Objective To explore the clinical application of spatio -temporal image correlation combined with multiplanar mode (STIC-MP) in the routine scanning of normal fetal heart ,and to provide evidence for the application of STIC in the routine scanning of fetal heart in second trimester .Methods One hundred pregnant women at 20-27 weeks′gestation were enrolled.The routine five views of normal fetal heart were examined and recorded by two-dimensional ultrasound,and the volume datasets were acquired with STIC.The time of picture storing and the fetal cardiac structures were recorded respectively .The quality of pictures obtained by both methods were compared by the scoring system .The imaging method of STIC-MP was explored and analyzed.Results Satisfactory gray-scale volume acquisitions were accomplished in all 100 cases.The quality of the four views(four chamber view,left outflow tract,right outflow tract,three vessel-trachea views) derived from volume datasets were comparable to that directly obtained from two-dimensional scanning.No significant difference of visualization rate ( χ2 =3.030,0.337,2.010,0.000,all P>0.05)was found between the STIC-MP(100/100,98/100,98/100,95/99 as 100.0%,98.0%,98.0%,96.0%)and two-dimensional(97/100,99/100,100/100,95/98 as 97.0%,99.0%,100.0%,96.9%).However,the difference of visualization rate was found in the stomach transverse view ( χ2 =9.776,P=0.001).The mean time for the examination and picture saving of fetal cardiac structures by STIC ,mean acquisition time was (1.17 ±0.52) min,which was much shorter than that by two-dimensional scanning (4.20 ±1.35) min (t=0.38,P<0.05).The mean time for obtaining the routine five views of fetal heart and analyzing by STIC and MP were (6.75 ±1.51) min,(1.35 ±0.30)min respectively,which was longer than (4.20 ±1.35)min and (0.83 ±0.22)min by two-dimensional ultrasound(t=11.75,11.75,both P=0.00).Conclusions STIC-MP simplifies the picture-gathering process,decreases the ultrasound exposure upon fetal heart obviously .No significant difference was found between the quality of the five views obtained from STIC-MP and two-dimensional ultrasound.The views of STIC-MP can satisfied the routine scanning of fetal heart ,although the interpretation time of STIC-MP was longer compared with two-dimensional ultrasound.There will be vital significance on the use of STIC in clinical application .

?AIM: To compare the clinical effect of 23G and 25G+vitrectomy for retinal detachment.?METHODS:Forty seven patients with retinal detachment were treated with 23G vitrectomy (27 eyes in 27 cases as group A) and 25G+ vitrectomy (20 eyes in 20 cases as group B ) . The operation time and the incidence of intraoperative complications were recorded. The occurrence of retinal reposition, visual acuity, intraocular pressure ( IOP ) and complications were observed. Postoperative follow-up time of the two groups were 3d, 1wk, 3mo. The relevant records were statistically analyzed and compared.?RESULTS: The operation time of 23G group and 25G+group were 50. 21+4. 52min, 49. 15+5. 14min,respectively and there was no significant difference between the two groups (P>0. 05). The main complications were retinal hemorrhage and iatrogenic retinal hole. There were 3 eyes with retinal hemorrhage, 2 eyes with iatrogenic retinal hole in 23G group, and 1 eye with retinal hemorrhage, 1 eye with iatrogenic retinal hole in the 25G+group, and the difference was statistically significant ( P<0. 05). The postoperative visual acuity of 23G group and 25G + group were significantly improved, and the differences between the two groups were not statistically significant at different time points after operation ( P>0. 05). The number of eyes with hypotonia in 23G and 25G+group were 3 and 1 eyes respectively, the difference was statistically significant ( P < 0. 05 ). But there were no significant differences between the two groups on IOP at 1wk and 3mo after surgery (P>0. 05). At the last follow-up, the results showed that 26 eyes ( 96%) with retinal reposition in 23G group, 19 eyes (95%) in 25G+ group, the difference was not statistically significant (P>0. 05).?CONCLUSION: The clinical effect of 23G and 25G+vitrectomy for retinal detachment is similar, but 25G+vitrectomy can reduce incidence of complications and early postoperative low IOP.

