Congenital diaphragmatic hernia (CDH) is one of the most common congenital malformations and the most deadly types of congenital disease.Pulmonary hypertension (PH) and pulmonary hypoplasia are the most important causes of determining the prognosis of CDH.The prenatal evaluation indicators and management of PH is a difficult point and hot issue of present international study.This article reviewed the new progress of pathogenesis,prenatal evaluation predictor,clinical diagnosis and treatment of CDH complicated with PH.

Humans ; Neoplasms, Muscle Tissue ; congenital ; diagnosis

Objective To share our experiences on integrated services in providing fetal diagnosis and postnatal treatment for congenital diaphragmatic hernia(CDH).Methods A retrospective analysis was conducted on 25 pregnancies diagnosed as CDH by both prenatal ultrasound and MRI in Maternal and Children Hospital of Guangdong Province from January 2012 to January 2014.All of the subjects received integral medical management including prenatal management (prenatal diagnosis and consultation), perinatal management (prenatal care and delivery) and neonatal treatment.Results Among the 25 CDH fetuses, 11 were mild, nine were moderate, and five were severe.One severe case, who was diagnosed at 26 gestational weeks, was aborted on demand of the mother.The other 24 cases continued their pregnancy and all delivered after 35 weeks including 13 cesarean sections (one due to twin pregnancy and 12 due to maternal demand) and 11 vaginal birth.The mean gestational age when CDH was diagnosed was (24.5 ± 3.5) weeks, and the 24 women delivered at an average of (37.5 ± 1.4) gestational weeks.The eleven mild cases accepted mask oxygenation.For those 13 moderate or severe CDH cases, all received dexamethasone to promote fetal lung maturity at 32 gestational weeks, seven were intubated before clamp the cord, and the other six did after.These 13 babies accepted high-frequency oscillation ventilation, with a median duration of 58 hours, and some of them treated with inhaled nitric oxide on requirement with a median duration of 52 hours.Except two cases died before operation, the rest 22 cases underwent neonatal surgery.One moderate case died at 48 hours after surgery due to pulmonary hypertension and respiratory failure.Another one severe case withdrew treatment at two months old.The other 20 infants recovered fully.Conclusions Integrated management including prenatal diagnosis and postnatal treatment, provides an effective and streamlined mode for diagnosis and treatment of CDH.Therefore,it might minimize potential medical risks.

Objective To investigate the effects of hyperbaric oxygenation(HBO)therapy on serum con- centrations of soluble intercellular adhesion molecule-1(slCAM-1),soluble vascular cell adhesion molecule-1(sV- CAM-1),soluble E-selectin(sE-selectin)and matrix metalloproteinase-9(MMP-9)in patients with aeute cerebral infarction and their clinical implications.Methods One hundred and twelve cases of cerehral infarction in the ca- rotid artery system were assigned into two groups.Patients in the routine treatment group(RT group,n=62)were treated with routine clinical treatment regime,whereas those in the HBO group(n=50)were treated with H BO ther- apy in additioo to routine clinical treatment.Thirty age- and sex-matched normal subjects were recruited and served as controls.The serum concentrations of sICAM-1,sVCAM-1,sE-selectin and MMP-9 were measured hy using ELISA method before and 10 days after treatment.The assessment of neurological deficits using National Institutes of Health Stroke Scale(NIHSS)score was conducted before treatment,and at 10 and 30 days after treatment,and the therapeutic efficacy was evaluated.Results The concentrations of sICAM-1,sVCAM-1,sE-selectin and MMP-9 of the patients were significantly higher than those of the control subjects.These parameters were all decreased signifi- cantly after treatment in the two patient groups.Moreover,these parameters were lower in the HBO group than those in the RT group after treatment.The NIHSS scores of HBO group were significantly lower than that of the RT group at the 30th clay post-treatment.The effective rate of HBO group was higher than that of RT group.Conclusion HBO therapy can decrease the serum levels of sICAM-1,sVCAM-1,sE-seleetin and MMP-9,which might be one of the mechanisms of HBO in the treatment of cerebral infarction.

