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Table of Content

    25 September 2019, Volume 40 Issue 9
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    Impact of the circadian rhythm on slow/noreflow phenomenon after emergency percutaneous coronary intervention#br#
    BAI Wenlou, QI Xiaoyong, GAO Man, CHEN Xuefeng, YAO Wenjing
    2019, 40(9):  996-1000.  doi:10.3969/j.issn.10073205.2019.09.002
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    ［Abstract］ Objective〖HTSS〗To evaluate the relationship between the circadian rhythm and the slow/noreflow phenomenon after percutaneous coronary intervention(PCI) in patients with acute STsegment elevation myocardial infarction(STEMI).
    〖HTH〗〖WTHZ〗Methods〖HTSS〗Three hundred and twelve STEMI patients treated with emergency PCI were divided into normal flow group (286 cases) and slow flow group(26 cases) or no reflow group according to the results of PCI. The basic clinical data of the two groups were compared. The correlation factors between slow blood flow and no reflow after emergency PCI were screened and further multivariate Logistic regression analysis was performed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗〖JP2〗Multivariate Logistic regression analysis showed that body mass index ≥〖JP〗28 and reperfusion time ≥6 h were risk factors for slow flow/no reflow after emergency PCI for STEMI patients(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Circadian  rhythm has no effect on the occurrence of slow blood flow or no reflow after emergency coronary intervention in patients with acute STEMI.
    Clinical characteristics and significance of thyroid dysfunction in patients with acute stsegment elevation myocardial infraction#br#
    SUI Yonggang, WU Yuan, DOU Kefei, TANG Yida,QIAO Shubin， WU Yongjian
    2019, 40(9):  1001-1004,1008.  doi:10.3969/j.issn.10073205.2019.09.003
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    ［Abstract］ Objective〖HTSS〗To investigate the differences of prognosis and the clinical characteristics in patients with acute STsegment elevation myocardial infarction (STEMI) and thyroid dysfunction after propensity score matching.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗Forty patients with STEMI and hyperthyroidism after group percutaneous coronary intervention were recruited. By using the propensity score matching model and based on the patients with hyperthyroidism(1〖DK〗∶1), STEMI patients with hypothyroidism(n=40) and STEMI patients with normal thyroid function(n=40) during the same period were retrospectively collected. The clinical medication, length of hospitalstay, and complications were analyzed in the three groups. 
    〖HTH〗〖WTHZ〗Results〖HTSS〗Significant differences were observed among three groups in E peak and left ventricular ejection fraction（P＜0.05）, and in receptor blockers and diuretics use（P＜0.05）. Compared with control group, the length of hospitalstay, the incidence of severe arrhythmia, atrial fibrillation, and heart failure in both hyperthyroidism and hypothyroidism group were significantly increased（P＜0.05）. Compared with hyperthyroidism group, hypothyroidism group had the longer length of hospitalstay and the higher incidence of severe arrhythmia, atrial fibrillation（P＜0.05）.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗For patients with acute STEMI and thyroid dysfunction after percutaneous coronary intervention, patients with hypothyroidism generally have a worse prognosis than patients with hyperthyroidism.
    Clinical medical research of nasal continuous positive airway pressure in moderate to severe capillary bronchitis
    JIA Xiqun, ZHANG Zhongfu, HAO Gailing, XU Lijuan, LI Qinghua, MA Haimin
    2019, 40(9):  1005-1008.  doi:10.3969/j.issn.10073205.2019.09.004
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    ［Abstract］Objective〖HTSS〗To investigate the safety and efficiency of nasal continuous positive airway pressure(nCPAP) in moderate to severe capillary bronchitis.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗This was a prospective study.Children who were admitted with moderate to severe capillary bronchitis and met the nCPAP ventilation indications.A total of 120 children were included,4 cases with incomplete data were excluded,and 116 cases were finally included.According to clinical outcomes,the two groups were divided into the successful group and the unsuccessful group.The differences in partial pressure of oxygen（PaO2）, partial pressure of carbon dioxide（PaCO2）, PaO2/fraction of inspiration O2（FiO2）, breath and heart rate of the two groups were compared between prenCPAP and postnCPAP at 2 h, 24 h and 48 h.