Objective To investigate the effect of intravenous thrombolysis with different doses of alteplase on neurological function in patients with acute ischemic stroke.Methods 120 patients with acute ischemic stroke were selected as the research subjects.According to the admission time,the patients were divided into the observation group and the control group,60 patients in each group.The observation group was treated with low dose alteplase(0.6mg/kg),the control group was given standard dose(0.9mg/kg).The clinical curative effect,incidence rate of adverse event,NIHSS score and mRS score before and after treatment were observed and recorded in the two groups.Results Before treatment,there was no significant difference between the two groups in NIHSS score(t=0.288 0,P=0.773 9).After treatment for 3 days,the NIHSS score of the control group decreased compared with before treatment,and was lower than that of the observation group at the same period,there was significant difference between the two groups(t=0.778 5,P=0.000 0).Before treatment,the mRS score between the two groups had no siginificant difference(t=0.801 0,P=0.424 7).After treatment for 90 days,the mRS score of the two groups decreased,the difference was statistically significant(t=6.811 5,P=0.000 0).After treatment,1 patient with cerebral hemorrhage was observed in the observation group,while 3 cases in the control group,the difference between the two groups was not statistically significant(χ2=1.034 5,P=0.309 1).The mortality of the observation group was 11.47％,which of the control group was 1.67％,there was significant difference between the two groups(χ2=4.821 4,P=0.028 1).The good prognosis rate of the observation group was 45％,which of the control group was 68.33％,the difference was significant between the two groups (χ2=6.651 6,P=0.009 9).Conclusion Standard dose of alteplase in the treatment of acute ischemic stroke has better efficacy than low-dose alteplase,it has improved conditions of neurological deficits in patients,better recovery of neurological function,the prognosis is good,it can be widely recommended.

Objective To investigate the effect of L-carnitine combined with psychological intervention on nutritional status and inflammatory status in maintenance hemodialysis patients. Methods 75 cases of maintenance hemodialysis patients treated in our hospital from September 2016 to December 2016 were randomly divided into control group(n=37) and study group(n=38)by single and double number method (hospital visit order). The control group in the hemodialysis treatment combined with Levocarnitine; the study group in the use of L-carnitine combined with psychological intervention. Results There were no significant differences in ALB, Hb, BMI, IL-6 and CRP between the two groups before treatment. After the corresponding treatment, the improvement of ALB, Hb, BMI, IL-6, CRP and other inflammatory indexes and nutritional indexes in the study group were better than those in the control group(P<0.05). Conclusion The application of L-carnitine in maintenance hemodialysis patients combined with psychological intervention can significantly improve the body's Micro inflammatory status and nutrition indicators, has positive significance to protect the patients' quality of life and physical and mental health.

Objective To investigate the effects of prostaglandin E1 (PGE1) on renal cell apoptosis in rats with diabetic nephropathy(DN). Methods Totally 55 male Wistar rats were intraperitoneally injected with streptozotocin (STZ) to develop DN model.46 successfully established DN rat models were randomly divided into 4 groups:PGE1 group received PGE1 intravenously at dose of 10 μg · kg-1 · d-1 for 10 d (n=12),angiotensin converting enzyme inhibitors(ACEI) group given ACEI orally at dose of 10 mg kg-1·d-1 for 8 W(n=12),PGE1+ACEI group given both PGE1 and ACEI (n=11),DN control group(n=11) and normal control group(n=10) given saline only.All rats were killed after 8 weeks and blood samples or kidney tissue were collected.Blood urea nitrogen (BUN),serum creatine(Scr),albuminuria of 24 h were detected.Renal pathological morphology and apoptosis of renal cells were observed by HE staining and terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling (TUNEL) test. Results At 8 week after treatment,the 24-hour urinary albumin levels were decreased significantly in the following order:DN control group＞ PGE1 group ＞ ACEI group ＞PGE1+ ACEI group＞ control group[(374.6±54.1)μg,(570.0±72.5)μg,(253.1±28.9)μg vs.(1123.4±106.2)μg,P＜0.01 or P＜0.05].BUN[(9.3±2.6)mmol/L,(11.0±3.5)mmol/L,(8.4±2.2)mmol/Lvs.(15.1±4.0)mmol/L]and Scr [(74.5±19.2) umol/L,(83.5± 15.8)μmol/L,(64.6±17.3) μmol/L vs.(117.7±33.0)μmol/L]levels after treatment were also reduced in PGE1,ACEI and PGE1 + ACEI groups as compared with DN control group (P＜0.01or P＜ 0.05). Pathological manifestations of all treatment groups showed better results than DN group,and PGE1 + ACEI group was the best.There was no obvious apoptosis in glomerular area with on significant differences between groups.While apoptosis of renal tubules was observed in DN rats. Conclusions Renal tubule but not glomerular cell apoptosis may play some role in Prostaglandin E1 reduciug albuminuria.

