Objective To explore the value of prenatal ultrasound in diagnosis of fetal anomalies of the inferior vena cava (IVC) and to improve the prenatal detection rate.Methods Fourteen cases of fetal anomalies of IVC examined by prenatal ultrasound from June 2013 to April 2016 in our hospital were analyzed,the prenatal ultrasonographic characteristics through abdominal transverse,coronal and IVC long axis were summarized,and were compared with the autopsy results.Results In 14 cases of anomalies of IVC,12 cases were isolated IVC interruption,and 2 cases were high confluence of IVC.In 12 cases of isolated IVC interruption,9 cases compicated by left isomerism,1 case complicated by sistus inversus viscerum,1 case complicated by isolated IVC interruption;2 cases of high confluence of IVC were combined with multiple malformations,including 1 case of chromosome 18-trisomy syndrome.Thirteen cases were confirmed by pathology,and 1 case of the high confluence of IVC lost follow-up.Conclusions Fetal anomalies of IVC have characteristic manifestations in prenatal ultrasonographic.When detecting the IVC interruption,left isomerism should be highly suspected.

BACKGROUND:CT perfusion technology is a common non-invasive detection method, which can be used to quantitatively determine the ischemia severity and range at early stage of cerebral infarction and then judge whether ischemic brain tissues can survive or recover. OBJECTIVE:To assess the neurological function recovery of cerebral infarction rats undergoing neural stem cel transplantation using CT perfusion imaging. METHODS:A total of 60 Sprague-Dawley rats were randomly divided into control group, cerebral infarction group, transplantation group, with 20 rats in each group. Rat model of middle cerebral artery occlusion was made in the latter two groups. After 24 hours of modeling, PBS and 8×105 neural stem cels were administratedvia the tail vein into the rats in the cerebral infarction and transplantation groups, respectively. CT perfusion-weighted imaging was performed at 1, 3, 7, 14, 28 days after transplantation. Modified neurological severity scores were recorded at 1, 2, 3, 4 weeks after transplantation. Triphenyltetrazolium chloride staining was used to calculate infarct volume at 4 weeks after transplantation. Hematoxylin- eosin staining was adopted to observe pathological changes of brain tissues at 2 weeks after transplantation. RESULTS AND CONCLUSION: There were no abnormal hemodynamic changes in the control group at different time points. The transplantation group exhibited an increasing CT value with time, and the increased cerebral blood flow could improve the survival rate of neurons in the ischemic penumbra. The modified neurological severity score and infract volume in the transplantation group were both significantly lower than those in the cerebral infarction group (P < 0.05). Cel necrosis was improved obviously in the transplantation group. These results show that CT perfusion imaging can be used to observe the neurologic function recovery of cerebral infarction rats in aspects of morphology and hemodynamics.

ObjectiveTo observe the shape, size, position and vessels of greater omentum. To explore the design of greater omentum and clarify its clinical significance. MethodsThree fresh and 12 formalin-fixed cadaveres were dissected. All of them had no damage nor injury. 1. Macro-micro-dissection: The shape, size and position of greater omentum were observed. The vessels of the greater omentum were studied.2.Lead oxide-gelatin injection technique and three-dimensional reconstruction.Results The length of greater omentum was(24.7±6.9)cm,the width was(28.3+2.8)cm. It could be divided into 3 types: thin type,middle type and thick type, the occurrence rate was 33.3％, 46.7％ and 20.0％ respectively. The blood supply of greater omentum mainly came from the gastroepiploic arch composed of the left gastroepiploic artery and the right gastroepiploic artery.There were 4 main arteries of the greater omentum: ①The right epiploic　artery: The external diameter at origination was (1.0±0.4)mm. ② The middle epiploic artery: The external　diameter at origination was(0.7 + 0.3)mm. ③The left epiploic artery:The external diameter at origination was　(1.2±0.4)mm.④ The accessary epiploic artery:The external diameter at origination was (0.5 ± 0.1)mm.ConclusionAccording to the characteristic of the anterior arch and posterior arch,the position of the middle epiploic artery divarication and the method of spread,the greater omentum is divided into 5 types.It should be according to the characteristic, when the greater omentum is designed and clipped.