    〖HTH〗〖WTHZ〗Results〖HTSS〗A total of 108 cases(93.1%) were successfully treated with nCPAP. Eight cases (6.9%) in the unsuccessful group were changed to treat by airway intubation and mechanical ventilation. PaO2, PaO2/FiO2 prenCPAP were lower，and PaCO2 were higher  in nCPAP unsuccessful group(P＜0.05). After nCPAP treatment, breath and heart rate, PaCO2 of the children in the successful group were significantly decreased(P＜0.05). PaO2, PaO2/FiO2 were significantly increased(P＜0.05). All children had good tolerance to nCPAP and no adverse events occurred.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗nCPAP treatment has significant efficacy and high safety, and can effectively improve oxygenation and relieve hypercapnia in children. However, for children with severe hypoxia and obvious carbon dioxide retention, invasive ventilation should be selected as soon as possible.
    Etiological analysis of patients with different degrees of hypercalcemia#br#
    ZHAO Nairui, SU Na, GAO Fang, GUO Ningning, WANG Guangya
    2019, 40(9):  1009-1012,1016.  doi:10.3969/j.issn.10073205.2019.09.005
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    ［Abstract］ Objective〖HTSS〗To investigate the etiological distribution of patients with different degrees of hypercalcemia.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗The clinical datas of 58 patients with hypercalcemia were analyzed retrospectively. According to the corrected serum calcium level, the patients were divided into mild hypercalcemia group(22 cases), moderate hypercalcemia group(15 cases)and severe hypercalcemia group(21 cases). The etiology distribution of different degrees of hypercalcemia was observed. The differences of the clinical characteristics between primary hyperparathyroidism(PHPT) and malignancy associated hypercalcemia(MAH) were compared.
    〖HTH〗〖WTHZ〗Results〖HTSS〗The causes of high calcium levels were found in PHPT, MAH, thyroid function hyperfunction, tertiary hyperparathyroidism. Among the 58 patients with hypercalcemia, PHPT 27 cases(46.55%), MAH 25 cases(43.10%), hyperthyroidism 4 cases(6.90%) with triplex hyperparathyroidism 2 cases(3.45%)   were found. There were more MAH patients in the severe hypercalcemia group than in the mild hypercalcemia group, and the difference was statistically significant(P＜0.05). There was a statistically significant difference in hyperthyroidism amony three groups(P＜0.05), but no statistically significant difference between two groups(P＞0.05). The MAH with the most hypercalcemia was compared with PHPT, and the MAH with lower serum albumin and parathyroid hormone levels than PHPT, higher serum phosphorus and serum creatinine than PHPT, with statistically significant differences(P＜0.05) and no statistically significant differences between MAH and PHPT alkaline phosphatase(P＞0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Hypercalcemia is most common in patients with PHPT and MAH. MAH is a major cause of severe hypercalcemia. MAH patients had low levels of albumin and parathyroid hormone and high levels of serum creatinine. The detection of biochemical indicators was helpful for clinical diagnosis and treatment.
