Objective:To explore the relationship between amniotic fluid and peripheral blood inflammatory factors and the pregnancy outcomes after emergency cervical cerclage, and to identify effective indicators for predicting adverse pregnancy outcomes after the procedure.Methods:A case-control study was conducted, including pregnant women who were hospitalized at Sun Yat-sen Memorial Hospital, from January 1, 2013, to July 31, 2019, and underwent emergency cervical cerclage due to cervical dilatation at gestational age between 16 and 28 weeks. A total of 85 pregnant women who underwent amniocentesis for the detection of amniotic fluid inflammatory factors during the perioperative period were included. Based on whether their baby was perinatal death, the participants were divided into the case group (28 cases with perinatal death) and the control group (57 cases with live births). Univariate logistic regression analysis was performed to identify risk factors associated with adverse pregnancy outcomes, followed by multivariate logistic regression analysis to establish a regression model and nomogram.Results:(1) The levels of tumor necrosis factor α (TNF-α), interleukin (IL)-1β, IL-6, IL-8, IL-10 in the amniotic fluid during the perioperative period and postoperative serum C-reactive protein (CRP) were significantly higher in the case group compared to the control group (all P<0.05). The case group underwent emergency cervical cerclage at an earlier gestational age compared to the control group, and their cervical dilation was greater than that of the control group (all P<0.05). However, there were no significant differences in the white blood cell counts, neutrophil percentage, and the level of preoperative CRP in the peripheral blood of pregnant women during the perioperative period (all P>0.05). (2) Univariate logistic regression analysis showed that the levels of amniotic fluid WBC, TNF-α, IL-1β, IL-2 receptor (IL-2R), IL-6, IL-8, IL-10, postoperative CRP in the peripheral blood, gestational age at cerclage and cervical dilation were associated with adverse pregnancy outcomes (all P<0.05). Multivariate regression analysis indicated that only the levels of amniotic fluid WBC and TNF-α were independent risk factors for perinatal death. (3) Based on clinical practice, a multivariate logistic regression model was constructed including the levels of amniotic fluid TNF-α, WBC, gestational age at cervical cerclage, and cervical dilation. A nomogram and calibration curve were plotted, which suggested its good predictive value for adverse pregnancy outcomes. Conclusions:During the perioperative period of emergency cervical cerclage, the levels of amniotic fluid WBC, TNF-α, IL-1β, IL-2R, IL-6, IL-8, IL-10 are associated with adverse pregnancy outcomes, with amniotic fluid WBC and TNF-α showing the closest relationship. However, there is no significant correlation between maternal peripheral hemogram during the perioperative period and adverse pregnancy outcomes. A model constructed by amniotic fluid TNF-α, WBC, cervical cerclage gestational age, and cervical dilation has a good predictive effect on adverse pregnancy outcomes.

Liver cirrhosis is a pathological stage in which most chronic liver diseases progress to the advanced stages, and the main complications of liver cirrhosis include portal hypertension, gastroesophageal variceal bleeding, and liver cancer. Transient elastography (TE) uses acoustic waves to obtain liver stiffness measurement (LSM) noninvasively and is currently widely used in clinical practice. At present, various studies on LSM and liver cirrhosis and its complications suggest that TE has the ability to identify liver cirrhosis and its complications and can thus reduce unnecessary invasive procedures to a certain degree. This article summarizes and elaborates on the advances in the clinical application of TE in liver cirrhosis and its complications.

Proton pump inhibitor (PPI) is often used for the prevention and treatment of digestive system diseases, and the adverse outcomes caused by the use of PPI are increasingly concerned by scholars. This article elaborates on the association of the complications of liver cirrhosis, such as upper gastrointestinal bleeding, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatocellular carcinoma, and infection, and the change in gut microbiota with the use of PPI, and points out that in clinical practice, it is important to master the medication rules of PPI, understand the risk of complications caused by PPI, and actively improve the complications caused by medication.

