Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

Objective:To explore the application value of different methods of segmented latissimus dorsi myocutaneous flap in repairing chest wall defects after local advanced breast cancer surgery.Methods:The clinical data of 64 patients with unilateral locally advanced breast cancer admitted to Shanxi Cancer Hospital from Feb. 2019 to Jan. 2020 were selected. All patients underwent modified radical mastectomy for breast cancer. The patients were divided into two groups according to the random number table method. Antegrade (group A, n=32 cases) and retrograde (group B, n=32 cases) were used to design and cut the segmented latissimus dorsi myocutaneous flap to repair the defects. The range of skin island cut was 14 cm×6 cm-19 cm×7 cm; The donor area of the flap was closed directly. The application effects of the two groups of methods were compared. Results:In group A, one antegrade flap was partially necrotic, while in group B, six retrograde flaps were partially necrotic ( P>0.05). The delayed healing rate of donor site incision in group A was 6.25%, significantly lower than that in group B (25.00%) ( χ2=4.267, P=0.039). All the patients in both groups were followed up for 12 to 24 months, and the appearance and texture of the flaps were satisfactory; Only linear scar was left in the donor area, and the shoulder joint activity was not affected. The mean survival time was 20.8 months. Conclusion:The antegrade latissimus dorsi myocutaneous flap can repair the large area defect of chest wall after LABC, which can ensure the blood supply of the flap to the greatest extent, reduce the closing tension of the donor area, the incidence of postoperative complications, and promote the healing of the incision.

Objective:To investigate the clinical characteristics and gene mutation of seven cases of CDKL5 gene related early-onset epileptic encephalopathy diagnosed by next-generation sequencing.Methods:The clinical data of children with early-onset epileptic encephalopathy from February 2018 to December 2019 in the Department of Neurology, Children′s Hospital Affiliated to Zhengzhou University were retrospectively analyzed. The whole exome sequencing method was used to analyze the entire exome of the proband, and seven cases of CDKL5 gene mutation positive were screened out, and Sanger sequencing verification on family members was performed to identify the source and the characteristics of gene mutations were analyzed.Results:Among the seven children diagnosed with CDKL5 gene related early-onset epileptic encephalopathy, the ratio of male to female was 2∶5, and the age of onset was 15 days to five months of birth. The clinical phenotypes all included different degrees of developmental delay and repeated seizures, which were manifested as general seizures, myoclonic seizures, convulsive seizures or focal seizures; the outcome of use of antiepileptic drugs to control seizures was poor, and some applications of ketogenic diet had better effects. CDKL5 gene mutation sites were all denovo mutations, including NM_003159: c.772_776del (p.K258Efs *10) frameshift mutation, NM_003159.2 (exon: 9-15) heterozygous deletion, CDKL5 hemizygous deletion, NM_003159: c.268 (exon5) G>T (p.E90 *, 941) and NM_003159: c.2578C>T (p.Q860 *, 171) nonsense mutation, NM_003159: c.211A>G (p.Asn71Asp) and NM_001323289: c.545T>C (p.L182P) missense mutation. Among them, c.772_776del (p.K258Efs *10), c.268 (exon5)G>T and c.2578C>T (p.Q860 *, 171) have not been reported. Conclusions:CDKL5 gene related early-onset epileptic encephalopathy is an early onset epilepsy, which is more common in women, and has different forms of seizures. The early electroencephalogram is characterized as severe abnormal brain discharge, and the disease progresses in various forms. There are no specific changes in head magnetic resonance imaging. Different gene mutation sites may lead to different phenotypes and prognostic differences. Many anti-epileptic treatments are ineffective, and ketogenic diets are effective for some patients.

