Objective To investigate the influencing factors of pregnancy outcome in patients with subchorionic hematoma(SCH) and recurrent spontaneous abortion(RSA) combined with SCH, so as to formulate corresponding treatment strategies and improve pregnancy outcome.Methods A total of 204 patients with subchorionic hematoma admitted to the Fourth Hospital of Shijiazhuang and the Second Affiliated Hospital of Hebei Medical University from June 2019 to June 2021 were retrospectively analyzed. The high-risk factors of adverse pregnancy outcomes were analyzed by analyzing the patient's age, BMI, gestational age when SCH was diagnosed, whether accompanied by vaginal bleeding, pregnancy history, coagulation indicators(platelet aggregation rate AA, platelet aggregation rate ADP, D-dimer, homocysteine), and recurrent miscarriage history. Results A total of 204 SCH patients were included in the study. After controlling confounding factors, vaginal bleeding(OR=3.443, 95%CI 1.613-7.351, P=0.001), the history of recurrent miscarriage(OR=2.392,95%CI 1.136-5.035,P=0.022), platelet aggregation rate(ADP)(OR=1.202,95%CI 1.118-1.292,P<0.001) were found that they were the risk factors for adverse pregnancy outcomes, and the number of gestational ages at diagnosis of hematoma(OR=0.963, 95%CI 0.938-0.989, P=0.006) and previous live births(OR=0.125, 95%CI 0.047-0.330, P<0.001) were the protective factors. After controlling confounding factors, platelet aggregation rate(ADP)(OR=1.171, 95%CI 1.043-1.316,P=0.008) and D-dimer(OR=1.011, 95%CI 1.002-1.020,P=0.020) were found to be risk factors for adverse pregnancy outcomes in 92 SCH patients with RSA, and the number of previous live births(OR=0.154, 95%CI 0.061-0.392, P<0.001) was a protective factor for adverse pregnancy outcomes. Conclusion Abnormal coagulation(hypercoagulability) is a risk factor for adverse pregnancy outcomes in patients with subchorionic hematoma or subchorionic hematoma combined with recurrent spontaneous abortion. Patients with subchorionic hematoma complicated with recurrent abortion should pay more attention to monitoring coagulation indexes(D-dimer, etc.) during pregnancy, and those with hypercoagulable state should be given corresponding anticoagulation therapy to improve pregnancy outcome.

Objective To investigate the protective effect and mechanism of honokiol(HK) on the heart of mice with myocardial ischemia/reperfusion injury(MIRI). Methods From June 2022 to July 2023, the experiment was conducted at the Traditional Chinese Medicine Diagnosis Experimental Center of the School of Basic Medicine, Shaanxi University of Chinese Medicine. 78 male C57BL/6J mice were randomly divided into sham group, MIRI group, and MIRI+HK group, with 26 mice in each group. Before surgery, the MIRI+HK group mice were given HK(0.2 mg·kg-1·d-1) intraperitoneal injection, while the Sham and MIRI groups were given equal amounts of solvent for 14 consecutive days. The Sham group only threaded without ligation, while the other groups ligated the left anterior descending branch for 30 minutes, then opened the suture and reperfusion for 2 hours to construct a MIRI model. After reperfusion, blood was immediately taken and the heart was stripped. Compare the levels of serum creatine kinase isoenzyme(CK-MB) and cardiac troponin T(cTnT) in each group. Echocardiography detects heart function. Calculate myocardial infarction area using 2,3,5-triphenyl tetrazolium chloride staining method; In situ end labeling technology was used to detect the level of cell apoptosis; Electron microscopy observation of mitochondrial structural damage. Western blot was used to detect mitochondrial apoptosis and protein expression related to the phosphoinositol-3 kinase/protein kinase B(PI3K/AKT) pathway. Results Compared with the Sham group, the MIRI group mice showed higher levels of serum CK-MB, cTnT, left ventricular end systolic diameter(LVESD), myocardial infarction area, and cell apoptosis rate, while the left ventricular ejection fraction(LVEF) and left ventricular short axis shortening rate(LVFS) decreased(P<0.001). Most myocardial mitochondria were swollen, with blurred inner and outer bilayers, reduced or absent cristae, and mitochondrial apoptosis related protein cytochrome(Cyto-C) The expression of Bcl-2 related X protein(Bax) and activated cysteine protease(Cleared Caspase-9) increased, while the expression of B lymphocyte tumor 2 gene(Bcl-2), p-AKT/AKT, and p-PI3K/PI3K decreased(P<0.001). Compared with the MIRI group, the serum CK-MB, cTnT, and LVESD levels, myocardial infarction area, and cell apoptosis rate of the MIRI+HK group mice decreased, while LVEF and LVFS increased(P<0.001). The mitochondrial ultrastructure of myocardial cells improved and the structure was more complete. The expression of Cyto-C, Bax, and Cleared Caspase-9 proteins decreased, while the expression of Bcl-2, p-AKT/AKT, and p-PI3K/PI3K increased(P<0.001). Conclusion HK can inhibit MIRI induced mitochondrial apoptosis in cardiomyocytes by activating the PI3K/AKT signaling pathway, thereby exerting a cardioprotective effect.

