Objective To assess the efficacy of transvaginal three-dimensional power Doppler ultrasound(3D-PDU)in predicting pregnancy outcomes after mild and moderate transcervical resection of adhesion(TCRA).Methods Sixty-six patients with mild and moderate intrauterine adhesions(IUA)who had fertility issues and underwent TCRA surgery in Tongde Hospital of Zhejiang Province from January 2020 to December 2021 were chosen,31 successful pregnancy patients were included in pregnancy group,and 35 unsuccessful pregnancy patients were included in non pregnancy group.3D-PDU examination was performed before and 3 months after surgery.The measurements of endometrial thickness(ED),uterine volume(EV),endometrial vasculogenesis index(VI),blood flow index(FI),and vasculogenesis-blood flow index(VFI)were taken.The pregnancy was followed up for 1 year to observe the prognostic value of the above related indicators on postoperative pregnancy.Results The ED,EV,VI,FI and VFI levels of patients post-operation were significantly higher than those before the operation(P＜0.05),the improvement of pregnant group patients was better than that of non pregnant group patients(P＜0.05),and area under the receiver operating characteristic curve were 0.80,0.84,0.68,0.65 and 0.88 respectively.Conclusion 3D-PDU can effectively predict the postoperative pregnancy outcome of TCRA in patients with mild to moderate IUA by measuring ED,EV,VI,FI,and VFI before and after surgery,providing reference for efficacy evaluation and guiding subsequent treatment.

【Objective】 To investigate the clinical characteristics and antibody distribution as well as evaluate the transfusion efficacy in unexpected antibody positive patients. 【Methods】 A total of 12 235 patients from January 1, 2022 to March 31, 2023 who hospitalized in our hospital and applied for blood transfusion were selected, and those with unexpected antibody were included. The clinical data, including gender, age, diagnosis, blood type, history of transfusion and pregnancy were collected for antibody distribution analysis. Patients who received transfusion were grouped according to the DAT results and the components of red blood cells transfused, and the Hb values of each group before and after transfusion were compared. 【Results】 Among12 235 patients, 118 were positive for antibody screening, with a prevalence of 0.96%. The antibodies from Rh system were the most common (27.43%, 48/175), followed by MNS system (8.57%, 15/175) and Lewis system (6.29%, 11/175), mainly anti-E (18.29%, 32/175), anti-M (8.00%, 14/175) and anti-Le^a (5.71%, 10/175). In addition, 62 transfused patients were divided into group A with suspended red blood cell transfusion and group B with washed red blood cell transfusion for positive DAT, and group C for negative DAT. Hb values (g/L) pre- and post-transfusion were 59.19±15.67 vs 77.52±15.09 in group A, 56.35±14.08 vs 74.44±15.63 in group B, 56.00±12.06 vs 75.00±4.73 in group C, respectively. The Hb values of post-transfusion for three groups were all higher than those of pre-transfusion (P<0.05). 【Conclusion】 Anti-E from Rh system is the most common antibody in patients with unexpected antibody. Appropriate red blood cells transfusion with Hb increases by an average of 6-7 g/L per 1 U of red blood cells indicating good transfusion efficacy. For positive DAT patients, transfusion of suspended red blood cell is feasible.

Objective:To investigate the efficiency and safety of peritoneal dialysis (PD) in pediatric patients with acute kidney injury (AKI).Method:A retrospective study of children who underwent PD for AKI in the First Affiliated Hospital of Xi’an Jiaotong University from 2003 to 2013 was performed, and the laboratory examinations, the causes, the complication, the prognosis and the risk factors were evaluated.Results:The study included 48 children, with the age of (67.6±51.7) months (ranging from 3 months to 15 years old), including 31 males (64.6%) and 34 co-infections (70.8%). Primary glomerulonephritis (27.1%) was the most common cause of AKI, followed by the hemolytic uremic syndrome (18.7%) and drug induced AKI (18.7%). Peritoneal dialysis was performed manually using percutaneous or adapted catheters. The duration of PD during hospitalization was 11(7,14) days. PD treatment was highly effective in attenuation of toxics retention and correction of electrolyte disturbances (all P<0.05). There were 3 cases of PD-related complications, including 1 case of peritonitis, 1 case of catheter outflow obstruction, 1 case of catheter exit site hematoma, and no child patient died of PD complications. Among the AKI children, 37 cases (77.1%) recovered with the PD treatment and had the catheter successfully removed till discharge, 7 cases (14.6%) needed further peritoneal dialysis and 4 cases (8.3%) died. The serum albumin level was significantly higher in patients who got recovered with PD treatment than other unrecovered cases [(32.6±6.7) g/L vs (23.2±4.3) g/L, t=-3.994, P<0.001]. Conclusions:PD can be safely and efficiently performed for the treatment of pediatric AKI. Low albumin level may be related to poor prognosis of AKI.