Objective:To investigate the clinical phenotype of a child with Jansen-de Vries syndrome, to clarify its genetic diagnosis and genetic characteristics, and to improve the understanding of this disease.Methods:Clinical data from a child with Jansen-de Vries syndrome diagnosed in the Children′s Affiliated Hospital of Zhengzhou University in October 2019 were collected, using core family-complete exon genomics detection (Trio-WES) and chromosome copy number variation (CNV) analysis techniques for genetic testing for the child and her parents, generation Sanger sequencing for family member verification for possible pathogenic mutations, and clinical and molecular genetic analysis. The relevant reports of PPM1D gene mutation in patients with mental retardation were reviewed.Results:The proband was a 11-month-old girl, presenting with mental retardation, lagging speech and motor development, autistic behavior, gastrointestinal dysfunction, and short stature, low flat nose bridge, low ear, short finger syndrome.Trio-WES results of the core family of the child suggested that PPM1D was a new transcoding heterozygous mutation, PPM1D (NM-003620): c.1216delA (p.Thr406Profs *3), and the karyotype and CNV analysis of the chromosome were normal. Literature retrieval showed currently a total of 18 cases were reported PPM1D gene mutation of mental disorders, described in the online human Mendel database for developmental disorder associated with gastrointestinal dysfunction and pain threshold increases, the age distribution in the seven months to 21 years of age, clinical manifestation of mental retardation, increased pain threshold, abnormal behavior, feeding difficulties, visual impairment, short finger syndrome, a group of syndromes associated with short stature, fever or vomiting, and congenital deformities. Conclusions:Jansen-de Vries syndrome clinically presents mainly with overall retardation (mental retardation/backward delayed motor development, language development, low muscle tone), abnormal behavior (lonely sample behavior, autism), craniofacial malformations (broad forehead, low ear nose bridge, thin upper lip), short finger syndrome (short feet, pinky stubby), gastrointestinal dysfunction (milk overflow, feeding difficulties, constipation). The child was diagnosed as a newly transcoding heterozygous mutation of the PPM1D gene. The current treatment is mainly rehabilitation training, and growth hormone replacement therapy can be given to part of the short height disease. The PPM1D gene [PPM1D(NM-003620): c.1216delA(p.Thr406Profs *3)] is the genetic cause of the child.

Objective: To understand the current situation of adolescents interactive health literacy in Yanbian poverty-stricken area and associated social-ecological factors, so as to provide scientific basis for targeted health education and policy adolescents in this area in the future. Methods: Using cluster sampling method, a questionnaire survey was conducted on 818 junior high school students in grades 7 and 8 of all 4 junior high schools in Antu County in November 2019. Results: The scores of interaction health literacy was in moderate level (101.38±20.12) in Yanbian poverty-stricken area. The average scores of all dimensions was (3.62±0.96), stress management (3.35±1.08), interpersonal relationship (3.29±0.82), nutrition (3.21±1.02), health awareness (2.99±0.82), physical activity (2.68±0.85). The results of multiple linear regression analysis showed that grade, gender, BMI, perceived health care, perceived academic performance, participation in extracurricular activities, types of guardians, parenting style; perceived school health policy; average screen time were associated with the level of adolescent interactive health literacy (P<0.05), explaining 54.5% of the total variation(F=35.97，P<0.01). Conclusion The health literacy level of adolescents in poverty-stricken areas is affected by personal, family environment, interpersonal relationship, school, media and other factors. It is recommended that future health literacy interventions for adolescents should consider the students themselves, as well as their socio-ecological environment.

Objective: To understand the relationship between childhood psychological resilience and of school violence awareness in rural areas in southern Henan, and to provide support and reference for the prevention and control of school violence. Methods: A total of 6 484 primary school children in grades 4-6 in the rural areas of Dengzhou, Xincai and Gushi counties in southern Henan were surveyed for psychological resilience and awareness on school violence. Results: The average score of psychological resilience of grade 4-6 pupils in rural areas of southern Henan was (39.92±8.18), and the average score of school violence awareness was (60.78±6.19). In terms of age, gender, grade, school type, personality, class performance, academic performance, smoking, intimate friends, playing games, truancy, loitering outside the school, relationship with siblings, father s education, mother s education, parental conflict, parenting style, the proportion of primary school students in different level of school violence awareness varied statistically different (P<0.01). Multivariate Logistic regression showed, after controlling for confounding factors, psychological resilience was an independent influencing factor affecting awareness on school violence (OR=1.06, 95%CI=1.05-1.08), with better psychological resilience, being associated with higher school violence awareness (P<0.01). Conclusion The level of school violence awareness and psychological resilience of pupils in southern Henan is relatively low. The higher level of psychological resilience, the higher level of school violence awareness; psychological resilience might be improved through education and household parenting modification to prevent and reduce the incidence of violence on campus.

