PurposeTo explore the value of prenatal ultrasound diagnosis of pentalogy of Cantrell.Materials and Methods A retrospective study was performed in 6 fetuses with pentalogy of Cantrell diagnosed with prenatal ultrasound. The first diagnostic ultrasound time, ultrasound images and follow-up results were reviewed to analyze ultrasonographic features.Results All the fetuses were characterized by omphalocele and ectopic heart. All 6 fetuses were diagnosed by prenatal ultrasound during the first ultrasound screening, of which 5 were diagnosed before 16 weeks of gestation. Five cases were confirmed with induced labor and 1 was confirmed postnataly. The accuracy of prenatal ultrasonic diagnosis was 100%.Conclusion The characteristic features of pentalogy of Cantrell are omphalocele and ectopic heart. Prenatal ultrasound is reliable and valuable to diagnose pentalogy of Cantrell.

Objective To investigate the related factors of clinical incidence and the ultrasound diagnostic value of endometrial polyps (EMP).Methods A total of 278 patients with clinical abnormal vaginal bleeding,menorrhagia,infertility,cervical polyps or physical examination showing EMP received vaginal ultrasound and hysteroscopy.The related clinical factors were recorded and single factors and multivariate unconditional Logistic regression analysis were carried.Results The univariate analysis showed that the number of pregnancy,menopause,placing intrauterine device,oral comtraceptives,history of hormone therapy,chronic endometritis,cervical polyp,merger endometriosis and obesity were the statistically significant factors of EMP incidence (P ＜ 0.05 or ＜ 0.01),which were used as dependent variables for multivariate Logistic regression analysis,indicating that menopause,chronic endometritis,history of hormone therapy and cervical polyp significantly affecting EMP incidence (P ＜ 0.05),with OR values of 4.068,4.122,3.770 and 3.983 respectively.Conclusion Menopause,chronic endometritis,history of hormone therapy,cervical polyps are the related risk factors of EMP.

OBJECTIVETo investigate the relationship between fetal lateral ventriculomegaly and chromosomal microarray analysis (CMA) abnormalities.

METHODSFifty fetuses with lateral ventriculomegaly detected by ultrasound and a normal karyotype were included. Forty four fetuses were classified as mild ventriculomegaly (MVM), in which the lateral ventricular atrium was 10-15 mm. Six had severe ventriculomegaly (SVM), with the lateral ventricularatrium being ≥ 15 mm. The fetuses were also divided into isolated (n= 21) and non-isolated groups (n= 29) based on whether they are associated with other anomalies.

RESULTSThirteen (26%) of the fetuses were found to be abnormal by CMA. For the 44 cases with MVM, 9 (20.9% ) were found to be abnormal, while for the 6 cases with SMV, 4 (66.7%) were found to be abnormal (P>0.05). CMA abnormalities were found in 2 (9.5%) of the 21 fetuses with isolated ventriculomegaly group and 11 (37.9%) of the 29 fetuses with non-isolated ventriculomegaly group (P<0.05).

CONCLUSIONChromosome microdeletions and microduplications are the most common abnormalities found in fetal lateral ventriculomegaly. When ventriculomegaly is associated with other anomalies, the incidence of CMA abnormally is much higher. Prenatal diagnosis is necessary for fetuses with lateral ventriculomegaly.

Adult ; Chromosome Aberrations ; Chromosome Deletion ; Chromosome Duplication ; Female ; Gestational Age ; Humans ; Hydrocephalus ; diagnosis ; diagnostic imaging ; genetics ; Lateral Ventricles ; abnormalities ; diagnostic imaging ; metabolism ; Microarray Analysis ; methods ; Pregnancy ; Reproducibility of Results ; Sensitivity and Specificity ; Ultrasonography, Prenatal ; methods ; Young Adult

