Objective To investigate the distribution of complications and the relationship with neurologic subtype and gross motor function in preterm infants with cerebral palsy (CP). Methods The type, grade of Gross Motor Function Classification System (GMFCS), intelligence,speech, ophthalmologic consultation, brainstem auditory evoked potential and electroencephalogram of 135 preterm infants with CP were reviewed. Results There were 284 complications in total, (2.10±1.33) per child, and was significantly different among various types of CP (F=5.50, P<0.001). The incidence of mental retardation and speech disorder was significant different among various types (P<0.05). The incidence of mental retardation, speech disorder, visual impairment and epilepsy increased significantly (P<0.05) in spastic quadriplegia infants,compared with those with diplegia and hemiplegia. The incidence of mental retardation, speech disorder, visual impairment and musculoskeletal disorder was significantly different (P<0.05) among various grades of GMFCS. The frequency of complications was more in children unable to walk (GMFCS Ⅳ~Ⅴ) than able to walk (GMFCS Ⅰ~Ⅲ) for children over 2 years old (t=70.05, P<0.001). Conclusion The incidence of mental retardation, speech disorder, visual and hearing impairment, secondary musculoskeletal disorder and the multiple disorders are related with neurologic subtype and/or the grade of GMFCS.

Objective To evaluate the role of three dimensional (3D) speckle tracking echocardiography (STE) in detection of subclinical left ventricular (LV) systolic dysfunction in patients with aortic stenosis (AS).Methods The study included 47 patients with AS and 50 age-matched healthy individuals.Conventional echocardiographic parameters were measures,and 3D Speckle tracking imaging of the peak systolic strain was recorded.Results Three-dimensional global longitudinal strain (3D-GLS) were significantly reduced in patients with AS compared to controls (P ＜ 0.01).Three-dimensional global circumferential strain (3D-GCS) were significantly increased (P ＜ 0.05).Three-dimensional global area strain (3D-GAS) and three-dimensional global radial strain (3D-GRS) were similar between two groups (P ＞0.05).Correlation analysis showed that |3D-GLS| was negatively correlated with left ventricular mass index (LVMI) (r =-0.59,P ＜0.05) irrespective of |3D-GAS|,|3D-GCS|,3D-GRS,and left ventricular ejection fraction (LVEF).Conclusions Patients with AS have evidence of subclinical LV systolic dysfunction despite preserved EF％.3D speckle tracking appears is useful in detection of subclinical LV dysfunction in patients with AS.

Objective To investigate the characteristics of vena cava connection in patients with asplenia syndrome diagnosed by ultrasound. Methods From October 2009 to February 2014, 49 patients with asplenia syndrome diagnosed in Fuwai Hospital by ultrasound were included in this study. The characteristics and percentage of varied types of anomalous connection of vena cava and pulmonary vena were analyzed. Results Thirty patients (61.2%) had bilateral superior vena cavies. In these cases, right vena cava was drainage into right atrium (or the right side of the single atrium), while left superior vena cava into left atrium (or the left side of the single atrium). For hepatic vein, drainage into inferior vena cava were found in 25 patients (53.2%), into left atrium (or the left single of the single atrium) in 1 patient (2.1%), into right atrium (or the right side of the single atrium) in 3 patients (6.3%), into both right and left atrium in 5 patients (10.2%) and into the middle of the single atrium in 1 patient (2.1%). For inferior vena cava, drainage into left atrium (or left side of the single atrium) were found in18 patients (36.2%), into right atrium (or right side of the single atrium) in 24 patients (51.1%) and into the middle of the single atrium in 1patient (2%). Total anomalous pulmonary venous drainage occurred in 20 patients (40.2%) and partially anomalous pulmonary venous drainage in 8 patients (16.3%). Conclusion Asplenia syndrome is frequently accompanied with anomalous vena cava and pulmonary venous drainage.