    The difference of expression  of ATG16L1, Gal9, IL1β, IL33 in its resting and onset stage of ulcerative colitis and clinical significance#br#
    WU Na， LI Duo， GAO Huibin， YU Yongqiang， YANG Jielin
    2019, 40(9):  1013-1016.  doi:10.3969/j.issn.10073205.2019.09.006〖JP〗
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    ［Abstract］Objective〖HTSS〗To investigate the differential expression and clinical significance of autophagy related protein 16 like protein 1(ATG16L1), galectin9(Gal9), interleukin1β(IL1β) and interleukin33(IL33) in patients of ulcerative colitis(UC) at rest and onset.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗One hundred and ten patients with UC were selected as study group. According to the Mayo score,the patients were divided into the resting UC group and the onset UC group, and 40 healthy subjects were selected as the control group. The levels of serum ATG16L1, Gal9, IL1β and IL33 were compared between the three groups, and their correlation with the Mayo score was analyzed. Multivariate Logistic regression analysis of UC onset period was performed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗The serum levels of IL1β, IL33, ATG16L1, and Gal9 in the resting UC group and the onset UC group, were significantly higher than those in the control group(P＜0.05), the active UC group was significantly higher than those of the resting UC group(P＜0.05). The serum levels of IL1β, IL33, ATG16L1 and Gal9 were positively correlated with Mayo score(P＜0.05). Multivariate logistic regression analysis showed that IL1β, IL33, ATG16L1, and Gal9 were the influencing factors of UC in the onset.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗The serum levels of IL1β, IL33, Gal9 and ATG16L1 are higher in patients with UC in the onset, which can be used as an independent judgment factor for UC in the onset.
    Ultrasoundassisted treatment on infant neural tube malformation#br#
    LI Xin, YANG Zhiguo, CHENG Zhenghai, LI Hongyan
    2019, 40(9):  1017-1020,1025.  doi:10.3969/j.issn.10073205.2019.09.007
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    〗［Abstract］Objective〖HTSS〗To explore the treatment of neural tube malformation in infants assisted by Bultrasound.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗The clinical data of 33 children with neural tube malformation were retrospectively analyzed. All cases were treated by microsurgery. Spina bifida neurological scale was used to evaluate the effect of the operation.
    〖HTH〗〖WTHZ〗Results〖HTSS〗Two cases were diagnosed as meningocele by ultrasound before operation. In addition to meningocele, longitudinal fissure of spinal cord was found during operation. The diagnostic results of the other children were consistent with the ultrasonic diagnosis, and the coincidence rate of ultrasonic diagnosis was 93.9%(31/33). During the followup of 12-36 months, there was no significant difference in the grade of nerve function before and after operation in children with different types of neural tube malformations(P＞0.05). The total effective rate of operation was 78.8%(26/33). There was no significant difference in surgical effect and total effective rate among different types of neural tube malformations(P＞0.05). During the followup period, Bultrasound examination showed that the blood flow at the end of spinal cord in 14 children was improved in varying degrees compared with that before operation.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Ultrasonic examination is nonradiation, convenient, rapid and reproducible. It can noninvasively and accurately evaluate the types and degrees of neural tube malformation in infants, improve the safety of operation, reduce the incidence of complications and provide important reference information for surgical treatment and postoperative followup.
    The therapeutic evaluation of transperitoneal 3D laparoscopy and traditional 2D laparoscopy in the treatment of children with ureteropelvic junction obstruction
    DU Lei, QI Jinchun, XUE Wenyong
    2019, 40(9):  1022-1025.  doi:10.3969/j.issn.10073205.2019.09.008
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    ［Abstract］ Objective〖HTSS〗To evaluate the curative effect of transperitoneal 3D laparoscopy and traditional 2D laparoscopy in the treatment of children with ureteropelvic junction obstruction.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗A total of 84 patients with the disease of ureteropelvic junction obstruction were enrolled. All of them were operated through the peritoneal pathway. 24 cases in the 3D group received 3D laparoscopic pyeloplasty, while 27 cases in the 2D group received 2D laparoscopic pyeloplasty. The surgical results were compared between the two groups.
    〖HTH〗〖WTHZ〗Results〖HTSS〗All of the surgeries were uneventful, and no serious complications were found after following up for more than 6 month. The operative time between the two groups had significant difference, which 3D group shorter than 2D group(P＜0.05)，but no obvious difference happened in the intraoperative blood loss and postoperative hospital stay(P＞0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗3D laparoscope can display threedimensional vision during surgery like the real vision, which can make the field of surgery lifelike, reduce the degree of surgery, shorten the operative time, and improve the accuracy and safety of laparoscopic surgery. 3D laparoscope can make a certainly curative effect and significantly clinical value.
