Objective To study the indications of percutaneous ultrasound-guided direct fetal blood sampling; the methods of fetal blood assessment; and the relationship between the different puncture techniques and the complications. Methods Direct fetal blood sampling were performed on 90 pregnant women whose gestational age were from 16 to 36 weeks for medical indications under the guide of ultrasound. None stress test were performed before and after the puncture. Ulrtrasonographies were done at 2 hours and 24 hours after the procedure. Results There were no severe maternal or fetal complications such as fetal loss and placental abruption. The incidence of bradycardia was 35.6%(32/90), all recovered within 60 seconds; the incidence of bradycardia happened within 4 hours after the puncture was 2.25(2/90). There was a positive relationship among the incidence of bradycardia, the volume of blood taken and the place of punctures,r=0.27 and 0.36 respectively. There was one case with placental changing happened after 2 hours of the puncture, the placenta changing incidence was 1.1%. No emergency cesarean section was done due to the complications of the procedure. All the umbilical cord were normal when the babies were born. Conclusions Direct fetal blood sampling is a safe technique for both fetus and the mother under the guide of real time ultrasound. The data come from fetal blood analysis give reliable informations about chromosome, congenital infections, the status of fetal metabolism, endocrine system and hematologic system directly, which make this technique unreplacable for intrauterine diagnosis.

Objective To analyze the hemodynamic characteristics in patients with iron deficiency anemia(IDA) using transcranial Doppler ultrasonography(TCD),and to discuss the diagnostic value of it.Methods There were 46 patients with IDA,among them 28 patients had moderate or severe anemia,and 18 patients had mild anemia.Hemodynamic changes in patients were observed with TCD,and compared with 40 case healthy controls. Results In addition to 3 case results of TCD were normal,the increase of velocity were found in the others patients.The cerenbral blood flow velocity of the moderate or severe anemia group were significantly higher than that of the mild anemia group(P<0.05),and these were significantly higher than that of the control group(P<0.01).The pulsatility index of the moderate or severe anemia group were significantly lower than that of the control group(P<0.01).2 case artery stenosis in 46 patients were found by TCD,there were 5 case with syncope in 46 patients.Conclusion The severness of anemia can be observed by the increased cerenbral blood flow velocities.TCD may be evaluat Effestiveness of blood flow,and TCD may be possible to raise the discover rate of artery stenosis in anemia.

Objective To evaluate the efficiency,safety and complication of transcatheter closure of large atrial septal defect (ASD) with Amplatzer occlusion device under the guidance of transthoracic echocardiography (TTE) Methods The study group consisted of 12 males and 9 females, age ranged from 17-45 years old, underwent transcatheter closure of ASD with Amplatzer occlusion device The diameter of ASD (balloon stretched diameter) was 30-36mm The Amplatzer occluder size was chosen to be 2-4 mm more than the balloon stretched diameter of ASD All cases were guided by TTE Results All cases were successfully treated under the guidance of TTE, the procedure successful rate was 100% No severe complication was observed except 1 patient with frequent atrial premature beats after procedure and disappeared 1 months later by drug Conclusion Transcatheter closure of ASD can be performed safty and effectively with Amplatzer occlusion device under the guidance of transthoracic echocardiography But it is necessary to perform TEE to examine the peri structure of ASD before procedure

Objective To study the compatibility and feasibility of construct tissue engineer bladder through biocompatibility of hair follicle stem cells (HFSCs) and heterogeneous bladder acellular matrix (BAM) in vitro and vivo.Methods The third-generation of rat HFSCs were cultured with the two-step enzymatic and different adhesion time method.The cells were identified by flow cytometry through detection expression of β1 integrin FITC-Conjugated.The New Zealand rabbit BAM were decellularized by the method of microdissection and chemical washing,and then examined by Masson staing and electron microscope to confirm no cell elements remained.The HFSCs of the rats were implanted in BAM and cultured for about 24 hours.Then the cells growth conditions on the material surface were examined by histology and scanning electron microscopy.The cells-scaffold composites were implanted in rats subcutaneously,samples and histological examination were harvested at 1,2 and 4 weeks after implantation.Results The BAM was white and translucent membranous.There were fiber network structures without cell elements remained under the examination of electron microscope.And the BAM prompted for collagen tissue composition under Masson staining,without significant residual cells.The growth condition of HFSCs beside the BAM was well that observed by inverted microscope at 48 h of co-culture.After 1 week the HFSCs extended and adhered to the matrix surface observed under the scanning electron microscope.No significant inflammatory response in rat subcutaneous implantation experiments,the single-layer cell structure in histological examination could be seen after 1 week,and multi-layer cell structure in histological examination could be seen after 4 weeks of implantation.Conclusion The biocompatibility of HFSCs and heterogeneous BAM is good,which provides a good experiment support for HFSCs to repair the bladder defects disease.

