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Objective To evaluate the effect of the comprehensive intervention of the oral health education for children aged 6 to 12 years.Methods The oral health knowledge questionnaire was used to evaluatethe children′s awareness about oral health and the correct rate of tooth-brushing before and after 12-month comprehensive intervention. Two organizational forms about pit and fissure sealant were adopted. In city school, students were brought by their parents to the hospital to do pit and fissure sealant, while in rural school, hospital medical team went to schools to do pit and fissure sealant for the students. Compare the sealants retention rate in 12-month follow-up between two forms. The total sealants retention rate among 6-month, 12-month and 24-month follow-up were compared.Results Before and after oral health education guidance, the rate of children′s oral health awareness was 68% and 96%, and the correct rate of tooth-brushing was 64% and 92% respectively (P

Objective To study the RHD genotyping of primary screening RhD negative population in Beijing, and analyze the serological characteristics of different genotypes and the distribution of Rh phenotypes. Methods From August 2022 to January 2024, 204 RhD negative samples in our hospital were initially screened by microplate or microcolumn agglutination method. RhD antigen phenotype was identified by saline tube method, and RhD negative confirmation test was performed by microcolumn gel-indirect antiglobulin technology.RHD genotyping was performed by polymerasing chain reaction-sequence specific primmer (PCR-SSP) method and sequencing technology, and the phenotypic frequency and gene frequency were calculated. Results The distribution of Rh serologic phenotypes in 204 RhD negative samples were 112 cases of ccee (54.90%) > 73 cases of Ccee (35.78%) > 9 cases of CCee (4.41%) > 6 cases of ccEe (2.94%) > 4 cases of CcEe (1.96%). A total of 7 RHD genotypes were detected in this study, including 129 cases of RHD* 01N.01 (63.24%), 44 cases of RHD* 01EL.01 (21.57%), 26 cases of RHD* 01N.03 (12.75%), 2 cases of RHD* 01N.16 (0.98%), 1 case of RHD* 06.03.01 (0.49%), 1 case of weak RHD* 15 (0.49%) and 1 case of RHD* 13.01/RHD* 01N.01 (0.49%). The frequency and phenotype distribution of Rh blood group antigen gene were consistent with Hardy-Weinberg equilibrium (P>0.05). Conclusion The RHD gene is polymorphic in the primary screening RhD negative population in Beijing, and the most common RhD negative genotype is RHD* 01N.01, and the RHD variant is RHD* 01EL.01.This study may provide data to support the clinical implementation of genotype-matched blood transfusions.

Objective To investigate the clinical efficacy of preoperative therapeutic plasma exchange(TPE) in preventing acute rejection after ABO incompatible kidney transplantation(ABOi-KT). Methods Nine patients with ABOi-KT who were admitted to the renal transplant department of our hospital from April 2022 to April 2024 were retrospectively analyzed. They received a total of 28 TPEs before kidney transplantation, and the treatment plan was summarized as follows: The proportion of the substitute fluid, as well as the frequency and volume of TPE were determined based on the patient′s ABO blood group system antibody titer, gender, height, weight, hematocrit and other indicators upon admission. The patient′s relevant laboratory indicators, including hemoglobin, platelets, leukocytes, coagulation function, total protein, albumin, globulin, A/G, creatinine and urea nitrogen upon admission and after TPE were monitored and statistically analyzed. After transplantation, changes in renal function indicators such as ABO blood group system antibody titers, creatinine and urinary excretion were observed, and clinical symptoms of acute rejection, such as swelling, pain and edema in the transplanted kidney area were observed. Results Nine ABOi-KT patients had an average of about 3 TPEs before transplantation surgery, with an average total volume of approximately 2 500 mL to 3 500 mL per TPE, or approximately about 1.01 to 1.16 plasma volume (PV). After multiple TPEs, pre-transplantation antibody titers decreased by an average of 3 times compared to before TPE. There were no statistically significant differences in Hb, PLT, PT, PTA, INR, TBil, ALB, Cr and BUN (P>0.05), while statistically significant differences were found in WBC, APTT, Fbg, TP, GLB and A/G (P

