Abstract: Objective To analyze the risk factors for neonatal preterm birth in 12 hospitals in Yunnan Province from 2016 to 2017, and to establish a nomogram prediction model for neonatal preterm birth, providing scientific evidence for the prevention of preterm birth. Methods A total of 20 445 pregnant women who gave birth in 12 hospitals in Yunnan Province from 2016 to 2017 were collected and grouped into a preterm group (n=1 186) and a full-term group (n=19 259) according to whether they had a premature delivery. The general information questionnaire of pregnant women designed by the research team was applied to understand the basic conditions and pregnancy information of the two groups, and the risk factors of preterm birth were determined by logistic regression analysis, R software was applied to draw a nomogram prediction model of neonatal preterm birth, and its predictive performance was tested. Results There were significant differences in the proportions of twins and above (9.11% vs 7.10%), pregnancy-induced hypertension (21.67% vs 18.57%), gestational diabetes mellitus (18.21% vs 15.90%), anemia (24.28% vs 20.70%), premature rupture of membranes (11.64% vs 9.76%), and abnormal placenta (7.08% vs 5.51%) between the preterm group and the full-term group (χ2=6.731, 7.055, 4.441, 8.691, 4.437, 5.232, all P<0.05); the logistic regression analysis showed that the risk factors for neonatal preterm birth were twins and above (OR=2.378), pregnancy-induced hypertension (OR=2.039), gestational diabetes mellitus (OR=1.824), anemia (OR=1.825), and premature rupture of membranes (OR=2.313) (all P<0.05); the discrimination (area under the curve was 0.794, 95%CI=0.738-0.850) and precision (goodness of fit HL test, χ2=8.864, P=0.312) of the nomogram model constructed to predict the occurrence of neonatal preterm birth were both good. Conclusions The nomogram model for preterm birth constructed based on 5 factors including number of fetuses, pregnancy-induced hypertension, gestational diabetes mellitus, anemia and premature rupture of membranes can predict the occurrence of neonatal preterm birth well, thus providing reference for the prevention of neonatal preterm birth.

Objective To discuss the key points of endovascular therapy for complex subclavian artery occlusive diseases. Methods During the period from January 2012 to December 2013, a total of 92 patients with complex subclavian artery occlusive disease were admitted to Xuanwu Hospital of Capital Medical University, Beijing, China. The clinical data were retrospectively analyzed. The features of the lesions, the success rate of endovascular therapy, the use of combined approaches, the relief of symptoms after treatment, etc. were evaluated. Results The complex subclavian artery occlusive diseases could be divided into three types. Type Ⅰ: long segment of the left subclavian artery was occluded; type Ⅱ: ostial stenosis or occlusion of the right subclavian artery; and type Ⅲ: subclavian artery stenosis or occlusion was associated with the ostial disorder of the vertebral artery, or the opening of vertebral artery was affected by the subclavian artery stenosis or occlusion. The technical success rate was 82.6%. Combination use of femoral artery and brachial artery approach was employed in 27.2% of patients, which had improved the technical success rate. After the treatment the symptom improvement rate was 81.6%. Conclusion Upper limb artery approach can improve the re-canalization rate of left subclavian artery with long segment occlusion, and can ensure the accurate positioning of stent at the site of right subclavian artery opening. During the procedure of endovascular intervention for subclavian artery occlusion disease, attention should be paid to the protection of the vertebral artery.