OBJECTIVE To realize the status and the impact factors of nosocomial infection among Jizheng patients.METHODS To investigate 562 former inpatients suffered from Jizheng in hospital from Jan 2004 to Dec 2005.RESULTS The incidence rates of nosocomial infection that calculated by the patients and the cases were 14.59% and 16.55%,respectively.Infection mostly occurred on the 22nd day in hospital on average.The main infection sites were lower respiratory tract(48.78%),urinary tract(15.85%),and alimentary tract(12.20%).The most risk factor was aging.CONCLUSIONS The high incidence of nosocomial infection is due to various factors.We should take measures respectively aiming at different factors to reduce the occurrence of nosocomial infection.

Objective To study the immunoreactivity of fascin and Ki-67 proteins in bladder carcinoma and the correlation between their expression and the pathological features.Methods The immunohistochemistry of fascin and Ki-67 proteins were detected in 111 cases of bladder carcinoma and 42 cases of normal bladder tissues.The correlation between their expression and the pathological features were analyzed statistically.Results There was no expression of fascin and Ki-67 in normal bladder tissues.The immunoreactivities of fascin and Ki67 were detected respectively in 94 and 92 of 111 bladder carcinomas.The immunoreactivity of fascin was correlated with TNM staging and the size of the tumor(P<0.05),and had no correlation with age,gender and pathological classification(P>0.05).The expression of fascin was positively correlated with the expression of Ki-67 in bladder carcinoma(P<0.01).Conclusion Fasicn and Ki-67 were expressed in bladder carcinoma.The combined detection of fascin and Ki-67 expression might be helpful to assess the prognosis of bladder carcinoma.Targeting the fascin and Ki-67 pathway could be a novel therapeutic strategy of bladder carcinoma.

Objective To evaluate ultrasonography combined with magnetic resonance imaging(MRI) diagnosis value for fetal brain deformities.Methods The results of ultrasonography and MRI was analysied in 12 fetuses with deformities,which were compared to postnatal,autopsy or other hospital inspection results and evaluated the accuracy.Results In 8 cases,the diagnoses established by ultrasonography were correct.3 cases were misdiagnosed by ultrasonography,1 case was missed the diagnosis.In 11 cases,the diagnoses established by MRI were correct and 1 case was missed the diagnosis.Conclusion Ultrasonography must be choosed in diagnosising fetal skull brain deformities,MRI was supplement to ultrasonography in complicated pregnancies.The combination of ultrasonography and MRI have an important value in guiding pregnant women to determine whether or not to continue the pregnancy.

Objective To improve the diagnosis and treatment of asymptomatic adrenal pheochromocytoma. Method The clinical data of 33 patients with asymptomatic adrenal pheochromocytoma were reviewed. Results All the patients were not preut with typical signs and symptoms of pheochromocytoma, 16 patients were found adrenal mass by routine physical examination, 15 patients presented with superior abdominal or flank pain, 1 patient was fever and 1 patient was diarrhea. Most of patients were prent with round mass with low density in the center of the tumor,5 patients had elevated level of plasma epinephrine and norepinephrine (16% ,5/31),24 hours urine CA and VMA were elevated in 6 patients (24%, 6/25) and 5 patients (20%, 5/25) respectively, 26 patients who were suspected pheochromocytoma preoperatively were treated with α-adrenergic blockade (prazosin) to control the blood pressure or with intravenous colloid fluids and blood transfusion to expand intravascular volume before operation. The tumors were removed successfully in 32 patients, and biopsy was done in 1 patient because of the serious invasion to the vena cava by the tumor. All the patients were diagnosed pheochromocytoma histopathologically,and followed up for 1 month to 7 years, no tumor recurrence. Conclusions The patients with asymptomatic adrenal pheochromocytoma have lower catecholamine excretion in their plasma and urine. Combination of modem imaging examinations are useful methods to diagnose asymptomatic adrenal pheochromocytoma. To lower the risk of operation, the control of blood pressure and the expanding of intravascular volume are important for the patients with huge adrenal mass or typical suspected appearance of pheochromocytoma.

e chain-link flap is the good way in the treatment of large areas of the lower leg soft tissue defects.