Objective To study the skills and effects of endoscopic retrograde appendicitis therapy (ERAT) in treating patients with uncomplicated acute appendicitis .Methods We enrolled 21 patients with suspected acute appendicitis who then underwent emergent ERAT between October 2014 and January 2015 .The data of treatment were collected and the operative skills and effects of ERAT were analyzed . Results ERAT was completed successfully in all the patients ,resulting in a success rate of 100% .Mean operation time of ERAT was (49 .7 ± 18 .2) min and mean hospital stay was (3 .3 ± 1 .6)d .Cannulation of the appendix lumen was the most critical step of ERAT ,and cannulation time [(5 .7 ± 4 .9)min , P< 0 .05] was shortened significantly by the use of LoopTip guidewire . Fourteen patients with intraluminal appendicoliths (7 of massive appendicoliths , 4 of sand‐like appendicoliths and 3 of sand‐like appendicoliths with luminal stenosis ) underwent endoscopic lithotomy successfully with balloon or basket ,with the success rate of 100% .One patient who presented perforation after appendicolith removal by basket was cured with conservative treatment .Appendix stent was inserted ,then pulled out after 1 week in 9 patients ,while no complaint or complication of the stent was observed .Operation time of ERAT shortened with the increase of case number .Conclusion ERAT is an effective and safe therapy for treating patients with uncomplicated acute appendicitis .The high success rate and safety of ERAT will be achieved by selecting suitable instruments for cannulation and appendicolith removal ,deciding suitable indications for stenting ,and accumulating of operative cases .

Objective To explore the relationship between the degree of intraplaque neovascularization in carotid artery and the level of serum homocysteine.Methods Contrast-enhanced ultrasound were performed on 72 carotid atherosclerotic plaques of 48 patients.Contrast-enhancement within the plaque was categorizde as grade 1 to grade 3.The level of serum homocysteine were detected in the fasting state during the same period.Results According to the degree of contrast enhancement(grade 1 to 3),patients were divided into 3 groups.The more new vessels in plaque,the higher the level of homocysteine.The levels of homocysteine in three groups increased in turn.There were distinct differences among the three groups(F =18.49,P ＜0.05),and there was significant difference between every two groups (P ＜0.05).The linear correlation analysis showed that the level of homocysteine was positively correlated with the degree of carotid plaque enhancement (r =0.66,P ＜ 0.01).Conclusions Contrastenhanced ultrasonography could semi-quantitate new vessles in plaque.There was positive correlation between the degree of intraplaque neovascularization with the level of serum homocysteine.Combine with the level of serum homocysteine based on intraplaque neovascularization detected by contrast-enhanced ultrasound,the plaque stability could be more accurately evaluated.

Objective To explore the characteristics of vena cava and pulmonary vena connection in patients with polysplenia syndrome ,and to improve the diagnosis of the polysplenia syndrome by echocardiography .Methods Forty‐five patients with polysplenia syndrome diagnosed by echocardiography were reviewed retrospectively .The characteristics and the frequency of the various types of anomalous connection of vena cava and pulmonary vena were analyzed .Results In 45 patients with polysplenia ,27 cases (60% ) had anomalous connection of superior vena cava ,anomalous inferior vena cava was found in 24 cases (53 3.% ) ,while 22 cases (48 8.% ) were diagnosed with hepatic vein anomalous drainage .Nineteen patients (42 2.% ) had anomalous pulmonary venous ,which partially anomalous venous drainage in 4 (8 9.% ) and total anomalous pulmonary venous drainage occurred in 15 patients (33 3.% ) .Conclusions Polysplenia syndrome often accompanied with anomalous vena cava and pulmonary venous drainage .Echocardiography can effectively diagnose polysplenia syndrome .

Objective To analyze the equity of the allocation of the health human resources in Chongqing from 1997 to 2012 , and to provide the basic information for regional health planning .Methods The statistical description ,Gini Coefficient and Theil in-dex are used to analyze the previous allocation and trends of the health human resources and the equity in Chongqing during the 16 years based on the distribution of demography and geography .Results The number of the health human resources grew rapidly from 1997 to 2012 .The Gini coefficients of health professionals and medical practitioners (and assistants) are under 0 .3 based on the distribution of demography ,while registered nurses′are fluctuation in 0 .4 .However ,from the distribution of geography ,the Gi-ni coefficient of health professionals ,medical practitioners (and assistants) and registered nurses are above 0 .5 .The Gini coefficient of the one hour economic circle is higher than two wings areas .The trends about the totle Theil index are consistent with the Gini coefficient .Based on the distribution of demography ,the Theil index between regions is higher than the one within the region .On the contrary ,the Theil index between regions is below the one within the region by the geographic distribution .Conclusion Com-pared to the national ,less total health human resources are reserved in Chongqing .Distribution by demographics about health human resources are more equitably than the one by geographic distribution .The variances between the economic circles contribute more to the total Theil index than those within the economic circles .The government′s leading role should be strengthen ,and enhancing the regional health planning .

