Objective To evaluate ultrasonography combined with magnetic resonance imaging(MRI) diagnosis value for fetal brain deformities.Methods The results of ultrasonography and MRI was analysied in 12 fetuses with deformities,which were compared to postnatal,autopsy or other hospital inspection results and evaluated the accuracy.Results In 8 cases,the diagnoses established by ultrasonography were correct.3 cases were misdiagnosed by ultrasonography,1 case was missed the diagnosis.In 11 cases,the diagnoses established by MRI were correct and 1 case was missed the diagnosis.Conclusion Ultrasonography must be choosed in diagnosising fetal skull brain deformities,MRI was supplement to ultrasonography in complicated pregnancies.The combination of ultrasonography and MRI have an important value in guiding pregnant women to determine whether or not to continue the pregnancy.

Objective To evaluate interventional therapy for acute massive and submassive pulmonary embolism.Methods From June 2011 to June 2014.53 patients were enrolled and divided into group massive pulmonary embolism (MPE,n =16) and group submassive pulmonary embolism (SPE,n =37),both receiving catheter thrombectomy + contact thrombolysis within 12 hours after diagnosis.Preand post-interventional measures were assessed,including mean pulmonary arterial pressure (MPAP),cardiac biomarkers,tricuspid regurgitation,right ventricular (RV) dilatation,and massive hemorrhage within 72 hours.Patients were followed up for 6 months for the occurrence of chronic thromboembolic pulmonary hypertension.Results In all 53 patients were successfully completed catheter thrombectomy +contact thrombolysis,the mean pulmonary artery pressure in group MPE decreased from (47 ± 6)mmHg to (34 ± 4) mmHg (P ＜ 0.05),and in group SPE decreased from (44.2 ± 1.5) mmHg to (31.4 ± 6.2) mmHg (P ＜ 0.05).The ventriculus dexter disfunction was alleviated in 78.4％ patient after therapy.Overall 1.9％ patients suffered from massive hemorrhage,(0) in group MPE,and (2.7％)in group SPE.The incidence of chronic thromboembolic pulmonary hypertension during 6 moths follow up was 0.Conclusion Early interventional therapy for massive and submassive pulmonary embolism decreased pulmonary artery pressure,relieved right ventricular dysfunction,reduced bleeding complications and the incidence of chronic thromboembolic pulmonary hypertension.

Objective To investigate the effect and synaptic plasticity mechanism of dexmedetomi-dine(Dex)on alleviating cognitive impairment induced by myocardial ischemia/reperfusion(I/R)in aged mice.Methods Forty elderly male C57BL/6 mice were randomly divided into sham group,Sham+Dex group,I/R group,and I/R+Dex group,with 10 mice in each group.On the 7th day of reperfusion,cognitive function was evaluated using an eight arm water maze and novel ob-ject recognition.Electrophysiological recordings of hippocampal CA1 area was performed to meas-ure field excitatory postsynaptic potential(fEPSP)in in vivo long-term potentiation(LTP).The serum levels of cardiac troponin T(cTnT),lactate dehydrogenase(LDH),and N-terminal pro-B-type natriuretic peptide(NT-proBNP)were detected by ELISA.Western blotting was used to determine the expression of brain-derived neurotrophic factor(BDNF),tyrosine kinase receptor B(TrkB)-FL,and TrkB-T1 in hippocampal tissues.Golgi-Cox staining was utilized to observe the density of dendritic spines in hippocampal CA1 area.Immunofluorescence staining was performed to detect the expression of synaptic growth factor(SYN)and postsynaptic dense protein 95(PSD95).Results On the 7th day of reperfusion,the working memory error(WME),reference memory errors(RME)and total errors(TE)of the eight arm water maze and the expression lev-els of cTnT,LDH,NT-proBNP and TrkB-T1 were significantly higher,and the recognition index,fEPSP and expression levels of BDNF,TrkB-FL,SYN and PSD95 and density of dendritic spines were remarkably decreased in the I/R group and I/R+Dex group than the Sham group and Sham+Dex group(P＜0.05).The I/R+Dex group had obviously reduced TrkB-T1 expression(0.86±0.07 vs 1.51±0.18),and increased expression levels of BDNF(0.70±0.07 vs 0.39±0.06),TrkB-FL(0.67±0.10 vs 0.45±0.08),SYN(20.53±0.59 vs 16.50±1.05)and PSD95(17.73±0.52 vs 14.71±0.91)when compared with the I/R group(P＜0.05).Conclusion Dex exerts protective effect on cognitive impairment induced by myocardial I/R in elderly mice,and the specific mecha-nism may be related to alleviating cardiac injury,increasing the expression of BDNF,SYN and PSD95,improving the imbalance of TrkB-FL and TrkB-T1 ratio in hippocampal tissue,and enhan-cing synaptic plasticity.