BACKGROUND: The existing electrocardiogram(ECG)measurement strongly depends on medical professionals and inefficient high-intensity,or relies on automatic identification method which is not accurately enough.Thus,this is difficult to meet high-speed testing,accurate results and ease application for common people.OBJECTIVE: To develop a new method that was simple and efficient to apply and very easy to learn.METHODS: Algorithms were programmed and test software was developed by delphi7.0.ECG was drawn on screen.The apex,the starting point and the ending point as well as the J-point of each ECG wave were clicked by mouse or stylus.Then the wave parameters and an initial diagnosis could be quickly obtained by test software.RESULTS AND CONCLUSION: The parameters of ECG waveform such as wave height,wave time,PR interval,ST segment,QT segment,PP/RR time,cardiac electrical axis and so on could be accurately measured,and heart rate,heart rhythm and the deflection of cardiac electrical axis could be diagnosed correctly.The method was simple to learn and easy to imply,and it was also efficient,quick and accurate.Thus,it could greatly improve the efficiency of measurement and analysis for specialists,and could meet application requirements of general medicals and ordinary people.

Objective To preliminary investigate fetal left heart function of fetuses in α-thalassemia using spatio-temporal image correlation (STIC).Methods 95 volumes from fetal hearts in singleton pregnancies at 20-28 weeks of gestation were collected.STIC datasets were frozen in end-systole and enddiastole.Ventricular volumes were measured using VOCAL,Inversion and SonoAVC.The stroke volume was calculated from these measurements.Results All data sets could be measured with all three techniques in this study.The intraclass correlation coefficients (ICCs) between techniques were all ＞ 0.90.The time necessary to measure the stroke volume was significantly shorter using SonoAVC than using VOCAL and Inversion.Bland-Altman plots showed no clinically significant mean percent differences between stroke volume measurements obtained from each ventricle using three techniques.The left ventricular end-systole volume(ESV),stroke volume(SV)and ejection fraction(EF)was significantly different than fetuses with normal heart (P ＜ 0.05).Conclusions This study shows the feasibility of measuring left ventricular volumes during either systole or diastole and thereby calculating stroke volumes with all three techniques.And there was a high degree of reliability for all three techniques,as shown by excellent ICCs.There was good accuracy of STIC techniques in measuring fetal left ventricular volumes with cardiomegaly.

