation and mechanical stretch on epithelial-mesenchymal transition (EMT) and hyaluronan (HA) production in human lung epithelial cells. Methods Human lung epithelial cell line BEAS-2B was cultured in vitro, which was divided into phosphate-buffer saline (PBS) + static group, HCl + static group, PBS + stretch group, and HCl + stretch group respectively in the logarithmic phase. The BEAS-2B cells in two stretching groups were challenged by cyclic stretch with 20% amplitude, frequency of 0.33 Hz, sine wave of the FX-5000T system for 48 hours. The morphology changes in cells before and after stretch were observed with inverted microscope. The protein expressions of epithelial markers E-cadherin and cytokeratin-8 (CK-8) as well as mesenchymal markers vimentin and α-smooth muscle actin (α-SMA) were determined by Western Blot. The secretion of HA was determined by enzyme linked immunosorbent assay (ELISA). Results ① It was shown by microscopic observation that BEAS-2B cells displayed cobblestone morphology, linked closely and cell polarity in PBS + static group, which did not change obviously after HCl stimulation alone. Given purely mechanical stretch after 48 hours, the cells morphology changed from cobblestone shape into long spindle, and increased intercellular space obviously. Double hit of HCl and stretch changed the cells morphology more significantly. ② It was shown by Western Blot that compared with the PBS + static group, HCl alone or combined with purely mechanical stretch after 48 hours, the expressions of E-cadherin and CK-8 were decreased, while those of vimentin and α-SMA were increased, and it was more pronounced in HCl + stretch group [the expression quantity (gray value) as base 1 in PBS + static group, E-cadherin: 0.16±0.08 vs. 1, CK-8: 0.10±0.03 vs. 1, vimentin: 3.35±0.38 vs. 1, α-SMA: 3.10±0.45 vs. 1, all P < 0.01]. ③ It was shown by ELISA that both HCl stimulation and stretch could induce BEAS-2B cells secreting HA as compared with PBS + static group (μg/L: 55.763±0.687, 63.005±0.493 vs. 49.876±1.867), and the production of HA increased more remarkably after double hit (μg/L: 78.220±1.085 vs. 49.876±1.867, P < 0.01). Conclusions Both HCl and mechanical stretch could induce EMT and increase HA secretion in human lung epithelial cells in vitro. Double hit of HCl stimulation and mechanical stretch induced EMT apparently, and further increased the production of HA.

Objective To assess the utility of single source-dual energy CT for distinguishing bladder cancer from hematoma. Methods We retrospectively identified 14 patients with postoperative or follow-up bladder hematoma who had undergone dual energy protocol (40-140 keV)scanning by single source-dual energy CT.The subjective scoring of tumor detection and image quality,the optimal monochrome images and iodine-water images were evaluated by two radiologists who didn’t know the results.The consistency of two observers was analyzed by Kappa test.Mann-Whitney U test was used to compare the difference between the two kinds of diseases and ROC curve was used to analyze the diagnostic efficiency.The statistical differences of image quality scoring among different images were obtained by using Mann-Whitney U test.Results The consistency of the two observers about scoring of lesion detection was good for all groups.There were statistical differences between two groups in non-enhanced phase and arterial phase of mixed-energy images,non-enhanced phase,arterial phase and delayed phase of optimal monochromatic images,and all phase of iodine-water images. The AUC of iodine-water images in the four phases (0.985,1.000,0.955,0.924,respectively)were all higher than that of polychrome unenhanced and arterial phase images (0.909,0.909).The diagnostic efficiency of arterial phase on iodine-water images was the highest.Sensitivity and specificity were both 100% when score was greater than 2.5.There was no statistical difference between two kinds of diseases on non-enhanced phase,delayed phases of mixed-energy or monochromatic images(P >0.05).There were no statistical differences in image quality scoring among the three groups with the same phases (P>0.05).Conclusion Optimal monochromatic images and iodine-water images of single source-dual energy CT are more effective than conventional CT in distinguishing bladder cancer from hematoma.

