Objective To observe the value of ultrasound for diagnosing esophageal foreign body in children.Methods Ultrasonic manifestations of 45 children with esophageal foreign body were retrospectively analyzed,and the diagnostic value of ultrasound was evaluated.Results Among 45 cases,cervical esophageal foreign body was found in 40 cases(40/45,88.89%),while thoracic esophageal foreign body was detected in 5 cases(5/45,11.11%).Ultrasound correctly diagnosed 44 cases of esophageal foreign body,with an accuracy rate of 97.78%(44/45).Among different kinds of foreign bodies,fruit pits mainly presented as arc strong echogenicity accompanied by behind sound shadow,plastic stickers exhibited strong echogenicity with clear edges in the form of stripes,fish bones presented as irregular or slender strong echogenicity,button batteries demonstrated in arc/short strip strong echogenicity accompanied by sound shadows in the rear,while cooked albumen appeared as irregular chunks without echo,and the sarcocarp,toy parts and coins often presented as different shaped moderate/strong/mixed echogenicity,metallic foreign bodies with"comet tail"sign behind the strong echoes.Among 44 cases ultrasound correctly diagnosed esophageal foreign body,no abnormal changes of surrounding esophageal wall was found in 31 cases(31/44,70.45%),whereas mucosal necrosis injury and ulcer formation were detected in 7 cases(7/44,15.91%),inflammatory edema of esophageal wall were noticed in 3 cases(3/44,6.82%),and 3 cases(3/44,6.82%)were found with esophageal perforation.Conclusion Ultrasound was convenient and feasible for diagnosing esophageal foreign body in children with high accuracy.

Aim To study the causal relationship between coffee consumption and atherosclerosis risk.Methods Based on the public genome database IEU Open GW AS project website,relevant data were obtained,and in-strumental variables closely related to exposure and outcome were screened.Mendelian randomization analysis was per-formed using the inverse variance weighted method,weighted median method,and MR Egger method to assess the causal relationship between coffee consumption and arteriosclerosis(including coronary atherosclerosis,peripheral atherosclerosis,cerebral atherosclerosis,and other atherosclerosis).In addition,the Egger intercept method was used to detect the level of pleiotropy,the Cochran Q test was used to assess the heterogeneity,and the leave one out method was used to perform sensitivity analysis,so as to ensure the robustness of the results.Results The study showed that the F-values of the instrumental variables included in the study were all greater than 10,and there was no weak instrumental variables bias.Coffee consumption was positively correlated with the risk of coronary atherosclerosis(OR=1.535 5,95％CI=1.108 4～2.127 2,P=0.009 9),peripheral atherosclerosis(OR=2.098 6,95％CI=1.182 2～3.725 7,P=0.011 4),and other atherosclerosis(OR=1.864 7,95％CI=1.052 9～3.302 4,P=0.032 6),but not with the risk of cerebral atherosclerosis.Heterogeneity test Q_pval＞0.05,level pleiotropy test interval P＞0.05.Conclusions The single nucleotide polymor-phisms selected in the study are all strong instrumental variables,and there is no heterogeneity or horizontal pleiotropy,in-dicating reliable results.The research shows that coffee consumption increases the risk of coronary atherosclerosis,pe-ripheral atherosclerosis and other atherosclerosis,and has no significant correlation with the risk of cerebral atherosclerosis.The health management of atherosclerosis patients should reduce coffee consumption.

