Objective To evaluate the diagnostic value of the diameter ratio of left subclavian artery to aortic isthmus(LSA/AoIS)in fetuses with aortic coarctation(COA).Methods A retrospective study of 79 fetal echocardiographic data was undergone on 49 COA fetuses.The COA cases were divided into four groups according to different gestational week (cases in each group including follow-up review of different gestational weeks):group 1 ,24-27+6 W;group 2,28 -31+6 W;group 3,32 -35+6 W;group 4,36 -39+6 W.The normal fetuses with gestational age matched were also divided into four control groups.The diameter of left subclavian artery(LSA) and aortic isthmus (AoIS) were measured,the ratio of LSA/AoIS of each group were calculated,and the data between the COA and control groups were compared.ROC curve analysis was used for LSA/AoIS to predict the demarcation point of postnatal COA.Results ①There was no statistic difference in the LSA diameter between COA groups and control groups (P >0.05):group 1 (1 .87±0.42)mm vs (1 .75 ±0.25)mm;group 2 (2.25 ±0.36)mm vs (2.21 ±0.22)mm;group 3 (2.74±0.32)mm vs (2.90 ±0.29)mm;group 4 (2.83 ±0.28)mm vs (3.06 ±0.30)mm;②The ratio of LSA/AoIS was significantly increased in COA groups than those in control groups:group 1 (0.88± 0.15) vs (0.66±0.06),group 2 (0.85±0.13)vs(0.64±0.05),group 3 (0.94±0.17)vs(0.73±0.07), group 4 (0.94±0.18)vs(0.70±0.07),the difference was statistically significant(P <0.05);③The cut-off value of LSA/AoIS ratio were 0.78,0.73,0.83,0.78 in each group,respectively.Conclusions The ratio of LSA/AoIS can be used as a useful echocardiographic parameter which suggest the presence of aortic coarctation.This ratio≥0.8 may have a certain diagnostic significance.

Objective To investigate the difference in cardiac structure and hemodynamics characteristics between fetuses with isolated persistent left superior vena cava (LSVC)and normal fetuses by using fetal echocardiography,in order to explore whether isolated PLSVC has some influence on the development of fetal heart structure development.Methods Twenty-two fetuses diagnosed with isolated PLSVC in the second and third trimester were enrolled in this study.The PLSVC fetuses were divided into two groups:group 1 ,twenty-two fetuses in the second trimester (23-27+6 W);group 2,twenty fetuses in the third trimester (28-39+6 W).Forty-nine fetuses without intra-cardiac and extra-cardiac anomalies with gestation age matched were involved as normal control groups:25 fetuses in the second trimester,and 24 fetuses in the third trimester.The parameters of cardiac structure and hemodynamics of the four groups were measured,including left and right sideheart size,the diameter of foramen ovale(FO),aorta(AO),aortic isthmus and pulmonary artery (PA).The ratio of RV/LV,RA/LA and PA/AO were calculated.The hemodynamic parameters included the flow velocity across mitral valve(MV),tricuspid valve(TV)and FO. All the parameters of PLSVC groups were compared with the normal groups respectively.Results In the second trimester group,the ratio of RV/LV and PA/AO of the PLSVC fetuses were significantly larger than normal,while the AO diameter,aortic isthmus diameter were smaller than normal group (P <0.05). However in the third trimester group,only the ratio of PA/AO of the PLSVC group was significantly greater,and the aortic isthmus diameter was still smaller than the normal group (P <0.05).Conclusions Isolated PLSVC connected with coronary sinus is associated with structural differences from normal.A dilated coronary sinus may have an influence on the development of fetal left heart structures.

G protein-coupled receptor 30 ( GPR30),a sort of novel functional estrogen transmembrane receptor,extensively participate in the pathological and physiological regulation by mediating the rapid nongenomic effects of the estrogen,which plays an important role in the occurrence and development of the hormone-related malignant neoplasms.

8 mg/L). The rdxA gene fragment (886 bp) of H. pylori was amplified by PCR and then sequenced. Finally polymorphism analysis was performed in the rdxA gene sequence from those strains resistant or susceptible to Mtz and standard strains H.pylori 26695. Results A total of 47 H.pylori strains were isolated from 51 patients positive for rapid urease test. Mtz resistance rate was 34% by E-test method and 31.9% by breakpoint susceptibility testing. Among them 15 strains were resistant to Mtz by the two tests. The rdxA genes of both 15 strains resistant to Mtz and 8 strains susceptible to Mtz were sequenced. Compared with that of strain H.pylori 26695, the sequence of rdxA gene nucleotide in 15 H.pyloristrains resistant to Mtz showed similarity ranging from 90% to 95% and being 92.5% on average, and the sequence of rdxA gene nucleotide in susceptible strains showed similarity ranging from 94% to 95% and being 94.5% on average. In most resistant strains, the rdxA genes occurred point mutation, single nucleotide insertion or deletion, however, the insertion or deletion of large nucleotide fragment were rare, and mutational site were variable. Conclusions The rdxA gene mutation in H.pylori strains resistant to Mtz may result from point mutations in several bases or insertional mutations or deletional mutations in one base, without insertion or deletion of large neuclectide fragment, and mutational position being variable.