ObjectiveTo observe the effects of Guben Fangxiao decoction-containing serum on the expression of transcription factors and cytokines associated with calcitonin gene-related peptide （CGRP）， γ-aminobutyric acid （GABA）， and type Ⅱ innate lymphoid cells （ILC2） in human bronchial epithelial cells （BEAS-2B） stimulated with interleukin-4 （IL-4） combined with interleukin-13 （IL-13）， and explore the possible mechanism of Guben Fangxiao decoction-containing serum in alleviating type Ⅱ inflammation of bronchial epithelial cells. MethodsBEAS-2B cells stimulated with IL-4 combined with IL-13 were treated with the sera containing high （20%）， medium （15%）， and low （10%） doses of Guben Fangxiao decoction and the montelukast-containing serum （10%）. Real-time PCR was used to measure the mRNA levels of CGRP， GABA， mucin 5AC （MUC5AC）， thymic stromal lymphopoietin （TSLP）， interleukin （IL）-25， IL-33， IL-5， GATA-binding protein 3 （GATA3）， and B cell lymphoma/leukemia 11B （Bcl-11B） in each group. Western blot was employed to determine the relative protein levels of CGRP and MUC5AC. The immunofluorescence assay was employed to observe the relative expression of CGRP and GABA in the cells. Enzyme-linked immunosorbent assay was used to quantify the protein levels of IL-33， MUC5AC， and IL-5 in the culture and cell supernatants. Periodic acid-Schiff staining was performed to assess mucin secretion. ResultsCompared with the control group， the model group showed up-regulated mRNA levels of CGRP， GABA， MUC5AC， TSLP， IL-25， and IL-33 （P<0.05， P<0.01）. Compared with the normal group， the Guben Fangxiao decoction-containing serum down-regulated the mRNA levels of CGRP， GABA， MUC5AC， IL-5， GATA3， and Bcl-11B （P<0.05， P<0.01） in a dose-dependent manner. Compared with the normal group， the model group showed up-regulated protein levels of CGRP， GABA， MUC5AC， IL-33， and IL-5 （P<0.05， P<0.01）， which were down-regulated by the Guben Fangxiao decoction-containing serum （P<0.05， P<0.01）. Compared with the normal group， the model group showed enhanced average fluorescence intensity of CGRP and GABA （P<0.01）， which was weakened by the Guben Fangxiao decoction-containing serum （P<0.01）. Compared with the normal group， the model group showed increased secretion of mucin， which was reduced by the Guben Fangxiao decoction-containing serum. ConclusionGuben Fangxiao decoction can treat bronchial asthma by alleviating type Ⅱ immune airway inflammation and reducing airway mucus secretion， which is achieved by regulating the expression of CGRP， GABA， MUC5AC， and ILC2-related transcription factors.

Objective:To construct the delirium prevention nursing program in ICU children and explore its clinical effect.Methods:The literature analysis and expert meeting method were used to construct the delirium prevention nursing program in ICU children. Using the convenient sampling method, a total of 315 ICU children who were admitted to Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from February to July 2020 were selected as the control group and 309 ICU children admitted from August 2020 to January 2021 were selected as the experimental group. The control group adopted routine nursing, while the experimental group adopted delirium prevention nursing program in ICU children on the basis of routine nursing. The differences in the incidence of delirium, mechanical ventilation time, ICU stay and ICU costs were compared between the two groups.Results:After the intervention, the incidence of delirium in the experimental group was 15.9% (49/309) and the ICU stay was 4.0 (2.5, 7.0) days, which were lower than 29.2% (92/315) and 5.0 (3.0, 10.0) d in the control group, and the differences were statistically significant (χ 2=15.892, Z=-2.341; P<0.05) . Conclusions:The establishment and application of delirium prevention nursing program for ICU children can effectively reduce the incidence of delirium in ICU children and length of stay in ICU.

Objective:To explore the prognostic value of lymphocyte subsets in adult hemophagocytic syndrome (HPS).Methods:A total of 172 adult HPS patients diagnosed in 8 medical centers from January 2013 to August 2020 were selected for the study, of whom 87 were male (50.6%, 87/172), and 85 were female (49.4%, 85/172), with 68 survivors and 104 deaths. The clinical data were summarized, and variables such as lymphocyte subsets, immunoglobulin characteristics and fibrinogen were retrospectively analyzed, and the correlation between the mentioned variables and patient prognosis was analyzed. The optimal cut-off values of continuous variables were calculated by MaxStat, and the prognostic factors of HPS patients were screened based on the Cox proportional hazard regression model.Results:The median age of HPS patients was 56 (42, 66) years old, and the 5-year cumulative survival rate was 37.4% (37.4/100). The median age, platelet and albumin were 48 (27, 63) years, 84×10 9/L and 32.3 g/L in the survival group, and 59 years, 45.5×10 9/L, and 27.3 g/L in the death group, respectively. The differences between the two groups was statistically significant ( Z=?3.368, P=0.001; Z=?3.156, P=0.002; Z=?3.431, P=0.001). Patients with differentiated cluster 8+(CD8+)<11.1%, CD3+<64.9%, CD4+>51%, and CD4/CD8 ratio>2.18 had poor prognosis (χ 2=7.498, P=0.023; χ 2=4.169, P=0.041; χ 2=4.316, P=0.038; χ 2=9.372, P=0.002). Multivariable analysis showed that CD4/CD8 ratio, age, fibrinogen and hemoglobin were independent prognostic factors in HPS patients ( HR=2.435, P=0.027; HR=5.790, P<0.001; HR=0.432, P=0.018; HR=0.427, P=0.018). Conclusion:Peripheral blood lymphocyte subsets can be used to evaluate the prognosis of patients with HPS; CD4/CD8 ratio, age, fibrinogen, and hemoglobin are independent prognostic factors in HPS patients.