Objective To explore the influences of the final concentration and adding time of Cytochalasin-B (Cyt-B) on radiation-induced nucleoplasmic bridges (NPB) in cytokinesis-block assay.Methods Hunan peripheral blood samples were divided into 5 final concentration groups (group 2,4,6,8,10 μg/ml) according to different final concentrations of Cyt-B.Moreover,blood samples were divided into 4 adding time groups (group 0,28,40,44 h) according to different adding times of Cyt-B.Blood samples were irradiated with 0 (sham irradiation) and 2 Gy 60Co-rays in vitro,at a dose rate of 1 Gy/min.A cytokinesis-block assay was carried out to prepare NPB samples.The percentages of mononucleated,binucleated and multinucleated cells,as well as the frequencies of NPB and micronucleus (MN) in binucleated cells were analyzed using an optical microscope.Results Nuclear division index (NDI) and the percentages of binucleated cells increased with increased concentration of Cyt-B,and decreased with delayed adding time of Cyt-B (except group 0 h) in both final concentration groups and adding time groups.After exposed to 2 Gy,NPB frequencies were no significant difference (except group 0 h).MN frequencies had the trend of decreased with the increased concentration of Cyt-B,but no significant difference with adding time of Cyt-B.Conclusions In cytokinesis-block assay,different final concentration and adding time of Cyt-B may induce to the variation of NPB frequencies,but there was no significant difference.Appropriate increased final concentration or ahead adding time of Cyt-B can increase the percentage of binucleated cells that help to improve the efficiency of analysis.

Objective To explore the clinical effect of periarticular knee fractures combined with anterolateral ligament (ALL) avulsion fracture.Methods From June 2014 to November 2015,13 patients with ALL avulsion fracture in periarticular knee fractures were fixed by the star plate,cannulated or screws suture anchor,including 9 male and 3 female with the mean age of 39.5 years (range from 28 to 51 years).6 patients were diagnosed distal femoral fracture,4 tibial plateau fracture,and 3 tibial intercondylar eminence avulsion fracture which all combined with ALL avulsion fracture.Postoperatively,all patients were treated with the adjustable knee brace for 3 months.Results All patients were followed up for 4-20 months,the mean follow-up time was 13.5 months.The average surgical time was 130 min (range from 90 to 210 min).In all 13 patients,ALL was found and identified.Bone union was obtained in all patients,and the bone union time was 11.4 weeks (10-12 weeks).7 cases were fixed with star plate,5 cases were fixed with hollow screw,and 1 case was fixed with anchor.All follow-up patients underwent anteroposterior and lateral X-rays.Pain,swelling and functional recovery of the knee joint were observed.Patients were assessed postoperatively with International Knee Documentation Committee (IKDC) score,Lysholm score,and Tegner activity scale to evaluate the clinical effect.At the last follow-up,all patients had full range of motion of the knee joint which from 0° to approximate 120°.The Lysholm,objective IKDC were 86.5 and 84.6 respectively.Among the 13 patients evaluated,9 patients were graded A,and 4 patients were graded B by subjective IKDC.The Tegner activity scale at the last follow-up was 6.7.Incision of poor healing in 1 case,and got healed after 32 d cleaning dressing.Conclusion This study confirmed the presence of the ALL.The fixation of ALL avulsion fracture in periarticular knee fractures can be an effective procedure at a minimum follow-up of 13.5 months.