Objective To explore ultrasonographic diagnosis of severe fetal limb deformity in early pregnancy.Methods A total of 5 843 cases of pregnant women were screened and 147 cases of suspected fetal malformation were sellected.The routine ul-trasound examination results were recorded as control group,and continuous order tracking ultrasonic method inspection results were recorded as observation group.The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value was compared.Results The clinical results obtained in multiparous or limb malformation fetus were 40 cases,accounting for 27.21%. In the observation group on limb loss and other detection rate of 100% (14/14)and 65.00% (13/20),significantly higher than those in control group 50.00% (7/14)and 5.00% (1/20).But in the observation group on finger deformity examination showed no advantage.Observation accuracy,sensitivity and negative predictive value was 91.84%,70.00%,89.92%,which were higher than those in the control group(78.91%,22.50%,77.54%).The differences were statistically significant (P <0.05).Conclusion The application of continuous order tracking ultrasonic method to check the first trimester fetal limb deformity with high accuracy,pro-vided sufficient time for prenatal diagnosis of fetal treatment and late.

Objective To explore the nursing care for the stiff-man syndrome patient.Methods Retrospective analysis had been performed for the nursing care of a patient with stiff-man syndrome.Results After 4 weeks of careful treatment and nursing care,the patient was discharged from the hospital.Conclusions Suitable nursing according to patients' condition,medication monitoring,psychological care,safety nursing and health guidance can prevent or delay the development of the disease and promote comprehensive rehabilitation for patients.

OBJECTIVE:To observe the clinical efficacy of Chinese medicine inunction wet dressing therapy and helium neon laser in the treatment of rheumatoid arthritis.METHODS:Both groups received Methotrexate tablets,Salazosulfapyridine tablets,Loxoprofen tablets.Observation group were additionally treated with Chinese medicine inunction wet dressing therapy and helium neon laser with a treatment course of 30 days.RESULTS:The effective rate was 70.00% for control group and 93.55% for observation group,there was significant difference between two groups(P

Objective To study the behavioural changes and biological effects of selective adenosine A2A receptor antagonist (CSC) in a rat model of levodopa(L-DOPA) -induced dyskinesia (LID).Methods The hemi-parkinsonian rat model was produced by stereotaxically injecting 6-OHDA to the right medial forebrain bundle. Rats were randomly divided into 4 treatment groups with a random number generating program to receive intraperitoneal injections twice daily for 21 days (n = 10): saline, L-DOPA at 25 mg/kg with benserazide at 6. 25 mg/kg, CSC at 2. 5 mg/kg alone and CSC at 2.5 mg/kg with L-DOPA at 25 mg/kg plus benserazide at 6. 25 mg/kg. Forepaw adjusting steps, abnormal involuntary movements (AIM) and rotational response duration were observed on 2, 9, 11,18 and 21 d. After sacrifice, the expression of adenosine A2A R and mGluR5 was observed by Western blot. Results Co-administration of LDOPA with CSC significantly increased the forelimb adjusting steps of parkinsonian rats during 21 days of treatment when compared to L-DOPA alone. CSC treatment alone increased the forelimb adjusting steps significantly. Co-administration of L-DOPA with CSC ( ( 11 ± 5 ) score) significantly decreased the AIM scores of limb and orolingual muscles when compared to L-DOPA alone (( 17 ± 4) score; t = 2. 44, P ＜0. 05). The subchronic L-DOPA treatment upregulated the striatal expression of adenosine A2A R and mGluR5. However, co-administration of L-DOPA with CSC reversed the shortening of the rotational motor response duration induced by L-DOPA administration during the period of the treatment and attenuated the LDOPA-induced upregulation of adenosine A2A R and mGluR5 expressions. Conclusions CSC improves motor function in a hemi-parkinson rat model, potentiates the antiparkinsonian effects with L-DOPA and partly attenuates LID. Co-administration of L-DOPA with CSC reverses the L-DOPA-induced upregulated expression of A2A R and mGluR5, indicating the involvement of both A2A R and mGluR5 in the onset and progression of LID. Adenosine A2AR antagonists may be promising drugs for treatment of LID.

