Objective To study the estimated value on normal reference ranges of inferior vena cava (IVC) Doppler indices from gestation 16 to 40 weeks of fetus with color ultrasound.Methods Seven hundred and forty-four single birth gravida with gestation 16 to 40 weeks were grouped according to the gestational weeks with 27-35 cases each.The IVC Doppler indices were measured by color ultrasound,including preload index,peak velocity index and pulsatile index.Results All IVC Doppler indices rapidly declined from gestation 16 to 24 weeks,and they were relatively constant or slightly decreased throughout the end of pregnancy.Conclusions To set up the normal reference ranges of IVC Doppler indices for gestation from 16 to 40 weeks means a lot for every pregnant.This normative data may be a useful noninvasive tool for evaluation of fetal cardiac function.

Objective:To explore the clinical effect of mild hypothermia combined with puncture aspiration operation on the hypertensive intracerebral hemorrhage and its effect on the serum TNF-α,IL-6 and CRP levels.Methods:112 cases of patients with hypertensive intracerebral hemorrhage admitted in our hospital from February 2015 to August 2016 were selected as the research objectives and randomly divides into 2 groups with 56 cases in each group.Both groups were treated with minimally puncture aspiration,and mild hypothermia was performed in the observation group additionally,the clinical effect,complication,short-term prognosis,serum TNF-α,IL-6,CRP levels at different time points before and after operation were compared between two groups.Results:The overall effective rate of observation group was 92.86％,which was significantly higher than of the control group(76.79％.P＜0.05).The incidence of MODS and complications were 0％ and 26.79％ respectively,which were significantly lower than those of the control group(P＜0.05).The serum TNF-α,IL-6,CRP levels of observation group were significantly decreased on the 3rd and 7th day postoperation,which were significantly lower than those before operation (P＜0.01).The serum TNF-α,IL-6,CRP levels of control group on the 3rd day postoperation were similar to those before operation (P＞0.05),but the serum TNF-α,IL-6,CRP levels on the 7th day postoperation were significantly decreased (P＜0.01).The serum TNF-α,IL-6,CRP levels on the 3rd,7th day postoperation were significantly lower than those of the control group at same time points (P＜0.01).The favorable prognosis of observation group was 80.36％,which was significantly higher than that of the control group (62.50％,P＜0.05).Conclusion:Mild hypothermia combined with puncture aspiration operation could effectively reduce the neurological deficits,inhibit the inflammatory response and decrease the mortality.

Objective To investigate the relationship between clinical types and related risk factors in female patients with post-adolescent acne.Methods Female outpatients with post-adolescent acne aged more than 25 years were enrolled from Department of Dermatology of Renji Hospital between January and October 2016.A questionnaire survey was conducted to investigate related risk factors for post-adolescent acne in the females.Skin lesions and clinical types were evaluated by dermatologists.Statistical analysis was carried out by t test for comparison of means between two groups and by chi-square test for comparison of ratios.Results A total of 312 female patients with post-adolescent acne completed the survey,including 268 (85.9％) with mild to moderate acne and 44 (14.1％) with severe acne,241 (77.2％) with persistent acne and 71 (22.8％) with late-onset acne,or 102 (32.7％) with comedonal post-adolescent acne (CPAA) and 210 (67.3％) with papular post-adolescent acne (PPAA).Survey on related risk factors showed that 121 patients reported seasonal factors and 59 (18.9％) patients became worse in summer,and spicy,sweet and fried foods can aggravate the condition in 131 (42％),93 (29.8％) and 85 (27.2％) patients respectively.Other risk factors such as premenstrual period (62.8％,196/312),psychological factors (51.6％,161/312) and exogenous chemical exposures (43.6％,136/312) were complained of by the patients.Furthermore,premenstrual period,diet and constipation were found to be more associated with PPAA compared with CPAA (x2 =4.523,4.068,3.910,respectively,all P ＜ 0.05).Exogenous chemical exposures,such as the use of cosmetics,exposure to polluted air environment and occupational hazards,were more associated with CPAA compared with PPAA,as well as with late-onset acne compared with persistent acne (x2 =6.579,9.057,both P ＜ 0.05).In addition,premenstrual exacerbation occurred more frequently in patients with persistent acne compared with those with late-onset ache (x2 =4.512,P ＜ 0.05).Conclusions The risk factors for the occurrence of female post-adolescent acne are very complex.Premenstrual exacerbation plays a major role in the aggravation of papular and persistent post-adolescent acne,diet and constipation are more associated with PPAA,and exogenous chemical exposures are still be considered in the aggravation of comedonal and late-onset post-adolescent acne.Thus,clinical types should be considered in the diagnosis and treatment of post-adolescent acne in females.

