This article suggests that doctors should keep the principle that patients’interest should be the first and respect the autonomy of pregnant woman during the prenatal diagnosis and intervention,and brings the ethical concept of fetus as a patient.Before prenatal diagnosis and intervention,doctors should tell the pregnant woman about the advantages and disadvantages of the project for her to make decision.For the fetus born with deformity but still having survival ability,fetal ethical principle prohibits against termination unless pregnant woman has diseases not permitting to continue pregnancy,although there is an increasing risk of morbidity and mortality.

With the development and universal use of sonographic technique,prenatal ultrasonography has become an essential part of prenatal diagnosis.The doctor-patient contradicts and medial tangles occur more due to safety and limitation of prenatal ultrasonography.This article puts forward some relevant policies to resolve the doctor-patient contradicts and medial tangles via analysing relative factors and ethical problems.

Objective To analyze MRI features of tuberculosis of spinal vertebra, spinal meninges and spinal cord. Methods Fifty cases with tuberculosis of spinal vertebra, spinal meninges or spinal cord confirmed by clinical and pathological evaluation were collected in this study. Findings of plain and Gd-DTPA enhanced MRI were retrospectively reviewed. Results In 40 patients with spinal vertebra tuberculosis, there were 137 involved vertebrae, 52 involved intervertebral discs, 30 peri-vertebra cold abscesses, 23 intraspinal abscesses and compression of spinal cord, 29 athological fractures, 12 posterior process of spinal columns, 2 involved appendix. There were 4 cases of spinal meninges tuberculosis, 4 of tuberculous myelitis and 2 combination of tuberculosis of spinal meninges and spinal column. Conclusion MRI, especially the contrast MRI, could accurately and early demonstrate the morphological and pathological changes of tuberculosis of spinal vertebra, spinal meninges and spinal cord.

Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis of fetal truncus artery. Methods Retrospective analysis was made in 10 cases with fetal truncus artery for their fetal echocardiography and follow-up findings. Echocardiographic characteristics was summed up in various fetal heart views. Results Truncus artery was confirmed by autopsy in 7 fetuses,and 3 cases were correspondingly verified by postnatal echocardiography. Echocardiographic characteristic images of fetal truncus artery was larger ventricular septal defect, only 1 great artery arising from heart, and pulmonary artery arising from truncus artery. Conclusions Echocardiography has important value in accurate diagnosis of fetal truncus artery and caution should be paid in differential diagnosis with other fetal complicated congenital heart diseases.

Objective To investigate the changes in myocardial deformation in donor and reeipient hearts in response to selective fetoscopic laser photocoagulation (SFLP) for twin-twin transfusion syndrome (TTTS).Methods Totally 25 twin pairs before 24-hour and 1 week after SFLP had fetal echocardiography and digital dynamic two-dimensional four chamber views which were interrogated off-line using velocity vector imaging (VVI) software.Global longitudinal strain (S),systolic strain rate (SRs) and diastolic strain rate (SRd) were measured off-line in the left (LV) and right (RV) ventricles.Results In the donor,SFLP resulted in increase in cardiothoracic ratio ( CTR,0.29 ± 0.03 versus 0.34 ± 0.05,P ＜ 0.01 ),with development of new onset tricupid regurgitation ( n =7 ) and pericardial effusion ( n =5 ) and worsening of all measures of myocardial deformation in both systole and diastole for LV and RV [ LV-S:( - 19.24 ± 3.68 )％ versus (-13.78±3.64)％,P＜0.01; LV-SRs:(-2.28±0.53) versus (-1.43 ±0.41) s-1,P＜ 0.01 ; LV-SRd:( 1.67 ± 0.43 ) versus ( 1.15 ± 0.70) s - 1,P ＜ 0.01 ; RV-S:( - 20.20 ± 3.19) ％ versus (-16.10±3.07)％,P＜0.01; RV-SRs:(-2.03 ±0.65) versus (-1.72±0.38) s-1,P＜0.05; RV-SRd:( 1.71 ±0.30) versus ( 1.50 ±0.36) s-1,P ＜0.05].In the recipient,CTR decreased (0.42 ± 0.04 versus 0.37 ±0.04,P ＜0.01 ) and all parameters for both LV and RV improved substantially [ LV-S:( - 10.62 ± 2.72) ％ versus ( - 16.46 ± 3.23 ) ％,LV-SRs:( - 1.09 ± 0.30) versus ( - 1.60 ± 0.31 ) s-1,LV-SRd:(0.99 ± 0.34) versus (1.53 ± 0.32) s-1,RV-S:( - 11.66 ± 4.56)％ versus ( - 17.96 ± 3.97 ) ％,RV-SRs:( - 1.26 ± 0.39) versus ( - 1.74 ± 0.45 ) s-1,RV-SRd:( 1.15 ± 0.49) versus ( 1.63 ± 0.44 ) s- 1 ; all P ＜ 0.01 ].Conclusion Myocardial deformational mechanics improve in the recipient but worsen in the donor following SFLP for TTTS.