Objective To investigate the Relationship between blood pressure variability rate and extent of critically in ill patients with sepsis. Methods From May 2012 to April 2013 in our hospital, 60 cases of sepsis patients for the study were divided into APACHE-II≥20 points(critical group)and APACHE-II<20 minutes(non-critical group), selected the same period to our hospital for medical examination of 30 cases of healthy subjects (control group). The risk and non-risk reorganization reorganization patients 24 h SBP-CV,24 h DBP-CV,dSBP-CV,dDBP-CV,nSBP-CV, nDBP-CV mutation rate, mutation rate and blood pressure APACHE-II score correlation analysis. Comparison of the three groups of patients with high-density protein cholesterol (HDL-C), low-density protein cholesterol (LDL-C), inter-leukin-6(IL-6),interleukin-18(IL-18)were compared. Results The danger of recombinant APACHE-II score was(29.56±0.79), non dangerous recombinant APACHE-II score was (13.15±0.58). Two groups of SBP mutation rate comparison, with statistically significant difference(P<0.05). Spearman analysis showed that 24 h SBP-CV,dSBP-CV,nSBP-CV,related to the mutation rate and APACHE-IIscore was positively(r=0.762,P=0.003). Critical group,non criti-cal group,control group HDL-C, LDL-C gradually increased, IL-6, IL-18 were lower, with statistically significant difference between the two groups (P<0.05). Conclusion The rate and blood pressure variability in the degree of sep-sis in critically ill patients was positively correlated, the mechanism may be the promotion of IL-6, inflammatory kookiness such as IL-18 secretion,and expand the inflammatory response.

Objective To explore the clinical value of tests of plasma type B natriuretic peptide (BNP) and troponin I (TnI) for elderly patients with sepsis. Methods A total of 108 elderly patients with sepsis who were admitted and treated in our department from January 2011 to January 2014 were selected. They were assigned to three groups according to the disease severity, 64 patients with common sepsis were as group A, 32 patients with severe sepsis were as group B, and 12 patients with septic shock were as group C. After being admitted to our department, mass concentration of plas-ma BNP and TnI for all patients were tested immediately. LVEF value of patients was tested by ultrasonic cardiogram, and APACHE II score was calculated. 28-day survival conditions for patients in group B and group C were followed up, each index between surviving patients and dead patients and connections between scores of BNP, TnI and APACHEIIwere compared. Results TnI and BNP for patients in group A were (0.08±0.01)μg/L and (206.42±76.15) pg/mL re spectively, in group B were (0.53±0.01) μg/L and (386.38±84.96) pg/mL respectively, in group C were (1.94±0.04) μg/L and (958.84±135.23) pg/mL respectively. The differences of mass concentrations of plasma BNP and TnI among the three groups were statistically significant (P<0.05). The more severe the disease conditions, the higher the mass con-centrations of plasma BNP and TnI. TnI and BNP for patients in the survival group were (0.47±0.08) μg/L and (692.59±22.17) pg/mL respectively, APACHEII was scored as (19.5±5.2), and LVEF was (52.1±13.9)%, while in the dead group were (1.23±0.05) μg/L, (986.25±22.65) pg/mL, (23.1±6.1) Scores, (41.5±11.5)%. The scores of BNP, TnI and APACHEII in dead group were significantly higher than those in the surviving group, and LVEF in dead patients was significantly lower than that in the survival group, the differences were statistically significant (P<0.05). Conclusion Mass concentration of plasma BNP and TnI can be used as effective indices for disease evaluation and prognosis for el-derly patients with sepsis.

Objective:To investigate the predictive value of serumal retinol-binding protein 4(RBP4) level fro fetal macrosomia of non-diabetic pregnant women .Methods :The serumal levels of RBP4 of 500 non-diabetic pregnant women at 12 week ,20 week and 24 week of pregnancy were measured by immune projection turbidimetric method .Fetal macrosomia was defined as birth weight≥4000 g .The cut-off value ,sensitivity and specificity were calculated with receiver operating characteristic (ROC) curve .Results:Of the 500 non-diabetic pregnant women ,30 cases(6% ) got fetal macrosomia .The ROC curve showed that the predictive cut-off values of RBP4 at 12 week ,20 week and 24 week of pregnancy were 61 .0 mg/L ,50 .5 mg/L and 52 .5 mg/L , respectively ;the predictive sensitivity and specificity at 12 week ,20 week and 24 week of pregnancy were 42 .9% and 94 .5% , 70 .0% and 69 .5% ,76 .9% and 73 .2% ,respectively .The predictive cut-off value of RBP4 no later than 24 week of pregnancy was 51 .5 mg/L ;the predictive sensitivity and specificity were 61 .8% and 69 .5% .There was significant difference(P<0 .05) between the serumal level of RBP4 at 24 week of pregnancy in group fetal macrosomia and that in group nonfetal macrosomia . Conclusions :The predictive sensitivity of RBP4 increases in accordance with the increase of serumal level of RBP 4 .The serumal level of RBP4 of non-diabetic pregnant women at 24 week of pregnancy may have higher sensitivity and specificity in the predic-tion of fetal macrosomia .If the serumal level of RBP4 no later than 24 week of pregnancy is beyond 50 mg/L ,then the risk of fetal macrosomia will be higher .

