Objective To discuss the prenatal diagnosis of abnormalities of fetal limb bone.Methods We selected 18 cases which long bone of fetus less than 2SD of average volume of gestational weeks or long bone changed into angle or other fetus's abnormalities by first B-mode ultrasonic. All above cases was delivered at Capital Medical University of Obstetric and Gynecological Hospital during Jan. 2006 to Dec. 2009. We B-mode ultrasonic was used to measure fetus's biparietal diameter (BPD) ,femur length (FL) ,abdominal circumference(AC) ,head circumference(HC) ,humerus length (HL) ,amniotic fluid index (AFI) and structures of organ and calculated FL/AC, growth speed of long bone. The standard of achondroplasia is that FL and HL are less than 4SD of average of gestational weeks or FL/AC less than 0. 16. The standard of Osteogenesis Imperfecta is fetal long bone of fetus shows short and thick, curves into angle, fracture in uterus by X-ray, or skull shows thin or sink by X-ray. Results (1) By B-mode ultrasonic and X-ray exam of all 18 cases: 7 cases shows that HC ＞2SD, 10 cases shows too much amniotic fluid, 12 cases shows AFI ＞ 18.0, 9 cases shows abnormalities of narrow cavitas thoracis, disordered vertebral column, or unusual architecture of heart. For cases 1 to 14 are achondroplasia, among which,11 cases are FL＜4SD and HL＜4SD, 2 cases are FL ＜3SD and HL ＜4SD, 1 case is not only FL ＜2SD and HL ＜3SD but also hydroncus all over the body of fetus. The growth velocity of long bone of fetus in all the 14 cases is more slowly than the normal rate. For all the above 14 cases, 12 cases FL/AC ＜0. 16, 1 case FL/AC =0. 19, 1 case FL/AC =0. 20. The length of femur or humerus is shorter than the normal rate and have other abnormalities the above last two cases. For case 15 and 16, they don't show any abnormalities of bone growth though one year's follow up studying. For case 17 and 18, they are osteogenesis imperfecta. (2) The result of fetal perinatal period fate and autopsy: there are 8 female and 10 male in all the 18 cases. One case is labored after 39 weeks pregnancy, and it is low birth weight infant, weight ＜3%th. All the other cases are normally birth weight infant. All the 18 cases of abnormalities of fetal limb bone are examined by chromosomes check, among which, 9 cases are amniocentesis, 7 cases are cordocentesis,2 cases are checked chromosomes by fetus cord blood, all the caryotype are normal. In the 16 autopsy cases,14 cases are achondroplasia or hypochondroplasis. It can be seen amplifying extremities, hyperplasia chondrocytes of tubiform born, karyomegaly, anachromasis, hyperplasia capillaries though microscope and grow up into cartilage irregularly. Also can be seen hyperplasia chondrocytes of epiphyses, delaying osteosis.2 cases are osteogenesis imperfecta. It can be seen broadening of metaphyses, exility of bone trabeculae. For the other two cases which the fetus is alive, we do the follow up studying to their one year old one of them is low birth weight new born, their limb and height are all normal. Conclusions To diagnose fetal Achondroplasia, it is not only based on the significantly shorter of femur or humerus length but also based on the dynamics observing the long bone growth velocity and calculating FL/AC. For osteogenesis imperfecta fetus, it should be diagnosed by fractures in uterus though X-ray.

Objective To compare the clinical curative effect of virus inactivating activity of plasma and albumin compound sodium chloride injection in liquid plasma exchange(PE)for treatment of severe systemic lupus erythematosus(SLE).Methods A total of 75 cases of severe SLE patients were randomized according to the number table method patients for virus inactivation of plasma group A(37 cases)and liquid albumin plasma group B (38 cases). The changes of immunoglobulin protein(IgG,IgA,IgM),ESR,complement C3,C -reactive protein(CRP),blood urea nitrogen(BUN)and serum creatinine(CR)index in the two groups were observed before and after PE.Clinical SLE-DAI(systemic lupus erythematosus disease activity index)score changes,adverse reactions occurred rate and clinical efficacy of two groups were compared.Results After treatment of group A was treated with PE,laboratory indicators except IgM(t =0.509,P =0.612),other indexes were significantly decreased,differences were statistically significant (t =29.447,186,56.447,41.867,12.841,92.675,92.980,all P <0.01).In group B,the IgM,IgA,CRP,C3 and preoperative showed no statistical significance(t =0.565,1.165,0.902,all P >0.05),while IgG and ESR,bun,crea and replacement of the differences have statistical significance(t value were 28.999,194.9,40.634,40.634104.918, P value <0.01 ).Ttotal efficiency of group A was 91.9%,the average clinical SLEDAI score was (9.4 ± 1.2)points,total efficiency of group B was 77.3%,clinical SLEDAI score was (13.8 ±1.1 )points and the difference between the two groups were statistically significant(χ2 =8.831,t =15.560,P <0.01).In group A,the adverse reaction rate was 15.3%,that of group B was 16.2%,there was no significant difference between the two groups(χ2 =0.509,P >0.05).Conclusion The clinical curative effect of virus inactivation of plasma replacement solution in treatment of severe SLE is better than that of albumin by Ringer's solution.