Objective To investigate the clinical significance of Doppler flow waveform of ductus venosus (DV) in screening of fetal cardiac malformation.Methods Color Doppler ultrasonography was used to study DV flow in 240 normal fetuses and 20 fetuses with cardiac malformation that were screened out from the high-risk fetuses with congenital heart disease (CHD).Results ① The normal Doppler flow waveform of the DV was a characteristic triphasic pattern with forward flow during cardiac cycle,reflecting ventricular systole (S),ventricular diastole (D) and atrial systole (A).② In the group of 20 fetuses with cardiac malformation,eight had reverse flow and nine had decreased or absent flow during atrial contraction,the indices of the DV in fetuses with cardiac malformation were higher than those in gestational age-matched normal fetuses ( P

Objective To describe the diagnostic approach and clinical outcomes of fetal intraabdominal extralobar pulmonary sequestration (IEPS).Methods Three cases of IEPS were diagnosed prenatally by ultrasound in our center.The data of these 3 cases and 43 cases in prior studies from 1986 to 2016 were retrospectively reviewed.The prenatal sonographic features,treatment,and outcomes were collected.Results The gestational age of diagnosis IEPS was (24.5±5.9)weeks,the male-to-female ratio was 3-4∶1,78.3% (36/46) of IEPS masses located on the left side,47.8% (22/46) of lesions were homogenous and hyperechoic,8.7% (4/46) of cases associated anomalies,78.3% (36/46) of patients were preformed resection and postoperative recovery and subsequent course were uncomplicated.Feeding arteries were detected in 15.2% (7/46) cases and confirmed by surgery or autopsy.Conclusions Prenatal ultrasound has the diagnostic accuracy of IEPS.Feeding arteries noted on color Doppler are strongly indicators of IEPS.Postsurgical outcomes are favorable.

A total of 120 patients with Ⅲ/Ⅳ degree hemorrhoids were randomly divided into 3 groups.Self-made drainage(A group),traditional device(B group)and stuffing(C group) were used at the end of operation.The patient postoperative complications and satisfaction were observed and compared.The results showed that postoperative abdominal distension,pain,medical dressing dampness and satisfaction were better in A group than those in B and C groups(all P ＜0.01).Postoperative abdominal distention in B group was lighter than that in C group and medical dressing dampness less in C group than that in B group (all P ＜ 0.01).Thus the self-made drainage device may reduce the levels of postoperative abdominal distension,pain and medical dressing dampness and increase postoperative patient satisfaction.

Objective:To assess effect of age on the characteristic of letf ventricular (LV) twist-displacement loop in health volunteers by velocity vector imaging (VVI) and to provide a new method for LV function evaluation in clinic.
Methods:Atfer obtaining basal and apical LV short-axis images in 98 healthy volunteers (18-75 years old) by 2-dimensional echocardiography, we use VVI sotfware to analysis LV twist motion and radial displacement at each plane off-line. hTe peak LV twist (Ptw), the peak untwist velocity (PutwV), the proportion of untwist in isovolumetric relaxation period (Iutw%) and LV radial displacement (Dis) were measured and calculated. Then we constructed LV twist-displacement loop and compared the characteristic of them among different groups.
Results:Ptw increased gradually with the increase in age. The biggest PutwV was in the group of 30-60 years old. Iutw%increased gradually before 60 years old, then decreased atfer that. Dis was not obviously different among the three groups. hTe characteristic of LV twist-displacement loop was like the configuration of 8. There was a linear relation between twist and displacement during systole, and the slope increased gradually with the increase in age. During early diastole, the relatively small radial expanding displacement displayed with untwisting, resulting in a much steeper twist-displacement relationship curve occurred in each group, which was getting smooth gradually when the radial expanding displacement increased during mid to late diastole.
Conclusions:VVI can be used to effectively and noninvasively assess LV twist-displacement loop with change in age and provide important information for LV function. hTe effect of age must take into account when evaluate the LV function by the twist-displacement loop.