Objective To find the changes of haemagglutination inhibition ( HI ) antibody level against A/California/07/2009 (H1N1) within one month after pandemic A/H1N1 influenza vaccine (A/H1N1InfV) vaccination, and to provide data for drawing up immunization protocols against novel influenza . Methods The HI antibodies against A/California/07/2009 (H1N1) in sera from the inoculated subjects were tested by HI test .The geometric mean titer ( GMT) , geometric mean increase ( GMI) , seroconversion (SC) rate, seroprotection (SP) rate of HI antibodies were compared among the sera collected on day 3, 7, 14, 30 post vaccination .Results 961 participants were injected with A/H1N1InfV.In subjects aged 3 to 11 years, the antibody level peaked on day 14 post vaccination, but neither on day 14 nor on day 30, the lower bound of the two -sided 95%CI for the SP rate could fulfill the criteria of the FDA for influenza vac-cine.In subjects aged 12 to 60 years, the antibody level peaked on day 14 post vaccination and the SC rate , SP rate and GMI fulfilled the criteria of the European Medicines Agency ( EMEA) and the FDA for influenza vaccine. In subjects aged more than 60 years, the antibody level peaked on day 30 post vaccination , and the SC rate, SP rate and GMI on day 30 fulfilled the criteria of the EMEA and the FDA .Conclusion One dose A/H1N1InfV vaccination was able to induce enough protection on day 14 for subjects aged 12 to 60 years, on day 30 for subjects aged more than 60 years;however , for subjects aged 3 to 11 years who were antibody-negative at baseline , the lower bound of the two-sided 95%CI for the SP rate on day 14 and day 30 couldn′t fulfill the criteria of the FDA for influenza vaccine .

ObjectiveTo observe the morphological changes of bone in the progress of chronic fluorosis.MethodsWistar rats were randomly divided into three groups,30 rats in each group:normal control group,experimental group Ⅰ and experimental group Ⅱ according to body weight.Rats in normal control group drank distilled water freely.Experimental group Ⅰ and group Ⅱ drunk distilled water with sodium fluoride preparation of fluorine containing ion 100,150 mg/L solution for six months,respectively.Bone mineral density was detected by X-ray,bone morphological changes were observed under light microscope and bone histomorphometric parameters were calculated using image analysis software.ResultsThe bone mineral density values were different statistically between the three groups after feeding for 2 and 4 months(F =19.79,3.28,all P ＜ 0.05).However no significant difference was found after feeding for 6 months(F =1.80,P ＞ 0.05).The bone mineral density of experimental group Ⅰ (0.20 ± 0.03,0.21 ± 0.03) was significantly higher than that of the normal control group(0.17 ± 0.03,0.20 ± 0.04) after feeding for 2 and 4 months.The bone mineral density of experimental group Ⅱ (0.21 ± 0.02) was lower than that of normal control group(0.22 ± 0.03) after feeding for 6 months.The bone lamella in experimental group Ⅰ was arranged disorderly,the number of osteocytes increased with their nucleus atrophy and the osteoblasts were more than that of control grouo which arranged in layers observed under light microscooy.In exoerimental group Ⅱ,the bone lamella was bent deformation,the number of osteocytes had decreased with their nucleus shrinking or even disappeared and the number of osteoclasts had increased significantly observed under light microscopy.In experimental group Ⅰ,the mean trabecular density [(0.33 ± 0.03)％] increased and the mean trabecular separation,thickness [( 163.57 ± 1.99),(59.26 ± 7.18 ) μm] decreased compared with that of normal control group [(0.31 ± 0.02)％,(186.60 ± 2.90)μm,(86.42 ± 1.48)μm,all P ＜ 0.05].In experimental group Ⅱ,the mean trabecular density[(0.26 ± 0.02)％] decreased,the mean trabecular thickness[(71.42 ± 10.77)μm] reduced compared with that of normal control group[(0.31 ± 0.02)％,(86.42 ± 1.48)μm].ConclusionsExcess fluoride can damage bone tissue.Low doses of fluoride can stimulate osteoblast activity and enhance osteogenesis.The activity of osteoblasts is great than that of osteoclasts.High doses of fluoride can stimulate both osteoblasts and osteoclasts activity,but mainly the activity of osteoclasts,and bone resorption increases.