Objective To investigate the expressions of CD28 and CD117 in patients with newly diagnosed multiple myeloma (MM) and their clinical significances. Methods The clinical data of 115 newly diagnosed MM patients in the First Affiliated Hospital of Zhengzhou University from May 2015 to December 2017 were retrospectively analyzed. The expressions of CD28 and CD117 were detected by using multiparameter flow cytometry. The relationship between the expressions of CD28 and CD117 and MM staging and clinical parameters was analyzed. The staging was performed according to the International Staging System (ISS). Results Among these 115 patients, there were 15 patients with CD117 positive and 30 patients with CD28 positive. Erythrocyte sedimentation rate (r ＝ -0.481, P ＝ 0.039), Cˉreactive protein level (r ＝ -0.314, P＝0.015), the proportion of plasma cells detected by bone marrow cytology (r＝-0.027, P＝0.001) were negatively correlated with CD117 positive expressions. CD28 positive expression was positively correlated with lactate dehydrogenase level (r ＝ 0.249, P ＝ 0.033) and ISS stage (r ＝ 0.319, P ＝ 0.017), while it was negatively correlated with hemoglobin level (r ＝ -0.372, P ＝ 0.026). CD28 positive was associated with light chain type, and nonˉsecretory type mostly occurred (P ＝ 0.016). The incidence of osteolytic lesions in CD28 positive group and CD117 positive group was high, but there was no statistical difference between CD28 positive group, CD117 positive group and CD28 negative group, CD117 negative group (P ＝ 0.052, P＝0.479). Conclusions The positive expression of CD117 in the early stage of MM patients is higher than that in the advanced stage, and the expression of CD28 positive in the advanced stage of MM patients is higher than that in the early stage. CD28 and CD117 can be used as indicators of prognosis stratification in the patients with newly diagnosed MM.

Objective To clarify the relationship between intracranial pressure monitoring and prognosis of patients with traumatic brain injury after decompressive craniectomy.Methods From December 2015 to December 2017,48 head-injured patients in Affiliated Suzhou Hospital of Nanjing Medical University were enrolled,who were underwent decompressive craniectomy in this retrospective study.The patients were subdivided into 2 groups based on whether postoperative was monitored (n =19) or not (n =29).The prognosis was evaluated by Glasgow Outcome Scale score,with 1 point of prognosis death,2 to 3 points of poor prognosis,and 4 to 5 points of good prognosis.Count data were expressed as a percentage (％).Count data were expressed as percentage (％).The chi-square test was used to compare the difference in the rate of good prognosis and mortality between the two groups.Results The mortality of monitoring group (10.5％) was significantly lower than that of control group (37.9％) (x2 =4.365 5,P =0.036 7) during hospitalization,The rate of good prognosis in the monitoring group (68.4％) and the control group (44.8％) was not statistically significant (x2 =2.573 8,P =0.108 6).Condusion The study showed that continuous monitoring in patients with severe craniocerebral injury could reduce the mortality of patients during hospitalization,but had no significant effect on the improvement of prognosis.

Objective To investigate the diagnostic value of contrast-enhanced CT and MR diffusion-weighted imaging (DWI) in differentiating autoimmune pancreatitis (AIP) from pancreatic carcinoma (PC).Methods Twelve patients with AIP (AIP groups) and 15 patients with PC (PC groups) were included in this study.Contrast-enhanced CT and DWI were performed in all patients.The manifestations of the pancreatic lesions,pancreatic duct and bile duct were observed.The CT attenuation values and the apparent diffusion coefficient (ADC) values of the lesions were calculated.Frequencies of the CT manifestations,and the mean CT attenuation values,and the ADC values were compared between the two groups.Results Most of the AIP showed diffuse enlargement,sausage shape,peripancreatic capsule,penetrating sign of pancreatic duct and thickness of the bile duct.The frequencies of the findings mentioned above were significantly different between AIP and PC (P＜0.05).The CT attenuation values of the lesions,and the rate of lesions' CT attenuation values to livers' in 3 phases of contrast enhanced CT were significantly different between AIP and PC (P＜0.05).The ADC values of AIP were significantly lower than that of PC (P＜0.05).Conclusion The changes of morphology of pancreas,pancreatic and bile duct may facilitate in differentiating AIP from PC.Quantitative analysis of CT attenuation values and ADC values measured on MR images may be helpful in differentiating AIP from PC.

