Objective To investigate the predictive value of serum thrombospondin-1(THBS-1),D-dimer(D-D)and tissue inhibitor of metalloproteinase-1(TIMP-1)levels in late pregnancy for postpartum hemorrhage(PPH)in re-pregnant women with scarred uterus.Methods Totally 108 re-pregnant women with scarred uterus admitted to the First Affiliated Hospital of Xinxiang Medical University from June 2020 to August 2022 were selected and divided into the PPH group(n=21)and the non-PPH group(n=87)according to whether PPH occurred after delivery.On the day of admission,5 mL elbow venous blood was collected from re-pregnant women in the two groups,and the levels of serum THBS-1,D-D and TIMP-1 of pregnant women in the two groups were detected by enzyme-linked immunosorbent assay.The serum THBS-1,D-D TIMP-1 levels and clinical data of pregnant women between the two groups were compared.The influencing factors on the occurrence of PPH in re-pregnant women with scarred uterus were analyzed by multivariate logistic regression,and the predictive value of serum THBS-1,D-D and TIMP-1 levels on the occurrence of PPH in re-pregnant women with scarred uterus was evaluated by receiver operating characteristic curve.Results The percentage of patients with ≥ 2 induced abortions,placental abruption,uterine incision laceration,uterine inertia or scar thickness＜0.3 cm,as well as serum THBS-1 and D-D levels in late pregnancy in the PPH group were significantly higher than those in the non-PPH group,and serum TIMP-1 level in late pregnancy were significantly lower than that in the non-PPH group(P＜0.05).The uterine inertia,as well as high D-D and THBS-1 levels,were independent risk factors for PPH in re-pregnant women with scarred uterus(P＜0.05),and low TIMP-1 level was a protective factor(P＜0.05).The area under the curve of combined serum THBS-1,D-D and TIMP-1 levels to predict PPH in re-pregnant women with scarred uterus was greater than that predicted by the three factors alone(P＜0.05).Conclusion Serum THBS-1,D-D and TIMP-1 levels in late pregnancy can be used as reference indicators for predicting the occurrence of PPH in re-pregnant women with scarred uterus,and the combination of the three indexes is more effective in predicting the occurrence of PPH.

Objective:To evaluate and analyze the ultrasonic findings of idiopathic clubfoot and positional clubfoot deformities.Methods:Forty-nine newborn babies with congenital clubfoot were examined in the Department of Ultrasound of the Third Affiliated Hospital of Zhengzhou University from December 2020 to January 2022, Including 21 newborn babies(32 feet) with idiopathic clubfoot, and 28 babies(53 feet) with positional clubfoot. Twenty-two normal infants in the same period and the normal feet of the single clubfoot were selected as control group. The distance between medial malleolus and scaphoids of all feet were measured by ultrasound. The distance from the tangent line of the lateral edge of calcaneus to the midpoint of the lateral edge of the chondroid bone, medial soft tissue thickness and tibial calcaneal angle were measured by ultrasound. The data of idiopathic clubfoot group, positional clubfoot group and control group were statistically analyzed.Results:A total of 71 newborn babies with 142 feet were evaluated.The idiopathic clubfoot group had born and joint changes in the medial, lateral and posterior side, and the differences were statistically significant compared with the control group (all P<0.05). Compared with the control group, there were statistically significant differences in the medial and lateral side of the positional group(all P<0.05). But no significant changes in the posterior side( P>0.05). There were significant differences between medial and posterior side of idiopathic and positional clubfoot group (all P<0.05), but no significant differences in lateral side ( P>0.05). Conclusions:Ultrasonography can clearly display the tarsus bones in clubfoot, and observe the deformity changes of the idiopathic clubfoot and positional clubfoot.

Streptococcus pneumoniae is the leading pathogen of community-acquired infections in children, and can cause invasive and noninvasive diseases.Due to the overuse of extensive use of antimicrobial agents in recent years, the problem of drug resistance of Streptococcus pneumoniae caused by the resistance clone alternatives becomes increasingly serious.The promotion of vaccine and rational use of antibiotics play an important role in controlling the spread of drug-resistant clones of Streptococcus pneumoniae.