Objective To systematically evaluate the safety and effectiveness of Taohong Siwu Decoction(TSD) in the treatment of diabetes peripheral neuropathy(DPN), so as to provide a basis for Chinese medicine intervention in DPN. Methods The PubMed database, Embase database, Cochrane Library database, CNKI, VIP, Wanfang data knowledge service platform were systematically searched, and the research literature on the treatment of diabetes peripheral neuropathy with Taohong Siwu Decoction was collected. The search time was from the establishment of the database to December 2023. Two researchers screened the literature, evaluated the quality, and extracted effective data. The Meta-analysis was conducted with Revman 5.4 software. Compare the clinical efficacy, median nerve conduction velocity, common peroneal nerve conduction velocity, traditional Chinese medicine syndrome score, TCSS score, glycated hemoglobin level(HbA1c), and adverse reactions between single/combined use of Taohong Siwu Decoction(experimental group) and conventional Western medicine(control group). Result The final inclusion of 13 RCTs included 1159 study subjects. The Meta-analysis showed that the experimental group had a better effect on improving clinical efficacy than the control group[RR(95% CI)=1.20(1.14, 1.27), P<0.001], the experimental group had a better effect on reducing traditional Chinese medicine syndrome scores than the control group[MD(95% CI)=-3.68(-4.64,-2.72), P<0.001], the experimental group had a better effect on reducing TCSS scores than the control group[MD(95% CI)=-1.77,(-2.43,-1.10), P<0.001], and the experimental group had a better effect on improving median nerve conduction velocity than the control group[MD(95% CI)=4.07(1.98, 6.15), P<0.001]. The experimental group showed a better effect on improving the conduction velocity of the common peroneal nerve than the control group, but there bad no significant statistical difference[MD(95% CI)=4.81(3.00, 6.61), P<0.001], the experimental group showed a better effect in reducing glycated hemoglobin levels than the control group, but there had no significant statistical difference[MD(95% CI)=-0.04(-0.28, 0.19), P<0.001].Conclusion Taohong Siwu Decoction can be used to treat diabetes peripheral neuropathy. The combination of western medicine has a significant effect, which is better than that of western medicine alone. However, it still needs to expand the sample size and collect more high-quality studies to verify.

Report a case of very early onest inflammatory bowel disease with NFKBIA gene mutation, and review the literature.

For the diagnosis and treatment of patients with coronary artery disease(CAD), it is of great clinical significance to evaluate the physiological function of the coronary artery, which can guide treatment decisions and improve the clinical prognosis of patients. Fractional flow reserve(FFR) is currently recognized as the gold standard for evaluating the physiological function of coronary arteries. However, the invasiveness and complexity of FFR limit its clinical application. Quantitative Flow Ratio(QFR), as a new guidewire free FFR technology based on coronary angiography, is highly consistent with FFR in assessing the function of coronary arteries, and has the advantages of non-invasive, safe and convenient. In recent years, QFR has become the focus at home and abroad.