    Application research of gasbladder laparoscopy combined with resectoscope in enucleation of bladder tumors#br#
    WANG Xin, JIA Jianghua, ZHANG Ming, QI Jinchun, QU Changbao, WANG Dongbin
    2019, 40(9):  1026-1028,1033.  doi:10.3969/j.issn.10073205.2019.09.009
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    ［Abstract］Objective〖HTSS〗To explore the application value of gasbladder laparoscopy combined with resectoscope in the  enucleation of bladder tumors.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗A total of 17 eligible patients with bladder cancer were selected. Complete enucleation of tumors via resectoscope on operation, artificial pneumatic bladder was established by suprapubic puncture, suture wound in bladder cavity, the operation time, bleeding volume, urinary extravasation, rectal injury, postoperative pain score and hospitalization days were recorded.
    〖HTH〗〖WTHZ〗Results〖HTSS〗All the 17 patients successfully have completed the operation.No case had to transit opening. The average operation time was （77.3±13.9） min,the average bleeding volume was （6.3±2.9） mL. No urinary extravasation occurred in all the 17 patients, no serious complications such as rectal injury. The average pain score was （4.2±1.3） at 4 hours after operation and （1.8±0.7） at 12 hours after operation, the average hospitalization days after operation were （3.7±1.1） days.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Gasbladder laparoscopy combined with resectoscope is a safe and effective method in enucleation of bladder tumors. It is an important supplementary method in the operation of bladder tumors.
    The effects of 17βestradiol on proliferation of ovarian clear cell carcinoma ES2 cell line and the possible mechanism
    ZUO Hongling1, YAN Xiaonan2, LIU Subin3, LI Xiuwen1, WANG Huilan1, XU Chunlin1, DU Hui1*
    2019, 40(9):  1029-1033.  doi:10.3969/j.issn.10073205.2019.09.010
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    ［Abstract］Objective〖HTSS〗To investigate effects of 17βestradiol(E2) on cell proliferation of ovarian clear cell carcinoma cell line ES2, and to explore its possible mechanism.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗The experiment was divided into E2 10-7mol/L group, E2 10-8mol/L group, E2 10-9mol/L group, E2 10-10mol/L group, E2 10-11mol/L group, solvent control group and blank control group. The proliferative activity of different E2 concentrations at different time(24, 48, 72 h) was measured by MTS method and expressed as absorbance(optical density OD) value, the invasive capability was detected after treated with different concentrations of E2 through transwell experiment. The expression of AT rich interaction domain 1A(ARID1A) protein，p53 and matrix metalloproteinase9(MMP9) protein in ES2 cells treated with different concentrations of E2 was measured by western blot.
    〖HTH〗〖WTHZ〗Results〖HTSS〗The proliferative activity of E2 group cells after treated with different concentrations of E2 for 24, 48, 72 hours was higher than solvent control group and blank control group(P＜0.05). The transwell experiment showed that the number of transmembrane cells in the E2 group were significantly higer than that in the control group(P＜0.05). Western blot analysis showed that with the increase of E2 concentration, the expression of ARID1A decreased gradually compared with the control group, while the expression of MMP9 and p53 increased with the increased(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗E2 could downregulate the expressions of ARID1A protein, upregulate the expressions of p53 and MMP9 protein. E2 could enhance the ability of proliferation and invasion of ES2 cell. Patients with clear cell carcinoma of the ovary who had undergone surgery should be more cautious in the use of estrogen therapy.