Objective To explore the prognostic impact and clinical application value of therapeutic plasma exchange(TPE) intervention timing and liver injury periodization in patients with exertional heat stroke(EHS). Methods Data of 127 EHS patients from the First Medical Center of the General Hospital of the People′s Liberation Army from January 2011 to December 2023 were collected, then divided into the death group and the survival group based on therapeutic outcomes and into 5 stages according to the dynamic changes of ALT, AST, TBIL and DBIL. According to propensity score matching analysis, 11 patients in the survival group and 12 patients in the death group were included in the statistical analysis, and 20 of them were treated with TPE. The changes in indicators and clinical outcomes before and after TPE were observed, in order to evaluate the impact of intervention timing on prognosis. Results Among the 23 patients, 14 had no liver injury or could progress to the repair phase, resulting in 3 deaths(with the mortality rate of 21.43%), while 9 patients failed to progress to the repair phase, resulting in 9 deaths(with the mortality rate of 100%), with significant differences(P

Objective To review the occurrence of allergic reactions during therapeutic plasma exchange (TPE) and to explore the risk factors of TPE allergic reactions. Methods The clinical data of 929 patients treated with TPE using plasma components by the Department of Transfusion Medicine in our medical center from 2018 to 2023 were collected. The influencing factors of allergic reactions were analyzed by univariate analysis, and the independent risk factors of allergic reactions were analyzed by logistic multivariate regression analysis. Results A total of 4 071 TPEs were performed in 929 patients.Among them, 198 patients (21.31%) experienced 349 times (8.57%) of allergic reactions, with the incidence of grade Ⅰ, Ⅱ and Ⅲ allergic reactions of 16.33%, 81.38% and 2.29%, respectively, and no deaths. The univariate analysis showed that the patient′s age, allergy history, diagnosis of immune-related diseases, ICU admission, plasma consumption, total blood volume, maximum blood flow rate and combined use of albumin were related to the occurrence of allergic reactions (P

Background In the context of aging in our country, the incidence and recurrence rates of acute ischemic stroke (AIS) are increasing year by year, and the mortality and disability rates are high. In recent years, the application of stress hyperglycemia ratio (SHR) in cardiovascular and cerebrovascular diseases has become more and more common, but its research in the recurrence of mild AIS is currently limited. Objective To explore the correlation between SHR and the recurrence of mild AIS in elderly patients within one year, and to provide a more theoretical basis for the prevention of AIS recurrence. Methods The study selected patients who were first diagnosed with mild AIS at the Shijiazhuang Fifth Hospital from May 2018 to January 2022. The study started with the diagnosis of mild AIS and ended one year after the diagnosis. A nested case-control study was conducted, and patients who were confirmed to have a recurrence within one year were included in the recurrence group. The non-recurrence group was matched at a ratio of 1∶3 based on 'diagnosis time, age, gender, infarction location, and whether they have diabetes'. A total of 70 patients were included in the recurrence group, and 210 patients were matched in the non-recurrence group. Through the Hospital Information System (HIS), patients gender, age, history of hypertension, history of atrial fibrillation, BMI, baseline NIHSS score, LDL-C, HbA1c, random blood glucose on admission, etc. were collected, and the SHR was calculated. Multivariate conditional Logistic regression analysis was used to explore the correlation between SHR and the 1-year recurrence of mild AIS in elderly patients. This study is likely investigating the influence of the SHR on the recurrence of AIS within one year in elderly patients. Results The average age of the 280 patients was (71.9±6.4) years; 176 were male (62.9%), and 104 were female (37.1%) ; 88 patients (31.4%) had a history of diabetes. According to the median of the data, stress hyperglycemia ≥10 mmol/L was considered high, 1.04 was considered high, ≤1.04 was considered low. Multivariate conditional Logistic regression analysis showed that stress hyperglycemia (OR=2.983, 95%CI=1.488-5.977), SHR (OR=3.056, 95%CI=1.579-5.914) were factors affecting the 1-year recurrence of mild AIS in elderly patients (P1.80 were more likely to affect the 1-year recurrence of mild AIS in elderly patients than SHR≤1.0 (P0.05, Ptrend

