Purpose To explore the value of three vessels and trachea view in rapid screening of aortic arch malformations. Materials and Methods 51 fetal subjects who were prenatally diagnosed with aortic arch abnormalities were enrolled, and their diagnoses were confirmed by postnatal echocardiography or autopsy results after induction. Targeted fetal cardiac examinations were conducted under obstetric ultrasound examination conditions, ultrasound images were restored and compared with sonographic features of normal aorta. Results Among the 51 fetus cases with aortic arch anomalies, right-oriented aortic arch with left subclavian artery vagus was shown in 17 cases, left-oriented aortic arch with right subclavian artery vagus in 2 cases, double aortic arch in 2 cases, aortic arch disarticulation in 6 cases, and aortic arch coarctation in 24 cases. Diagnostic accuracy of ultrasound was 94.1%. Sonographic changes were displayed in three-vessel or three vessels and trachea view in all cases. Conclusion Three vessels and trachea view plays an important prompt role in ultrasound diagnosis for fetal aortic arch abnormalities. But when it is manifested as the“1oo”sign, it will be rather difficult for the differential diagnosis of aortic arch disarticulation and severe aortic arch coarctation.

Objective To explore the clinical value of transvaginal four-dimensional hysterosalpingo-contrast sonography (TVS 4D-HyCoSy)in evaluation of the patency of fallopian tubes. Methods Totally 53 patients underwent SonoVue TVS4D-HyCoSy to observe the tubal patency. Results Among the 106 tubes in 53 patients, TVS 4D-HyCoSy showed 47 unobstructed tubes, 23 obstructed tubes, and 36 partially passable tubes. In unobstructed cases, the fallopian tubes were smooth and regular in morphology, and contrast agents flowed into and dispersed over pelvic cavity rapidly and evenly. In the cases of partially passable tube, fallopian tubes were discontinuous and irregular in morphology, and contrast agents lfowed into and dispersed over pelvic cavity slowly and unevenly. In obstructed cases, there were no or little contrast agents into the fallopian tubes. Compared with the results of laparoscopy, the diagnostic accuracy of TVS 4D-HyCoSy was 94.4%(17/18). Conclusions TVS 4D-HyCoSy is a useful tool in demonstrating the morphological features of fallopian tube, diagnosing intrauterinc adhesion and lesion and assessing the tubal patency.

Purpose To characterize normal growth of the fetal fourth ventricle in the second trimester of pregnancy by standardized ultrasonography.Materials and Methods 516 cases of pregnant women with single fetus aged 18-27 weeks and 6 days were examined by conventional ultrasound.At the standard section of the fourth ventricle,the transverse dimension,anteroposterior dimension,circumference and area of the fourth ventricle were measured.Results The display rate of the fourth ventricles of fetuses aged 18-27 weeks and 6 days was up to 100％.There were no significant differences in the values of the fourth ventricles between fetuses with different gender (P＞0.05).The values of the fourth ventricle,including transverse dimension,anteroposterior dimension,circumference and area,increased linearly with the increase of gestational age,and there were positive correlations (r=0.374,0.378,0.387,0.379,P＜0.05).Conclusion The normal size of the fourth ventricle can be obtained by standardized measurement,which can be used as a reference for the clinical evaluation of the size of the fourth ventricle.

ObjectiveTo summarize the value of prenatal ultrasonography in the diagnosis of fetal absent pulmonary valve syndrome (APVS).MethodsBetween January 2010 and January 2014, ifve cases with fetal APVS diagnosed by prenatal ultrasound and conifrmed by autopsy in West China Second Hospital of Sichuan University were reviewed. Four conventional views of fetal echocardiography were used to diagnose APVS, including two-dimentional images, color Doppler lfow imaging (CDFI) and pulsed Doppler lfow spectrum.ResultsTypical signs of fetal APVS in 3 of 5 cases were found: no pulmonary valve was found in the main pulmonary artery, and pulmonary annulus was relatively smaller compared with a tumor-like expansion in pulmonary trunk; “to and fro” sign in the pulmonary trunk were observed steadily by CDFI and “to and fro” spectrum were detected by pulsed Doppler. Another 2 of 5 cases of fetal APVS have no pulmonary expansion, but “to and fro” sign could be detected by color and spectral Doppler, including 1 case with tricuspid atresia and 1 case with Ebstein’s anomaly.ConclusionsPrenatal ultrasonography has important diagnostic value for Fetal APVS. Fetal APVS on prenatal ultrasound has many characteristics and is easy to diagnose. Color and spectral doppler can detect and diagnose fetal APVS effectively.

