Objective:To evaluate the efficacy and safety of temporary loop ligation of the infrarenal abdominal aorta for control ofintraoperative blood loss in patients with pernicious placenta previa.Methods:We retrospectively analyzed the clinical data of 14 patients with pernicious placenta previa,who underwent temporary loop ligation of the infrarenal abdominal aorta for control of blood loss during cesarean section between July 2013 and December 2014.Results:Eight patients received conservative management to preserve the uterus and 6 patients underwent cesarean hysterectomy.The occlusion time of the abdominal aorta was (31.42±12.67) min.The average estimated intraoperative blood loss was (1 117.85±745.13) mL.The volume of packed red blood cell transfusion was (3.91±3.24) units,and the volume of fresh frozen plasma transfusion was (192.85± 156.71) mL.Post-operative histologic diagnosis revealed 6 cases of placenta percreta,4 of increta,3 of accreta and 1 non-creta.All patients experienced an uneventful postoperative recovery.Conclusion:In patients with pernicious placenta previa,temporary ligation of the infrarenal abdominal aorta provide a safe and effective means for controlling intraoperative hemorrhage during cesarean section.Additionally,the procedure may provide an opportunity to preserve fertility by avoiding a cesarean hysterectomy.

Objective:To establish an HPLC method for the determination of chlorogenic acid in honeysuckle stem and honeysuck-le from different sources in different harvest periods. Methods:A Waters C18 column(250 mm × 4. 6 mm,5 μm)was used. The mo-bile phase consisted of acetonitrile-0. 4% H3 PO4(10:90)with the flow rate of 1. 0 ml·min-1 . The detection wavelength was 327 nm and the column temperature was 30℃. An external standard method was established for the determination of chlorogenic acid in honey-suckle stem and honeysuckle in six different harvest periods from three sources. Results:There was a good linear relationship within the range of 0. 065-1. 300 μg for chlorogenic acid(r=0. 999 8). The content of chlorogenic acid in honeysuckle was the highest in Sep-tember and October. The content of chlorogenic acid in Lonicera acuminata was the highest among the honeysuckle stem from three dif-ferent sources. Conclusion:The content of chlorogenic acid in honeysuckle has a certain relationship with the harvest time,which can provide theoretical basis for the choice of harvest time for honeysuckle stem.

Objective To evaluate the systolic function of left ventricle in myocardial infarction(MI)patients with ventricular aneurysm and the changing law of blood flow in ventricle with regional abnormality of wall movement by vector flow mapping (VFM).Methods Tirty-one MI patients with ventricular aneurysm and 35 healthy participants were enrolled in this study.The characteristic of vector and streamline,and the changing of the velocity gradient in left ventricular outflow tract (LVOT), and the average flow quantity through aneurysm neck were detected in the isovolumic contraction period, the rapid ejection period and the slow ejection period by VFM.Results The distinction between aneurysm and control group was mainly the persistance of vortex in aneurysm.The size of vortex in aneurysm was highly correlated with that measured by 2-D ultrasound(P ＜0.01).The percentage of vortex duration to cardiac cycle in patients group was significantly greater than that in control group(P ＜0.01).In the early systolic contraction the velocity gradient in LVOT in patients with ventricular aneurysm was smaller than that of control group(P ＜0.05).The average flow through aneurysm neck was notablely decreased compared with control group(P ＜0.01).Conclusions VFM can reveal the hemodynamics of left ventricle with aneurysm directly as well as quantitively measure the regional velocity and flow quantity.VFM can evaluate the systolic function of left ventricle exactly.

Objective To evaluate the diagnostic value and misdiagnosis cause of echocardiography (UCG) and CT in aorto-left ventricular tunnel (ALVT). Methods UCG and CT of 5 patients who were diagnosed as ALVT by surgical operation during August 2010 to October 2014 in Wuhan Asia Heart Hospital were reviewed and analyzed. Results By UCG, 4 cases were diagnosed as ALVT. The abnormal tunnel between aortic root and left ventricle could be clearly displayed with two dimensional echocardiography. On color Doppler flow image (CDFI), it could be clearly demonstrated that the blood flow went into aorta from left ventricle in systolic period via aortic valves and ALVT, and back to left ventricle in diastolic period via ALVT. Bicuspid aortic valve (BAV) was found in 2 patients, and aortic valve reflux in 1 patient. According to Hovaquimian classification, 2/4 patients were diagnosed as ALVT of typeⅠ, and other 2 patients as ALVT of typeⅡ. One case was misdiagnosed as left coronary artery-left ventricle fistula. By CT, 2 cases were diagnosed as ALVT and 1 case was misdiagnosed as left coronary artery-left ventricle fistula. Conclusion The combination of UCG and CT is a reliable technique in the diagnosis of ALVT, which has significance in therapeutic strategy making and prognosis prediction.

