Objective To explore the value of systematic continuous sequence approach combined with two- and three-dimensional ultrasonography in screening of fetal hand deformity. Methods Systematic continuous sequence approach was performed with two- and three-dimensional u1trasonography in 28 541 cases to detect the fetal hand from January 2011 to December 2014 in the 105th Hospital of PLA. Prenatal ultrasonic diagnosis was compared with clinical delivery follow-up and pathology results of induced labour, then prenatal ultrasound features of various fetal hand deformities and the causes of missed diagnosis were analyzed. Results Thirty-four cases of fetal hand deformity were diagnosed out of 28 541 fetuses by prenatal ultrasonography (43 hands). In the 34 cases, there were 5 cases of cleft hand, 13 cases of ectrodactyly with fingers abnormal morphology, 3 cases of forearm and hand dysplasia, 7 cases of wrist or finger abnormal posture and 6 cases of hand absence of abnormal. Three missed cases included 1 case of polydacty, 1 case of middle phalanx and distal phalanx of the little thumb absence and 1 case of middle phalanx of little thumb absence. Hand deformity rate was 0.13%(37/28 541). The detection rate ofprenatal ultrasonography was 91.89%(34/37). The rate of hand deformity complicated deformity with one or more other organ was 52.94%(18/34). The rate of chromosome abnormalities was 13.51%(5/37). Cleft hand showed that fetal hand from the central longitudinal split into two halves. Ectrodactyly with fingers abnormal morphology showed that one or multiple fingers were absent combined with residual finger abnormal morphology. Forearm and hand dysplasia showed that the forearm was abnormally developed, the ulna and radius were short and the structure of the wrist disappeared. Wrist or finger abnormal posture showed that a hook-shaped wrist or half fist shaped hand, thumb adduction flexion, the index finger bending baroclinic on the dorsal of the middle finger and small finger bending baroclinic on the dorsal of the ring finger dorsal. Hand absence showed that no fetal hands. Conclusions Application of systematic continuous sequence approach combined with real time three-dimensional ultrasonography in the diagnosis of fetal hand deformity, such as ectrodactyly with fingers abnormal morphology and wrist or finger abnormal posture, can make up for the shortage of two-dimensional ultrasonography and obtain more diagnostic information.

Objective To evaluate the cognitive dysfunction and its influential factors in patients with symptomatic and asymptomatic lacunar infarction(LI). Methods Mini-mental state examination (MMSE), MoCA and P300 were carried out among 70 patients with first attack of LI 1 week after, 66 patients with asymptomatic LI and 54 patients for control at first visit. The tests were performed again in the follow-up of half a year and one year. Results (l)The scores of MMSE and MoCA at 1 week, half a year and one year of LI at acute stage were lower than asymptomatic LI(P＜0. 01) and control group(P＜0. 01). Latent periods of P300 at each time point were longer than those in patients with asymptomatic LI (P＜0. 05) and control group (P＜0. 01). (2)The scores of MMSE and MoCA at first visit, half a year of follow-up and one year of follow-up in patients with asymptomatic LI were lower than those in control group(P＜0. 01), and the latent period of P300 was longer than that in control group(P＜0. 01). (3)The scores of MMSE and MoCA at 1 week of LI at acute stage and first visit of asymptomatic LI were higher than those after one year(P＜0. 05). The latent periods of P300 were shorter than those after one year(P＜0. 05). Compared with those half a year after, MMSE and MoCA one year after decreased more and the latent period of P300 prolonged(P＞0. 05). (4) The scores of MoCA in the aspects of visuospatial and executive function, abstract thinking and attention were lower than those in control group (P＜0. 01). (5)The score of MoCA in LI patients with multiple foci was lower than that in LI patients with single focus(P＜0. 01). The scores of MoCA in patients with foci in basal ganglia, frontal lobe, temporal lobe and thalamus were lower than those in patients with foci in other parts (P＜0. 01). Conclusion LI (both symptomatic and asymptomatic) is easily accompanied with cognitive dysfunction. The cognitive damage becomes more severe as time prolongs. The common symptoms include damages of visuospatial and executive function, abstract thinking and attention. Patients with multiple foci and with LI in key parts easily suffer from cognitive dysfunction. Thus, it needs to evaluate and prevent early.

Objective:To evaluate the reliability and validity of the Chinese version of HEMO-FISS-QoL(HF-QoL) questionnaire (HF-QoL-C) in the Chinese population with hemorrhoids.Methods:From November 2021 to November 2022, a self-constructed general information questionnaire, HF-QoL-C, and the 36-item short form health survey (SF-36), Goligher classification, and Giordano severity of hemorrhoid symptom questionnaire (GSQ) were used to conduct a questionnaire survey on 760 hemorrhoid patients in the anorectal department of six hospitals. The data was analyzed for reliability and validity using SPSS 21.0 and AMOS 26.0 software.Results:The Cronbach's α coefficient of HF-QoL-C and its dimension ranged from 0.831 to 0.960, and the split coefficient was 0.832-0.915. Four common factors were extracted through principal component exploratory factor analysis. Confirmatory factor analysis indicated acceptable structural validity( χ2/ df=8.152, RSMEA=0.097, CFI=0.881, IFI=0.881, NFI=0.867). HF-QoL-C was correlated with SF36 and GSQ( r=-0.694, 0.501, both P<0.01). There were differences in the total score and dimensional scores of HF-QoL-C between surgical and drug treated patients, different grades of Goligher classification for hemorrhoidal disease, and different ranges of hemorrhoid prolapse (all P<0.001). No ceiling effect was found in the total score and the scores of each dimension(0.3%-2.0%). There was a floor effect in both psychological function and sexual activity dimensions (16.7%, 35.1%). Conclusion:HF-QoL-C has good reliability and validity, which can be used to measure the quality of life of Chinese hemorrhoid patients.