Objective To compare the sonographic and pathologic features of calcified and non-calcified ductal carcinoma in situ DCIS Methods A total of 83 lesions in 82 consecutive patients with pathologically confirmed pure DCIS were recruited One patient had bilateral lesions All lesions were divided into calcified DCIS and non-calcified DCIS according to the presence of calcifications on mammography Their sonographic features and pathologic reports for all patients with DCIS were retrospectively reviewed Statistical comparisons were performed using the chi-square test Results 1 Calcified DCIS showed positive ultrasound US findings in 80% 44 55 of cases The most common US finding was nonmass lesions 43 6% 24 55 Nine cases had pure ductal dilatations 16 4% 9 55 Non-calcified DCIS showed positive US findings in 96 4% 27 28 of cases The most common US finding was mass 89 2% 25 28 Two cases had pure ductal dilatations 7 1 % 2 28 No significant difference was found in the shape margin orientation posterior feature of a mass between the calcified and non-calcified groups P >0 05 Significant difference was observed in the size boundary echogenicity on ultrasound of the two groups P <0 05 2 At histopathology the pathological scores high nuclear grade positive ER status positive PR status positive Ki67 status and the presence of Her-2 neu oncogene were more common in the calcified group than in the non-calcified group Conclusions Calcified and non-calcified pure DCIS have different pathologic and sonographic features Calcified DCIS has more aggressive histological features than non-calcified DCIS.

Objective To study the factors which affect the preparation of compound lobelia gel and establish the optimal preparation process. Methods Based on single factor test, formability, spread performance, stability were used as comprehensive evaluation indicators to select the preparation process by orthogonal design, taking the dosage of carbopol-940, drug loading, 5% hydroxy ethyl benzene ethanol solution and triethanolamine as factors.The content of scutellarin in gel was determined by HPLC.Results The best prescription of compound lobelia gel was as follows: substrat of carbopol-940 was 0.25 g, 10% Azone for promoting the permeability was 2 g, pH regulator of triethanolamine was 1.0 g, moisturizer of glycerol was 0.4 g; preservatives of 5% ethylparaben ethanol solution was 0.3 g; the drug loading was 1 g processed herbs per 1 g gel. Conclusion The preparation process of compound lobelia gel is simple, the product is texture and delicate stable.

Botulism ; therapy ; Child ; Female ; Humans ; Respiration, Artificial

Objective To evaluate the performance of bone suppression images on the detection of lung nodules in comparison with the radiologists'reading results.Methods There were 141 standard posteroanterior digital chest radiographs,which included 95 patients with a solitary nodule and 46 controls.In this observational study,4 observers,including 2 radiologists and 2 residents,in-dicated their confidence level regarding the presence of a nodule for each lung,first by use of standard images,then with the addition of bone suppression images.Receiver operating characteristic (ROC)curve analysis was used to evaluate the observers'performance. Results Average nodule size was (1.9±1)cm (range from 0.9 cm to 2.9 cm).The mean value of the area under the ROC curve (AUC)was significantly improved from 0.844 with use of standard images alone to 0.873 with use of bone suppression images (P<0.01).Conclusion The use of bone suppression images can improve radiologists'performance on detection of lung nodules on chest radiographs.

Objective To evaluate the effect of CT temporal subtraction(TS) for detection of lung nodules.Methods 80 cases of CT images (current and previous CT images) and corresponding CT TS images were presented, which included 30 cases with nodules(75 nodules) and 50 controls.4 observers, including 2 radiologists and 2 residents, indicated their confidence level regarding the presence of a new emerging or larger or solid component than before,which first used standard CT images, then with the addition of CT TS images.Receiver operating characteristic(ROC) curve analysis was used to evaluate the observers'' performance.Results The mean value of the area under the ROC curve (AUC) were 0.860 and 0.925 for four observers without and with TS images,respectively(P<0.01).Average sensitivity for detection of lung nodules was improved from 77.3%(58/75) to 89.3%(67/75) by using CT TS images.Conclusion The use of CT TS images can significantly improve radiologists'' performance for detection of lung nodules,especially when a small size solid or subsolid nodule presents near the pulmonary hilum.CT TS is more helpful for residents.