Objective: To explore the effect of plan-do-check-act (PDCA) cycle on contraceptive methods after induced abortion in female college students. Methods: A total of 456 unmarried female college students who underwent artificial abortion in Tongde Hospital of Zhejiang Province from January 2018 to May 2019 were selected. These students were randomly divided into control group (n=228) and intervention group(n=228). Students from the control group accepted Post Abortion Care (PAC) service, while the intervention group accepted the management of PDCA cycle on basis of PAC services. Results: In the intervention group, the rate of highly effective contraception immediately after abortion and six months after abortion were 91.23% and 71.17% respectively, while in the control group were 82.89% and 60.00%, the intervention group was higher than the control group(χ2=7.03, 5.98, P<0.05). The rate of unsafe contraceptive in the intervention group six months after abortion was 3.60%, while in the control group was 20.00%, the intervention group was lower than the control group(χ2=28.35, P<0.05). Conclusion The PDCA cycle can effectively improve the utilization rate of high efficiency contraceptive methods after induced abortion in college students, reduce the rate of unsafe contraceptive six months after abortion, and it is helpful to reduce the incidence of short-term unplanned pregnancy after abortion.

Objective: To explore the effect of reproductive health education on health literacy of hospitalized female adolescents,and to provide reference for the protection of their physical and mental health. Methods: A total of 102 female adolescents who were hospitalized in department of gynaecology from January 2019 to December 2019 were selected for reproductive health education and questionnaire survey. Results: There were 65 cases of unplanned pregnancy (4 cases of tubal pregnancy), 18 cases of gynecological tumor (1 case of ovarian malignancy), 11 cases of gynecological inflammation (1 case of tubal abscess), and 8 cases of abnormal uterine bleeding (2 cases of blood transfusion).Eighty-six patients (84.3%) were treated surgically, 7 cases had their ovaries and/or fallopian tubes removed. After reproductive health education,health literacy of menstruation and ovulation, reproductive organ tumor, gynecological inflammation(inducing factors,clinical manifestations,harmfulness), harm of premature sexual life, scientific contraception, sexually transmitted diseases(types,transmission routes,preventioe measures), abortion hazard(short-term and longterm complications) and necessity of health examination improved significantly(χ2=14.8, 25.1, 15.7, 30.6, 18.6, 25.9, 31.1, 17.8, 19.1, 15.2, 40.1, 58.6, 69.8, P<0.05). Conclusion The lack of reproductive health knowledge of female hospitalized adolescents may lead to unplanned pregnancy, tumor, inflammation and abnormal uterine bleeding.Reproductive health education can significantly improve the health literacy of female adolescents and ensure their physical and mental health.

Objective: To understand the influence of post-abortion care (PAC) on the reproductive health of unmarried female college students,and to provide scientific basis for reproductive health education. Methods: A total of 486 unmarried female college students who received artificial abortion voluntarily due to unwanted pregnancy and had complete follow-up data were investigated by questionnaires before and six months after the operation from July 2017 to June 2018 in the Tongde hospital of Zhejiang Province. Results: There were 248 patients with abortion history, including 15 patients with abortion frequency ≥3 times.72 cases of high-risk abortion, the high-risk factors were re-abortion within half a year and the number of abortion ≥3 times; After PAC intervention, the awareness rate on menstruation and ovulation knowledge, scientific contraceptive knowledge, prevention of sexually transmitted diseases knowledge(types of diseases,raltes of transmission and preventive measures), and the harm of abortion knowledge(short-term and longterm complications), was higher than before(χ2=21.42, 69.65, 71.09, 52.80, 63.25, 187.59, 356.02, P<0.05). Before intervention, only 53.7% (261/486) of female college students used medium and low efficiency contraceptive measures, only 0.4% (2/486) were high-efficiency contraceptive measures. After intervention, all of them used contraceptive measures, The rate of effective contraceptive measures in the immediate and six months after operation was 85.4% (415/486) and 68.3% (332/486) respectively, which was significantly higher than before(χ2=786.10, P<0.05). Conclusion PAC service for female college students can improve awareness rate of sexual and reproductive health, enhance effective contraceptive measures, reduce the risk of repeated abortion.

Objective To explore the gender differences in disgust processing in patients with ob-sessive-compulsive disorder ( OCD). Methods A total of 74 patients with obsessive-compulsive disorder (39 males and 35 females) and 65 normal healthy controls (35 males and 30 females) were assessed with Padua inventory-Washington State University revision (PI-WSUR),Yale-Brown obsessive-compulsive scale (Y-BOCS) and were tested the lexical decision task,in order to evaluate their OCD symptoms and severity. The results of reaction time,accuracy and rating intensity of core disgust words,moral disgust words and neu-tral words were recorded,and the gender differences in disgust processing in patients with obsessive-compul-sive disorder and normal healthy controls were analyzed. Results The reaction time of core disgust words ((753.6±84.1) vs (711.8±83.8)ms),the reaction time of moral disgust words((813.5±89.0) vs (749.4± 81.4)ms) and neutral words((775.3±91.8) vs (725.9±104.2)ms) showed significant differences between males and females in pateints with OCD,but there were no differences in accuracy and rating intensity(P＜0.05 or P＜0.01). In normal healthy controls,there were only differences between males and females in reac-tion time of neutral words,females were also showed shorter reaction time than males (P＜0.01). Pearson cor-relation analysis showed that both male and female patients had a negative correlation between the reaction time of core disgust words and total PI-WSUR scores (P＜0.05). There was a gender difference in the relative variables of PI-WSUR,Y-BOCS and disgust processing in OCD patients. Conclusion There were gender differences in disgust cognitive processing in patients with obsessive-compulsive disorder,females with ob-sessive-compulsive disorder have higher core disgust and moral disgust than males. Females with OCD have a special high sense of moral disgust.

