Objective To detect the normal values of the fetal coronary sinus(CS) in length(L) .diameter (D) and diameter-to-length ratio(D/L) using fetal echocardiography and assess the clinical significance of dilated CS. Methods Fetal echocardiography were performed in 218 normal fetuses from the 20th to the 40th week of gestation. The L,D and D/L of CS were measured and the standard values of the normal fetal CS were established. A second group of 8 fetuses with dilated CS were assessed compared to the values of normal fetuses. Results The L and D of normal fetal CS correlated well with the gestational weeks (Linear regression equation is L= - 0. 94 + 0. 4 weeks, r = 0. 661, P<0. 0001 ;D= - 0. 07 + 0. 08 weeks, r = 0. 433, P <0. 0001). And the D/L did not vary significantly throughout pregnancy(D/L = 0. 21 0.04, r = 0. 115, P = 0.08). Therefore, the D value of normal fetal CS is less than 3.9 mm and D/L is less than 0.3 throughout pregnancy (20-40 gestational weeks). Conclusions The values of D and D/L of fetal CS in prenatal echocardiography might be useful and important parameters for fetal cardiac or extracardiac anomaly.

Transient ischemic attack (TIA) traditionally refers to temporary brain dysfunction lasting no longer than 24 hours due to a shortage of blood and oxygen, without any residual neurological deficit. In recent years, the development of imaging technology enables us to have a new awareness about TIA. This article reviews the effects of MRI, especially diffusion-weighted imaging, in the diagnosis and prognostic prediction of TIA.

0 05).The size of PEI group was larger than that of PAI group 2 months after treatment (P

Objective To study the expression of programmed death 1(PD-1) on the peripheral T lymphocytes and the serum cytokine levels in different phases of hepatitis B virus (HBV) infection (immune tolerance,immune clearance and non-replicating phases).Methods A total of 105 HBV infected patients in different phases of infection were enrolled in Wuxi No.5 People's Hospital from Apr to Sep 2011,and divided into three groups:the immune tolerance group (35 cases),the immune clearance group (35 cases) and the non-replicating group (35 cases).Meanwhile,20 healthy people were enrolled as controls.The peripheral blood was collected and PD-1 expressions on the surface of T lymphocytes were assessed by flow cytometry.The cytokine levels in different groups were analyzed by enzyme-linked immunosorbent assay (ELISA).The data were analyzed by t test and Pearson correlation analysis.Results The PD-1 expression on surface of CD8+ T lymphocytes of HBV infected patients was (12.35± 3.48)％,which was significantly higher than healthy control group [(4.65±1.21) ％] (t=9.76,P＜0.01).The PD-1 expression on CD4+ T lymphocytes was (4.95±2.87) ％,which was not significantly different from the healthy controls [(4.08±2.14) ％] (t =1.29,P＞0.05).The PD-1 expressions on CD8+ T lymphocytes of patients in the immune tolerance group,the immune clearance group and the non-replicating group were (15.87±3.18)％,(7.69±3.64)％and (10.12±2.84) ％,respectively; that in the immune tolerance group was higher than the immune clearance group (t=10.01,P＜0.01) and that in healthy control group was lower than those in the other 3 groups (t=15.12,3.61 and 8.17,respectively; all P＜0.01).The PD-1 expression on the surface of CD8+ T lymphocytes in chronic HBV infected patients was positively correlated with the serum interleukin-10 (IL-10) level (γ=0.377,P＜0.05),while that was negatively correlated with interferon-γ (IFN-γ) level (r=-0.620,P＜0.05).Conclusions PD-1 is up-regulated on the surface of CD8+ T lymphocytes from chronic HBV infected patients.And PD-1 is negatively correlated with serum IFN-γ levels and positively correlated with serum IL-10 levels.The expression of PD-1 on the surface of CD8+ T lymphocytes influences the balance of helper T cell (Th)1/Th2,which might play a role in the persistence of HBV infection.

Objective To investigate the role of natural killer cells (NK cells) in patients with chronic hepatitis B (CHB). Methods Blood samples and liver biopsies from 108 CHB patients including 43 mild, 28 moderate and 37 severe CHB patients were collected. The levels of interferon (IFN) gamma in liver tissues and peripheral blood were detected by intracellular cytokine staining.The data were analyzed by t test. Results The levels of IFN gamma produced by NK cells in liver tissues and peripheral blood of patients with severe CHB were (8. 12±4. 26) % and (4. 59±2. 95) % ,respectively, which were significantly higher than those in patients with mild CHB [(3. 53±1. 56)%and (2. 26±0.61)%, respectively; t=3. 80 and t = 4. 30, respectively; both P<0. 05] and those in patients with moderate CHB [(4. 59±1. 98)% and (2. 48±1. 05)%, respectively;t=2. 62 and t =3. 28, respectively; both P<0. 05]. While there were no differences of IFN gamma produced by NK cells both in liver tissues and peripheral blood between mild and moderate CHB patients (t=0. 99 and t=1. 27, respectively; both P>0. 05). The levels of IFN gamma produced by NK cells in liver tissues and blood samples in severe phase of severe CHB were (10. 02 ± 4. 15)% and (6. 78 + 2. 91)%, respectively, those in recovery phase were (6. 13±2. 01)% and (3. 13± 1. 52)%, respectively (t = 1. 89 and t=1. 74, respectively; both P<0. 05]. Conclusion NK cells may play a pivotal role in the pathogenesis of severe CHB.

