目的 探讨围产期各种相关因素与高间接胆红素血症发病的关系。 方法 选择2011年1月－5月85例产科出生足月高间接胆红素血症患儿血清总胆红素升高(依据其小时龄)达到全国新生儿学组干预推荐方案光疗标准、且结合胆红素＜34 μmol/L，即高间接胆红素血症。同时按同性别同年龄阶段出生抽取85例无高胆红素血症足月儿按1︰1配对作对照组。采用单因素分析和条件logistic回归分析的方法，筛选高间接胆红素血症发病的危险因素。 结果 引起高间接胆红素血症的围生因素包括胎龄、产式、窒息、开奶时间延迟、胎粪排出时间延迟、喂养方式、出血、低血糖、红细胞比容和出生体质量下降。其中引起高间接胆红素血症独立的高危围生因素为胎龄、开奶时间延迟、低血糖、出血、红细胞增多症和出生体质量下降。 结论 临床对具有多种高危围生因素的患儿应提高对其发生高胆红素血症可能的预见性，及早采取预防措施。
Objective To analyze published literature about the clinical studies on elective single versus double embryo transfer using meta-analysis, so as to provide more convincing evidence for the clinical application of elective single embryo transfer. Methods We electronically searched foreign and domestic biomedical databases including PubMed, Ovid, EMbase, MEDLINE and CENTRAL, to collect randomized controlled trials (RCTs) on elective single versus double embryo transfer. According to Cochrane systematic review method, two reviewers independently screened studies according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results A total of 9 RCTs involving 2 784 cases were included, of which, 1 452 were in the trial group while the other 1 332 were in the control group. The results of meta-analysis indicated that, compared with elective double embryo transfer, during each transfer period elective single embryo transfer reduced the live birth rate (RR=0.66, 95%CI 0.59 to 0.73, Plt;0.000 01), multiple pregnancy rate (RR=0.05 95%CI 0.02 to 0.11, Plt;0.000 01), preterm birth rate (RR=0.39, 95%CI 0.26 to 0.60, Plt;0.000 1), and low birth weight rate (RR=0.25, 95%CI 0.15 to 0.44, Plt;0.000 01). However, it had no effect on the ectopic pregnancy rate (RR=0.55, 95%CI 0.11 to 2.77, P=0.47), miscarriage rate (RR=1.33, 95%CI 0.92 to 1.91, P=0.13), and neonatal mortality rate (RR=0.31, 95%CI 0.03 to 2.76, P=0.29). Conclusion Compared with elective double embryo transfer, during each transfer period elective single embryo transfer reduces the live birth rate, multiple pregnancy rate, preterm birth rate, and low birth weight rate. No significant difference was found between the two groups in the other indicators.
ObjectiveTo investigate the influence of buried thread nasal augmentation on dorsal soft tissue of nose and revision rhinoplasty. Methods A clinical data of 29 patients requesting revision rhinoplasty after buried thread nasal augmentation, who were admitted between July 2017 and July 2019 and met the selection criteria, was retrospectively analyzed. All patients were female with an average age of 26.8 years (range, 18-43 years). The patiens were admitted to the hospital at 3-48 months after buried thread nasal augmentation (median, 15 months). Among them, there were 18 cases of insufficient nasal tip projection, 22 cases of insufficient nasal root projection, 7 cases of threads ectasia, 5 cases of threads exposure, 3 cases of infection, and 10 cases with two or more conditions. There were 9 cases of combined short nose deformity, 1 case of spherical hypertrophy of the nasal tip, 3 cases of deviation of the nasal columella, 3 cases of excessive width of the nasal base, and 1 case of nasal hump. Three infected patients only underwent threads removal and debridement. The rest patients underwent revision rhinoplasty, and the dorsum of the nose was made with polytetrafluoroethylene expansion; the tip of the nose was reshaped by taking autologous rib cartilage and alar cartilage in 16 cases, and by taking autologous septal cartilage and alar cartilage in another 10 cases. The threads and surrounding tissue specimens removed during operation were subjected to histologic observation. Nasal length and nasal tip projection were measured after revision rhinoplasty and the ratio was calculated to evaluate the nasal morphology; patient satisfaction was evaluated using the Likert 5-grade scale. ResultsPatients were followed up 12-48 months (mean, 18 months). Inflammation was controlled in 3 patients with infections caused by buried thread nasal augmentation. The remaining 26 patients had satisfactory results immediately after revision rhinoplasty. Before revision rhinoplasty and at 7 days and 6 months after revision rhinoplasty, the nasal length was (4.11±0.34), (4.36±0.25), and (4.33±0.22) cm, respectively; the nasal tip projection was (2.34±0.25), (2.81±0.18), and (2.76±0.15) cm, respectively; and the nasal tip projection/nasal length ratio was 0.57±0.08, 0.65±0.05, and 0.64±0.04, respectively. There were significant differences in the nasal length and the nasal tip projection between time points (P<0.05). There was a significant difference in the nasal tip projection/nasal length ratio between pre- and post-operation (P<0.05), but there was no significant difference between 7 days and 6 months after operation (P>0.05). The Likert score for satisfaction ranged from 1.5 to 5.0 (mean, 4.05). During follow-up period of 26 patients, no nasal prosthesis was exposed, and the shape of the nose was stable, and the nasal skin of 5 patients with exposed threads could be seen with different degrees of scarring; there was no infection, cartilage resorption, and no cartilage deformation, displacement, or exposure. Histological observation showed that absorbable threads were not only absorbed after implantation, but also with the prolongation of time, the inflammatory changes in the surrounding tissues caused by decomposition and absorption of the threads showed a gradual aggravation of the first, the heaviest inflammatory reaction in 6 to 12 months, and then gradually reduce the trend. Conclusion After implantation of the absorbable thread into the subcutaneous tissue of the nasal dorsum, the nature of the thread is different from the body’s own tissue, which will affect the soft tissue compliance of the nasal dorsum. The degradation and absorption of the thread will stimulate the infiltration of inflammatory cells and the proliferation of fibroblasts in the surrounding tissue and then form scar tissue, which will affect the design and effect of revision rhinoplasty.
Objective To establish the three diamension-model and to observe the contribution of endothelial progenitor cell (EPC) in the angiogenesis and its biological features. MethodsEPC was obtained from the rats’ peripheral blood. Its cultivation and amplification in vitro were observed, and the function of the cultural EPC in vitro was detected. The three diamension-model was established and analyzed. ResultsEPC was obtained from the peripheral blood successfully. The proliferation of the EPC which induced with VEGF(experimental group) was better than that without VEGF （control group） at every different phase (P＜0.01). It was found that EPC grew into collagen-material from up and down in the three diamension-model, and its pullulation and infiltration into the collagen were seen on day 1 after cultivation. With the time flying, there were branch-like constructions which were vertical to the undersurface of collagen and interlaced to net each other. It showed that in experimental group the EPC grew fast, its infiltration and pullulation also were fast, the branch-like construction was thick. But in control group, the EPC grew slowly, infiltration and pullulation were slow, the branch-like construction was tiny and the depth of infiltration into collagen was superficial. The number of new vessels in experimental group was larger than that in the control group at every different phase (P＜0.01). ConclusionRat tail collagen can induce EPC involved in immigration, proliferation and pullulation in angiogenesis. The three-diamension model of EPC can be used to angiogenesis research. VEGF can mobilize and induce EPC to promote the angiogenesis.