    The evaluation of anatomical hepatectomy for severe liver trauma#br#
    GUO Wei, ZHANG Chong, LI Guixian, WU Jiaxing, JIANG Jianhui,YAO Hongbing
    2019, 40(9):  1034-1037.  doi:10.3969/j.issn.10073205.2019.09.011
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    ［Abstract］Objective〖HTSS〗To explore the safety and feasibility of anatomical hepatectomy for severe liver trauma.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗Retrospective analyzed of clinical data of 20 patients with severe liver trauma after anatomical hepatectomy. The all patients underwent anatomical hepatectomy with pringle′s maneuver or regional hepatic portal occlsion. Operation time,intraoperative blood loss， and perioperative complications were observed.
    〖HTH〗〖WTHZ〗Results〖HTSS〗All the 20 cases underwent anatomical hepatectomy successfully.The operations included left lateral lobectomy(n=4),right anterior lobectomy(n=2), segment Ⅶ hepatectomy(n=2), segment Ⅴ hepatectomy(n=3), segment Ⅵ hepatectomy(n=3), segment Ⅳb hepatectomy(n=3),left hemihepatectomy(n=1)， right hemihepatectomy(n=2). One of cases combined with posthepatic inferior vena cava injury underwent inferior vena cava repair successfully when anatomical right hemihepatectomy. Four cases with different degrees of biliary injury underwent repair and T tube drainage during the operation.The operation time was 2-6 h. The intraoperative blood loss was 300-1 000 mL. 1 case suffered from bile leakage after operation,and 2 cases suffered from subphrenic infection and 2 cases suffered from pulmonary infection,1 case suffered from introabdominal hemorrhage after operation. All recovered after symptomatic treatments.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗The treatment of severe liver trauma is not only emphasis on hemostasis, on the premise of ensuring the stability of vital signs, but also the prevention of postoperative complications. Anatomical hepatectomy is one of the safe and effective surgical methods in the treatment of severe liver trauma.
    Establishment of orthotopic transplantation tumor model of human ovarian cancer cell line 3AO#br#
    ZHAO Dayin1, LIU Chun2, CHEN Dong2, WANG Yuan2, CAO Xuexia2, ZHANG Lijuan2
    2019, 40(9):  1038-1041.  doi:10.3969/j.issn.10073205.2019.09.012
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    ［Abstract］Objective〖HTSS〗In order to study occurrence and matastasis of human ovarian carcinoma, a kind of animal model was establish via orthotopic transplantation of human ovarian mucinous adenocarcinoma 3AO cell lines.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗Human ovarian mucinous adenocarcinoma 3AO cells(1×107)  in exponential phase of growth were inoculated in right ovary of BALB/C(nu/nu) female. The general condition, growth and metastasis of tumor were observed. 〖JP2〗Nude mice were anatomized at 3-8 weeks after transplation, inspection by microscopy and immunohistochemical〖JP〗 analysis were applied to both ovaries and organs.
    〖HTH〗〖WTHZ〗Results〖HTSS〗The success rate of orthotopic transplanted tumor model was 86.67%. Three weeks after transplantation, the right ovary became large, it grew into mass and metastasized to left ovary, intestines, liver, spleen, lung and lymph nodes, 1-3 mL ascites appeared colorless. The pathology features of transplated tumors and matastatic tumors were consistence with human ovarian mucinous adenocarcinoma by light microscopy. The expression of human carbohydrate antigen 125 were positive or strong positive. The stain areas were located in cytoplasm.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗The orthotopically transplanted nude model by  human ovarian mucinous adenocarcinoma 3AO cells is established successfully. It is similar to human ovarian carcinoma in biological mode, and can be a good in vivo modle in research of human carcinoma.

    Brief analysis on the risk factors of different gene types of human papillomavirus
    FANG Yue1， WANG Xiaodong1， WANG Lili1， YU Suxiang2
    2019, 40(9):  1042-1046.  doi:10.3969/j.issn.10073205.2019.09.013
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    ［Abstract］Objective〖HTSS〗To analyze the risk factors of human papilloma virus (HPV) genotypes in patients with cervical cancer.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗A total of 322 women diagnosed as cervical cancer were tested for HPV genotyping and investigated by epidemiological questionnaire. Meanwhile, the main influencing factors of different HPV genotypes were analyzed by multiple factor regression method to find out the high risk factors.