Objective To investigate the application value of three-dimensional power Doppler ultrasonography(3D-PDU) for synovial disease in patients with rheumatoid arthritis(RA). Methods Forty four patients with RA were divided into active (23 cases) and non-active (21 cases) groups. 3D-PDU was used in the wrists to measure the volume of synovium(V) ,vascular index(VI) in synovium.and Doppler spectrum was used to measure synovial artery peak systolic blood flow velocity(PSV) , end diastolic velocity (EDV) and resistance index(RI). Results There were significant differences of the V [(1. 73 0. 73) cm3] and VI (9. 53 6. 11) in the group of active patients compared to the V [(1. 09 0. 76) cm3 , P = 0. 008] and VI [(3.86 4.99), P = 0.000] in the ones of inactive patients. No differences were found for PSV [(16. 8 6. 29) cm/s vs (13. 5 8. 54) cm/s, P = 0. 282] ,EDV [(5. 51 1.77) cm/s vs (5. 03 2. 76) cm/s, P = 0. 539] and RI (0. 66 0. 07 vs 0. 62 0. 08, P = 0. 095)in the comparison of two groups. Conclusions 3D-PDU in determining RA disease activity in patients with synovial medium has a higher application value, VI can be used as an effective indicator to determine the disease activity.

Objective To evaluate the application value of three‐dimensional ultrasonography OmniView technology in diagnosis of fetal cleft lip/palate . Methods Three‐dimensional volume data was acquired from 100 normal singleton fetuses and 18 cleft lip/palate fetuses ,and was analysed by OmniView technology . Two‐dimensional ultrasonography and three‐dimensional OmniView technology were compared in the displaying rate of different planes of the lip and palate and the diagnosis accordance rate of cleft lip/palate.Results ①ThedisplayingrateofthelipandpalateofOmniViewtechnologywashigherthanthatof two‐dimensional ultrasonography ( the displaying rates were 64% -88% and 30% -65% ,respectively , P <0 .05) . Further more ,the curved plane tiled imaging of palate was successfully reconstructed by OmniView technology ,displaying the nonplanar panorama of the palate . ② There was no significant difference in diagnosis accordance rate of fetal cleft lip/palate between two‐dimensional ultrasonography and OmniView technology( the accordance rate was 89% -94% and 78% -100% ,respectively , P >0 .05) . Conclusions Three‐dimentional ultrasonography OmniView technology can improve the displaying rate of the hard and soft palate .The application of this technology in the fetuses who has a high risk of cleft palate may be beneficial to the diagnosis of cleft palate .

This paper summarized perioperative nursing care of three patients undergoing surgical tumor resection and anterolateral femoral skin flap repair,with tumors involving intra-and extra-cranial regions from scalp squamous cell carcinoma breaking through the skull directly into the brain. Three surgical procedures were successfully per-formed by cooperation between two surgical departments and the average duration was 7 hours. The effective preop-erative infection control,perfect surgical plan,intraoperative team collaboration,effective aseptic technique and tumor-free technique were key points for the success of the operations. Close postoperative observation and positive psy-chological nursing also guaranteed operation success.

Object To determine the activities of various antioxidant enzymes, including superoxide dismutase, catalase, peroxidase and glutathione peroxidase, and the contents of some simpler antioxidants such as glutathione, chlorogenic acid and certain flavonoids in the leaves, stems and fruits of Viscum coloratum (Kom ) Nakai Methods The activities were determined as described in various literature reports Results The plant was found to be rich in various antioxidants Conclusion V coloratum, with its abundant antioxidant constituents, is proved to be a strong antioxidation drug for medical use especially its leaves

ObjectiveTo explore the effect of combined usage of expanding coronal decompressive craniectomy and sequential dural incision for treating severe bilateral frontal contusion (SBFC).Methods Forty-three patients with SBFC were randomly divided by sequential single day after hospitalization into two groups.Observation group(23 cases) treated with expanding coronal decompressive craniectomy and sequential dural incision.Control group (20 cases) treated with standard hemicraniectomy and routine dural incision.ResultsThe occurrence rate of acute cephalocele was significantly lower in observation group [ 17.4％(4/23) ] than that in control group [ 55.0％(11/20) ] (P ＜ 0.05).According to Glasgow outcome scale (GOS) score of six-month observation after operation,17 cases(73.9％,17/23) of observation group got favourable recovery or moderate deficit,other 6 cases(26.1％,6/23) got severe deficit,persistent vegetative status or death.While only 8 cases(40.0％,8/20) got favourable recovery or moderate deficit,12 cases ( 60.0％,12/20 ) got severe deficit,persistent vegetative status or death in control group.The rate of favourable recovery and moderate deficit of two groups had statistical significance (P ＜ 0.05).ConclusionCombination application of expanding coronal decompressive craniectomy and sequential dural incision is an effective method to treat patients with SBFC,and can obviously improve the rate of successful rescue and decrease the rate of mortality and disability.