Objective To compare the expression levels of pncA gene in pyrazinamide （PZA）-resistant and multidrug-resistant Mycobacterium tuberculosis before and after PZA drug stimulation， and to explore the relationship between PZA-resistant Mycobacterium tuberculosis and pncA gene expression. Methods PZA-resistant and multidrug-resistant Mycobacterium tuberculosis was cultured， and the minimal inhibitory concentration （MIC） of rifampicin and PZA was detected. The strains were cultured in medium containing 0 and 50 μg/mL PZA， and the expression level of pncA was detected by real-time fluorescence quantitative PCR. Results The MIC of PZA of 21 strains of Mycobacterium tuberculosis was ≥ 1 600 μg/mL，400-800 μg/mL for 12 strains， and 100-200 μg/mL in 5 strains，and their corresponding PZA resistance levels were defined as high，medium and low，respectively. The median MIC of rifampicin was 128， 128 and 64μg/mL， respectively. Chi-square test showed that there was no significant difference between any two groups （all P > 0.05）. According to the relative quantitative 2-ΔΔCt method， the expression levels of pncA in the high，medium and low levels of PZA drug-resistant Mycobacterium tuberculosis was 0.904（0.202， 2.653）， 1.157（0.658， 1.511） and 1.147（0.372， 1.347）， and 1.544（0.611， 3.191）， 0.846（0.421， 1.237） and 0.726 （0.225， 3.017） in the 50 μg/mL treatment group，respectively. There was no significant difference in pncA gene expression between the control and PZA drug-containing culture groups（P > 0.05）. Conclusion No significant changes are observed in the expression levels of pncA in multidrug-resistant and PZA-resistant Mycobacterium tuberculosis before and after PZA drug stimulation.

Objective To investigate whether neutrophils extracellular traps (NETs) treated with microcystin-LR may promote the migration of colorectal cancer cell. Methods Isobaric tags for relative and absolute quantification (iTRAQ) technology was used to detect the secreted proteins in colorectal cancer cell culture supernatant after MC-LR exposure, and Gene Ontology (GO) functional enrichment analysis was performed to analyze in which pathway the differentially expressed proteins were enriched. The quantity of neutrophils in MC-LR-treated tumor tissue of xenograft nude mice was detected by flow cytometry. The expressions of CD11b, neutrophil elastase (NE) and citrulline histones 3 (citH3) in colorectal cancer tissues of BALB/c mice treated with MC-LR were detected by immunohistochemistry. The effect of NETs treated with MC-LR on colorectal cancer cell migration was determined by Transwell migration assay. Results Eleven differentially expressed proteins treated with MC-LR were screened out after MC-LR exposure(P＜0.05), and the differentially expressed proteins were enriched in the way of leukocyte migration. MC-LR increased the counting of neutrophils in colorectal cancer tissue of nude mice (P＜0.05). The expression of CD11b, NE and citH3 in orthotopic colorectal cancer tissues of BALB/c mice was increased after MC-LR administration compared with those in control group (P＜0.05). NETs treated with MC-LR enhanced the migration of colorectal cancer cell (P＜0.05). Conclusions MC-LR may promote migration of colorectal cancer cell by inducing the formation of NETs in the tumor microenvironment (TME).

Objective To preliminarily explore whether there is a correlation between heat shock protein gene hspX and drug resistance of Mycobacterium tuberculosis （MTB） by comparing the sequence and expression of hspX in MTB with different drug resistance types. Methods Ten strains sensitive to all four first-line anti-tuberculosis drugs （S）， one drug resistance （rifampicin-resistant MTBR+， isoniazid-resistant MTBH+， streptomycin-resistant MTBS+ and ethambutol-resistant MTBE+） and multidrug resistance （MDR） to isoniazid and rifampicin were selected， respectively. The DNA and RNA of strains in each group were extracted by modified SDS lysis method and TRIzol method， respectively. The existence and expression of hspX gene were determined by PCR and RT-PCR using specific primers. PCR products were sequenced to check the forward and reverse polymorphism， and DNAman software was employed to compare the sequence with the standard strain H37Rv. The difference in the expression of hspX among MTB strains with different drug resistance types was analyzed by pairwise with the sensitive strain group as the control group. Results The specific hspX gene was successfully obtained by PCR. The hspX gene sequence was 97%-99% identical with H37Rv， and there was no significant difference. The mean expression level of hspX through relative quantitation 2-ΔΔCt in S， MDR， MTBR+， MTBH+， MTBS+ and MTBE+ strains was calculated as 0.98（0.89， 1.23）， 1.49（1.10， 2.04）， 1.41（0.55， 2.80）， 1.37（0.68， 2.71）， 0.91（0.59， 1.62）and 0.70（0.48， 1.18）， respectively. There was no significant difference in the expression of hspX among different drug-resistant strains groups when the sensitive strain group was regarded as the control group （all P > 0.05）. Conclusion The hspX gene is conserved in MTB. In natural state， there is no significant correlation between hspX gene and drug resistance of MTB.