Objective To analysis the clinical outcome at discharge and its risk factors of extremely preterm infants.Method To retrospectively analysis the clinical outcome at discharge and it's risk factors of extremely preterm infants (less than 28 weeks gestation) admitted from September 2008 to August 2014 in our Hospital.Result A total of 179 cases were enrolled.Survival rate was 59.2％ (106/179).Unfavorable outcome rate was 74.3％ (133/179),among them 73 cases died.The top five causes of death were severe bronchopulmonary dysplasia (BPD) (28 cases),Ⅲ ～ Ⅳ o intraventricular hemorrhage (IVH) (19 cases),sepsis (16 cases) and necrotizing enterocolitis (NEC) (6 cases).Among the 60 survivals with unfavorable outcomes,35 cases had either severe neurologic or ophthalmological sequela,and 25 cases had severe pulmonary sequela.Univariate analysis showed that,comparing with improved group,unfavorable outcome group had higher rates of not receiving prenatal steroids,placental abruption,male,small for gestation age,resuscitation with chest compression,admission age older than 72 hour,severe respiratory distress syndrome (RDS),without pulmonary surfactant (PS) usage,mechanical ventilation beyond 2 weeks and sepsis (P ＜ 0.05).Logistic regression analysis showed that those without prenatal steroids (OR =9.402,P =0.002),small for gestational age (OR =8.271,P =0.018),resuscitation with chest compression (OR =6.325,P =0.023),admission age older than 72 hour (OR =4.174,P =0.028) were independent risk factors for unfavorable outcome of extremely premature at discharge.Conclusion Extremely preterm infants have a higher rate of unfavorable outcome at discharge.Avoid small for gestational age,transfer properly and in time both in utero and after birth,and conduct prenatal steroids could improve their clinical outcome at discharge.

Serum folate and vitamin B12 were measured in 171 healthy children under 14 years of age, 30 normal adults and 30 samples of normal cord blood. All the 171 children had been supplied with adequate folic acid and vitamin B12 before measurements. The results -were: 1. The lower limits of normal serum folate values were 6.1 nmol/L under 4 years, 8.4 nmol/L at age of 4-14 years and 5.0 nmol/L in adults. 2. The lower limits of normal serum vitamin B12 values were 459 pmol/L under 1 year and 107 pmol/L at age of 1 year to adults.

OBJECTIVE:To provide references for the application and management of anti-infectives.METHODS:Data on sale volume,DDDs etc.of anti-infection drugs in6hospitals of Guang'an city from2001to2004were statistically analyzed.RESULTS:The DDDs of oral lomefloxacin dominated the first or2nd places for the4years;The DDDs rank orders of isoniazid and rifampin were No.4and No.5respectively in the4years;The DDDs of penicillin for injection dominated the first place on the injectable preparation lists(2001～2003);The latecomer levofloxacin assumed the tendency of surpassing the early starters not only in sale volume but also the DDDs.CONCLUSION:The proportion for anti-infectives in sales volume to the sum total drug consumption of the above mentioned area were close to those of the other medical institutions in southwest area,there are less new drug varieties and the grade of drugs used in the area was low.