Objective To discuss the clinicopathological features and prognostic factors of patients with triple negative breast cancer (TNBC) in Shanxi province. Methods The medical records of 958 female TNBC patients who were admitted to Shanxi Provincial Cancer Hospital and the First Hospital of Shanxi Medical University from January 2005 to December 2015 were retrospectively analyzed. The clinicopathological features and prognostic factors were summarized. Results The median age of TNBC patients in Shanxi province was 46 years old (21-87 years old), the median body mass index (BMI) was 24.42 kg/m2 (15.0-37.5 kg/m2), and the rural population was slightly more. The left breast cancer was more than the right breast cancer, and 492 patients (51.4％) were in stage T2. The main histological type was invasive ductal carcinoma. The main surgical method was modified radical mastectomy. Univariate Cox regression analysis showed that the patient's place of residence, fertility status, age at first birth, breastfeeding history, tumor size, American Joint Committee on Cancer Staging, lymph node metastasis, and surgical approach were associated with the risk of death in TNBC patients (all P<0.05);but the BMI, menstrual status, menarche age, and family history were not associated with the risk of death (all P>0.05). Multivariate Cox regression analysis showed that rural residents (HR= 1.46, P= 0.044), positive lymph node metastasis (HR= 2.51, P< 0.01), non-fertility (HR=1.08, P= 0.009) and no surgery (HR= 2.53, P= 0.004) were independent risk factors affecting the risk of death, a history of breastfeeding was a protective factor affecting the risk of death in TNBC patients (HR=0.44, P=0.013). Conclusions In Shanxi province, TNBC is more common in premenopausal women and the main pathological type is invasive ductal carcinoma. Rural population, lymph node positive, non-fertility, and no surgical treatment are independent risk factors for the prognosis of TNBC patients.

Objective:To explore the clinical efficacy, especially the comprehensive improvement of blood glucose and lipid of probucol and metformin in the treatment of type 2 diabetes mellitus with hyperlipidemia. Methods:Totally 105 patients with type 2 di-abetes mellitus complicated with hyperlipidemia were randomly divided into the control group1 (35 cases), the control group 2 (34 ca-ses) and the observation group (36 cases). The control group 1 was treated with diet control, exercise and metformin, the control group 2 was treated with rosuvastatin calclum tablets based on the group 1, and the observation group was treated with probucol based on the group 1. The three groups were continuously treated for 12 weeks. The improvement of the fasting blood-glucose (FPG), 2h postprandial blood glucose (PBG), hemoglobin A1C (HbA1C), fasting insulin levels (Fins), insulin resistance indices (HOMA-IR) and TC, TG and HDL-C, and the adverse reactions among the three groups were compared. Results:The total effective rate in the ob-servation group was higher than that in the control group 1 and 2 (P<0. 05). After the treatment, all the indices of blood glucose and lipid in the three groups were significantly improved (P<0. 05), and those of blood glucose in the observation were better than those in the control group 1 and 2(P<0. 05), those of blood lipid in the observation group and the control group 2 were better than those in the control group 1 (P<0. 05), and the level of HDL-C in the observation group was much higher than that in the control group 2 (P<0. 05). The adverse drug reactions in the three groups were mild without statistical significance (P>0. 05). Conclusion:Probucol as one of lipid-lowing drugs with antioxidant action combined with metformin can improve blood lipid and lower blood glucose at the same time, which is worthy of promoted application in clinics.

Objective:Some medical liquid needs to be heated to the human body temperature, so the constant temperature case is a necessary equipment. But the common constant temperature case is often bulky, inconvenient application and the price is very high, so this paper is mainly to develop a convenient and cheap thermostat device for medical liquid heating.Methods:The system used single-chip microcomputer for temperature control. The temperature sensor collected and displayed the temperature of the box when the temperature was set up. Then the heating module started when the temperature was lower than the set point, and stopped heating when reaching to the set point.Results: The temperature control effect of constant temperature case tested by calibrated mercury thermometer, the temperature of constant temperature case was not significantly different from that of mercury thermometer.Conclusion: The portable constant temperature case for medical liquid have the characteristics of precise temperature control, high temperature resolution, and small temperature fluctuations. It can meet the clinical needs and be worth to popularizing in clinical applications.