Objective To study the diagnostic method with computed radiography for congenital dislocation of the hip(CDH) and developmental dysplasia of the hip(DDH) in early stage in newborn and infant.Methods Followed-up with computed radiography made a comparison between 47 abnormal hips (CDH and DDH ) in 26 infants ,and 60 normal hips in 30 infants.Results (1)The normal pattern of acetabulum in neonate and infant appeared as definite“—”,indefinite“—” was considered as abnormal,its sensitivity,specificity and accuracy was 100%,91.59 and 85% respectively,and statistical comparison P

Objective:To observe the outcome of posterior staphyloma (PS) marginal retinal photocoagulation in pars plana vitrectomy (PPV) for high myopia macular hole retinal detachment eyes accompanied with PS.Methods:From January 2017 to June 2019, 49 patients (49 eyes) with high myopia macular hole retinal detachment accompanied with PS who were undergone PPV operation from Tianjin Eye Hospital were included in this study. There were 13 males (13 eyes) and 36 females (36 eyes). All patients underwent best corrected visual acuities (BCVA) and optical coherence tomography examinations. The standard logarithmic visual acuity chart was used for BCVA examination, and the visual acuity was converted to minimum resolution angle in logarithmic (logMAR) when recorded. The patients were randomly divided into two groups according to surgical options: conventional PPV with internal limiting membrane (ILM) peeling (group A, 24 eyes), PS marginal retinal photocoagulation in PPV with ILM peeling (group A, 25 eyes). The mean preoperative logMAR BCVA of group A and B were 1.87±0.28 and 1.80±0.37, the difference was not statistically significant ( t=0.604, P=0.551). The patients in the group A received 23G PPV, triamcinolone acetonide staining during the operation, the epiretinal membrane was peeled off, indocyanine green assisted staining, the posterior macular ILM was peeled off, and the peripheral retina was examined in detail during the operation. Areas with retinal degeneration were reinforced by laser photocoagulation, and the subretinal fluid was drained through the macular hole and filled with silicone oil. The eyes of the group B were subjected to retinal photocoagulation for 2 to 3 rows at the edge of the PS in addition to the usual surgical procedures. The average follow-up time was 8.34±3.21 months. Surgical outcome were estimated by the average number of operation, retinal reattachment rate, macular hole closure rate and BCVA. The χ2 test or Fisher exact probability was used to compare the count data. Independent sample t test was used to compare the measurement data. Results:Retinal reattachment was obtained in 17 eyes (70.8%, 17/24) and 24 eyes (96.0%, 24/25) in group A and B after first surgery respectively, the difference was statistically significant ( χ2=3.984, P=0.046). Final retinal reattachment was obtained in all 49 eyes. Final macular hole closure was in 15 eyes (62.5%, 15/24) and 19 eyes (76.0%, 19/25) in group A and B, respectively, the difference was not statistically significant ( χ2=1.051, P=0.305). The mean postoperative logMAR BCVA of group A (1.20±0.47) and B (1.08±0.39) were all improved than preoperative BCVA, the differences were all statistically significant ( t=2.899, 5.327; P=0.001, 0.000), the differences of mean postoperative logMAR BCVA between two groups was not statistically significant ( t=0.675, P=0.506). The mean number of operation of group A (2.63±0.88) was more than group B (2.08±0.28), the difference was statistically significant ( t=3.003, P=0.006). Conclusion:In comparison with conventional PPV, combined PS marginal retinal photocoagulation can improve retinal reattachment rate after first surgery, and reduce the number of reoperations.

Objective:To observe the changes of macular microvessels in patients with retinal vein occlusion (RVO) and macular edema (ME) after intravitreal injection of aflibercept (IVA), and analyze its correlation with best corrected visual acuity (BCVA).Methods:A retrospective case study. Thirty patients (30 eyes) with monocular RVO with ME (RVO-ME) who were diagnosed in the clinical examination of Tianjin Eye Hospital from April 2019 to February 2020 were included in the study. Among them, there were 12 males (12 eyes) and 18 females(18 eyes); the average age was 54.30±13.17 years. The average course of disease was3.43±1.97 months. Both eyes were examined by BCVA and optical coherence tomography (OCTA). The on-demand injection was adopted after the first injection in IVA treatment regimen. The macular area 6 mm×6 mm in both eyes was scanned with an OCTA instrument, and the area of the foveal avascular area (FAZ), FAZ circumference (PERIM), and out-of-roundness were measured at baseline and 1, 3, and 6 months after treatment. Index (AI), blood flow density within 300 μm width of FAZ (FD-300), foveal retinal thickness (CMT), superficial retinal capillary plexus (SCP), deep retinal capillary plexus (DCP) blood flow density. The paired t test was used to compare the quantitative parameters of the affected eye and the contralateral healthy eye at baseline; the changes of the quantitative parameters at baseline and 1, 3, and 6 months after treatment were analyzed by repeated measures analysis of variance. Pearson correlation analysis was used to analyze the correlation between BCVA, retinal perfusion, and macular blood supply parameters at 6 months after IVA treatment. Results:At baseline, compared with the contralateral healthy eye, the FAZ area ( t=-4.091), PERIM ( t=-5.098) and AI ( t=-9.093) of the RVO-ME eye were enlarged, and FD-300 ( t=7.237) and overall SCP and DCP blood flow density ( t=8.735, 9.897) decreased, the difference was statistically significant ( P<0.001). Six months after treatment, the BCVA of RVO-ME eyes was significantly increased, CMT decreased, FAZ area expanded, and AI decreased ( t=8.566, 16.739, -6.469, 9.719; P<0.001), the difference was statistically significant. There was no significant change in the blood flow density of FD-300 and overall SCP and DCP, and the difference was not statistically significant ( t=1.017, 1.197, 0.987; P>0.05). Compared with baseline, the FAZ area of RVO-ME eyes gradually expanded at 3 and 6 months after treatment, and the difference was statistically significant ( F=21.979, P<0.001). Correlation analysis results showed that BCVA at 6 months after treatment was positively correlated with the overall SCP and DCP blood flow density at baseline and 6 months after treatment ( r=-0.538, -0.484, -0.879, -0.854; P<0.05). There was a negative correlation with the area of FAZ 6 months after treatment ( r=0.544, P=0.001). The number of ME recurrences was negatively correlated with BCVA and overall SCP and DCP blood flow density 6 months after treatment ( r=0.604, -0.462, -0.528; P<0.05), it was positively correlated with FAZ area ( r=0.379, P=0.043). Conclusion:Within 6 months of IVA treatment in RVO-ME eyes, ME is significantly reduced and visual acuity is improved; SCP blood flow density decreases, and FAZ area expands.

