ObjectiveTo evaluate the probability of the fetal heart scanning in first trimester(11 -14+6 week) by transabdominal ultrasonography.MethodsBy using advanced ultrasound machine with high resolution transabdominal probe,249 fetal hearts were scanned.Four chamber view,left and right outflow view,three vessels view were obtained.The successful observation rates of these views under different gestational age were recorded.For 18 pregnant women with suboptimal transabdominal scanning condition,transvaginal scan were supplemented.ResultsAmong 249 singleton fetuses with low risk of congenital heart disease,four chamber view was successfully visualized in 227 (91.2％),left outflow view in 125(50.2％),right outflow view in 102(40.9％),three vessels view in 98(39.4％).The successful observation rate of these four views increased with gestational ages.The successful observation rate of each view in successive gestational age showed remarkable difference (P ＜ 0.05).The four chamber view had the highest successful observation rate with 95％ after 12 weeks.After 13 weeks,left and right outflow views visualizing rate was above 85％.Transvaginal scanning can increase the four chamber view successful observation rate.For observation of other views,transvaginal scanning,however,showed no superior than transabdomial scanning.ConclusionsHigh resolution transabdominal probe can be used to perform the fetal hearts scanning in early trimester.It will benefit to find the fetal heart malformation.

ObjectiveTo develop a new formula to estimate macrosomia weight and compared with published 25 formulas.Methods1153 fetuses including 239 macrosomia within one week of delivery were considered.Two-dimensional ultrasound measurements of the fetal biparietal diameter (BPD),head circumference (HC),abdominal circumference (AC) and femur length (FL) were performed and recorded by experienced sonographers.The birth weight were measured after the babies born.The formula finding group,1034 fetuses including 914 fetuses weighting less than 4000g and 120 macrosomia,were utilized to generate an overall regression formula by stepwise linear regression.120 macrosomia were used to established the formula for estimating macrosomic weight.As the training group,other 119 macrosomia were used to test the new formula and compared with other 25 existing formulas.ResultsThe new formula for whole weight was:lgBW =0.180 (HC) + 0.00628 (AC) - 0.00318 (HC)2 + 0.00173 (AC) (FL) +0.0000430(BPD)(HC)2.The new formula for macromia was:lgBW =0.730(BPD) -0.0375 (BPD)2 +0.000264(AC) (FL).The new method gave ( - 87.89 ± 230.95)g of estimation error and (4.4 ± 3.9) ％ of absolute percentage error,while the best existing formula provided (115.61± 345.09)g and (6.8 ± 5.4)％.With the new method,89.1％ of estimates fell within ± 10％ of the actual birth weight,while the best existing formula gave 75.6％.ConclusionsThe new formula was based on typical Chinese Han women,the error was lower and more suitable than those developed formulas for Chinese populations,especially for macrosomia fetuses.

Objective To explore the Csx/Nkx 2.5 gene expression in the heart during the embryonic period and its mutation in subjects with congenital heart disease(CHD). Methods Immunohistochemistry was used to reveal the Csx/Nkx 2.5 gene expression, and PCR-SSCP-silver staining and DNA sequencing for mutation. Sixty-three embryos or fetus, 126 children with congenital heart diseases and 30 normal controls were included in the study. Results Elevated expression of Csx/Nkx 2.5 gene was found in atrium and trabecular of ventricle. After 16 weeks of gestation, the expression in atrium was stable, while slightly reduced in the trabecular. The expression in the ventricle was lower than that in the atrium in early embryonic stage followed by continuous increase which was most remarkable in 13~16 weeks and kept stable after 16 weeks. No expression of Csx/Nkx 2.5 was detected in epicardium. Three different kinds of gene polymorphisms in the third base of the 21st amino acid codon were found in all subjects:A,G,A/G. Conclusions Gene Csx/Nkx 2.5 plays an important role during the fetal heart development and its expression varies in different parts of the heart during different period in fetal development. Neither the sporadic nor the CHD cases showed any mutations in this study.

Acute kidney injury (AKI) is caused by a variety of causes resulting in rapid decline in renal function and manifestingclinical syndrome, whether mild or severe kidney damage it caused, the permanent loss of renal function will exist; the mortality of patients with septic AKI is as high as over 70%. Renal replacement therapy (RRT) can significantly improve the clinical prognosis of patients with AKI and reduce its mortality. However, the selections of RRT treatment mode, dose and timing of start or stop exist a lot of controversies. In this report, as using RRT to treat critically ill patients with AKI is still a hot topic in academic research, the related literatures of RRT guidelines, score evaluation, renal function indexes and biological marker aspects were reviewed and summarized.