Background Degenerative lumbar spinal stenosis (DLSS) is a costly disease that mainly occurs during the old age, which seriously affects the normal life. There are many treatment options for DLSS. The development and clinical application of high-quality clinical practice guidelines are major ways to improve the diagnosis and treatment of DLSS. Objective To provide a reference for the development and reporting of clinical practice guidelines of DLSS, with guidelines of DLSS evaluated using AGREEⅡ and RIGHT, from the perspectives of methodology and quality. Methods Databases were searched for clinical practice guidelines, consensuses and specifications about DLSS, including CBM, CNKI, Wanfang Data, VIP, PubMed, Medlive, WHO, the National Institute for Health and Care Excellence, Guidelines International Network, National Guideline Clearinghouse and Scottish Intercollegiate Guideline Network from January 1, 2010 to January 1, 2022. The methodological quality and reporting quality of included studies were evaluated by two raters independently. And the recommendations in the studies were compared under the uniform grading criteria. Results Six studies were enrolled, including four guidelines and two consensuses. One guideline is based on TCM, and the other three are evidence-based guidelines. The evaluation results of AGREEⅡ showed that the ratio of the actual total score to the full score of the six included studies was 78.2%, 53.6%, 45.7%, 37.7%, 28.2% and 15.0%, from highest to the lowest. RIGHT evaluation showed that the ratio of the actual total score to the full score of the four guidelines was 72.9%, 72.9%, 62.9% and 34.3%, from highest to the lowest. A total of 46 therapeutic and 11 non-therapeutic recommendations were developed in the six studies. Conclusion The methodological quality and reporting specification of the present DLSS guidelines and consensuses require to be further improved. Further reference should be made to international standards such as AGREE Ⅱ and RIGHT in the process of guideline development and reporting. Surgical treatment is the preferred recommendation for patients with moderate or severe DLSS.