Objective:To investigate the role of NIMA-related kinase-7 (NEK7) in breast cancer (BC) and its potential molecular mechanism.Methods:Quantitative real-time reverse-transcription (RT-qPCR) was used to detect the expression of NEK7 in BC tissue and cell lines. The effect of NEK7 on BC cell proliferation was examined by CCK-8. Proteins interacted with NEK7 were screened in Biological database. The effect of overexpression of NOD-like receptor protein 3 (NLRP3) on BC cell proliferation was evaluated. Western blot was used to detect NLRP3 protein expression, and ELISA was employed to evaluate IL-1β and IL-18 expression level.Result:NEK7 was upregulated in BC tissues and cells, and enforced-expression of NEK7 promoted BC cell proliferation[NEK7 over-expression group: 24 h: (0.33±0.02) , 48 h: (0.59±0.02) , 72 h: (0.76±0.02) ; Blank group: 24 h: (0.30±0.02) , 48 h: (0.45±0.02) , 72 h: (0.62±0.03) ; NEK7 empty vector group: 24 h: (0.32±0.02) , 48 h: (0.46±0.02) , 72 h: (0.63±0.03) ]. There was a positive correlation between NEK7 and NLRP3 ( R=0.13) . Overexpression of NLRP3 increased the proliferation ability of BC cell[NLRP3 over-expression group: 24 h: (0.35±0.02) , 48 h: (0.65±0.02) , 72 h: (0.80±0.03) ; Blank group: 24 h: (0.33±0.02) , 48 h: (0.51±0.02) , 72 h: (0.66±0.03) ; NLRP3 empty vector group: 24 h: (0.34±0.02) , 48 h: (0.52±0.03) , 72 h: (0.66±0.03) ]. NEK7 could positively regulate NLRP3 protein and up-regulate IL-1β (NEK7 over-expression group: 129.96±7.62 pg/ml, Blank group: 19.80±2.42pg/ml, NEK7 empty vector group: 21.30±1.77 pg/ml) and IL-18 (NEK7 over-expression group: 144.08±17.20 pg/ml, Blank group: 16.84±2.34pg/ml, NEK7 empty vector group: 17.64±1.94 pg/ml) expression. Conclusion:The upregulation of NEK7 was involved in the process of BC progression by inducing NLRP3 inflammasome activation, suggesting that NEK7 might be a promising therapeutic target for BC.

Metabonomics involves the unbiased quantitative and qualitative analysis of the complete set of metabolites present in cells, body fluids and tissues (the metabolome) based on modern analytic technique with high throughput, high sensitivity, and high resolution. Gas chromatography-mass spectrometry (GC-MS) is used to gain qualitative results of detected metabolites for biological samples as it provides superior distinguishability, detection sensitivity and integrated standard mass spectrometry library. In this article, the historic developments of GC-MS and its application in metabonomics in the past several years were reviewed. Firstly, the classification and the derivative methods of GC-MS were introduced. Subsequently, sample pretreatment process, qualitative and quantitative analysis and data analysis during detecting metabolites by GC-MS were introduced, then its application in microorganism, plant and disease diagnosis was systematically summarized. Finally, the problems in metabonomics study based on GC-MS and the research prospect in the future were discussed.
Gas Chromatography-Mass Spectrometry ; methods ; Metabolomics ; methods

This study summarizes the skills training work of the National College Students' Clinical Skills Competition for 9 consecutive years, and explores a set of teaching methods suitable for the standardized training of residents of anesthesiology. This method is applied to the clinical operation, professional theory, clinical thinking, humanistic care, doctor-patient communication and other aspects of the standardized training of residents. The results show that the teaching effect of all aspects of standardized training of residents is more practical and efficient, and residents can quickly master the basic operation skills of anesthesia in a short time, indicating that the training method of clinical skills competition of college students can be applied in the standardized training of anesthesia residents, which can effectively improve the training effect.