ObjectiveTo investigate the value of high-frequency ultrasound in assessment of the therapeutic efifcacy of traditional Chinese medicine in patients with breast dysplasia using.MethodsFrom March to September in 2014, 50 patients with breast dysplasia in the Third Affiliated Hospital of Beijing University of Chinese Medicine were enrolled in the study. In addition, they were treated with Xiaozheng pills. Before and after treatment, these patients were examined using ultrasound. The thickness of the breast gland layer in each patient was measured. When the dilated ducts lactiferous, cysts, hypoechoic areas, or nodules of the breast were detected, the diameter or volume was measured or calculated. A grading system of the breast dysplasia was used to evaluate the disease degree, and the quadrants of the breast dysplasia were counted. The thickness of the breast gland layer, the volume of cysts and nodules, the diameter of hypoechoic areas and the dilated ducts lactiferous, the number of the breast dysplasia were compared with the pairedt-test. The grading of the breast dysplasia was compared with rank sum test.ResultsThere were significant decreases in the thickness of the grand layer, the diameters of the ducts lactiferous and the hypoechoic area after treatments [(15.92±4.73) mm vs(13.02±4.20) mm,t=2.240,P<0.01; (2.26±0.58) mm vs (1.71±0.47) mm,t=5.202,P<0.01; (21.14±5.57) mm vs(17.80±4.63) mm,t=5.529,P<0.01]. However, there were no significant differences in the volume of cysts and nodules. The grading of the breast dysplasia showed statistical difference (z=-5.667,P<0.01), and the number of the breast dysplasia quadrants was reduced markedly (5.38±1.85 vs3.28±1.97,t=7.566,P<0.01).ConclusionsUltrasound can be an effective method in assessment of patients with breast dysplasia treated with the traditional Chinese medicine. The assessment can be based on some signs, including the thickness of the grand layer, the diameters of the ducts lactiferous, and the diameters of the hypoechoic area. The grading system and breast quadrants counting in these patients may be added as supplementary criteria to make a complete therapeutic evaluation.

[ABSTRACT]OBJECTIVETo evaluate the clinical value of ultrasound guided fine-needle aspiration (US-FNA) in the diagnosis of thyroid nodules with different size.METHODSThe clinical data of 122 thyroid nodules of 109 cases referred to FNAC for diagnosis were retrospectively reviewed. The final operating histological results of 122 nodules were considered gold standard. RESULTSNon-diagnostic FNAC results occurred in 17 nodules (13.9%). FNAC achieved a sensitivity of 78.6%, a specificity of 93.9%, a positive predictive value of 93.6%, a negative predictive value of 78.3%, and a total accuracy of 85.7%. There was no significant difference between the diameter of the nodule≤1 cm group and>1 cm group, except negative predictive value. The non-diagnostic results rate was no significant difference between groups of different nodule size, benign or malignant nodules, and different operators. CONCLUSIONFNAC is a sensitive, specific and accurate method for differential diagnosis of thyroid nodules.

Objective To understand the current situation of dispensary setting and personnel of community health service centers in Pudong New District in Shanghai (hereinafter referred to as Pudong New District).Methods Questionnaire survey covering the 45 community health service centers in Pudong New District was used.Results 42 community health service centers were equipped with TCM dispensaries among the 45 total units (93.3%);12 of them adopted outsourcing mode (26.7%);the average area of community dispensary was (32.3 ± 17.3)m2;the average number of TCM practitioners was 3.5 ± 2.0 people.Conclusion Community health service centers need to increase the allocation area of TCM dispensary and improve qualification of TCM practitioners.

ObjectiveTo study the effect of rehabilitation on psychological health in first schizophrenic patients. Methods86 patients were divided into observation group and control group equally. Patients in both groups received medical treatment and routine health education. Patients in observation group received rehabilitation in addition. They were assessed with Symptom Checklist-90 （SCL-90）before and 8 weeks after treatment.ResultsAfter treatment, the scores of SCL-90 in both groups reduced significantly （P<0.05）, and less in the observation group than in the control group (P<0.01).ConclusionRehabilitation can improve the psychological health for patients with first schizophrenia.

Twenty eight polycystic ovarian syndrome (PCOS) patients complicated with insulin resistance, whose testosterone and luteinizing hormone levels were normal, received metformin treatment (500 mg b.i.d) for 3 months.Blood anti-Müllerian hormone (AMH) levels, endocrine and metabolic parameters were measured before and after treatment.The mean levels of AMH were not significantly changed after 3 months of treatment [(8.4±3.2) vs.(8.5±3.2) μg/L, P=0.148].However, the BMI[(27.6±4.1) vs.(29.3±4.4)kg/m2], fast glucose[(5.32±0.47) vs.(5.55±0.71)mmol/L], fast insulin [(93.3±17.8) vs.(147.7±44.1)pmol/L] and homeostasis model assessment of insulin resistance (HOMA-IR) (3.17±0.71 vs.5.27±1.85) were significantly decreased after treatment (all P<0.05).The results indicate that metformin treatment may not significantly affect serum AMH levels, although it can improve the insulin resistance and reduce the BMI value in PCOS patients.

Objective To evaluate 16-SCT in diagnosing aeute appendicitis.Methods The CT findings of 34 cases were retrospectively analyzed.These cases were all proved acute appendicitis by surgical-pathology.Results 30 cases were confirmed by CT,with accuracy 88% (30/34).The diameter of 28 appendix was more than 6mm;2 collapsed with thickening wall.Periappendiceal fat stranding could be seen in 25 cases.Perforated appendicitis happened in 4 cases.Abscess performed in 2 cases.3 cases were missed,1 misdiagnosed.Conclusion 16-SCT could confirm acute appendicitis and its complication timely and accurately.