Purpose To investigate the risk factors of severe hypocalcemia after ultrasound-guided thermal ablation for secondary hyperparathyroidism.Materials and Methods A retrospective case-control study was used to study 91 patients with uremia complicated with secondary hyperparathyroidism in the First People's Hospital of Yulin from May 2019 to May 2023.All patients underwent ultrasound-guided thermal ablation and were divided into severe hypocalcemia group(SH)and non-SH group according to postoperative blood calcium levels.The difference of clinical data between the two groups was compared,and the independent risk factors of SH were investigated by multivariate Logistic regression analysis.Results A total of 317 glands were ablated in 49 cases of microwave ablation and 42 cases of radiofrequency ablation.SH occurred in 57 cases(62.64%)after ablation.The comparison of clinical data between the two groups showed that there were significant differences in the preoperative intact parathyroid hormone(iPTH),decline rate of iPTH 1 d,preoperative serum alkaline phosphatase,the proportion of parathyroid glands≥4 and the total gland volume between the two groups(all P<0.05).Receiver operating characteristic curve analysis was used to obtain the best cut-off point of iPTH 1 d decline rate,the result was 74.59%,the area under the curve was 0.866(95%CI 0.787-0.945)(P<0.05),the sensitivity was 84.2%,and the specificity was 78.1%.Multivariate Logistic regression analysis showed that preoperative alkaline phosphatase(OR=1.015,95%CI 1.005-1.025,P=0.030)and decline rate of iPTH 1 d≥74.59%(OR=30.423,95%CI 5.938-155.858,P<0.001)and parathyroid glands≥4(OR=4.355,95%CI 1.027-18.469,P=0.046)were independent risk factors for postoperative SH(all P<0.05).Conclusion Preoperative alkaline phosphatase and decline rate of iPTH 1 d≥74.59%and the number of parathyroid glands≥4 are independent risk factors for SH after thermal ablation.

Objective To observe the risk factors of recurrence after ultrasound-guided thermal ablation for treating uremia secondary hyperparathyroidism(SHPT).Methods Totally 59 patients with uremia SHPT who underwent ultrasound-guided thermal ablation were enrolled,including 23 cases with(relapse group)and 36 without SHPT recurrence(non relapsed group).Clinical data were compared between groups,univariate and multivariate logistic regression analysis were performed to screen independent risk factors of SHPT recurrence.Results There were significant differences of serum free thyroxine(FT4),urea,intact parathyroid hormone(iPTH)1 day after ablation,1 day decrease rate of iPTH,the maximum diameter of the largest nodule,ablation time,total ablation energy,energy to volume ratio and the proportion of 1 day decrease rate of iPTH≤90%between groups(all P＜0.05).Higher urea,lower energy to volume ratio and 1 day decrease rate of iPTH≤90%were all independent risk factors of SHPT recurrence(all P＜0.05).Conclusion Higher urea,lower energy to volume ratio and 1 day decrease rate of iPTH≤90%were independent risk factors of recurrence after ultrasound-guided thermal ablation for treating uremia SHPT.

Objective:To evaluate the effects and adverse reactions of external skin care products containing oltides and bio-polysaccharides on epidermaligopep barrier function of sensitive skin.Methods:From December 2019 to July 2020, there were 30 sensitive skin volunteers diagnosed and treated in the dermatology clinic of Beijing Tongren Hospital, including 3 males and 27 females, aged 18-57 years, with an average of 34 years, and the course of disease was 1-10 years, with an average of 5.75 years. They were treated once with products containing oligopeptides and biopolysaccharides on the day of enrollment. Before treatment, 1 week and 4 weeks after treatment, we observed and evaluated through VISIA analysis; skin physiological index measurement, subjective and objective improvement assessment, and product safety were evaluated through questionnaire surveys.Results:The VISIA data showed that the red zone was significantly lower than the baseline, and the data at the 4th week and before treatment were significantly improved ( P<0.05). On skin physiology, the test showed that after treatment, the difference between two follow-up visits and the water content before was statistically significant ( P<0.05). TEWL value after 4 weeks of treatment was significantly improved as compared with the baseline ( P<0.05). During the entire study process, no adverse reactions related to the product occurred. Conclusions:This skin care product containing oligopeptides and biopolysaccharides can increase the water content of the sensitive skin, reduce the water loss through the skin, and improve the skin barrier function. Meanwhile, no server adverse reaction is detected through the whole experiment.