Background Angiogenesis is an essential event for the growth and mobility of malignant tumors,but there is little literature about the effects of anoxia and angiogenesis-related factors on angiogenesis in choroidal melanoma.Objective The aim of this study was to investigate the expression of angiogeneic factors such as hypoxia inducible factor-1α(HIF-1α),inducible nitric oxide synthase(iNOS),cyclooxygenase-2(COX-2),and vascular endothelial growth factor(VEGF)in choroidal melanoma and their clinical significance.Methods The specimens from 44 cases of choroidal melanoma and 16 cases of eyelid nevi identified by pathology were collected.Immunohistochemistry SP was used to examine the expression of HIF-1α,iNOS,COX-2 and VEGF in the samples.The expression of HIF-1 α,iNOS,COX-2 and VEGF in tumors with different sizes,different pathological types and different growth patterns was evaluated.The correlations among these four proteins in tumor growth and development were assessed.Results The expression of HIF-1α,iNOS,COX-2 and VEGF in choroidal melanoma were significantly higher than those in the eyelid nevi group(x2 =6.58,4.105,8.350,13.240,P＜0.05).The expression of VEGF was associated with tumor size(x2 =9.389,P＜0.05),but not associated with pathological types(x2 =1.186,P＞0.05)and infiltration depth(x2 =5.398,P＞ 0.05).The expression of HIF-1α was associated with tumor size(x2=8.664,P＜0.05)and pathological type(x2=6.622,P ＜ 0.05),but not associated with infiltration depth(x2=4.914,P＞0.05).The expression of iNOS was associated with tumor size(x2 =8.609,P＜0.05),but was not associated withpathological type(x2 =4.789,P＞0.05)and infiltration depth(x2 =4.309,P＞0.05).The expression of COX-2 was associated with tumor size(x2 =7.320,P＜0.05),but was not associated with pathological type(x2 =2.772,P＞0.05)and infiltration depth(x2 =2.103,P＞0.05).The expression of HIF-1 α,iNOS,and COX-2 were significantly correlated with the expression of VEGF(r =0.943,1.000,0.986,P ＜ 0.05).The expression of COX-2 was significantly correlated with the expression of iNOS(r =0.986,P＜0.05).The expression of HIF-1 α was significantly associated with the expression of COX-2(r=0.986,P＜O.05).The expression of HIF-1α was significantly associated with the expression of iNOS(r=0.943,P＜0.05).Conclusions The expressions of the HIF-1 α,iNOS,COX-2 and VEGF protein are up-regulated in choroidal melanoma.They may play important roles in the angiogenesis of the choroidal melanoma.Assessment of the expression of HIF-1α,iNOS and COX-2 may be useful for the diagnosis and therapy of choroidal melanoma.

Various questionnaires for screening diabetes in Chinese population were evaluated. Two questionnaires (Finnish Diabetes Risk Score and Danish Diabetes Risk Score) were applied. Sensitivity, specificity and the area under the receiver operating characteristic (ROC) curve (AUC) for both questionnaires were calculated. The AUCs were 0. 760 (95% CI: 0.713-0.806) for the Finnish questionnaire (P<0.01) and 0.706 (95% CI: 0.647-0.764) for the Danish one (P<0.01). The sensitivities, specificities and predictive values of both questionnaires were not so good in the present survey as in the published reports. It suggests that these screening questionnaires must be modified to suitable for Chinese population.

Objective To investigate the relationship of the metastasis-associated genes and its copy numbers variation in the highly metastatic human epithelial ovarian cancer cell line HO-8910PM. Methods The differentially expressed genes and its copy number variation between HO-8910PM cell line and normal ovarian tissues was detected by human genome UI33A 2.0 gene chip and human mapping 10K array 2.0 gene chip, and the data was analyzed by bioinformatics. Some of metastasis-associated genes were validated the results of single nucleotide polymorphism (SNP) and cDNA chips by fluorescence in situ hybridization (FISH) and real-time quantitative PCR. Results Integrate analysis of two gene chips data showed that there were 385 differentially expressed genes in the same and 379 SNP positional point (6 of them, included 2 genes) between HO-8910PM cell line and normal ovarian tissues, these copy number amplification of 379 SNP positional point of chromosome were ≥3, which had 240, deletion ≤ 1 had 139. Chromosome location analysis showed that there were 385 differentially expressed genes located at all chromosomes, and 261 of them ( 67.8%, 261/385 ) located at 10 chromosomes, included that 34 (8.8% ), 33 ( 8.6% ), 28 (7.3%), 27 (7.0%), 25 (6.5%), 24 (6.2%) of them located at chromosome 3, 2, 9, 10, 1 and 11 respectively, and 23 (6.0%) of them at chromosome 6 and 12 each, 22 (5.7%) of them at chromosome 4 and 5 each. For the function of differentially expressed genes, the results showed that 99 (25.7% ) genes belonged to the family of enzymes and their regulators, 54 ( 14.0% ) genes associated with signal transduction, 50 (13.0%) genes associated with nucleic acid binding, and 36 (9.4%) genes associated with protein binding. Conclusion We have demonstrated that there are 4 kinds of differentially expressed genes related to metastasis of ovarian cancer, which belonged to the families enzyme and its regulator, nucleic acid binding, signal transduction and protein binding, and located at chromosome 1, 2, 3, 4, 5, 6, 9, 10, 11 and 12.