Objective To investigate the respiratory pathogen distribution characteristics in children with acute respiratory disease(ARD).Methods Distribution of respiratory pathogen in 28 600 children with ARD,treated from January 2011 to December 2014 in this hospital,were analyzed.Results Among the 28 600 children,12 162 cases were pathogen positive,including 7 704 cases(63.34%) with single pathogen infection and 4 458 cases(36.66%) with more than two kinds of pathogens infection.Time,season,sex and age distribution of pathogen infection were with statistical difference(P<0.05).There was significant difference in infection rate of pathogens between different time(P<0.05).Infection rate of Mycoplasmal pneumonia(MP) was the highest,and the infection rate of MP and influenza B virus(IFB) increased year by year.Except Legionella pneumophila(LP),the season distribution of infection rate of MP,Coxiella burneti(COX),Chlamydia pneumoniae(CP),adenovirus(ADV),respiratory syncytial virus(RSV),influenza A virus(IFA),IFB and parainfluenza virus(PIVs) were with statistical difference(P<0.05).The infection rate of MP and IFB were higher in the whole year.Conclusion Distribution of respiratory pathogen in children with ARD might be related with the changes of gender,age and season.Detection of respiratory infection pathogen could be with guiding value for clinical diagnosis and drug selection.

Purpose:To evaluate the effect and toxicity of gemcitabine cisplatin combination in elderly patients with advanced NSCLC.Methods:32 elderly patients were treaded with Gemcitabine 1 000 mg/m 2 on day 1,8 and DDP 70 mg/m 2 on day 1. The second treatment cycle was given on day 22.Results:Each patient was given at least 2 cycle chemotherapy. All together 134 cycles were given. The overall response rate (the completed response plus partial response) was 43.8%. The main toxicity was bone marrow depression. The proportion of WHO grade 3 4 hemoglobin, leukocyte and thrombocyte decrease cycles was 7.5%, 12.7%, 23.1%, respectively.Conclusions:Gemcitabine cisplatin combination is effective and well tolerated for elderly patients with NSCLC.

Objective To analyze the characteristics and influencing factors of sleep disorders and nocturnal hypoxemia of patients with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Four hundred and twenty-five patients with snoring were scored by Epworth Sleepiness Scale ( ESS), and monitored by polysomnography (PSG). The possible correlations between sleep structure, hypoxia parameters, ESS and clinical features were analyzed and compared in those patients. Results Four hundred and twenty-five patients were divided into 4 groups according to the apnea-hypopnea index (AHI). There were 65 primary snoring patients (15.3%) and 360 OSAHS patients (84. 7% ) including 187 patients (44. 0% ) in severe OSAHS group. ESS was increased as aggravation of OSAHS. There were significant statistical differences in ESS among each group. Compared with primary snoring group, sleep efficiency, NREM1 + 2, oxygen desaturation index ( ODI), time with pulse oxygen saturation below 90% (T(SpO2 <90% ) ) were significantly higher in the OSAHS groups, and NREM3 +4, lowest pulse oxygen saturation level ( LSpO2 ) were lower. ESS was correlated positively with AHI (r= 0. 474,P <0. 01 ). They were both correlated positively with ODI, T (SpO2 <90% ) and NREM1 + 2( ESSr =0. 392, 0. 356,0. 194;AHI r = 0. 714, O. 682, 0. 365, all P < 0. 01 ), and correlated negatively with LSpO2, NREM3 + 4 ( ESS r = - 0. 414, - 0. 196; AHI r = - 0. 740, - 0. 385, both P < 0. 01 ). LSpO2, ODI and T (SpO2 < 90% ) were the primary influencing factors. Common clinical presentations and subjective symptoms were presented including daytime sleepiness, impaired memory, fatigue, dry mouth, oppressive wake and morning headache, etc. Percentage of individuals with daytime sleepiness in the severe OSAHS group was 73. 3% (137/187). These had serious impact on the patients' quality of life, leading to difficulty concentrating, poor memory and cognitive impairment. Conclusions Sleep disorders are found in the patients with different degrees of OSAHS. The excessive daytime sleepiness interrelated partly with the structure of sleep, and totally with hypoxia parameters. The more severity the patients have, the more nocturnal hypoxia, sleep disorders and higher ESS are found.