Objective To summarize and analyze prenatal ultrasound and postnatal autopsy ifndings in fetuses with urorectal septum malformation sequence (URSMS). Methods An analysis of prenatal ultrsound ifndings and postnatal autopsy features was performed on eleven cases of fetuses with URSMS that were identiifed by ultrasonography at Shenzhen Maternity&Child Healthcare Hospital in the period of January 2003 to December 2012. Results Prenatal ultrasonography showed a large abdominal cystic mass concomitant with imperforate anus in eleven fetuses with URSMS. The cyst contained unilocular or bilocular cystic structures in two fetuses, and trilocular cystic structures in nine fetuses. The cyst was demonstrated as clear acoustic transmission in three fetuses and unclear in eight fetuses. Out of them, seven fetuses had kidney abnormalities, six had ascites, and three had enterolithiasis. The associated systemic abnormalities included tethered cord in two fetuses, single umbilical artery in two fetuses, sacrococcygeal dysplasia in one fetus, and myocardial noncompaction in one fetus. 21-trisomy was found in one fetus by chromosome examination. Eleven cases were all identiifed as female fetuses by autopsy ifndings, including a single perineal opening and ambiguous genitalia with clitoral hypertrophy and labial fusion. The internal genital abnormalities included double vagina or longitudinal vaginal septum in nine fetuses, double uterus or uterus bicornis in ten fetuses and vaginal dysplasia in one fetus. Conclusions URSMS is a complex congenital malformation, which includes abnormalities of the urinary system, reproductive system and gastrointestinal track. An abdominal cystic mass visualized by prenatal ultrasonography might be the distinctive lesion in female with URSMS, and have an important diagnostic value. The kidney abnormalities and ambiguous genitalia can contribute to the diagnosis of URSMS.

ObjectiveTo summarize prenatal ultrasound image features of Cantrell′s syndrome (Cantrell′s pentalogy).MethodsFrom January 2007 to December 2013 in Shenzhen Maternity & Child Healthcare Hospital, there were twenty cases diagnosed and conifrmed by postmortem as Cantrell′s syndrome. The prenatal ultrasound image features and outcomes were analyzed.ResultsAmong the twenty cases, eighteen were singleton and two were twins with the other normal fetus. Prenatal ultrasound image: two obvious ultrasound image features of ectopic heart and hight omphalocele (seventeen cases) or gastroschisis (three cases) were appeared in prenatal ultrasound of twenty cases. Fourteen cases were complete ectopic heart (Ectopic heart was located within the omphalocele in one case, ectopic heart was completely exposed in amniotic lfuid in thirteen cases), six cases were incomplete ectopic heart, three cases were ventricular septal defect in which one was associated with pulmonary stenosis, two cases were single atrium and single ventricle in which one was associated with a single arterial trunk, one case was tetralogy of Fallot, and six cases were without signiifcant heart abnormalities. Associated with other abnormalities: seventeen cases were associated with other abnormalities in twenty cases, in which eleven cases were spinal abnormalities, nine cases were umbilical cord abnormalities (short umbilical cord in six cases, single umbilical artery in two cases, short umbilical cord associated with single umbilical artery in one case), ifve cases were neurological abnormalities (exencephalia in four cases, encephalocele in one case), four cases were limb abnormalities, three cases were cheilopalatognathus, one case was giant bladder. Three cases weren′t associated with other abnormalities. Nuchal Translucency: in eight cases, nuchal translucency were measured in early pregnancy. Nuchal translucency of ifve cases were thick, one case was cervical hygroma in one of the two twins. Chromosome examination results: only three cases had chromosome examination in twenty cases, in which one case was trisomy 21, another two were chromosome normal. Fetal outcome and examination results: in twenty cases, one of the two twins can′t survive after birth, and the other one of two twins was reduced in intrauterine, so the specimen could not be obtained. Eighteen cases of singleton underwent labor induction. The results of postmortem appearance (nineteen cases) and autopsies (ifve cases) were all consistent with prenatal ultrasound scan.ConclusionsEctopic heart and hight omphalocele or gastroschisis appearing at the same time was the characteristic of Cantrell′s syndrome in prenatal ultrasound and other abnormalities may be part of the Cantrell′s syndrome spectrum. It is beneift to detect and diagnose Cantrell′s syndrome by prenatal ultrasound in the ifrst trimester.