Objective:To evaluate the application of puncturing the umbilical cord under the ultrasound guidance in prenatal diagnosis,clinical high risk factors of fetal chromosomal abnormalities were discussed.Methods:283 pregnant women who had the percutaneous umbilical cord blood sampling were recruited and the karyotyping was done.The detection rate of chromosomal abnormalities and correlate factors in different subgroups of prenatal diagnosis were analyzed.Results:The success rate of puncture was 100%.Major complications were bleeing at the puncture site(33 cases,11.67%)and fetal heart brachycadia(5 cases,1.77%).25 chromosomal abnormalities were found and the detection rate was 8.83%.There was significant correlation between the couple's chromosomal abnormalities and the fetal's(r=22.348,P=0.000).Conclusions:The ultrasound guided percutaneous umbilical cord blood sampling proves to be valid in the prenatal diagnosis,especially when couples have chromosomal abnormalities.

OBJECTIVE: To investigate the preventive and therapeutic effects and the possible mechanisms of Dilingdan Decoction (DLDD), a compound Chinese herbal medicine, on rats with renal tubulointerstitial fibrosis induced by unilateral ureteral obstruction (UUO). METHODS: Sixty SD rats were randomly divided into sham-operated group, untreated group, enalapril-treated group and DLDD-treated group. Blood urea nitrogen (BUN), serum creatinine (SCr), urine protein quantization in 24 hours and pathological changes of the obstructed kidney were observed. The expressions of transforming growth factor-beta1 (TGF-beta1), alpha-smooth muscle actin (alpha-SMA), fibronectin (FN) and laminin (LN) were detected by immunohistochemical method and colored-multimedia pathological image analysis system. RESULTS: Massive inflammatory infiltrates and collagen expression in renal interstitial in the untreated group were observed on the 7th day. Compared with the sham-operated group, percentages of area of TGF-beta1, alpha-SMA, FN and LN expressions in the untreated group were markedly increased (P<0.05), while the percentage of area of interstitial fibrosis was decreased in the DLDD-treated group as compared with the untreated group (P<0.05). On the 14th day, the percentages of area of TGF-beta1, alpha-SMA, FN and LN expressions were declined in two treated groups as compared with the untreated group (P<0.05), but had no statistical difference in biochemical indicators, including BUN, SCr and 24-hour urinary protein. On the 21st day, the level of SCr and the percentage of area of TGF-beta1 expression in the DLDD-treated group were lower than those of the enalapril-treated group (P<0.05). CONCLUSION: DLDD can reduce the excretion of urinary protein and the degree of interstitial fibrosis, and significantly inhibit the expressions of TGF-beta1, alpha-SMA, FN and LN. DLDD is superior to enalapril in protecting renal function after long-time application in rats.

Objective To establish the high-performance liquid chromatography(HPLC)method for measuring concentrations of methotrexate(MTX)in rat lung and some other tissues through internal iliac artery infusion.Methods Fifly female Sprague-Dawley rats were included in this study.The rats were randomly assigned to two groups.Methotrexate was injected to group one through internal iliac artery,and was injected to group two through femoral vein.Blood and tissues were collected in each group at 15,30,60.90 and 120 minutes for detection of the drug concentrations with HPLC.Results The area under the concentration time curve(AUC)in rat lung,ovary and uterus in the artery group were separately(3.77±0.28),(4.40±0.40),(9.97±0.89)μg·h-1·g-1,which were significantly different from those of the vein group[(2.31±0.25),(3.91±0.19),(7.65±1.54)μg·h-1·g-1;P<0.05].The AUC in the rat plasma,heart,kidney,liver and spleen in the artery group were separately(6.13±0.53),(1.90 ±0.11),(5.32±0.89),(14.16±1.96),(0.76±0.20)μg·h-1·g-1.There were no significant differences from the vein group[(5.79±0.71),(1.64±0.29),(5.15±1.69),(14.29 ±3.47),(0.76±0.13)μg·h-1·g-1;P>0.05].Conclusions Through internal iliac artery infusion,there are higher drug concentrations in lung.uterus and ovarian compared to venous injection.The internal-arterial chemotherapy may be used to treat pulmonary metastasis of gynecological tumor.