Objective Through the network informatization management, postoperative pain assessment, nursing records, process the results into the network electronic medical records, more standardized postoperative pain management, improve the effectiveness of postoperative analgesia. Methods A total of 3 680 patients after the operation from November to December in 2015 were selected and divided into control group and observation group according to the operation time. In November for the traditional postoperative pain management in control group (1 850 cases), in December as observation group (1 830 cases), with Hospital Information System and Anesthesia Information System, all of the records in the postoperative pain management content network electronic information management, according to the degree of pain and analgesia method to select a different form, data sharing, wrong alarm to remind, handle in time. To establish a network of WeChat public platform to perform health education and information communication. The analgesia effect and patient′s satisfaction were compared between two groups. Results The incidence of incomplete pain was 12.5%(231/1 850) in control group and 4.2%(77/1 830) in observation group, and there was significant difference between two groups(c2= 82.22, P<0.01). The satisfaction score was (5.9 ± 3.7) points in observation group and (4.4 ± 2.6) points in control group, and there was significant difference between two groups(t = 2.10, P<0.05). Conclusions Postoperative pain management network informatization can effectively improve the effect of postoperative analgesia, improve work efficiency.

Objective Based on the diagnostic technique of electric meridian detection, to observe the clinical efficacy of acupuncture in treating angioneurotic headache.Method Totally 106 patients with angioneurotic headache were randomized into a treatment group and a control group, 53 cases in each group. The treatment group received acupuncture based on the electric meridian detection, while the control group received medication treatment. The hemorheology indexes [plasma viscosity (PV), erythrocyte sedimentation rate (ESR)] and McGill Pain Questionnaire (MPQ) [Pain Rating Index (PRI), Visual Analogue Scale (VAS), and Present Pain Intensity (PPI)] were observed before and after intervention, and the clinical efficacies were compared. Result The total effective rate was 88.7% in the treatment group versus 71.7% in the control group, and the between-group difference was statistically significant (P<0.05). After intervention, the hemorheology indexes and MPQ scores were significantly changed in both groups (P<0.01,P<0.05).Conclusion Acupuncture based on electric meridian detection is an effective method in treating angioneurotic headache.

Objective To assess the value of acoustic radiation force impulse (ARFI) imaging in the pathological damage of Henoch-Schonlein purpura nephritis on children by comparison with renal biopsy.Methods 50 cases of healthy control group as group A; 58 children with HSPN were divided into three groups according to pathological grading:Ⅰ ～ Ⅱ class (group B),Ⅲ class (group C) and Ⅳ ～ Ⅵ class (group D).ARFI was then used to measure the shear wave velocities(SWV) of renal cortex of each group,compared the differences SWV of each group.Results SWV values of children's renal cortex with HSPN were significantly higher (t =5.883,P =0.017) than those in the group A.Pairwise comparisons found that there were statistically significant differences between group D and the other three groups (P ＜0.05).According the ROC curve,the cut-off value of SWV was 2.59 m/s when the maximum area under the curve equal to 0.719,the sensitivity and specificity were 63％ and 67％.Conclusions ARFI technology can quantify the elastic properties of the kidney,which is expected as an important indicator to evaluate the pathological extent of damage of the HSPN.

In this study, the rapid resolution liquid chromatography-quadrupole time-of-flight mass spectrometry (RRLC-QTOF/MS) was used to profile the metabolites of urine samples from chronic heart failure (CHF) patients and healthy controls to find the differential metabolites which could provide the scientific evidence to explain the pathogenesis of the disease and supply a better therapy plan.Urine samples from 15 CHF patients (age (62.27±3.14) years) and 15 healthy controls (age (65.41±4.63) years) were analyzed by RRLC-QTOF/MS.After processing the data, the multivariate statistical analysis (principal component analysis, PCA) was performed to find the potential biomarkers.Result showed that urine samples of CHF patients were successfully distinguished from those of healthy controls.Two significantly differentially expressed metabolites, uridine and alanyltryptophan, were found and identified as potential biomarkers.The result showed that the LC-MS based metabolomics approach had good performance to identify potential biomarkers, and the disorder of uracil metabolism and Tryptophan metabolism may play an important role in the mechanism of CHF.