Objective:Rapid assessment of the outcome after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) is an important clinical issue. In this study, an electrocardiogram (ECG) analysis method based on dynamic learning was proposed.Methods:A total of 203 patients with ACS after successful PCI were enrolled for prospective analysis at the Emergency Department of Qilu Hospital of Shandong University from April 2019 to December 2020. All patients were divided into group without ≥70% postoperative stenosis ( n=72) and group with ≥ 70% postoperative stenosis ( n=131) according to the presence of 70% or more stenosis after PCI. The clinical data of ACS patients were collected and analyzed by χ2 test, t-test, or Mann-Whitney test. ECGs were recorded before and 2 h after PCI, and were dynamically analyzed to generate cardiodynamicsgram (CDG) using dynamic learning. In the group without ≥ 70% postoperative stenosis, the model and CDG index for evaluating myocardial ischemia were obtained by training support vector machine (SVM) using 10 times 10-fold cross-validation. Results:There was no significant difference in clinical data between the two groups. The prediction accuracy and sensitivity of the support vector machine model for myocardial ischemia in group without≥70% postoperative stenosis were 73.61%, and 84.72% respectively. CDG transformed from disorderly to regular after PCI, and CDG index decreased significantly ( P<0.001): 90.28% (65) patients in group without≥70% postoperative stenosis, and 79.39% (104) patients in group with≥70% postoperative stenosis had lower CDG indexes than before PCI. Conclusions:In this study, CDG obtained by dynamic learning can intuitively and effectively evaluate the changes of myocardial ischemia before and after PCI, which is helpful to assist clinicians to formulate the next treatment plan.

Objective To investigate the current situation and annual trend of injuries among primary and middle school students in Changning District, Shanghai, and to provide scientific evidence for decision-making of prevention and control. Methods The monitoring data of various types of injuries was collected from the ^“cause of class absence^” system during the 2010-2017 school years. The Joinpoint regression analysis was used to estimate the annual percent change and average annual percent change, and to perform the trend test. Results During the 2010-2017 school years in Changning District, a total of 2,286 cases of injuries occurred among primary and middle school students, with an injury rate of about 0.70%. The top three prevalent injury types were falls, traffic accidents, and burn-related injury. The results of Joinpoint trend analysis indicated that the incidence of total injuries in Changning District was generally decreasing, which was mainly due to the effective control of injuries caused by falls, traffic accidents, and burns, and to the decreasing injury incidence among primary school students. Conclusion The overall situation of injuries among primary and middle school students in Changning District has improved significantly, but falls and traffic accidents are still important health threats. More attentions should be paid to certain groups, such as vocational and special education students.

Objective To evaluate the efficacy and safety of autologous peripheral blood stem cell transplantation (APBSCT) in treatment of patients with decompensated hepatitis B cirrhosis.Methods Sixty two patients with decompensated hepatitis B cirrhosis admitted in Ningbo Second Hospital during January 2010 and December 2013 were enrolled in the study.Patients were randomly assigned in two groups: 50 patients in control group received comprehensive medical treatment only, and 12 patients in combination group received APBSCT on the basis of medical treatment.The levels of serum total bilirubin (TBil), albumin (Alb), alanine aminotransferase (ALT) and prothrombin time (PT) in two groups were mearsured at the 4th,12th,24th week.Overall survival (OS),progression-free survival (PFS) and complications were compared between two groups after 3 years follow-up.SPSS17.0 software was used to analyze the data.Results After APBSCT treatment, the level of Alb and PT at week 4,12 and 24 in combination group improved significantly(tAlb=-4.437,-5.210 and-6.915,tPT=12.083,11.251 and 10.640,all P<0.01),there were also significant differences between combination group and control group (tAlb=4.985, 5.565 and 6.260,tPT =-3.013、-3.727 and-3.983,all P<0.01).The 3-year OS and 3-year PFS of patients in combination group were higher than those of control group [(90.9±8.7)%vs.(60.7±7.4)%, (75.8±12.5)% vs.(47.9±7.3)%](χ2=6.887 and 5.565,P<0.05).Besides,APBSCT had more advantages than control group in reducing ascitic fluid and hepatic encephalopathy(χ2=7.992 and 4.681,P<0.05 or <0.01).Conclusion APBSCT combined with medical treatment can improve liver function and 3-year survival rate with mild adverse reaction in patients with decompensated hepatitis B cirrhosis.