Objective To establish a satisfactory lung metastasis model of human choriocarcinoma using severe combined immunedeficient(SCID)mice and explore the appropriate cell concentration for the model.Methods Forty SCID mice aged between 5-6 weeks were randomly difided into four groups.1×107 cells/ml ×0.1 ml.5×106 cells/ml×0.2 ml and 1×106 cells/ml×0.1 ml of human choriocarcinoma cells JEG-3 were respectively injected in SCID mice of experimental groups by lateral tail vein,the remain group was assigned to the control group.The status and weisht of mice were observed every three days.When these mice were being dying.the size and the number of the lesions of lung metastasis in every mouse were inspected with Micro CT.After Micro CT inspection,the SCID mice were executed dissected to note whether there were tumors on all organ surfaces witll naked eyes.then made pathological sections from the metastaticfoci of fresh lung tissues,and cultured primarily cells and purified cells and passaged cells isolated from the same metastastic foci.The pathological sections were observed under the microscope.The special antigen human chorionic gonadotropin-beta subunit(β-hCG)of the choriocareinoma cells was immunohistochemically detected in the pathological sections and the cells out of cultured primarily cells.The chromosomes of the cells out of cultured primarily cells were analysed.Results Of the group inoeutated 1×107 cells/ml×0.1 ml.all mice died when inoculating.In the group of 5×106 cells/ml×0.2 ml,when inoculating, 3 mice died; the remain 7 mice were being dying on ( 18. 0 ±2. 0) days after injection. 5 of them, there were 1 - 3 lesions of lung metastasis after Micro CT inspection in each mice, and the diameter of the tumors lesions reached 1.5 - 3.5 ram, which was choriocarcinoma confirmed by pathological sections.The special antigen β-hCG was detected by immunohistoehemical method in the pathological sections of pulmonary tissue with tumor and in the cells, which were purified and passaged from being cultured primarily cells isolated from metastastic foci of fresh lung tissues from the SCID mice. The chromosome numbers of these cells out of cultured primarily ceils were variety from 19 to 128, and medal numbers were variety from 70 to 79. Conclusions We successfully established the lung metastatic model of human choriocarcinoma in SCID mice by injecting JEG-3 cells into lateral tail vein, of which 5 × 106 cells/ml × 0. 2 ml is the suitable concentration and volume for the model.

Objective To evaluate the feasibility and safety of transabdominal ultrasound-guided suction curettage to treat cesarean scar pregnancy (CSP) and investigate factors affecting prognosis of CSP. Methods This was a retrospective case study of 43 cases who were diagnosed as CSP and treated by suction curettage under transabdominal ultrasound guidance as an initial treatment of CSP in Obstetrics and Gynecology Hospital of Fudan University over past 7 years (from 2007 to 2013);factors affecting prognosis of CSP were investigated. Results 39 of the 43 cases (91%) were successfully treated. There were no statistically significant differences in maternal age, gravidity, abortion frequency, and the time interval between current CSP and last cesarean delivery, the myometrium thickness between the gestational sac and the bladder wall between the success group and the failure group (all P>0.05). Statistically significant difference was found in crown-rump length (CRL) between the two group (median of the two group was 18.5, 2.0 mm) by rank sum test (P=0.047). Univariate logistic regression analysis demonstrated that CRL was strongly associated with the prognosis and the OR for no complications was 18.50, comparing CRL≤6 mm versus CRL>6 mm (P=0.020). Conclusion Transabdominal ultrasound-guided suction curettage is effective and safe in the treatment of CSP with CRL≤6 mm.