Adenoma ; diagnosis ; etiology ; Adult ; Esophageal Neoplasms ; complications ; diagnosis ; Humans ; Male ; Parathyroid Neoplasms ; diagnosis ; etiology

Actins ; metabolism ; Adult ; Desmin ; metabolism ; Diagnosis, Differential ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Immunohistochemistry ; Leiomyoma ; pathology ; Leiomyosarcoma ; metabolism ; pathology ; surgery ; Male ; Mediastinal Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Allergic rhinitis and rhinosinusitis often complicate with asthma,and their relationship has long been investigated.From the view of epidemiology,all of these three diseases have higher prevalence,complicate with each other,are risk factors and prognostic factors for each other.Besides,they share common in anatomy and pathophysiology.In this paper,the interrelationship among allergic rhinitis,rhinosinusitis and asthma in pathogenesis is discussed.

Objective To assess the effectiveness of supracricoid partial laryngectomy in the treatment of laryngeal cancer. Methods This study infiuded 22 patients operated on from 1993 to 2000 using this surgical procedure. 22 were males with mean age of 63 years (ranging from 43 to 74 years). 21 were glottic cancers (3 T1aNoMo, 4 T1bNoMo, 11 T2NoMo, 3 T3NoMo) and 1 supraglottic cancer (T2N1Mo) according to the 1997 UICC system. Supracrieoid partial laryngectomy was performed, with the epiglottis preserved and reconstructed with cricohyoidoepiglottopexy (CHEP). Results The overall 3-year and S-year survival rates were 88.24％ and 70％, respectively. All patients were decannulated. The average time for decannulation was 25 days (ranging from 14 to 60 days). Speech was good in all cases. Conclusion CHEP not only excises the neoplasms completely and safely but also preserves the laryngeal physiologic function well.

ObjectiveTo measure fetal lung volumes in different gestational age (GA) by using 3D ultrasound,and further to obtain the regression formula between fetal lung volume and GA.MethodsTotal 228 fetal lung data had been collected.By using the 3D reconstruction function in Philips Qlab,fetal lung volumes were obtained by subtracting the non lung volumes from the whole thoracic volumes.For each slice of 3D data,thoracic area and non-lung area were manually outlined.The contour stacking technique in Qlab was then used to transform 2D slices into 3D volumes.ResultsThe measurement results of total 228 cases indicate that the fetal lung volumes increase with the GA.The average lung volume at GA of 20 weeks was 8.85 cm3,and 70.5 cm3 at 36 weeks.The fetal lung volume increases about 3- 4 cm3 in each week,and the increasing trend turns to a little lower after 24 weeks.During 33 to 34 week there was a great increasing in fetal volumes.Second-order regression,exponential regression and logarithmic regression were respectively used to characterize the relationship between fetal lung volume and GA.The second-order regression formula was:Volume =39.52 - 4.48 × GA + 0.149 × GA2.The exponential regression formula was:Ln (Volume) =- 8.233 + 1.747 × Ln(GA2 ).The logarithmic regression formula was:Ln(Volume) =- 2.413 + 0.29× GA- 0.003 × GA2.The correlation coefficients of three formulas are equal,with r =0.99,P ＜ 0.001.Conclusions 3D ultrasound fetal lung volume measurement is useful for fetal lung maturity assessment and thus can provide important referential information for prenatal diagnosis.

Objective To evaluate the accuracy of the fetal weight estimation system in terms of estimating the fetal weight.Methods The fetal weight estimation system developed by the Department of Electronic Engineering,Fudan University was applied to estimate the fetal weight in many hospitals,and the differences between the estimated results of the system and the actual weight of newborn fetuses,as well as the accuracy of the estimation system and the traditional estimation methods were compared.Results A total number of 610 cases were employed,with each case including the ultrasound images of fetus before birth,the corresponding measurement data and the newborn weight.The correlation coefficients between the weight of the newborn babies and the fetal parameters,which were measured by the estimation system in terms of the biparietal diameter,the head circumference,the abdomen circumference and the femur length,were higher than those obtained by manual annotations,with improvements of 0.08,0.17,0.09 and 0.05,respectively.The absolute error of the estimated weight of the system with respect to the actual weight was 44 g smaller than those estimated by traditional method,and the variance of the absolute error was 53 g smaller;while the corresponding absolute percentage error was 1.8％ lower,and the corresponding variance percentage was 1.5％ lower.Conclusions The fetal weight estimation system improves the accuracy of the prenatal ultrasound assessment and provides reliable information to clinical diagnosis.