ObjectiveTo measure the iodine content of normal thyroid and the sternocleidomastoid muscle with gemstone spectral imaging (GSI),in order to offer diagnostic reference for iodine excess or iodine deficiency disorders.MethodsA total of 226 cases of patients with suspected neck or cervical disease underwent GSI of the neck,the thyroid and the sternocleidomastoid muscle.One hundred and nineteen cases were male and 107 female,aged 18 to 77 years,average age(46 ± 17) years.Data were transmitted to AW 4.4 workstation and processed using GSI Viewer software to obtain the best contrast-to-noise ratio(CNR) of thyroid to sternocleidomastoid muscle and corresponding singe-energy images.Iodine content of left and right thyroid lobes and both sides of sternocleidomastoid muscle as well as iodine content ratio of thyroid to sternocleidomastoid muscle were calculated in the iodine-based images.ResultsTotal iodine content of the left and the right lobes of the thyroid was (1.5233 ±0.4318)mg/cm3,of the left lobe was (1.5230 ± 0.4271 )mg/cm3,of the right lobe was (1.5236 ± 0.4365 )mg/cm3,there was no significant difference statistically between the two(t =0.0084,P ＞ 0.05).The iodine content of the male was (1.6395 ± 0.4105)mg/cm3,and of the female was (1.4238 ± 0.3832)mg/cm3,there was statistically a significant difference between the two(t =3.4743,P ＜ 0.01 ).Iodine content ratio of thyroid to sternocleidomastoid muscle was 96.6271 ± 33.2442,the ratio in male was 94.6250 ± 37.3621 and in female was 98.0000 ± 29.0737,there was no statistical difference between the two(t =0.3817,P ＞ 0.05).The iodine content of thyroid decreased gradually with age,the difference between groups was statistically significant(F =9.66,P ＜ 0.01 ).The iodine content in ＜ 40 age group[(1.7256 ± 0.4631)mg/cm3] was higher than that in 40 - 60 age group[(1.4517 ±0.3643)mg/cm3] and ＞ 60 age group [(1.4368 ± 0.3465)mg/cm3; q =5.6195,5.4158,all P ＜ 0.01).Conclusions It is easy to calculate thyroid iodine content with gemstone spectral imaging,which can reflect the iodine level of our body,and is helpful for the diagnosis of iodine excess or iodine deficiency disorders.