Objective To assess the utility of single source-dual energy CT for distinguishing bladder cancer from hematoma. Methods We retrospectively identified 14 patients with postoperative or follow-up bladder hematoma who had undergone dual energy protocol (40-140 keV)scanning by single source-dual energy CT.The subjective scoring of tumor detection and image quality,the optimal monochrome images and iodine-water images were evaluated by two radiologists who didn’t know the results.The consistency of two observers was analyzed by Kappa test.Mann-Whitney U test was used to compare the difference between the two kinds of diseases and ROC curve was used to analyze the diagnostic efficiency.The statistical differences of image quality scoring among different images were obtained by using Mann-Whitney U test.Results The consistency of the two observers about scoring of lesion detection was good for all groups.There were statistical differences between two groups in non-enhanced phase and arterial phase of mixed-energy images,non-enhanced phase,arterial phase and delayed phase of optimal monochromatic images,and all phase of iodine-water images. The AUC of iodine-water images in the four phases (0.985,1.000,0.955,0.924,respectively)were all higher than that of polychrome unenhanced and arterial phase images (0.909,0.909).The diagnostic efficiency of arterial phase on iodine-water images was the highest.Sensitivity and specificity were both 100% when score was greater than 2.5.There was no statistical difference between two kinds of diseases on non-enhanced phase,delayed phases of mixed-energy or monochromatic images(P >0.05).There were no statistical differences in image quality scoring among the three groups with the same phases (P>0.05).Conclusion Optimal monochromatic images and iodine-water images of single source-dual energy CT are more effective than conventional CT in distinguishing bladder cancer from hematoma.

OBJECTIVE Aim to evaluate the mental level in 4-6 years old children with obstructive sleep apnea hypopnea syndrome(OSAHS). METHODS Children who were diagnosed as OSAHS with a whole night PSG monitor in the sleep center between January 2015 and August 2016, and 30 healthy children were included in the study. Intelligent levels were evaluated at the enrollment day. The following intelligent levels evaluation questionnaires were used: Wechsler Intelligence Scale for children and infants. Intelligent levels were compared between the patient and healthy control groups. RESULTS The 60 children, including 30 children with OSAHS(patient group) and 30 healthy children(control group) were enrolled. Comparison of the patient versus the control groups revealed that total intelligence quotient(FIQ) was 96.59±12.60 vs 102.53±8.44; language capability(VIQ) was 94.00±13.24 vs 101.03±9.41; comprehension test was 5.96±2.5 vs 7.57±2.14; visual analysis was 8.85±2.32 vs 10.3±1.93. All the 4 values in the patient group were significantly lower than those in the control group(all P ＜0.05). The accumulated time of SO2＜90％ correlated with PIQ negatively and significantly. CONCLUSION The intelligent level of children with OSAHS was in the normal range, but lower than that of healthy group. Snoring affects the IQ level of 4-6 years old children, and the influence on PIQ is closely related to the accumulated time of SO2＜90％ in total sleep time.

OBJECTIVE:To establish HPLC fingerprints of taproot and rhizome of Paenoia lactiflora,and to compare the similarity and difference of them.METHODS:The determination was performed on Phenomenex C18 column with mobile phase consisted of acetonitrile-0.1％ phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 230 nm,and column temperature was 30 ℃.The sample size was 10 tL.Using paeoniflorin as reference,HPLC chromatograms of the taproot and rhizome of P lactiflora were established.Common peak identification and similarity evaluation were performed by using TCM Chromatogram Fingerprint Similarity Evaluation System (2012 edition).RESULTS:There were 9 common peaks in HPLC chromatograms of taproot and rhizome of P lactiflora.The similarity of taproot with rhizome of P lactiflora was higher than 0.9.CONCLUSIONS:Established fingerprints can provide reference for identification and quality evaluation of P lactiflora.The effective constituent of taproot and rhizome of P lactiflora are uniform but have small difference.

Humans ; Clavicle ; Fractures, Bone/surgery*

To summarize the reform measures of nursing vertical management in our hospital under the background of diagnosis related groups,including refined performance management,cancellation of nursing main pharmacy classes,implementation of attending nursing working group,establishment of DRGs nursing quality control coder position,head nurse responsible for bed allocation,deepening nursing quality management and other measures,so as to provide references for other hospitals to carry out the reform of nursing vertical management under the background of DRGs.