People with diabetes and chronic kidney disease (CKD) are at high risk for kidney failure, atherosclerotic cardiovascular disease, heart failure, and premature mortality. The American Diabetes Association (ADA) and the Kidney Disease: Improving Global Outcomes (KDIGO) established joint group, and integration of evidence-based recommendations for diabetes management in patients with CKD in accordance with the ADA 2022 standards of medical care in diabetes and KDIGO 2022 Clinical Practice Guideline for Diabetes Management in CKD, and to form the Diabetes Management in Chronic Kidney Disease: a Consensus Report by the ADA and KDIGO. The consensus not only re-emphasizes the published guidelines for screening and diagnosis of CKD, glycemia monitoring, lifestyle therapies, treatment goals, and pharmacologic management, but also specifically emphasizes the importance of comprehensive care in which pharmacotherapy based on a foundation of healthy lifestyle. The consensus states seven core recommendations which provide specific guidance for the use of renin-angiotensin system inhibitors, metformin, sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide 1 receptor agonists, and a nonsteroidal mineral corticoid receptor antagonist. These areas of consensus provide clear direction for implementation of care to improve clinical outcomes of people with diabetes and CKD. Focusing on the main contents of the consensus, we interpreted main recommendations in order to provide concise and practical guidance for clinicians, to achieve the goal of improving the prognosis of patients with diabetes mellitus complicated with CKD.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Objective To investigate the clinical effect of endoscopic two-way catheterization in the treatment of anastomotic fistula after esophageal cancer surgery. Methods From August 2017 to October 2020, 211 patients with postoperative anastomotic fistula of esophageal cancer treated in Zhongshan People's Hospital were selected for retrospective study. The 105 patients treated with routine intravenous nutritional support and gastrointestinal decompression were served as control group. The 106 patients placed with fistula drainage tube to the fistula mouth and three lumen nutritional tube to the jejunum under endoscopy was served as observation group. The fistula healing time, recovery eating time, hospital stays, clinical cure rate of the anastomotic fistula, nutritional status indexes(prealbumin, albumin, hemoglobin and transferrin) and the quality of life(SF-36 scale) were compared between two groups. According to CUSUM method, all cases were divided into learning improvement stage(n=60) and mastery stage(n=46), the change trend of anastomotic fistula healing time and hospital stay in the observation group with the increase of the number of surgical cases was analyzed. Results Compared with the control group, the fistula healing time, recovery eating time and hospital stays in the observation group were significantly reduced, and the clinical cure rate of the anastomotic fistula, SF-36 scale score and nutritional status indexes such as prealbumin, albumin, hemoglobin and transferrin were significantly increased(P＜0.01). The fistula healing time, recovery eating time and hospital stays, pain score and physical recovery score of patients in the mastery stage were significantly lower than those in the learning improvement stage(P＜0.01). Conclusions Endoscopic two-way catheterization is safe and effective in the treatment of postoperative anastomotic fistula of esophageal cancer,60 cases can master the operation and improve the clinical curative effect.

Objective To establish deferral criterion of HIV ELISA (enzyme-linked immunosorbent assay) and electrochemiluminescence immunoassay(ECLIA) by using receiver operating characteristic curve(ROC) method to screen HIV reactive blood donors suitable for entering the re-entry process and improve the management efficiency of reactive blood donors. Methods The test results of 92 001 blood donors from February to September 2019 were analyzed, and 177 reactive samples were screened by conventional screening mode (twice ELISA and once nucleic acid), supplemented with electrochemiluminescence immunoassay assay (ECLIA), and confirmed by Western blotting (WB). Screening reactive samples were divided into three groups: group A was both serological and nucleic acid reactivity, group B was only serological reactive, and group C was only nucleic acid reactivity. Its efficacy in blood donor classification was assessed by drawing ROC curves with 99% specific corresponding S/CO low values as the deferral criterion of the corresponding serological method. Results 1) A total of 177 HIV reactive samples were detected in conventional mode, including 34 in group A, 142 in Group B and 1 in Group C. The positive predictive value (PPV) was 100%, 0.75% and 100%, respectively. ECLIA detection mode (once ECLIA and once NAT), a total of 67 HIV reactive samples including 34 in group A, 32 in group B and 1 in group C, with positive predictive values of 100%, 3.7% and 100%, respectively.2) The HIV test results showed diversity, with 36 true positive samples including 1 HIV elite controller and 3 early HIV infections (1 HIV ELISA antigen/antibody window and 2 ELISA HIV antibody window), and 32 serological and NAT cases were reactive infections.3) The deferral limit of ELISA 1 and ELISA 2 in conventional screening mode were 20.25 and 9.85, respectively, can screen 97.14% (34/35) of all true positive samples in group A and B, except for one ELISA HIV antibody window (ELISA 2 reactivity). The positive predictive values were 93.94% and 92.85%, respectively. The ECLIA deferral limit of 7.83 can screens all true positive samples in Groups A and B (35/35)in ECLIA mode. The positive predictive value was 94.59%. Conclusion The establishment of deferral limits in this study can effectively screen HIV-positive blood donors, and the number of screened blood donors is greatly reduced, which is helpful to fine and scientific management of HIV-reactive blood donors. The deferral limit values of different testing reagents are quite different, so each laboratory should choose appropriate testing methods to establish the deferral limit values suitable for the laboratory according to its own testing ability, so as to provide technical support for optimizing the process of returning blood donors to the team.