Objective To investigate the hemodynamic changes of contralateral vertebral arteries with transcranial Doppler (TCD)in patients with subclavian artery steal syndrome. Methods Forty-five outpatients or inpatients with subclavian artery stenosis or occlusion confirmed by TCD and color Doppler flow imaging (CDFI)and treated at Baoan District Center Hospital of Shenzhen from March 2012 to April 2015 were analyzed retrospectively. According to the TCD detection,the degrees of intracranial arterial steal were divided into 4 groups:non-blood steal (n=8 ),blood steal phase Ⅰ(n=21 ),phase Ⅱ(n=11 ), and phase Ⅲ(n =5 );45 healthy subjects from Baoan District Central Hospital were used as a control group. The contralateral vertebral artery hemodynamic indexes of each blood steal group were detected respectively,and they were compared with the control group. Results Of the patients without blood steal,6 patients had mild subclavian artery stenosis,2 had moderate stenosis;of the patients with phase I blood steal,12 had mild subclavian artery stenosis,9 had moderate stenosis;of the patients with phaseⅡblood steal,3 had moderate subclavian artery stenosis,7 had severe stenosis,and 1 had occlusion;of the patients with phase Ⅲ blood steal,3 had severe subclavian artery stenosis,2 had occlusion. The degree of blood steal was positively correlated with the lesion degree of subclavian artery stenosis (r=0. 78, P<0. 05). TCD findings revealed that the contralateral vertebral artery systolic blood flow velocities in patients with phase Ⅰ,Ⅱ,andⅢsteal groups were 70 ± 23,85 ± 30,and 104 ± 32 cm/s,respectively;their mean flow velocities were 39 ± 10,46 ± 16,and 54 ± 17 cm/s,respectively;their pulsatility indexes were 1. 17 ± 0. 20,1. 27 ± 0. 31,and 1. 43 ± 0. 36,respectively,and they were all significantly higher than 49 ± 9,34 ± 7,and 0. 66 ± 0. 08 cm/s of the control group (all P<0. 01),and 50 ± 11,34 ± 10,and0.68±0.12cm/s of the non-blood steal group (all P<0.01),and there were significant differences among the steal blood groups in each phase (all P <0. 01 ). Conclusion Detecting the hemodynamic indexes of contralateral vertebral arteries using TCD can preliminaryly assess the subclavian artery lesions and their steal degree.

Objective To evaluate the biomechanical effect of cortical screw support technique in fixation of the femoral neck fractures. Methods The models of subcapital femoral neck fracture were made in eight matched pairs of embamled cadaver femurs and decided into experiment group and control group (four pairs per group). The side of experiment group was fixed using three cannulated compression screws with cortical screw support and that of control group with conventional screw placement. The speci-mens in two groups were tested in aspects of torsion and axial loading. Results In axial load test at load of 600 N and 800 N, the displacements in cortical screw support group were (0.677±0.135) mm and (0.907±0.132) mm respectively, while those of femoral head in conventional screw placement group were (0.899±0.160) mm and (1.202±0.152) nun respectively (P <0.05). There was signifi-cant difference between the two groups (P < 0.05). The maximal vertical loading for failure of the fixa-tion was (2 782±228) N in cortical screw support group and (1 950±281) N in conventional screw placement group (P < 0.01). In torsibility test at 4° and 6° torsibility, the torque-moments of cortical screw support group were (10.406±1.515) Nm and (15.328 ±1.471) Nm respectively and those of conventional screw placement group (6.628±1.163) Nm and (9.072±1.570) Nm respectively, with statistical difference between two groups (P <0.01). The maximal torque-moment for failure of the fixa-tion was (25.437±5.213) Nm in cortical screw support group and (13.235±3.012) Nm in conven-tional screw placement group (P < 0.01). Conclusion Fixation of femoral neck fractures by using cortical screw support can significantly enhance anti-torsion and anti-compression of internal fixation.

Objective To observe the effect of ulinastatin on tumor necrosis factor(TNF-α)and interleukin-6(IL-6)in radiation-induced lung injury.Methods Severity-two female SD rats were randomly divided into 3 groups as control group,irradiation group and treatment group(administered with Ulinastatin).Rats in irradiation group and treatment group were irradiated with linear accelerator at a single dose of 25 Gy.After irradiation rats in treatment group were injected daily with ulinastatin at a dose of 100000 U-kg-1·d-1 for 7 days through caudal vein while rats in control group and irradiation group were injected with the same volume of saline.Rats were killed at 2 h,4,8 and 24 weeks.Samples of lung tissues were observed by using HE staining.Expression of TNF-α in lung was determined by Western blot and expression of IL-6 in serum was determined by ELISA.Data were analyzed by SPSS software.Results Expressions of TNF-α in lung and IL-6 in serum increased significantly after irradiated in irradiation group compared with control group,and it reached the peak at 4 weeks(q=5.63、6.21,P＜0.01).Though expressions of TNF-α and IL-6 in ffeatment group also increased compared with control group,the difference between irradiation group and treatment group was statistic significantly(q=4.97、7.42,P＜0.01).Conclusions TNF-α and IL-6 play an important role in radiation-induced lung injury.Ulinastatin could suppress the inflammatory response and radiation-induced lung injury effectively by decreasing the levels of TNF-α and IL-6.