Objective To evaluate the application value of whole exome sequencing (WES) in diagnosis of NDDs (neuro-developmental disorders) children.Metheod WES was used for the diagnosis of 35 unexplained NDD children, which admitted to the outpatient and ward of Children′s hospital affiliated to Capital institute of pediatric from November 2015 to November 2016.These children′s clinical data was collected detailedly.Using bioinformatics software tools combining with patient′s phenotype, the candidate genetic/genomic variants of these patients were identified from WES data.The final pathogenicity of genetic/genomic variants was interpreted according to the guideline of the American College of Medical Genetics and Genomics (ACMG), meanwhile, the variants validation and co-separation analysis in the parents and their family members were performed by Sanger sequencing, real time-PCR and multiplex ligation-dependent probe amplification (MLPA).Results 14 pathogenic single nucleotide variants (SNVs) and three pathogenic copy number variations (CNVs) were detected in the 35 NDD children, the detection rate in this study is 48.6%.Among the 14 pathogenic SNVs, 11 of them are the definite NDD-related genes according to OMIM database (such as CHARGE syndrome, Wiedemann-Steiner syndrome, Cockayne syndrome, etc.), and six of them are de novo (6/11, 54.6%).Three pathogenic CNVs were identified from WES data, including two microduplications and one microdeletion.Meanwhile, a female child carrying a frame shift mutation in MECP2 was found and the germline mosaicism with low-frequency mutation of this site (8.4%) was confirmed by his father's sperm.Conclusions The diagnosis rate of WES in NDDs children is 48.6% in our small-sample study.In addition to pathogenic/likely pathogenic SNVs, CNVs can be detected successfully from WES data, which effectively improved the diagnosis yield in NDDs children.

Objective To investigate the expression of BRCA1 in familial thyroid cancer (FTC) and the relationship between BRCA1 expression and clinicopathologic features.Methods The expression of BRCA1 protein and mRNA was detected respectively by immunohistochemistry and RT-PCR in 37 FTC tissues,35 sporadic thyroid carcinoma tissues and 35 normal thyroid tissues.Results BRCA1 mRNA expression was significantly downregulated in FTC (0.210±0.025) compared with sporadic thyroid carcinoma(0.943±0.021) and normal thyroid tissues(1.001±0.087)(P＜0.01).The positive rate of BRCA1 protein expression was significantly lower in FTC(56.8％,21/37) than that in sporadic thyroid carcinoma(85.7％,30/35) and normal thyroid tissues(94.5％,33/35) (P＜0.05).There was a correlation between BRCA1 protein expression and FTC clinicopathologic features (P＜0.05).FTC patients with lower BRCA1 protein expression tended to have higher risk for bilateral carcinoma,lymph node metastasis,capsular invasion,morbidity under 30 years old and more than 2 patients in a family.Conclusions The expression of BRCA1 protein and mRNA is downregnlated in FTC.BRCA1 protein might serve as a potential biomarker for predicating biological behavior and prognosis of FTC.

Objective This study aims to investigate the moral disgust cognitive processing of patients with obses?sive-compulsive disorder (OCD) and its relationship with OCD symptoms. Methods Twenty-eight OCD and 30 healthy controls matched for gender, age and education completed lexical decision task, recording reaction time and accuracy of words and assessing the degree of disgust. Yale-Brown obsessive-compulsive scale (Y-BOCS) and Padua Invento?ry-Washington State University Revision (PI-WUSR) were used to assess the symptoms. Results OCD group showed significantly longer reaction time to core disgust-related words [(762.69 ± 128.25) ms vs. (648.69 ± 162.66) ms] and moral disgust-related words [(798.73 ± 115.26) ms vs. (727.00 ± 106.06) ms] than the healthy controls (P<0.05). OCD group showed significantly higher aversion degree to core disgust-related words [(6.38 ± 1.78) vs. (5.03 ± 1.64)] and moral dis?gust-related words [(7.08 ± 1.23) vs. (5.77 ± 1.44)] than control group (P<0.05). Y-BOCS total score, Y-BOCS obsessive thoughts score, Y-BOCS compulsive behavior score, total score of PI-WUSR, cleaning/pollution force factor score, hurt?ing themselves and others force factor were positively correlated with two types of disgust-related words in patients group (P<0.05). Multiple stepwise regression analysis between disgust words and Y-BOCS/PI-WUSR scores pointed that only CWCF influenced disgust degree of core disgust-related words (β=0.61, P<0.01) and moral disgust-related words (β=0.54, P<0.01), respectively. Conclusion The core disgust and moral disgust of OCD are stronger compared to controls.