    〖HTH〗〖WTHZ〗Results〖HTSS〗Among 322 women surveyed, 23 subtypes of HPV were detected. The top three subtypes of HPV infection rate were HPV18, HPV16 and HPV53, accounting for 17.8%, 15.0% and 13.8% respectively. Univariate analysis of variance showed that the main risk factors affecting HPV18 infection were age, number of sexual partners and first intercourse(P＜0.05). The main risk factors affecting HPV16 infection were age, number of pregnancies, age of first sexual life(PP＜0.05). Age and number of pregnancies were risk factors for HPV53 infection(P＜0.05). The results of binary logistic regression analysis showed that age and number of sexual partners were independent risk factors for HPV18 infection. Age and number of pregnancies were independent risk factors for HPV16 infection. Number of pregnancies is independent risk factors for HPV53 infection(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Age and number of sexual partners are related to HPV18 infection, age and number of pregnancies are related to HPV16，and number of pregnancies is related to HPV53 infection,so timely intervention should be given in daily education.
    The value of acoustic palpation tissue quantitative in differentiating focal pancreatic lesions#br#
    WANG Yi， FENG Yujin， YANG Xiaoyun， WANG Wengang， XU Wensheng， ZHANG Tongdi
    2019, 40(9):  1047-1049,1054.  doi:10.3969/j.issn.10073205.2019.09.014
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    ［Abstract］Objective〖HTSS〗To investigate  the value of acoustic palpation tissue quantitative(VTQ) in differentiating focal pancreatic lesions.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗Eighty patients with pancreatic focal lesions treated in our hospital were selected as the research objects. The benign and malignant lesions of pancreatic focal lesions were analyzed. Thirtyeight patients with benign lesions were included in the benign group, and the remaining 42 patients with malignant lesions were included in the malignant group. All patients underwent VTQ diagnosis after admission, and the repeatability of shear wave velocity(SWV) measurements was analyzed to differentiate the diagnostic value of SWV, SWV in adjacent pancreatic parenchyma and SWV difference in focal pancreatic lesions.
    〖HTH〗〖WTHZ〗Results〖HTSS〗The age and diameter of malignant group were significantly higher than those of control group(P＜0.05) . The SWV value and SWV difference between malignant group and peripheral pancreatic parenchyma were significantly higher than those of benign group(P＜0.05) . The SWV value and SWV difference between pancreatic cancer and peripheral pancreatic parenchyma were significantly higher than those of pancreatic parenchyma(P＜0.05). The SWV value and SWV difference between pancreatic cancer lesions and surrounding pancreatic parenchyma were significantly higher than those of pancreatic inflammatory lesions(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗SWV has good reproducibility and accuracy in the differential diagnosis of pancreatic focal lesions. The application of VTQ can provide data support for clinicians to differentiate benign and malignant pancreatic lesions, and has positive significance for the formulation and improvement of followup treatment plan of patients. It can be considered for clinical application.
    Application value of ultrasonic scoring combined with MRI in the diagnosis of sinister placenta previa combined with placenta accrete#br#
    ZHANG Jinhui， ZHANG Yu
    2019, 40(9):  1050-1054.  doi:10.3969/j.issn.10073205.2019.09.015
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    ［Abstract］ Objective〖HTSS〗To explore the clinical value of ultrasound scoring combined with magnetic resonance imaging（MRI）magnetic resonance imaging in the diagnosis of dangerous placenta previa and predicting the degree of risk.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗Retrospective analysis of clinical data of 71 patients with suspected placenta implanted in the third trimester of pregnancy who were hospitalized and terminated. Preoperative evaluation of the risk of placenta previa and placenta implantation were performed according to the ultrasound score combined with MRI. The diagnostic sensitivity, specificity, positive predictive value and negative predictive value were evaluated postoperatively.