Objective To analyze the potential factors affecting the prognosis of patients with sepsis and evaluate their values in predicting the disease outcome. Methods A clinical prospective study was conducted. Fifty-three septic patients admitted to intensive care unit (ICU) of the First Affiliated Hospital of Guangzhou Medical University from October 17th, 2012 to August 8th, 2013 were enrolled, and in the same term 35 volunteers having passedphysical check-up were assigned in the healthy control group. According to the severity of the patients, they were divided into sepsis, severe sepsis and septic shock groups. Furthermore, based on the difference in scores of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), the patients were divided into low-risk (APACHE Ⅱ scores < 10), middle-risk (APACHE Ⅱ scores 10 - 19) and high-risk groups (APACHE Ⅱ scores≥ 20 ). According to whether the coagulation dysfunction occurred or not and whether the dysfunction was adjusted or not at the end of observation, the septic patients were divided into non-coagulation defect group, and adjusted and non-adjusted coagulation defect groups. After entrance of groups, the clinical data, including gender, age, body temperature, blood pressure, prothrombin time (PT), prothrombin time activity (PTA), activated partial thromboplastin time (APTT), international normalized ratio (INR), levels of D-dimer, fibrinogen (Fib), blood lactate, and serum procalcitonin (PCT) were recorded, and APACHEⅡscore was calculated. In 24 hours after admission, blood samples were collected, and the levels of interleukins (IL-6, IL-8) were tested by Bio-Plex 200 System. The prognostic factors related to sepsis were screened by binary multivariate logistic regression analysis. The receiver operating characteristic curve (ROC) were used to evaluate the prognostic values of blood lactate, PCT, IL-6, IL-8 and APACHE Ⅱ scores for patients with sepsis. Results Fifty-three patients were enrolled, including 17 patients in sepsis group in which blood coagulation dysfunction occurred in 8 cases, of them 7 being adjusted, and 5 died; 15 patients in severe sepsis group, in which blood coagulation dysfunction occurred in 7 cases, of them 2 being adjusted, and 7 died;21 patients in septic shock group in which blood coagulation dysfunction occurred in 18 cases, of them 4 being adjusted, and 18 died. Both IL-6 and IL-8 levels of sepsis group were significantly higher than those in healthy control group (both P<0.01). Univariate logistic regression analysis showed that the grade of sepsis severity, APACHEⅡscore, IL-6, IL-8, blood lactate, PCT and coagulation dysfunction were related to the prognosis of septic patients. Multivariate logistic regression analysis confirmed that blood lactate concentration [β=0.891,χ2 = 5.872, P = 0.015, odds ratio (OR) = 2.438, 95% confidence intervals (95%CI) was 1.186 - 5.013] and coagulation function status (non-adjusted coagulation defect group:β=3.563,χ2=9.980, P=0.002, OR=35.286, 95%CI was 3.868-3.563) were independent prognostic factors of septic patients. The ROC curve analysis showed:for the level of blood lactate, the area value under ROC curve (AUC) was 0.767, the best cutoff value was 2.15 mmol/L with the Youden index of 0.386;for PCT, the AUC was 0.698, the best cutoff value was 9.39μg/L with the Youden index of 0.406;for IL-8, AUC was 0.686, the best cutoff value was 20.06 ng/L with the Youden index of 0.312;and for IL-6, AUC was 0.681, the best cutoff value was 45.44 ng/L with the Youden index of 0.406. Multivariate logistic regression analysis confirmed that the plasma levels of IL-6 and IL-8 were the independent risk factors of septic patients' coagulation function. The IL-6 concentration of non-coagulation defect group was significantly lower than that in adjusted coagulation defect group (ng/L:29.26 vs. 67.98, P<0.05) and non-adjusted coagulation defect group (ng/L:29.26 vs. 128.00 P<0.05). There was no significant difference in IL-6 level between the adjusted and non-adjusted coagulation defect groups (P>0.05). The IL-8 level of non-coagulation defect group was significantly lower than that of adjusted (ng/L:24.67 vs. 27.23, P<0.05) and non-adjusted coagulation defect groups (ng/L:24.67 vs. 60.14, P<0.05). There was no statistically significant difference in IL-8 concentration between adjusted and non-adjusted coagulation defect groups (P>0.05). Conclusions The grade of sepsis severity, APACHEⅡscore, whether existence of coagulation dysfunction being present or not and whether its presence being adjusted or not during the septic patients' stay in ICU, the levels of blood lactate, PCT, IL-6 and IL-8 on the first day in ICU are significantly correlated to the prognosis of septic patients. Whether the existence of coagulation dysfunction being present or not, whether coagulation dysfunction being adjusted or not and the blood lactate level are the independent prognostic factors of septic patients, and the plasma concentrations of IL-6 and IL-8 are the independent affecting factors of whether coagulation dysfunction occurring or not, therefore they have predicting value concerning the occurrence of coagulation dysfunction in septic patients.

Objective To explore the causes of rising carbapenem resistance in Acinetobacter baumannii isolates by analysis of the carbapenemase genotypes in A .baumannii .Methods WHONET 5 .4 was used to analyze the changing resistance profile of A .baumannii isolates over years .A total of 320 carbapenem‐resistant A .baumannii isolates were collected from the patients in an intensive care unit from January 2008 to December 2012 .All strains were identified and tested by VITEK 2 for their susceptibility .The metallo‐β‐lactamases genes and OXA carbapenemase genes were investigated by polymerase chain reaction . Results The resistance rate of A .baumannii isolates to meropenem and imipenem increased rapidly from 10 .8% to 80 .4% and from 13 .5% to 83 .5% during the period from 2008 and 2012 .The prevalence of blaOXA‐23and ISAba1‐associated blaOXA‐23genes increased from 25 .0% to 97 .1% .No metallo‐β‐lactamase encoding genes were detected .Conclusions Our results indicate that the rising carbapenem resistance in the A . baumannii isolates in our intensive care unit may be associated with the high prevalence of blaOXA‐23 and IS A ba1‐associated blaOXA‐23 genes .