Objective To evaluate the accuracy of MSCT in the pre-operative N-staging and diagnosis of metastatic lymph nodes in each group of gastric cancer.Methods Pathological and CT data of 91 patients with gastric cancer proved by surgery and pathology were analyzed retrospectively.Three-phase dynamic enhancements were performed before surgery in a unified way of hypotonic oral water,N-stage and grouping of lymph nodes of the preoperative CT imaging were evaluated by using the established diagnostic criteria and then compared with the results of surgery and pathology,the accuracy of staging and grouping was analyzed by using Kappa test.Results The accuracy of MSCT diagnosing the N-staging as a whole was 86.3%.The accuracy for N0,N1,N2 and N3 was 83.5%,89.0%,83.5% and 89.0%,respectively.The sensitivity was 86.5%,83.3%,50% and 47.4%,respectively.The specificity was 79.5%,89.4%,89.6% and 100.0%, respectively.The sensitivity for N0 was statistically different from that for N2, N0 and N3(P≤0.007).The detected accuracy for the group of left side of the cardium (No.2), periphery of the splenic hilum (No.10), posterior of the pancreastic head (No.13) were higher than other groups on MSCT with the accuracyof 100%.The sensitivity for the group of No.2,periphery of the coeliac trunk(No.9),No.10,and No.13 was 100%.The specificity for the group of No.2,No.10,and No.13 was 98.9%.Conclusion Relatively high accuracy in the preoperative N-staging and diagnosis of metastatic lymph nodes in each group of gastric cancer can be obtained by MSCT, which provide reliable information for preoperative assessment and intraoperative lymph node dissections.

Objective To learn the recent development and regional distribution of clinics in China.Methods Based on statistics and a nationwide survey of clinics in the country,a simple linear regression was made to find factors determining clinics regional distribution.Results Clinics in China were found to have grown sizably from 134 000 in 2008 to 155 000 in 2014;medical technology workers to 2.31 per clinic in 2014;and the total revenue of these clinics accounted for only 0.724% of all medical institutions,while there are more clinics in the east than the west regions in China.Conclusions The role of clinics in attracting high quality medical resources to primary care should be further enhanced for development of the hierarchical medical system in China.

AIM: To investigate the signaling mechanisms involved in the priming effects of lipopolysaccharide(LPS) on heat killed Staphylococcus aureus(HKSa)-induced nitric oxide(NO) production in macrophages.METHODS: Murine macrophage RAW264.7 was used in the experiment.Griess reagent was used to measure the content of nitrite in culture medium.Real-time PCR and Western blot was utilized to examine the mRNA and protein levels of toll-like receptor 2(TLR2),respectively.Dual luciferase reporter assay was used to assess the transcriptional activity of nuclear factor of activated T cells(NF-AT).RESULTS: The RAW264.7 cells pretreated with LPS for 24 h significantly enhanced NO production induced by HKSa,suggesting that LPS primed the macrophages and increased the reactivity of the cells to HKSa.LPS increased the mRNA and protein levels of TLR2 in a dose-dependent manner in RAW264.7 cells.The RAW264.7 cells pretreated with LPS enhanced NO production induced by peptidoglycan,one of the specific ligand of TLR2.The priming effect of LPS on HKSa-induced NO production was partly blocked by TLR2 neutralizing antibody.LPS significantly enhanced the transcriptional activity of NF-AT,which was inhibited by BAPTA/AM(a cell-permeable cytosolic calcium chelator) and cyclosporine A(CsA,an inhibitor for calcineurin).Both BAPTA/AM and CsA inhibited the priming effect of LPS on HKSa-induced NO production in RAW264.7 cells.CONCLUSION: The present study confirms the priming effect of LPS on the reactivity of RAW264.7 cells to HKSa.Pattern recognition receptor TLR2 and calcium/calcineurin/NF-AT signaling pathway may be involved in the priming process initiated by LPS.