Regression discontinuity design (RDD) is a rigorous quasi-experimental method. Based on the randomness of the distribution of samples around the critical value, the data on both sides are used for regression respectively, so as to avoid the interference of potential confounding factors and provide strong evidence for the inference of causal correlation. This study introduces the RDD and its research progress, and expounds its application in detail combined with cases, in order to provide reference for the application of RDD in epidemiological research.

Regression discontinuity design (RDD) is a rigorous quasi-experimental method. Based on the randomness of the distribution of samples around the critical value, the data on both sides are used for regression respectively, so as to avoid the interference of potential confounding factors and provide strong evidence for the inference of causal correlation. This study introduces the RDD and its research progress, and expounds its application in detail combined with cases, in order to provide reference for the application of RDD in epidemiological research.

Objective:To investigate the value of texture analysis based on T 2WI and apparent diffusion coefficient (ADC) maps in discriminating low grade from high grade prostate cancer (PCa). Methods:Retrospective analysis was performed on patients who were confirmed to be PCa by pathology after surgery and underwent MRI examination in the department of radiology,Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology before radical surgery, including routine T 1WI, T 2WI and diffusion weighted imaging (DWI) sequences. 3D data analysis module of the MaZda software was used to manually draw region of interest (ROIs) slice by slice on T 2WI and ADC images, and generate volume of interest (VOI) of the entire tumor. MaZda software was also used to extract texture features. The independent sample t test or Mann-Whitney U test were used to identify the texture features with statistically significant differences between low and high grade PCa groups. Lasso regression model was used to select the best combination of texture features for identifying low and high grade PCa, and then the model was built. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of the model in both training cohort and test cohort. Results:The best texture feature combination selected by Lasso regression model were the S (1, 0, 0) correlation of T 2WI and the S (1, 0, 0) correlation, S (1, -1, 0) sum entropy and vertical-run length nonuniformity of ADC maps. The area under the ROC curve (AUC) of the model in training cohort was 0.823, and the sensitivity and specificity were 70.4% and 80.8%, respectively, which were better than the single texture feature. The AUC of the model in test cohort was 0.714, which was worse than training cohort. Conclusion:The texture analysis of T 2WI and ADC maps is valuable for the identification of low and high grade PCa.

Objective: To compare the accuracies of quantitative computed tomography (CT) parameters and semiquantitative visualscore in evaluating clinical classification of severity of coronavirus disease (COVID-19). Materials and Methods: We retrospectively enrolled 187 patients with COVID-19 treated at Tongji Hospital of Tongji MedicalCollege from February 15, 2020, to February 29, 2020. Demographic data, imaging characteristics, and clinical data werecollected, and based on the clinical classification of severity, patients were divided into groups 1 (mild) and 2 (severe/critical). A semiquantitative visual score was used to estimate the lesion extent. A three-dimensional slicer was used toprecisely quantify the volume and CT value of the lung and lesions. Correlation coefficients of the quantitative CT parameters,semiquantitative visual score, and clinical classification were calculated using Spearman’s correlation. A receiver operatingcharacteristic curve was used to compare the accuracies of quantitative and semi-quantitative methods. Results: There were 59 patients in group 1 and 128 patients in group 2. The mean age and sex distribution of the two groupswere not significantly different. The lesions were primarily located in the subpleural area. Compared to group 1, group 2 hadlarger values for all volume-dependent parameters (p < 0.001). The percentage of lesions had the strongest correlation withdisease severity with a correlation coefficient of 0.495. In comparison, the correlation coefficient of semiquantitative scorewas 0.349. To classify the severity of COVID-19, area under the curve of the percentage of lesions was the highest (0.807;95% confidence interval, 0.744–0.861: p < 0.001) and that of the quantitative CT parameters was significantly higher thanthat of the semiquantitative visual score (p = 0.001). Conclusion The classification accuracy of quantitative CT parameters was significantly superior to that of semiquantitativevisual score in terms of evaluating the severity of COVID-19.