Objective To investigate the clinical application of liquid pressurization under obstruction of healthy-side uterine horn with the tip of double lumen balloon catheter combined with guidewire recanalization in treating unilateral obstruction of fallopian tube.Methods Hysterosalpingography was performed in infertility patients.A total of 50 patients with unilateral obstruction of fallopian tube were selected.Attempt was made to use catheter tip to obstruct the healthy-side uterine horn,then liquid pressurization was carried out to reopen fallopian tube,and the relationship between the success of recanalization and uterine morphology was analyzed;further guidewire recanalization was employed when liquid pressurization method failed,and the recanalization rate was calculated.Results In 33 among the 50 patients,the distance from the uterine horn to the cervical internal orifice was shorter than the catheter length that was inserted into the uterus,besides,the width of the uterine horn was smaller than the catheter diameter,thus the uterine horn was tightly occluded by the catheter tip.Recanalization of the fallopian tube was obtained in 19 patients,and recanalization of the fallopian tube failed in 14 patients because the obstruction was very severe.In 17 among the 50 patients,the distance from the uterine horn to the cervical internal orifice was longer than the catheter length that was inserted into the uterus,besides,the width of the uterine horn was larger than the catheter diameter,thus the uterine horn could not be tightly occluded by the catheter tip,resulting failure of recanalization of fallopian tube.Further guidewire recanalization had to be carried out for the 33 patients whose recanalization of fallopian tube with liquid pressurization method failed,and recanalization of fallopian tube was achieved in 22 patients.Conclusion Liquid pressurization under obstruction of healthy-side uterine horn with the tip of double lumen balloon catheter can reopen the obstructed fallopian tube in some patients,and the success of recanalization is closely related to the uterine morphology.Additional use of guidewire recanalization technique can significantly improve the recanalization rate for unilateral fallopian tube obstruction.

Objective To analyze the clinical features and prognosis of CD34-positive and CD34-negative adult patients with acute T-lymphoblastic leukemia (T-ALL),and to explore the value of CD34 expression for prognosis of patients with T-ALL.Methods 75 adult patients diagnosed with T-ALL from January 2012 to July 2015 in the Department of Hematology,the First Affiliated Hospital of Zhengzhou University,were analyzed retrospectively.According to the expression of CD34,the patients were divided into CD34-positive group and CD34-negative group,and then the clinical characteristics and prognosis of both groups were analyzed.Results In 75 patients,CD34-positive group had 24 (32.0 ％) patients and CD34-negative group had 51 (68.0 ％) patients.Between the two groups,there was no significant difference in these factors,such as sex,age,infiltration of liver,spleen and lymph nodes,thrombocytopenia,high white blood cell count,abnormal karyotype,complete remission within 4 weeks and central nervous system leukemia (CNSL).The proportions of patients with hemoglobin (Hb) ＜ 90 g/L and expression of myeloid lineage marker were higher in the CD34-positive group than those in the CD34-negative group (x2 =5.888,P=0.015;x2 =10.758,P =0.001,respectively).There were only 18 patients treated with hematopoietic stem cell transplantation (HSCT),57 patients were not.In patients without HSCT,the median survival time in the CD34-positive group and CD34-negative group was significant different (5 months vs.32 months,x2 =9.172,P =0.002).Conclusions CD34 expression in adult patients with T-ALL appears to be associated with Hb ＜ 90 g/L and the expression of myeloid lineage markers.For the patients without HSCT,CD34 is likely negatively related with the prognosis.

Objective To explore the effects of a new simple device for blood collection by tail snipping in rats so as to provide a safe, practical and repeatable method. Methods The rats were held by simple devices which made from plastic bottles and block and treated by some moderate ways for blood collection. Results The device was easy to be made and handled. 20 rats could have 6 times of blood collec-tion by this device in one day. There was no mouse death and no person injure during the experimental course. Conclusion This device is a safe and ideal equipment for blood collection by tail snipping in rats.