Objective To observe the clinical effect of bevacizumab and temozolomide combined with concurrent radiotherapy for elderly patients with malignant brain glioma after the surgery . Methods A total of 55 patients in department of neurosurgery of Lanzhou Military Region General Hospital from January 2013 to December 2015 were enrolled. The patients were divided into control group and observation group. The 25 cases in the control group received radiotherapy and temozolomide. The 30 cases in the observation group received bevacizumab and temozolomide combined with concurrent radiotherapy. After treatment for 6 and 12 months, the clinical effects and adverse reactions of the two groups were compared byχ2 test, and the survival was compared by Log-rank test . Results Patients in the treatment group were followed up for 6 months after chemoradiotherapy, the response rate (RR) was 80 ％ (24/30), the disease control rate (DCR) was 97 ％ (29/30). The RR and DCR in the control group were 68 ％ (17/25) and 84 ％(21/25). There were significant differences between the two groups (χ2 values were 3.742 and 8.000, both P<0.05). After 12 months of follow-up, the RR and DCR in the treatment group were 40 ％ (12/30) and 80 ％(24/30), the control group were 16％(4/25) and 56％(14/25). There were significant differences between the two groups (χ2 values were 3.547 and 1.983, both P< 0.05). The adverse effect rates had no significant difference between the two groups (all P> 0.05). The 2-year survival rates in the treatment group and control group were 28.2 ％ and 11.0 ％, the difference was statistically significant (χ 2 = 4.512, P = 0.034). Conclusions Temozolomide and bevacizumab combined with concurrent radiotherapy in treatment of malignant glioma is superior to temozolomide combined with radiotherapy, and bevacizumab is safe and has few side effects. It is a preferred treatment and is worthy of clinical promotion.

Objective This study was provided the evidence of infection respiratory tract clinical treatment through examining 695 cases of pathogen .Methods Using indirect immunofluorescence(IFA) IgM antibody with 9 respiratory pathogen in serum of 695 patients from August 2015 to March 2016 with respiratory tract infection from espiratory ,pediatrician ,thoracic surgery clinics were detected in this paper in order to provide the basis for clinical treatment .Results The results showed that single pathogen de‐tection positive rate was 33 .9% in 695 cases ,The top three of positive rate were MP(14 .1% ) ,IFB(9 .6% ) ,RSV(4 .8% );the posi‐tive rate of two mixed infection was 7 .79% ;The postive rate of MP ,IFB have obvious difference in seasons ,but which of Coxiella burneti was no obvious seasonal difference;there was an obvious difference between the sex ratio .Conclusion MP ,IFB ,RSV infec‐tion were given priority to detection rate in our region .

Objective:It is more difficult to conduct precision radiotherapy for organs of the human body with the respiratory movement. It is necessary to compensate a certain degree of deviation which is produced by many thoracic and abdominal organs with breathing exercises. To develop a new breathing control system of tumor target for precision radiotherapy is the practical demand in hospital.Methods: According to the current active breathing control system, there are gasbag, control box, handle switch for the patients, computer, automatic gasbag controller, respiratory sensor and communication tools. The Pneumotach PowerCube pulmonary function respiratory sensor and C++ high level programming language were selected to program the breathing control system.Results: The system could make patients conduct respiratory control better, reduce the deviation of pulmonary tumor caused by respiratory movement and improve the accuracy of treatment.Conclusion: The system had a lot of functions, such as dispersion, oscillation, ventilation and so on. It is refitted on the current instruments and successful to clinical application.