Objective To investigate the pathogenic gene mutations and clinical characteristics in a patient with compound heterozygote gene mutations in luteinizing hormone/choriogonadotropin receptor (LHCGR) gene. Methods Clinical features, laboratory data and radiologic manifestations were collected. The whole exon was sequenced. Pathogenicity of the mutations was evaluated by using the Mutation Taster, PANTHER software. The relationship of the splice site mutation and the phenotype of the LHCGR gene was investigated by literature review. Results 1)The patient presented with a micropenis.2)The level of gonadotropins was high but level of testosterone was low. 3)Compound heterozygotic mutations including a splicing mutation (c.233+1G＞A) and a missense mutation (c.547G＞A) were identified in LHCGR gene. Both variations were derived from his parents with normal epitope so it was the first case reported in this familiy. 4)The patient had a good response to testosterone therapy. Conclusions LHCGR mutation may cause micropenis. Our report expands the spectrum of clinical manifestations and mutation of LHCGR gene.

Objective To investigate the biological function of RNA binding protein polycytosine-binding protein 1 (PCBP1) in the maintenance of pluripotency of human embryonic stem cells (hESC) and to explore the new mechanism of regulating hESC pluripotency. Methods PCBP1 knockdown technology was used to detect the clonogenicity. The alkaline phosphatase staining profile and the expression of pluripotency/differentiation marker genes were detected by qPCR. Meanwhile, the nucleus and cytoplasm of hESC were isolated for RNA sequencing, and the nucleoplasmic changes of RNA generated by PCBP1 knockdown were analyzed by multi-level analysis. Results PCBP1 knockdown significantly inhibited clonogenesis of human embryonic stem cells (P＜0.01) and reduced the RNA level of pluripotency related genes (P＜0.01). The expression of differentiation related genes increased(P＜0.01)that significantly affected the overall nucleoplasmic distribution of RNA in hESC and the nucleoplasmic distribution of mRNA related to embryonic development and cell differentiation. Conclusions PCBP1 regulates hESC pluripotency by regulating the expression of pluripotency/differentiation marker genes and the nucleoplasmic localization of mRNA.

Objective To perform electrochemiluminescence immunoassay (ECLIA) and Western blotting (WB) confirmation tests for HIV reactive samples in blood screening, and analyze the correlation between ELISA (enzyme-linked immunosorbent assay), ECLIA results and confirmed infection, so as to provide data support for the application of ECLIA in blood screening. Methods 177 HIV reactive samples in blood screening testing detected by our laboratory from February to October 2019 were collected, of which 137 were reactiv to isolated ELISA reagent e, 39 to dual ELISA reagent, and 1 in window period. Ten maker-negative samples were randomly selected to undergo ECLIA with the above 177 samples. HIV reactive samples were sent to Centers for Disease Control and Prevention (CDC) for confirmation tests, and the results were analyzed and compared. Results Among the 177 HIV reactive samples, 66 were ECLIA reactive, 111 negative, and the 10 maker-negative samples remained negative. The sensitivity, specificity, positive predictive value, negative predictive value and total concordance rate of ECLIA were 97.1%, 81.1%, 55%, 99.1% and 84.2%, respectively, showing better performance than that of two ELISA reagents(P0.05). The positive predictive value and specificity were tested by chi-square test, and the difference between ECLIA and reagent 2 was statistically significant (P