    〖HTH〗〖WTHZ〗Results〖HTSS〗All patients were considered as sinister placenta preoperatively. The postoperative pathology confirmed the sensitivity of the ultrasound score combined with MRI for the risky placenta previa with placenta implantation was 95.65%, the positive predictive value was 80.00%, and the negative predictive value was 87.50%. Both were higher than singleuse ultrasound scoring or MRI.The specificity is 56.00%, which is lower than a single inspection method.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗For pregnant women who are suspected to be sinister placenta previa in late pregnancy, feasible ultrasound scoring combined with MRI to predict the degree of risk, with high diagnostic accuracy, improve maternal and child postpartum quality of life and other advantages, it is worth promoting in clinical applications.
    Risk factors of lifethreatening asphyxia hematoma after thyroid surgery
    ZOU Yue1,2， YU Xuerong1*
    2019, 40(9):  1055-1057,1062.  doi:10.3969/j.issn.10073205.2019.09.016
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    ［Abstract］Objective〖HTSS〗To investigate the risk factors of lifethreatening asphyxia hematoma after thyroid surgery, and to provide reference for clinical work.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗A total of 14 patients(bleeding group) with lifethreatening asphyxiated hematoma caused by postoperative thyroid hemorrhage were screened by the case retrieval system. At the same time, according to the operating period, surgeon, anesthesia, etc., the condition was 1〖DK〗∶2. The proportions were matched and 28 patients with thyroid surgery without bleeding were selected(control group). The basic data and related indicators of the two groups of patients were compared, and multivariate logistic regression analysis was used to determine the risk factors of lifethreatening asphyxia hematoma caused by postoperative thyroid hemorrhage.
    〖HTH〗〖WTHZ〗Results〖HTSS〗The proportion of total thyroidectomy in the bleeding group was lower than that in the control group. The proportion of papillary carcinoma in the pathological type was lower than that in the control group. The postoperative hospital stay was longer than the control group, and the difference was statistically significant(P＜0.05). Multivariate logistic regression analysis showed that the surgical procedure was a risk factor for airway obstruction caused by postoperative thyroidectomy. The risk of this complication after partial thyroidectomy was 9.116 times that of total thyroidectomy.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗 Partial thyroidectomy is an independent risk factor for hemorrhagic hematoma after thyroid surgery.
    Network pharmacology study on mechanism of Xiebai Syrup for cough#br#
    GAO Yanhua1, WANG Xu1, TIAN Yuhuan1, ZHANG Guanhua1, LIU Xin1, ZHANG Jian2*
    2019, 40(9):  1058-1062.  doi:10.3969/j.issn.10073205.2019.09.017
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    ［Abstract］Objective〖HTSS〗To screen the active ingredients of Xiebai Syrup and to explore its core targets and mechanism for the treatment of cough.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗Network pharmacology methods were employed. The active ingredients of the Xiebai Syrup were found and screened by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) and literature. Gene targets related to cough were searched using the Therapeutic Target Database(TTD), the Genetic Association Database(GAD), and the Pharmacogenetics and Pharmacogenomics Knowledge Base(PharmGKB) database and normalized by the Uniprot database. Protein interaction networks was constructed with Cytoscape 3.7.1 software in order to find core targets. The Metascape database was used to analyze Gene Ontology of the core targets.
    〖HTH〗〖WTHZ〗Results〖HTSS〗Fiftyfour core targets were screened and 20 main pathways related with cough were found, involving response to endoplasmic reticulum stress, immune responseactivating signal transduction and so on.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗This study reflected the “multicomponent, multitarget, multipathway” characteristics of Xiebai Syrup, which provides a theoretical basis of the clinical use of Xiebai Syrup.