Huazhong University of Science and Technology is one of the five schools that trial implementing eight-year program medical education of first batch.Eight-year program medical students in Tongji college came into obstetrics and gynecology clinical contact in 2010.According to the characteristics of students and discipline,obstetrics and gynecology department used multiple teaching methods and means as PBL teaching,integrated case management,typical clinical case conference,clinical diagnosis and treatment,academic lecture,research report,experimental design,scientific research and experi-ment,etc.Available practice mode was reformed.Those students accomplished clinical practice,and achieved expected effect.

Objective To study the changes of the thyroid hormones leval of human fetus and newborans Methods More than 71 cases of medically indicated cordocentesis have been done in 16 36 gestational weeks in our hospital during last three years. Among them, 71 fetus who were free of diseases and their maternal thyroid function were normal were included into the study group. The blood samples were sent to analysis of thyroxine (T 4), triiodothyroxine (T 3), free thyroxine (FT 4), free triiodothyroxine (FT 3) and thyrotropin (TSH). 140 umbilical cord blood samples taken at the time of term delivery were sent to analysis of FT 4,FT 3 and TSH as a control. Normal range of different gestational weeks was calculated. Statistical analysis was done for the changes of all these thyroid hormones before 28 weeks and after Results All the thyroid hormones can be detected in 16 weeks of pregnancy,FT 4 already reaches the top level of adults (5.8?2.6) pmol/L and will continually increase with the increase of gestational age. There was a parallel increment of all the fetal thyroid hormone concentrations with the gestational age. The concentrations of T 4,T 3 and FT 4 have a rapidly increase after 28 weeks and have a statistically significant difference from (2.8 ?1.8) nmol/L, (37.2?27.2) nmol/L and (10.6?3.1) pmol/L,respectively to (5.8?2.6) nmol/L, (55.9?33.3) nmol/L,( 13.0?4.5) pmol/L, respectively. TSH level of fetus was increased gradually along the gestation, reaching the up level of the adults at the 20 weeks and peaking at the birth time. While the T 3 and FT 3 keep in a lower level in gestation Conclusions Fetal thyroid hormones increase with the gestational age.The diagnosis of congenital fetal thyroid hormone malfunction in the second half of the pregnancy should be monitored mainly by the T 4, FT 4 and TSH levels in different gestational age. For this consideration, to set up a reliable data for normal human fetus thyroid hormone concentrations is a very important and essential step to provide a practical guide for doctors to do intra uterine diagnosis and treatment of associated high risk groups. The peaking level of TSH at the birth time will surely company the changing of other thyroid hormones, so it might not be the best time to screening the congenital thyroid malfunction at the 72 hours after birth.

Objective To explore clinical value of the color Doppler ultrasonic(CDU)and TNM staging of renal cell carcinoma.Methods 265 cases of renal cell carcinoma(RCC)confirmed by surgical pathology were retro-spectively analyzed.According to the WHO 2004 pathological types of classification standards and the American Joint Committee on Cancer(AJCC)cancer staging manual/6th TNMstaging criteria.The analyzed application of a CDFI to TNMstaging of renal cell carcinoma,and surgical pathology results werecompared.Results 265 cases of RCC and right kidney in 136 cases,129 cases of left kidney;Diameter of 1.5 -12.8cm;Pathological diagnosis of renal clear cell carcinoma in 226 cases(85.28%),28 cases of papillary renal cell carcinoma(10.57%),renal too color cell car-cinoma in 5 cases(1.89%),4 cases of multilocular cystic renal cell carcinoma(1.51%),Bellini duct carcinoma in 2 cases(0.75%).Diagnosis results of CDU and pathological in 250 cases(94.34%),CDU misdiagnosis leakage 15 cases(5.66%).Within the kidney showed low echo or high echo,and mixed echo lumps,and invasive growth to the surrounding tissues or organs sign for it.CDU showed the various blood flow signals were given priority to with renal clear cell carcinoma;CDU and surgical pathology TNMstaging coincidence rate was 90.40%(226 /250),inclu-ding T1 N0 -1 M0 ,T2 N0 -1 M0 ,T3 N0 -2 M0 -1 and T4 N0 -2 M0 -1 of coincidence rate were 92.12%(152 /165),85.71%(36 /42),82.14%(23 /28)and 100.00%(15 /15).Conclusion CDU can be used as the preferred method of diag-nosis and evaluation of renal cell carcinoma,which can can provide valuable information for TNMstaging.