Constipation has become a common clinical symptom in the elderly. Many factors can result in constipation, including diet,physiological aging, lack of exercise, inappropriate medication, psychological factors, perianal disease, and so on. If the individualized, targetedand comprehensive care interventions that consist of health education, psychological intervention, dietary intervention, medicationguide, functional exercise, passive attention to bowel training and abdominal massage etc. are done well, it can decrease the incidence ofconstipation, reduce a variety of complications and adverse effects caused by the constipation and improve the quality of life in the elderly.So it has important clinical significance.

Objective The aim of this study was to analyze the influence of combined therapy with L-carnitine and erythropoietin on renal anemia and nutritional status in patients treated with maintenance hemodialysis.Methods The combination of computer and manual searches were used.A Meta analysis was made regarding the effect of combined therapy with L-carnitine and erythropoietin on the improvement of renal anemia and nutritional status in patients treated with maintenance hemodialysis.The quality of the 9 studies was evaluated with the Jadad score.Statistical analysis was carried out by RevMan 5.0.Results A total of 428 patients in 9 reports were analyzed.Metaanalysis showed that there were significant improvement in hemoglobin (Hb) [WMD =9.21,95％ CI (7.69 ～10.73)] and hematocrit (Hct) [WMD =2.61,95％ CI (2.28 ～ 2.93)],albumin (ALB) [WMD =1.64,95％ CI (1.04 ～ 2.24)] and total protein (TP) [WMD =2.72,95 ％ CI (0.67 ～ 4.77)] in the treatment group compared with the control group.The level of erythropoietin dosage [WMD =-38.24,95％ CI (-76.87 ～ 0.39)] was decreased significantly.But there were no significant differences in triglyceride and serum phosphorus.Conclusion Combined therapy with L-carnitine and erythropoietin in patients treated with maintenance hemodialysis leads to significant improvement of renal anemia and nutritional status.

Objective To analyze the clinical features, diagnosis and treatment of the primary omental torsion (POT).Method The clinical data of 12 patients with POT admitted to our hospital from May 2010 to May 2015 were retrospectively reviewed.The clinical manifestations, laboratory investigation, medical image, treatment and outcomes of patients were analyzed.Results Twelve cases were all males with median age of 50.The POT was diagnosed during surgical exploration and confirmed pathologically after operation.Right abdominal pain was the main complaint in 11 cases, and pain migration to right lower quadrant in 1 case.In physical examination, the local peritonitis signs were elicited, including right quadrant tenderness and rebound tenderness at same location.All cases had mal temperature except one presenting low fever of 37.5 ℃.White blood cell counts was 12×109/L in one case, and(4-10)109/L in other 11 cases.Abdominal solid mass was found in one case by ultrasonic scan, measured 7 cm×5 cm with unclear surrounding boundary.Mesenteric fat opacity and dropsy were shown in 10 cases on CT plain scan, while thickness and effusion of hepatic flexure of colon was found in one case;however, none of them were suggested as POT by these two image study before operation.All patients were gnosed as localized peritonitis or appendicitis clinically before emergent surgical exploration.The necrotic omentum was resected and all patients recovered smoothly.There were no complications in all cases during one-year follow-up.The CT images were reviewed after operation, which indicated that the mesentery of dropsy and the thickened hepatic flexure of colon should be the imaging signs of omental torsion;and also 9 of 12 cases had whirlpools sign.Conclusion The preoperative diagnosis of POT is difficulty, the typical whirlpools sign of abdominal mass on CT imaging is of highly value in diagnosis.The surgical removal of omental infarction is effective and the prognosis is good.

Objective To evaluate the significance of sIL 2R and TNF ? in chronic cor pulmonale.Methods The sIL 2R and TNF ? were detected by means of ELISA.The correlation with PaO 2 and PaCO 2 was analyzed using linear correlation.Results The levels of sIL 2R and TNF ? in patients at exacerbation stage were higher than that of remission stage and normal controls (P

Objective To explore the significance and methods of surgical treatment of mammary hyperplasia. Methods Patients with mammary hyperplasia were treated by different operative procedures,and cosmetic operations were performed synchronously on some selected patients. Results 523 cases were treated by surgery. All cases were diagnosed as mammary hyperplasia on the pathological examination and were in good condition postoperatively. The results of synchronous cosmetic operation were satisfactory . Conclusions The surgical treatment of mammary hyperplasia should be done if the efficacy was not satisfatory after the therapy combined traditional chinese medicine with western medicine . The operative indications must be defined carefully.

Objective To investigate the clinical value of remote electronic fetal monitoring network in intrahepatic cholestasis of pregnancy(ICP). Methods Non-stress test (NST) was carried on in 54 cases of ICP by remote electronic fetal monitoring network(study group). Fifty-four cases of ICP served as control group were monitored by fetal movement counting daily and regular NST check-up in hospital. Abnormal NST and perinatal outcome were compared between the study group and control group. Results The incidence of abnormal NST was significantly higher in the study group than that in the control group ( 36.1% vs 27.2%, P 0.05). Conclusion Remote fetal monitoring network can be used to improve perinatal outcome of ICP. It is a new method of FHR self-monitoring for ICP case.