Objective:To analyze the risk factors affecting the efficacy of arterial balloon occlusion intervention in cesarean sections for women with placenta accreta spectrum (PAS).Methods:A retrospective study was conducted on 55 PAS patients who underwent arterial balloon occlusion during cesarean sections in the obstetrics department of the First Affiliated Hospital of Guangxi Medical University from January 2015 to March 2021. The patients were divided into two groups based on surgical blood loss: ≥2 000 ml group (27 cases) and <2 000 ml group (28 cases). Baseline data, surgical management, and pregnancy outcomes were analyzed between the two groups. For patients who underwent MRI, prenatal MRI characteristics were analyzed. Intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, or Chi-square test (or Fisher's exact test). Bonferroni correction was used for multiple comparisons. Results:(1) The variation in patients' bleeding volume across different years during the study period was not statistically significant. The proportion of placenta percreta in the ≥2 000 ml blood loss group was significantly higher than in the <2 000 ml group [placenta accreta, increta, and percreta in both groups were 0.0% (0/27) vs. 7.1% (2/28); 25.9% (7/27) vs. 53.6% (15/28); and 74.1% (20/27) vs. 39.3% (11/28), respectively; Fisher's exact test, P=0.019]. (2) The ≥2 000 ml group showed a trend towards higher rates of hysterectomy and failed uterine preservation after placental removal compared to the <2 000 ml group [25.9% (7/27) vs. 3.6% (1/28), Fisher's exact test], but the difference was not statistically significant ( P=0.074). (3) The ≥2 000 ml group had significantly higher blood loss, transfusion of ≥5 units of red blood cells, incidence of disseminated intravascular coagulation, longer surgery time, and higher postoperative transfer to intensive care unit rates compared to the <2 000 ml group [3 600 ml (2 550-5 050 ml) vs. 1 100 ml (600-1 500 ml), Z=756.00; 77.8% (21/27) vs. 21.4% (6/28), χ2=17.40; 33.3% (9/27) vs. 0.0% (0/28), Fisher's exact test; (253±94) min vs. (150±57) min, t=4.92; 40.7% (11/27) vs. 3.6% (1/28), χ2=11.13; all P<0.05]. The bladder injury rate in the ≥2 000 ml group showed a trend towards being higher than in the <2 000 ml group, but the difference was not statistically significant [22.2% (6/27) vs. 3.6% (1/28), Fisher's exact test, P=0.051]. There were no statistically significant differences in other maternal and neonatal outcomes between the two groups. (4) Among the study subjects, 50 patients had prenatal MRI data, with 22 in the ≥2 000 ml group and 28 in the <2 000 ml group. The ≥2 000 ml group had a significantly higher proportion of local exophytic masses, asymmetric placental thickening/shape, and placental invasion in the S2 region compared to the <2 000 ml group [81.8% (18/22) vs. 53.6% (15/28), χ2=4.38; 81.8% (18/22) vs. 50.0% (14/28), χ2=5.41; 95.5% (21/22) vs. 53.6% (15/28), χ2=10.72; all P<0.05]. Conclusions:When the placenta invades the S2 region and the depth is invasive, arterial balloon occlusion in cesarean sections for PAS still faces a high risk of massive hemorrhage. Prenatal MRI should focus on assessing the extent and depth of placental invasion to identify potentially severe PAS cases, thereby optimizing the clinical application of arterial balloon occlusion.