    Expression and significance of HIF1α and SDF1 in differentiated thyroid carcinoma#br#
    ZHOU Dan1, LIU Jun2, LUO Zhen2, SHEN Tingting2, TANG Jiali1*
    2019, 40(9):  1063-1067.  doi:10.3969/j.issn.10073205.2019.09.018
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    ［Abstract］ Objective〖HTSS〗To investigate the expression and significance of hypoxia inducible factor1 α(HIF1α) and stromal cell derived factor 1(SDF1) in differentiated thyroid carcinoma.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗According to the presence or absence of metastasis, the patients with differentiated thyroid carcinoma（DTC）were divided into three groups: carcinoma in situ group, metastatic cancer group and control group (paracancerous tissue). The expression of HIF1α and SDF1 in tissues was detected by qPCR. At the same time, SW579 cells were cultured in vitro, knocking out HIF1α to detect the transcription and protein expression of SDF1 and cell proliferation and invasion ability. The transcription of SDF1 and cell proliferation and invasion ability of SW579 cells were detected by exogenous addition of SDF1 100 ng/mL，and the proliferation and migration ability of SW579 cells was detected with replenishing SDF1.
    〖HTH〗〖WTHZ〗Results〖HTSS〗The transcriptional expression levels of HIF1α and SDF1 in the excised tissues of DTC patients were significantly higher than those in the adjacent tissues, and the expression levels in the metastasis group were significantly higher than those in the in situ cancer group. The transcription level of SDF1 in HIF1αsiRNA group and HIF1αsiRNA+SDF1 group was lower than that in siNC group and siNC+SDF1 group(P＜0.05). At the same time, the level of SDF1 protein in the HIF1αsiRNA group was also lower than that in the SiNC group. The cell proliferation and cell invasion of siNC+SDF1 group were higher than those of siNC group. The cell proliferation and cell invasion of HIF1αsiRNA group were lower than siNC group and siNC+SDF1 group. The cell proliferation and cell invasion of HIF1αsiRNA+SDF1 group were lower than those of siNC+SDF1 group, but higher than HIF1αsiRNA group, the difference was statistically significant(P＜0.05).
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗HIF1α and SDF1 are highly expressed in DTC tumors, and HIF1α plays an important role in the metastasis of DTC by regulating SDF1.
    Comparison of different staining methods for exosomes#br#
    ZHU Yan1， ZHANG Lei2， ZHOU Chenming1， YAN Jing1， MENG Li1*
    2019, 40(9):  1068-1071.  doi:10.3969/j.issn.10073205.2019.09.019
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    ［Abstract］ Objective〖HTSS〗To compare and analyze the staining effect and select the best negative dyeing solution for exosomes after negatively staining the exosomes with four kinds of dyes, such as osmium tetroxide, phosphotungstic acid, ammonium molybdate and uranyl acetate.
    〖HTH〗〖WTHZ〗Methods〖HTSS〗After exosomes were extracted by differential centrifugation, the exosomes were negatively stained with four different dyeing solutions of osmium tetroxide, phosphotungstic acid, ammonium molybdate and uranyl acetate by means of floating method, and observed by transmission electron microscopy. The clarity of the cupshaped or discshaped structure of the exosomes, the sharpness of the film edge, the cleanness of the staining background, and the contrast effect werecompared according the effects of the four dyeing solutions.
    〖HTH〗〖WTHZ〗Results〖HTSS〗Osmium tetroxide staining background appeared a large number of vesicles, exosome structurewas not obvious. The dyeing effect of phosphotungstic acid on exosomes was not as good as that of uranium dioxide acetate and ammonium molybdate. The cell membrane edge of exosomes was not clear and the dyeing background was impurities. Ammonium molybdate had a better staining effect on exosomes. The membrane structure of the vesicles was clear, and the cupsupporting structure of the exosomes can be clearly seen, but the contrast was weak. Under uranium acetate hydrogen peroxide staining, the typical cupshaped or discoid structure of exosome were clearly visible, the edge of membrane was sharp, the dyeing background was clean, and the contrast effect were good.
    〖HTH〗〖WTHZ〗Conclusion〖HTSS〗The uranyl acetate has the best staining effect on exosomes, and it is the most suitable negative dyeing solution.