OBJECTIVETo observe the changes of electrocardiogram (ECG) and pregnancy outcome of the late pregnancy women.

METHODSLate pregnancy women were divided into two groups by age: over 35 group and under 35 group. The incidence of abnormal electrocardiogram was recorded when the patients were subjected to routine ECG examination. Then the pregnancy, delivery outcome and if there's low birth weight newborn were recorded later.

RESULTSThe incidence of abnormal ECG in over 35 group was significantly higher than that in under 35 group (P < 0.05). And the incidence of ST segment changes, arrhythmia in the group of former was higher than that in the group of latter (P < 0.05). Among the different type of arrhythmia, the incidence of sinus bradycardia and ventricular premature beat in the group of former were higher than those in the group of latter (P < 0.05). But the incidence of sinus tachycardia in the former group was obviously lower than that in the latter group (P < 0.05). The incidence of pregnancy loss in over 35 with abnormal ECG group was significantly higher than that in under 35 with normal or abnormal ECG groups (P < 0.05). The incidence of premature birth in over 35 with abnormal ECG group was significantly higher than that in over 35 with normal ECG group (P < 0.05). The incidence of low body weight in over 35 with abnormal ECG group was significantly higher than that in under 35 with normal ECG group (P < 0.05).

CONCLUSIONThe late pregnancy women with the age of over 35 are more likely to have ECG abnormalities, such as arrhythmia, myocardial ischemia and so on. The older pregnant women with abnormal ECG easily suffer from pregnancy losing, premature birth and having a low birth weight baby.

Adult ; Age Factors ; Arrhythmias, Cardiac ; epidemiology ; Electrocardiography ; Female ; Humans ; Pregnancy ; Pregnancy Outcome ; epidemiology

OBJECTIVETo search for an optimum method for testicular prothesis implantation in the treatment of testis loss.

METHODSWe retrospectively analyzed the surgical methods and outcomes of 53 cases of terminal prostate cancer and 4 cases of unilateral testicular torsion treated by implantation of testicular prothesis with the polypropylene mesh.

RESULTSThe 57 male patients all received testicular prothesis with the polypropylene mesh. All the patients were satisfied with the appearance and size of the scrotum after surgery. No scrotal hematoma, prosthesis infection, or autoimmune disease occurred postoperatively.

CONCLUSIONTestis loss is not a rare condition clinically, for the treatment of which surgical implantation of testicular prothesis with the polypropylene mesh can achieve both a fine tissue compatibility and a desirable scrotal appearance.

Humans ; Male ; Polypropylenes ; Prostatic Neoplasms ; surgery ; Prostheses and Implants ; Retrospective Studies ; Scrotum ; Spermatic Cord Torsion ; surgery ; Surgical Mesh ; Testis

Follicle-stimulating hormone (FSH) is synthesized and secreted by the anterior pituitary, which binds to its receptors expressed on the membrane of Sertoli cells in the testis to bring about spermatogenesis. With the development of DNA sequencing technology, FSH SNPs rs10835638 and FSHR SNPs rs6165, rs6166, and rs1394205 were detected, which might directly affect the expression of FSH and activity of FSHR, resulting in male spermatogenic dysfunction. This review focuses on the relationship of FSH and FSHR gene polymorphisms with male infertility.
Follicle Stimulating Hormone ; genetics ; Humans ; Infertility, Male ; genetics ; Male ; Polymorphism, Single Nucleotide ; Receptors, FSH ; genetics ; Sertoli Cells ; Spermatogenesis ; Testis