Objective To study the effect and safety of endoscopic retrograde appendicitis therapy (ERAT) in treating patients with uncomplicated acute appendicitis. Methods Patients with uncomplicated acute appendicitis were enrolled and divided into ERAT group and LA group received laparoscopic appendectomy. Then compare treat-ment condition, complications and follow-up of the two groups. Results ERAT were completed successfully in all the patients in ERAT group, while one patient underwent a reversion to open appendectomy for technical difficulties in LA group. Mean operative time was (49.7 ± 18.2) min for ERAT group and (68.9 ± 25.9) min for LA group (P <0.05). Fever relief time (1.3 ± 0.5) d, WBC normalization time (2.0 ± 0.9) d, mean bed time (0.1 ± 0.2) d and mean hospital stay (3.3 ± 1.6) d for ERAT group were significantly lower than LA group (P <0.05). 14 patients with intra-luminal appendicoliths (7 of massive appendicoliths, 4 of broken appendicoliths and 3 of broken appendicoliths with luminal stenosis) underwent endoscopic lithotomy successfully in ERAT group, resulting in a success rate of 100.00%. One patient presented perforation after ERAT was cured with conservative treatment. During the follow-up of at least 1/2 year, the rate of recurrence was 10.00% in ERAT group. 1 patient (5.00%) underwent LA at the 5th month after ERAT during the follow-up. Conclusion ERAT is an effective and safe therapy in treating patients with uncomplicated acute appendicitis with advantages of minimal invasiveness and quick recovery. Uncomplicated acute appendicitis with appendicoliths and/or luminal stenosis are the most suitable indications for ERAT.

Objective To investigate the trend of early neural development in premature infants. Methods At the age of 12 months and 24 months, Bayley Scales of Infant Development were used to assess the mental development index (MDI) and the psychomotor development index (PDI) in preterm (corrected age) and full-term infants. Results At 12 months, there was no significant difference in corrected age PDI scores among different gestational age groups (<32 , 32–33+6 and 34–36+6 weeks) (P=0.820). The actual age MDI and PDI scores of full-term infants and premature infants in 34~36+6 weeks group were significantly higher than those of premature infants in <32 and 32-33+6 weeks groups, and the PDI score of full-term infants was significantly higher than that of premature infants in 34-36+6 weeks group (P<0.05). There was no significant difference in actual age PDI scores among different birth weight groups (P=0.166). The actual age MDI and PDI of full-term infants and premature infants in birth weight≥2500 g group were significantly higher than those of premature infants in <1500 g, 1500~1999 g and 2000~2499 g groups (P<0.05). At 24 months, the actual age MDI scores of full-term infants were significantly higher than those of premature infants in different gestational age and birth weight groups (P<0.05). The actual age MDI curve of premature infants in birth weight <1500g group showed a downward trend, while the actual age PDI curve showed a significant upward trend. Conclusion The neurodevelopment of preterm infants at the corrected age of 12 and 24 months reaches the level of full-term infants.

Objective: To establish the aortic regurgitation model in Chinese miniature pigs under echocardiography guidance. Methods: The animal models were established by following steps: general anesthesia, measuring body weight and then receiving echocardiography examination to exclude aortic valve lesions; carotid artery was exposured by surgery, catheter was sent to aortic sinus with stiff guide wire penetrates and the position of catheter was adjusted to obtain aortic valve damage. The aortic valve injury and regurgitation were evaluated by ultrasound; then the pigs were killed and the heart was taken to observe aortic valve damage. Results: A total of 7 pigs were used including 4 male and 3 female with the mean body weight of (24.7 ± 3.6) kg. Aortic regurgitation model was successfully established in 5 pigs including 1 mild, 1 mild-moderate, 2 moderate, 1 severe aortic valve regurgitation, and 4 were with valve lealfets perforation and 1 with lealfets tearing. Conclusion:①Echocardiography can smoothly guide wire go through aortic valve and make valve damage at different degrees, it is reliable to establish aortic valve regurgitation model in experimental pigs.②Echocardiography may clearly identify the position and degree for aortic valve injury.