Objective: To explore the detection efficacy of ultrasound(US) and magnetic resonance imaging(MRI) for pernicious placenta previa(PPP) and PPP with placenta accreta, and analyze the causes for missed diagnosis. Methods: A total of 134 pregnancies with pernicious placenta treated at the International Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine during January 2015 to December 2019 were enrolled. All the pregnancies underwent US and MRI, and image characteristics of both were retrospectively analyzed. Findings of US and MRI were compared with the results of intraoperative and postoperative pathological examination, and detection efficacy of US and MRI for PPP was assessed. Results: For PPP, US identified 124 out of 134 cases, with a detection rate of 92.5%, and 10 cases were missed because of obesity(2 cases), intestine gas interference(1 case), placenta position (placenta covering lateral or posterior wall of the uterus)(2 cases) and multi-causes(more than 2 causes, 2 cases). MRI recognized 126 out of 134 cases, with a detection rate of 94%, and 8 cases were missed because of placenta position and complicated surrounding structure. With combined use of US and MRI, 128 cases were recognized and 6 cases were missed. For PPP with placenta accreta, 73 cases were diagnosed by US in 80 patients, with a sensitivity of 91.25%, and 7 cases were missed for obesity (1 case), intestine gas interference (1 case), placenta position (1 case) and complicated surrounding structure (4 cases); 75 cases were diagnosed by MRI, and 5 cases were missed. US combined with MRI could recognized 75 out of 80 PPP with placenta accreta, and 5 cases were missed because of non-obvious placental thickening, lack of blood sinuses in posterior or inner of placenta, and complicated anatomical structure. US detection for PPP was in good consistency with that of MRI(Kappa>0.8). Conclusions: Color Doppler US and MRI have good diagnostic efficacy for PPP and PPP with placenta accreta, and US is still the preferred method for prenatal diagnosis because of its low costs and convenience. MRI can be used as a supplementary method when US diagnosis is not clear.

Objective To explore the clinical strategy and method of the preliminary discrimination model of prognosis and survival in the treatment of advanced esophageal cancer with Traditional Chinese Medicine(TCM). Methods Univariate test was performed on multiple factors affecting the prognosis of advanced esophageal cancer, and variables with statistical significance were included. Non-parametric discriminant analysis was used to establish a survival prediction model of traditional Chinese medicine treatment for advanced esophageal cancer. Totally 72 patients with advanced esophageal cancer were included in the study, which were divided into the dominant group, the intermediate group and the disadvantaged group based on the overall survival. Results Univariate analysis showed that location of onset (including upper esophagus), location of onset (including middle esophagus), differentiation degree of cancer cells, metastasis, hot food, smoking, drinking, symptom assessment after TCM treatment, emotion assessment after TCM treatment and lung metastasis showed statistical significance (α=0.1). Conclusions After incorporating the elements of TCM characteristic syndromes, the prediction model is established through 7/3 verification (70% samples as training set, 30% samples as verification set), and the prediction accuracy is 56%.

Currently, the main sample pretreatment methods for forensic toxic analysis are liquid-liquid extraction （LLE） and solid-phase extraction （SPE）. As a simple, convenient, and low-cost LLE method, dispersion liquid-liquid microextraction （DLLME） has high enrichment factor and good extraction efficiency, and therefore has attracted the attention of many researchers in the field of toxicology analysis in recent years. As a multi-functional microextraction method, DLLME has been widely used in the analysis of pesticides, sleeping sedatives, drugs and heavy metal poisons in forensic toxic analysis. Meanwhile, it can also be used in combination with such a variety of analytical instruments as gas chromatography-electron capture detectors （GC-ECD）, high performance liquid chromatography-diode array detectors （HPLC-DAD）. As a sample pretreatment method, DLLME has the advantages of simple operation, less use of organic solvent, reliable results and good reproducibility, thus can meet the requirements of modern court toxic analysis.

Objective To estimate lung volume in normal population by a combination of multi-slice spiral CT and Pulmo software. Methods Scans of the lung were performed on 45 normal individuals using Emotion 16-slice spiral CT and Pulmo software. A measurement instrument of work station was used to measure the vertical diameter of left and right lungs, the maximum anteroposterior and transverse diameters at the layers of apex pulmonis 1 cm below, arcus aortae, subcarinal and diaphragmatic dome, and the lung volume. Regression analysis was performed on normal lung volume and each measured parameter by SPSS 20.0 and an optimal model was selected. Results The goodness of fit between the best curvilinear equations of the normal bilateral lung volumes was 0.981. The goodness of fit between the curvilinear equations of the normal bilateral lung volume and the product of the vertical diameter and the maximum transverse diameter of diaphragmatic dome were 0.977 and 0.972, respectively. Fifteen cases were selected to make a retrospective test on the 3 models. No significant difference was found between the estimated and measured with Pulmo software lung volumes. Conclusion The normal lung volume before injury can be estimated by the curvilinear equations established in this study. The percentage of lung compression can be measured based on the volume of compressed lung, which can provide a reference for the identification of lung compression degree.