Photothermal therapy (PTT) is a highly effective anti-tumor method. However, when laser radiation was used to ablate tumors, it usually triggers a series of inflammatory reactions, promoting the further development of tumors and affecting the effect of anti-tumor therapy. Therefore, it is an effective method to improve the anti-tumor effect by suppressing the inflammatory response through the precise targeted delivery of anti-inflammatory drug while realizing the photothermal treatment of tumors. To this end, the redox-responsive linker 3,3'-dithiodipropionic acid was used to bond the classic hydrophobic anti-inflammatory drug 18β-glycyrrhetinic acid (18β-GA) and the hydrophilic fragment methoxy-polyethylene glycol (mPEG-NH₂) to obtain redox-responsive amphiphilic polymer PEG-DA-GA in this study. Then, photothermal agent IR-780 was encapsulated to prepare redox-responsive polymer micelle PDG/IR-780 NPs. The PDG/IR-780 NPs exhibited uniform particle size of 80.2 ± 5.3 nm and the polydispersity index (PDI) was 0.215 ± 0.079. All animal experiments followed the ethical requirements formulated by the Ethics Committee of Sichuan University. The results showed that PDG/IR-780 NPs could respond to the abundant glutathione (GSH) in tumor cells to promote the disintegration of nanoparticle and the release of 18β-GA, thus significantly improved the killing efficiency on 4T1 cells, when compared with the non-redox-responsive control PSG/IR-780 NPs. When the concentration of 18β-GA was 50 μg·mL^-1, the cell viability of 4T1 cells in the PDG/IR-780 NPs group was only (19.29 ± 1.80) %, which was significantly lower than the result of in PSG/IR-780 NPs group (29.30 ± 1.37) %. The results of frozen sections of tumor tissues showed that the designed PDG NPs can promote the tumor-targeted distribution of drugs compared with the free drug group. Eventually, PDG/IR-780 NPs achieved wonderful anti-tumor efficacy on 4T1 triple-negative breast cancer model, revealing the new possibility of the combined therapy strategy of photothermal and anti-inflammatory therapy.

Objective To explore the pulmonary function,DVH and radiation pneumonitis after three-dimensional conformal radiation treatment ofⅢphase non-small-cell lung cancer.Methods 71 pa- tients (male 52,female 19,median age 63,KPS≥80) were evaluated by pulmonary function tests before radiotherapy and in M1 and M3 after radiotherapy respectively.After 3 months of follow-up time,it reviewed the appearance and grade of radiation pneumonitis.Then V_(20),V_(30) and MLD were worked out from dose vol- ume histogram.Results All patients completed radiotherapy,and total dose was 66-70 Gy.FVC (L), FEV1 (L) and CLCO were (2.58?0.65) L,(1.85?0.58) L and (15.15?4.65)ml/(min)before radio- therapy,with (2.96?0.76) L,(2.13?0.65) L and (14.71?3.92) ml/(min) in Ml after radiotherapy, with (2.65?0.61) L,(1.92?0.52) L and (13.15?3.71)ml/(min)in M3 after radiotherapy.The ac- cidence of radiation pneumonitis was 30%,moderate and severe radiation pneumonitis was 7%.With V_(20), V_(30) and MLD increasing,the grade of radiation pneumonitis was increasing.V_(20),V_(30) and MLD were related to the change in CLCO value among before,M1 and M3 after radiotherapy,and the correlation coefficient was more than 0.2.Conclusions There is a relationship in the pulmonary function,DVH and radiation pneu- monitis surely.The change in C_LCO value between before radiotherapy and M1 after radiotherapy could pre- dict the radiation pneumonitis.V_(20),V_(30) and MLD are not only correlated to radiation pneumonitis evidently but the change in FEV_1 and C_LCO after radiotherapy.

Objective To investigate the relationship between high-sensitivity C-reactive protein(hsCRP), pulse pressure(PP) and microalbuminuria(MAU) in patients with essential hypertension.Methods Consecutive 60 patients with essential hypertension were classified based on the MAU level:patients with MAU(n=30) and the group of patients with normoalbuminuria(NMAU,n=30) with 30 healthy subjects as control.MAU,hsCRP,PP were determined.Results The level of hsCRP and pulse pressure in MAU group were higher than those in NMAU patients and healthy subjects (P