Objective To investigate the correlation between body mass index (BMI) and the occurence of papillary thyroid carcinoma (PTC) among the patients with thyroid nodules. Methods This cross-sectional study collected the data of 4 350 patients with thyroid nodules who underwent thyroidectomy in our hospital from January 1994 to December 2013. The patients were divided into normal weight (BMI 18.50~23.9 kg/m 2), overweight (BMI 24.0~27.9 kg/m 2), and obese (BMI≥28.0 kg/m 2) groups according to BMI, as well as benign nodules and papillary thyroid carcinoma groups based on their pathological finding. The differences of age-sex composition, nodule diameter, TSH level, overweight and obese constituent ratio between two groups were also analyzed. Logistic regression method was used to evaluate the risk factors of PTC. Results (1) Compared with the benign nodule group, there was a higher proportion of patients under the age of 40 years (34.1% vs 19.5%, P<0.01) in PTC group, with smaller tumour diameters [ 1.0 (0.7-2.0) cm vs 3.0 (2.0-4.0) cm, P<0.01]and higher TSH levels [ 1.9 (1.2-3.0) mU/L vs 1.6 (0.9-2.5) mU/L, P<0.01]. (2) The proportion of obese patients was higher in PTC group than that in the benign nodule group (28.7% vs 20.7%, P<0.01) among male patients. While the difference was not found among female patients. (3) Stratification analysis according to gender and age showed that the proportion of overweight (49.4% vs 44.1%, P<0.05) or obese (26.5% vs 15.3%, P<0.01) in PTC group was higher than that of benign nodule group among male patients aged≤40 years and the proportion of obese patients in PTC group was higher than that of benign nodule group (30.8% vs 22.2%, P<0.01) among male patient aged 41 to 65 years. (4) A multivariate analysis indicated that overweight (OR=4.947) and obesity (OR=7.648) were all independent risk factors for PTC (P<0.01) among male patients aged≤40 years. Conclusion Overweight and obesity are associated with higher PTC risk for male patients aged 40 years or less.

Objective To investigate the trends in the clinicopathological characteristics of thyroid cancer patients undergoing surgery from 1994 to 2013. Methods A retrospective analysis was conducted on the clinical data of inpatients with thyroid nodular diasease undergoing thyroidectomy with pathology results from January 1994 to December 2013. The trends in the pathogenic constituent of thyroid nodule and the clinicopathological characteristics of 3 399 patients with thyroid cancer were analyzed. Results (1) Over the past 20 years, the proportion of patients diagnosed as thyroid cancer was gradually increased, especially those with papillary thyroid cancer (PTC). Whereas the proportions of benign nodule and other rare thyroid cancer were gradually decreased(P<0.01). (2) The average age of patients with thyroid cancer was (44.30±11.72) years, with the peak incidence at 30~59 years. The incidence of thyroid cancer was increasing in both males and females, especially more evident in the absolute increase in women(P<0.05). (3) Among 3 399 patients with thyroid cancer, 56.20%(1 910/3 399)underwent subtotal lobectomy. 20.74%(705/3 399)underwent total/near total thyroidectomy, showing an increase trend (P<0.01). Ultrasound-guided aspiration biopsy for thyroid nodule were performed in 48.87% (1 661/3 399)patients before operation. The proportion of aspiration biopsy was gradually increased since 2004. (4) An increase in thyroid cancer of tumor sizes less than 2.0 cm was observed, especially those size≤1.0 cm(P<0.01). 83.96%(2 854/3 399)patients revealed TNM Ⅰ~Ⅱ stage, and the proportion of patients with TNM Ⅲ~Ⅳ stage was gradually decreased since 2006(P<0.01). Conclusion Over the past 20 years, the proportion of thyroid cancer, especially papillary thyroid microcarcinoma reveals an ascending tendency. The percentages of patients undertaking total/near total thyroidectomy and ultrasound-guided aspiration biopsy before operation are on the rising.