ObjectiveTo detect the concentration and distribution of fluoride ions in osteoblasts exposed to fluoride in vitro culture,and to provide basic information for studying the effect of fluoride on osteoblast injury.MethodsIn vitro cultured osteoblasts were exposed to 0,5,10,20,40 mg/L fluoride for 3,10,30 d (n =6),respectively.Concentration and distribution of fluoride ions in the cytoplasm and the nucleus of these osteoblasts were determined by nuclear magnetic resonance spectroscopy.Results(①) After cultured for 3 d,fluoride ion content of the bone cytoplasm exposed to different concentrations of fluoride 0,5,10,20,40 mg/L were (0.83 ±0.65),(0.54 ± 0.23),(0.65 ± 0.77),(0.59 ± 0.87),(3.64 ± 1.21 )mg/L,respectively,and the values of exposed to 40 mg/L fluoride group was significantly higher than that of exposed to 0,5 mg/L groups (all P ＜ 0.05).(②)after cultured for 10 d,the composition of the fluoride ion in cytoplasm of exposed to fluoride 10,20,40 mg/L groups were (4.03 ± 1.23),(3.66 ± 0.98),(6.26 ± 2.10)mg/L,respectively,which were higher than that of exposed to 0,5 mg/L groups [(0.78 ± 0.75),(2.69 ± 0.89)mg/L,respectively,all P ＜ 0.05].Of fluoride 20,40 mg/L groups,the composition of the fluoride ion in nucleus were (1.63 ± 1.19),(2.17 ± 1.21 )mg/L,respectively,which were higher than that of 0,5 mg/L groups[(0.65 ± 0.46),(1.57 ± 0.33) mg/L,all P ＜ 0.05].(③)After cultured for 30 d,of the exposed to fluoride 10,20,40 mg/L groups,the composition of the fluoride ion in cytoplasm were (3.99 ± 0.84),(4.33 ± 1.67),(5.80 ± 1.38)mg/L,respectively,which were higher than that of 0,5 mg/L groups[(0.88 ± 0.44),(2.84 ± 0.43)mg/L,all P ＜ 0.05].The composition of the fluoride ion in nucleus of the fluoride 20,40 mg/Lgroups were (3.33 ± 1.46),(3.53 ± 1.22)mg/L,respectively,which were significantly higher than that of 0,5mg/L groups [(0.70 ± 0.66),(1.99 ± 0.76)mg/L,all P ＜ 0.05].ConclusionsWhen osteoblasts are exposed to fluoride environment,fluoride ions enter into the osteoblasts quickly,and quickly accumulate in the nucleus,showing a special affinity between fluoride and bone tissue.Intracellular fluoride ions increase with the increase of contact time and exposure dose.

ObjectiveTo observe the distribution of vitamin D receptor(VDR) gene polymorphisms in coal-burning borne fluorosis in Guizhou province and investigate the relationship between VDR gene polymorphisms and the susceptibility to coal-burning borne fluorosis.MethodsOne hundred and fifty villagers from non-improving cooking stove villages were selected as a non-intervention group in Bijie area,Guizhou province where coal-burning borne fluorosis was prevailing; 150 villagers were chosen from cooking stove improved villages as a intervention group; 150 villagers were selected from non-endemic area Changshun county as a control group.DNA was extracted from peripheral blood samples of these people.Genotype of VDR gene Bsm Ⅰ and Fok Ⅰ loci were detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).ResultsDistribution of Bsm Ⅰ polymorphism site of VDR gene of control group [AA:19.3％ (29/150),AG:39.3％ (59/150),GG:41.3％(62/150)],was compared with that[AA:4.7％(7/150),AG:14.0％(21/150),GG:81.3％(122/150)] of the non-intervention group and that[AA:7.3％(11/150),AG:23.3％(35/150),GG:69.3％(104/150)] of intervention group,and the difference was statistically significant(X2 =56.6,P ＜ 0.05).The frequency of VDR-Fok Ⅰ loci in non-intervention group [TT:29.3％(44/150),TC:55.3％(83/150),CC:15.3％(23/150)] and intervention group [TT:32.7％(49/150),TC:55.3％(83/150),CC:12.0％(18/150)] was compared with that [TT:45.3％(68/150),TC:48.7％(73/150),CC:6.0％(9/150)] of control group,and the difference was statistically significant(X2 =11.9,P ＜ 0.05).Univariate analysis showed that individuals carrying the GG genotype had increased risk of suffering fluorosis than individuals carrying the AA and AG genotypes(OR values were 6.2,3.2,all P ＜ 0.05),while carrying the TC and CC genotype had increased risk of suffering fluorosis than individuals carrying the TT genotype (OR values were 1.3,2.8,1.3,2.1,all P ＜ 0.05).ConclusionVDR gene polymorphisms may be one of the predisposing factors of coal-burning borne fluorosis.