Objective:To analyze the risk factors affecting the efficacy of arterial balloon occlusion intervention in cesarean sections for women with placenta accreta spectrum (PAS).Methods:A retrospective study was conducted on 55 PAS patients who underwent arterial balloon occlusion during cesarean sections in the obstetrics department of the First Affiliated Hospital of Guangxi Medical University from January 2015 to March 2021. The patients were divided into two groups based on surgical blood loss: ≥2 000 ml group (27 cases) and <2 000 ml group (28 cases). Baseline data, surgical management, and pregnancy outcomes were analyzed between the two groups. For patients who underwent MRI, prenatal MRI characteristics were analyzed. Intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, or Chi-square test (or Fisher's exact test). Bonferroni correction was used for multiple comparisons. Results:(1) The variation in patients' bleeding volume across different years during the study period was not statistically significant. The proportion of placenta percreta in the ≥2 000 ml blood loss group was significantly higher than in the <2 000 ml group [placenta accreta, increta, and percreta in both groups were 0.0% (0/27) vs. 7.1% (2/28); 25.9% (7/27) vs. 53.6% (15/28); and 74.1% (20/27) vs. 39.3% (11/28), respectively; Fisher's exact test, P=0.019]. (2) The ≥2 000 ml group showed a trend towards higher rates of hysterectomy and failed uterine preservation after placental removal compared to the <2 000 ml group [25.9% (7/27) vs. 3.6% (1/28), Fisher's exact test], but the difference was not statistically significant ( P=0.074). (3) The ≥2 000 ml group had significantly higher blood loss, transfusion of ≥5 units of red blood cells, incidence of disseminated intravascular coagulation, longer surgery time, and higher postoperative transfer to intensive care unit rates compared to the <2 000 ml group [3 600 ml (2 550-5 050 ml) vs. 1 100 ml (600-1 500 ml), Z=756.00; 77.8% (21/27) vs. 21.4% (6/28), χ2=17.40; 33.3% (9/27) vs. 0.0% (0/28), Fisher's exact test; (253±94) min vs. (150±57) min, t=4.92; 40.7% (11/27) vs. 3.6% (1/28), χ2=11.13; all P<0.05]. The bladder injury rate in the ≥2 000 ml group showed a trend towards being higher than in the <2 000 ml group, but the difference was not statistically significant [22.2% (6/27) vs. 3.6% (1/28), Fisher's exact test, P=0.051]. There were no statistically significant differences in other maternal and neonatal outcomes between the two groups. (4) Among the study subjects, 50 patients had prenatal MRI data, with 22 in the ≥2 000 ml group and 28 in the <2 000 ml group. The ≥2 000 ml group had a significantly higher proportion of local exophytic masses, asymmetric placental thickening/shape, and placental invasion in the S2 region compared to the <2 000 ml group [81.8% (18/22) vs. 53.6% (15/28), χ2=4.38; 81.8% (18/22) vs. 50.0% (14/28), χ2=5.41; 95.5% (21/22) vs. 53.6% (15/28), χ2=10.72; all P<0.05]. Conclusions:When the placenta invades the S2 region and the depth is invasive, arterial balloon occlusion in cesarean sections for PAS still faces a high risk of massive hemorrhage. Prenatal MRI should focus on assessing the extent and depth of placental invasion to identify potentially severe PAS cases, thereby optimizing the clinical application of arterial balloon occlusion.

Objective To explore the main problems of ultrasonic quality management in Qinghai Province.Methods The ultrasound departments of 19 tertiary hospitals and 51 secondary hospitals in Qinghai Province were investigated.The x2 test was carried out to analyze the setting of departments,subspecialty,instrument status,ultrasonic quality control,workload,and personnel specialty and educational composition ratio.Results There was a statistically significant difference between tertiary and secondary hospitals in department settings,sub-specialty,instrument status,ultrasound quality control,workload,personnel specialty,and personnel qualifications (x2=30.49,38.208,36.87,7.913,28.518,7.111 and 322.363,respectively,P ＜ 0.01 for all).Conclusions The above-mentioned observation indexes are better in the 19 tertiary hospitals than in the 51 secondary hospitals in Qinghai Province.Strengthening construction from these aspects and improving ultrasound quality control management play an important role in improving the level of ultrasound diagnosis and promoting the homogeneity of ultrasound diagnosis.

Objective: To compare the pharmacodynamic action of Radix Notoginseng after fermented by different strains bioconversion.Methods:The models of cerebral ischemia and hypoxia were established,thrombosis in vivo were induced by collagen-Adr,ventricular fibrillation of mice by chloroform,and perfusion experiment of the ex vivo heart of cavia cobaya was used.Results:100,200mg/kg doses of all samples had protective effects on ischemia and hypoxia mice,1# sample can inhibit thrombosis induced by collagen-adrenaline obviously after intraperitoneal injection in dosage of 200mg?kg-1?d-1 for 5days.All groups significantly reduced the incidents of ventricullar fibrillation induced by chloroform in mice except 100mg/kg dose of 1#,furthermore,compared with control high dose group(5#),the incidents of high dose groups of 3、4# deceased significantly.All samples had the effect of dilating coronary artery,but there effects on myocardial contractile force and cardiac preload were different.Conclusion:The primary cardiovascular related pharmacological researches demonstrated the vary action changes of 1-4# samples compared with the sample 5#.This result has revealed that the chemical structure of Radix Notoginseng transformed and that is coincide with initial analysis of phytochemical analysis.