Objective To explore the potential influence of gender on screening value of aldosterone-renin ratio (ARR) for primary aldosteronism (PA).Methods The biochemical parameters were collected of 451 PA patients and 300 essential hypertension (EH) patients who were diagnosed in the General Hospital of PLA from 1992 to 2014. Each group was then divided into two groups by gender. The clinical characteristics were compared and then the receiver operating characteristic curve (ROC) was conducted to evaluate the best cut-off value.Results The plasma aldosterone concentration (PAC), serum sodium and ARR were much higher, but the plasma rennin activity (PRA), serum potassium and BMI were much lower in PA patients than in EH patients (P<0.01), and no significant difference existed between the two groups in age, duration of hypertension and blood pressure. The PRA was obviously lower in males than in females either in PA or in EH patients, but no signicantcant difference existed between males and females in PAC (P>0.05). The best cut-off value of ARR in male PA patients was 19.11, the relevant area under the curve (AUC) was 0.968, the sensitivity and specicantcity was 92.44% and 93.08%, and the Youden index (YI) was 0.86. The best cut-off value of ARR in female PA patients was 27.26, with AUC 0.956, sensitivity 92.07%, specicantcity 90.00% and YI 0.82, respectively. If the cut-off value was set at 27.26 in males, the specicantcity would rise a little, but the sensitivity and YI would sharply decrease. Similarly, the sensitivity would increase a little but the specicantcity and YI would fall substantially if the cut-off value in females was set at 19.11. The best cut-off value of ARR in men was smaller than the ocantcial value recommended by guidelines.Conclusion Gender is an important factor should be considered while ARR is used in PA screening, and the cut-off value of ARR in screening female PA patients should be setting higher.

Objective To study the influencing factors and clinical significance of ultrasonic quantitative analysis of the hip-flexion coronal section in the normal infants.Methods Totally 100 normal infants were enrolled.Angle α,angle β and FHC on different positions(mild-flexion and flexion of the hip) were mearured.And angle β on different points(the labrum central and the acetabular tips) were measured.The variation of the measurement index between different positions were analyzed.Results ①There was no significant difference in angle α between the neutral position and hip-flexion position (P ＞0.05).② FHC decreased in the hip-flexion position,and there was significant difference compared with the neutral position (P ＜0.05).③βc were greater than βt in the two positions (P ＜0.05);βc and βt were all greater in hip-flexion position than those in neutral position,the difference was statistically significant (P ＜0.05).Conclusions The results obtained from angle α is stable under the coronal flexion view of the normal infants,and does not vary with changing position.The change of the angle β and FHC with the hip flexion could be used to evaluate the stability of the hip.Measured angle β on the labrum tip has good repeatability.So this point should be selected to measure the angle β.

Objective To clarify the role of the known genes and new discovered genes, which were important to the pathogenesis of Alzheimer's disease (AD), in order to provide targets for clinical prevention, diagnosis and treatment. Methods In order to predict AD susceptible genes, the website databases (OMIM, AlzGene) and a variety of pathogenic gene prediction tools such as Endeavour, Gene Prospector, GLAD4U and ProphNet were used to make biological analysis. Results Disease-causing genes were directly obtained from the OMIM and Alzgene databases, and related genes were collected by 4 kinds of tools (select gene whose frequency was 3 or more). The data were shared and a list of 25 genes was gotten. These genes were CALHM1、 ABCA7、 A2M、 CLU、 SORL1、 HFE、 CD2AP、 APP、 ACE、 PICALM、 APOE、 NOS3、 MS4A6A、 PLD3、 CR1、 ADAM10、 MS4A4E、 BLMH、 PSEN1、 CD33、 PSEN2、 MPO、 APBB2、 BIN1 and PLAU. Conclusion CALHM1, ABCA7, A2M and CLU, etc., have a certain correlation with AD, which provide theoretical basis for further research of AD genics and clinical treatment.