Objective:To evaluate the safety and outcomes of robot-assisted electrode insertion in cochlear implantation.Methods:We first reported the case of robot-assisted electrode insertion of cochlear implantation in October 2019. A new slim electrode array of Nurotron cochlear implant (CS-10A TM) and RobOtol ? robot system were used in this case. The robotic assistance procedures, surgical outcomes were analyzed. Results:Robot-assisted electrode insertion was successfully performed in this adult patient. The preparation of robot system cost six minutes, the electrode array was slowly and fully inserted into tympanic scala with robot assistance. No damage in the surgical field occurred by the robotic instrument. Intraoperative electrode impedances and neural response measurements were normal. No postoperative complications occurred. Up to three months of follow up after implantation, the cochlear implant functioned well and rehabilitated hearing was satisfactory.Conclusion:Otological robot system shows its advantage in the elimination of human involuntary tremors and the augmentation of accuracy during micromanipulation, it could safely assist cochlear implantation to realize minimally invasive and full tympanic scala insertion of the electrode array, and to ensure the good preservation of the intracochlear fine structure.

Objective:To explore the trend of postpartum hemorrhage after two-child policy and to analyze the high-risk risks of postpartum hemorrhage so as to put forward intervention measures to reduce the postpartum hemorrhage.Methods:We retrospectively selected 8 784 delivery women with routine production inspection and hospitalized at a ClassⅢ Grade A hospital from 2014 to 2018. We collected the general information, record of production inspection, delivery record and analyzed the trend of postpartum hemorrhage rate, blood loss and related high-risk factors.Results:From 2014 to 2018, there were statistical differences in the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss ( P<0.05) . The trend showed an increasing trend. In 2017, the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss were 16.9%, 6.1% and (540.1±758.2) ml respectively highest in those years. From 2014 to 2018, the percentage of delivery women with advanced ages, multiple pregnancy, pregnancy times≥2, history of cesarean section≥2 were increasing; delivery women with the prenatal hemoglobin≤110 g/L and percentage of natural labor were decreasing with a statistical difference ( P<0.05) ; the percentage of emergency cesarean section was on the rise; the percentage of placental expulsion time from 15 to 30 minutes declined with statistical differences ( P<0.05) ; the percentage of placental expulsion time≥30 minutes and above was no significant trend. Conclusions:From 2014 to 2018, the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss did not show an increasing trend. However, the percentage of high-risk pregnant and delivery women increased gradually. Therefore, we should carry out the pregnancy risk assessment rating for pregnant and delivery women and formulate a suitable high-risk assessment tool for postpartum hemorrhage so as to reduce the incidence of postpartum hemorrhage.

Objective:To explore the influencing factors of the failure of labor induction by oxytocin and delivery outcome, and provide a basis for standardizing pregnancy management and process management of labor induction by oxytocin.Methods:Using a self-designed data collection form, the data of 1 705 pregnant women who underwent labor induction by oxytocin in the Department of Obstetrics of China-Japan Friendship Hospital from 2014 to 2018 were retrospectively collected, and the influencing factors of the failure of labor induction by oxytocin and the outcome of delivery were analyzed.Results:A total of 1 705 primary mothers were included in the study. Multiple factor analysis show that, amniotic fluid pollution, macrosomia, and the duration of labor induction by oxytocin were independent influencing factors for the failure of labor induction by oxytocin. The duration of labor induction by oxytocin was related to the method of delivery, weight of the newborn, and amount of postpartum hemorrhage, and the difference was statistically significant ( P<0.01) . The outcome of delivery labor induction by oxytocin was the cause of cesarean delivery, and "intrauterine fetal distress" and "cephalopelvic disproportion" accounted for the highest proportion. Conclusions:The main influencing factors for the failure of labor induction by oxytocin are amniotic fluid pollution, macrosomia, etc., and the influencing factors will gradually increase with the process of labor induction, thereby reducing the natural delivery rate. Therefore, it is necessary to strengthen pregnancy management, control pregnancy weight and fetal weight, and reduce pregnancy complications. It is also necessary to strengthen clinical management of labor induction by oxytocin, provide sound education and guidance for labor induction by oxytocin, and increase the vaginal delivery rate after labor induction by oxytocin.