ObjectiveTo understand the relationship between mycoplasm load in bronchoalveolar lavage lfuid (BALF) with the status of Th1/Th2 immune response in children withMycoplasma pneumoniae pneumonia (MPP).MethodsThe levels of IL-4, IFN, IL-8 , TNF-α in BLAF and total IgE, ECP in serum from 90 children with MPP were measured by ELISA.MP DNA in BALF was detected quantitatively by lfuorescent real-time PCR. Children with MPP (n=90) were divided into two groups of low MP-DNA load (n=24) and high MP-DNA load (n=26) according to the copies of MP DNA in BALF. The cytokines in BALF, and total IgE and ECP in serum were compared between the two groups. The relationship between the levels of cytokines in BLAF and the copies was evaluated.ResultsThe levels of IL-4 and the IL-4/IFN ratio in BALF from the high DNA-load group were signiifcantly higher than that of the low group (t=4.280, 2.076, allP<0.05). The level of IL-4 was signiifcantly correlated with the copies of MP-DNA in BALF from children with MPP (r=0.509,P<0.05). The percentage of total IgE and ECP positive result in serum from the high DNA-load group is higher than that of the low group. (χ2=24.638, 6.392,allP<0.05).Conclusion Infection with high-load MP in children may cause the imbalance of Th1/Th2. And the Th2 cytokines response seems predomi-nant.

Objective To observe the influence of edaravone on hydrocephalus and prognosis of patients with moderate and severe traumatic brain injury (TBI).Methods 124 patients with hy-drocephalus due to moderate and severe TBI admitted were randomly divided into treatment group (n =63)and control group (n =61).Routine treatment was given to control group,on which basis edara-vone was intravenously injected to treatment group.Hydrocephalus volumes before treatment and 3,7, 14 and 28 days after treatment,Glasgow Coma Scale (GCS)scores 28 days after treatment as well as Glasgow Outcome Scale (GOS)scores 6 months after follow up were observed.Results Hydroceph-alus volumes 3 and 7 days after treatment extended significantly than those before treatment in both groups (P <0.01),decreased apparently 14 and 28 days after treatment (P <0.01),and were smal-ler in treatment group than in control group (P <0.01 ).28 days after treatment,GCS scores in-creased significantly in both groups than those before treatment (P <0.01)and were higher in treat-ment group than in control group (P <0.01).6 months after follow up,GOS score was better in treat-ment group than in control group (P <0.05).Conclusion Edaravone can significantly reduce hydro-cephalus in patients with moderate and severe TBI and improve the prognosis.

Objective To observe the influence of edaravone on hydrocephalus and prognosis of patients with moderate and severe traumatic brain injury (TBI).Methods 124 patients with hy-drocephalus due to moderate and severe TBI admitted were randomly divided into treatment group (n =63)and control group (n =61).Routine treatment was given to control group,on which basis edara-vone was intravenously injected to treatment group.Hydrocephalus volumes before treatment and 3,7, 14 and 28 days after treatment,Glasgow Coma Scale (GCS)scores 28 days after treatment as well as Glasgow Outcome Scale (GOS)scores 6 months after follow up were observed.Results Hydroceph-alus volumes 3 and 7 days after treatment extended significantly than those before treatment in both groups (P <0.01),decreased apparently 14 and 28 days after treatment (P <0.01),and were smal-ler in treatment group than in control group (P <0.01 ).28 days after treatment,GCS scores in-creased significantly in both groups than those before treatment (P <0.01)and were higher in treat-ment group than in control group (P <0.01).6 months after follow up,GOS score was better in treat-ment group than in control group (P <0.05).Conclusion Edaravone can significantly reduce hydro-cephalus in patients with moderate and severe TBI and improve the prognosis.

Objective To explore the effects of removing-stasis and resuscitating methods on patients with severe cerebral injury. Methods Retrospective analysis was performed with clinical data of 47 patients. All 47 patients were recruited into a control group(n=21) and a treatment group(n=26). The control group was treated with conventional western medicines; while the treatment group was additional treated with traditional Chinese medicine on the basis of the control group. Results The rate for resuscitation after one week's treatment was 73.08% and 57.14% in the treatment group and the control group respectively, showing significant differences (P<0.01). The total effective rate was 76.92% and 61.90% in the treatment group and the control group respectively, also showing significant difference (P<0.05) . Conclusion The method of removing-stasis and resuscitating can promote severe cerebral injury patients regain their consciousness, and improve their prognosis.