Objective To observe the macular morphology and circumpapillary retinal nerve fiber layer thickness (RNFL) in Parkinson's disease (PD) evaluated by spectral-domain optical coherence tomography (SD-OCT). Methods A total of 37 patients (74 eyes) with PD were in the PD group, 32 age-and sex-matched healthy subjects (64 eyes) in the control group. All subjects underwent SD-OCT examination with 5 line scanning, macular cube 512×128 scanning and optic disc volume 200×200 scanning. The retinal thickness, central foveal thickness (CFT), macular volume and thickness of circumpapillary, superior, inferior, nasal, and temporal of RNFL between two groups were comparatively analyzed. The relationship between SD-OCT parameters and age, disease duration, scores of Hoehn-Yahr and unified PD rating scale (UPDRS) in PD patients was analyzed by Pearson correlation analysis. Results Both of the retinal thickness and macular volume in PD group were significantly reduced than those in control group (t=?2.546,?3.410;P=0.012, 0.001). There was no difference of CFT (t=?0.463, P=0.644) and the thickness of circumpapillary (t=?1.645, P=0.102), superior (t=?0.775, P=0.439), inferior (t=?1.844, P=0.067), nasal (t=?0.344, P=0.732) and temporal (t=?0.541, P=0.590) of RNFL between two groups. The retinal thickness, macular volume, CFT and the thickness of circumpapillary, superior, inferior, nasal, temporal of RNFL had no relationship with age, disease duration and scores of Hoehn-Yahr and UPDRS in PD patients (P>0.05). Conclusions In PD patients, the retinal thickness and macular volume are decreased, however, the circumpapillary RNFL have no obvious alterations.

[ ABSTRACT] AIM:To investigate the effects of sphingosine kinase l ( SphK1) and focal adhesion kinase ( FAK) on the epithelial-mesenchymal transition ( EMT) of human colon cancer HCT 116 cells.METHODS:Human colon cancer HCT116 cells were divided into 3 groups.N, N-dimethylsphingosine (DMS) was used to suppress the activity of SphK1. PF573228 was used to suppress the activation of FAK .The cells treated with equal volume of culture medium severed as control group.The cell viability was measured by MTT assay .The protein expression of SphK1, FAK and the EMT relative protein E-cadherin, N-cadherin, vimentin and matrix metalloproteinase (MMP) 2 was analyzed by Western blot.The mR-NA expression of SphK1, sphingosine-1-phosphate (S1P), FAK, E-cadherin and vimentin was detected by real-time PCR. The ability of tumor cell migration was measured by wound-healing assay.RESULTS:The cell viability of HCT116 cells was suppressed by DMS and PF 573228 in dose and time dependent manners .DMS significantly suppressed the expression of SphK1, FAK, N-cadherin, vimentin and MMP2, meanwhile enhanced the expression of E-cadherin.PF573228 reduced the expression of FAK , SphK1, N-cadherin, vimentin and MMP2, meanwhile increased the expression of E-cadherin (P<0.01).In addition, the migration ability of HCT116 cells was significantly decreased by treating with DMS and PF573228 (P<0.01).Compared with control group , the mRNA expression of FAK, SphK1, S1P and vimentin was de-creased, while the expression of E-cadherin was increased significantly in PF573228 group and DMS group (P<0.05). CONCLUSION:SphK1 and FAK signaling pathways may play an important role in the occurrence of EMT in the colon cancer HCT116 cells.

Objective To investigate the application of preoperative autologous blood donation (PABD) in selective operation.Methods Retrospective investigations and analysis were carried out in clinical datas of 1 026 patients of PABD in selective operation from January 2016 to may 2017,comparing with those who had not performed PABD in the same time.Results ①The surgeries of PABD were mainly neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery,respectively,which accounted for 5.97％,4.90％,3.78％,3.76％ and 3.55％ of the patients in the same period;②The rate of transfusion of allogeneic red blood cells of selective operation in PABD group of neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery were 5.66％,2.51％,4.89％,0 and 4.88％,respetively,while not performed PABD group were 25.46％,28.58％,24.77％,10.62％ and 17.54％,respetively;③The rate of transfusion of the group of hemoglobin (Hb)＜ 120 g/L is significantly higher than those Hb is (120-129.9) g/L,(130-139.9)g/L and ≥ 140 g/L(7.65％vs 2.44％,3.66％ and 2.70％,P＞0.05).Conclusion ①PABD is mainly carried out in neurosurgery,urology,orthopedics,gynecology and hepatobiliary surgery;②The group of Hb＜ 120 g/L has a high rate transfusion of allogeneic erythrocyte in selective operations;③Only the PABD is improved can patients make benefit from it.