According to the medical history,imaging and pathological diagnosis,the advanced gastric cancer patients able to tolerate radiotherapy can be divided into the following three groups:(1) unresectable locally advanced or locally recurrent disease;(2) metastatic disease at primary diagnosis with stage Ⅳ;(3) patients experiencing severe tumor-related clinical symptoms.The role of palliative radiotherapy in patients with advanced gastric cancer would be discussed by reviewing 33 articles (8 in last five years,13 in ten years).

Objective To evaluate the clinical application of ultrasound-guided Mammotome system in the treatment of breast lesions.Methods A total of 1081 patients with 1913 breast lesions received Mammotome minimally invasive excision,and the efficacy of treatment and follow-up results were retrospectively analyzed.Results All 1913 lesions in 1081 patients were treated with the Mammotome system.The duration of operation was 4 minutes,and the average excision times was 15 for every lesion,1894 lesions (99.01%) in 1063 patients were benign breast masses,19 lesions (0.99%) in 18 patients were breast carcinoma.Complication occurred in 39 lesions (2.04%).Conclusion Ultrasound-guided Mammotome system is one of the effective ways in the clinical diagnosis and treatment of breast lesions.

Congresses as Topic ; Head ; surgery ; Neck ; surgery ; Otolaryngology ; Periodicals as Topic

· AIM: To analyze the pathogeny of corneal endotheliitis and to investigate the causes of its misdiagnosis and the key to treatment.endotheliitis presented with predisposing factors, clinical manifestations and treatment were analyzed retrospectively.junctiviis, and the other 7 were misdiagnosed as acute close-angle glaucoma, glaucomatocyclitic crisis, inflammatory reaction after cataract extracapsular extraction and IOL implantation, disciform stromal keratitis and iridocyclitis, respectively. All the 7 cases were cured through treatment, and recurrence appeared in 1 case.unclear yet. Properly grasping its features and key points for differential diagnosis and seriously and detailed examining patients will benefit to timely diagnosis. After clinical treatment, maintaining treatment for more than 4wk will lower the recurrence of corneal endotheliitis.

AIM: To observe the clinical features of glaucomatocyclitic crisis and to investigate its pathogenesis, diagnosis,treatment and prognosis.METHODS: The clinical data of 15 cases (15 eyes) subjected to glaucomatocyclitic crisis were retrospectively analyzed including clinical manifestation and treatment.RESULTS: Visual field was normal in 13 eyes, and 2eyes had glaucomatous visual field defects. C/D ratio was ≤0.3 in 10 eyes and ≥0.6 in 2 eyes. Through pharmacotherapy the symptoms in 14 eyes disappeared after 2wk. One eye was diagnosed as being complicated by primary open-angle glaucoma and well treated with surgery.CONCLUSION: Glaucomatocyclitic crisis is a kind of ocular syndrome with unknown pathogenesis. It should be differentiated from primary glaucoma and uveitis clinically. Its prognosis is not absolutely benign, and the patients should be followed up regularly.

Automatic Data Processing ; Humans ; Medicine, Chinese Traditional ; Pulse

Anticoagulants ; therapeutic use ; Blood Coagulation Tests ; Blood Component Transfusion ; methods ; Disseminated Intravascular Coagulation ; blood ; diagnosis ; etiology ; therapy ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Fibrinolysis ; Fibrinolytic Agents ; therapeutic use ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Infant, Newborn ; Intensive Care Units, Pediatric ; Male ; Platelet Count ; Predictive Value of Tests ; Sepsis ; complications