Objective To explore the clinical application of spatio -temporal image correlation combined with multiplanar mode (STIC-MP) in the routine scanning of normal fetal heart ,and to provide evidence for the application of STIC in the routine scanning of fetal heart in second trimester .Methods One hundred pregnant women at 20-27 weeks′gestation were enrolled.The routine five views of normal fetal heart were examined and recorded by two-dimensional ultrasound,and the volume datasets were acquired with STIC.The time of picture storing and the fetal cardiac structures were recorded respectively .The quality of pictures obtained by both methods were compared by the scoring system .The imaging method of STIC-MP was explored and analyzed.Results Satisfactory gray-scale volume acquisitions were accomplished in all 100 cases.The quality of the four views(four chamber view,left outflow tract,right outflow tract,three vessel-trachea views) derived from volume datasets were comparable to that directly obtained from two-dimensional scanning.No significant difference of visualization rate ( χ2 =3.030,0.337,2.010,0.000,all P>0.05)was found between the STIC-MP(100/100,98/100,98/100,95/99 as 100.0%,98.0%,98.0%,96.0%)and two-dimensional(97/100,99/100,100/100,95/98 as 97.0%,99.0%,100.0%,96.9%).However,the difference of visualization rate was found in the stomach transverse view ( χ2 =9.776,P=0.001).The mean time for the examination and picture saving of fetal cardiac structures by STIC ,mean acquisition time was (1.17 ±0.52) min,which was much shorter than that by two-dimensional scanning (4.20 ±1.35) min (t=0.38,P<0.05).The mean time for obtaining the routine five views of fetal heart and analyzing by STIC and MP were (6.75 ±1.51) min,(1.35 ±0.30)min respectively,which was longer than (4.20 ±1.35)min and (0.83 ±0.22)min by two-dimensional ultrasound(t=11.75,11.75,both P=0.00).Conclusions STIC-MP simplifies the picture-gathering process,decreases the ultrasound exposure upon fetal heart obviously .No significant difference was found between the quality of the five views obtained from STIC-MP and two-dimensional ultrasound.The views of STIC-MP can satisfied the routine scanning of fetal heart ,although the interpretation time of STIC-MP was longer compared with two-dimensional ultrasound.There will be vital significance on the use of STIC in clinical application .

Objective To observe the effectiveness of the percutaneous transluminal angioplasty (PTA) and percutaneous transluminal stenting (PTS) for central vein occlusion in maintenance hemodialysis patients.Methods From January 2010 to August 2015,a total of 42 patients with center vein occlusion of arteriovenous fistula were treated with maintenance hemodialysis,and the surgery and postoperative conditions,revascularization and improvement of vascular stenosis were observed.Results Among the 42 patients,38 cases were successfully carried out with PTA,and the patency rate was 90.5%(38/42).A total of 32 intravascular stents were placed in 30 patients whose vein stenosis were still greater than 30% after PTA.After surgery,the swelling of the patient receded rapidly and the internal fistula went back to normal.Conclusion PTA and PTS are effective methods for maintenance hemodialysis patients with central vein occlusion,and they could help protecting functional access in patients with autogenous fistulas with smaller wounds and faster effects.

Objective To investigate the clinical effect of honghua injection on hemorrheology in the prevention of deep venous thrombosis ( DVT) after operation of lower limbs fractures.Methods 100 cases with operation of lower limb fracture meeting the inclusion critera were randomly divided into two groups equally.Besides conventional treatment, the control group was treated with rivaroxaban, while the observation group was treated with honghua injection and rivaroxaban.The incidence of DVT, pro-inflammatory factors, hemorheology indices and adverse reactions were observed and compared. Results The observation group had a total DVT incidence of 10.0%, which was statistically lower than that of 28.0% in the control group(P<0.05). Three days after the operation, pro-inflammatory factors of TNF-α, IL-6 and IL-8 in the observation group was respectively statistically lower than that in the control group(P<0.05).As to hemorheology indices, in comparison with the control group, hematocrit, whole blood viscosity and fibrinogen in the observation group were statistically lower (P<0.05).During the treatment, there were no case of severe adverse reactions, and the incidence of adverse reactions in the two groups were statistically same.Conclusion Treatment of honghua injection in combination with rivaroxaban in the prevention of DVT is reliable, which could significantly reduce the incidence of DVT, alleviate inflammatory reaction and improve blood hypercoagulable state with minor adverse reactions.

Objective To explore the diagnosis and treatment of liver trauma.Methods A retrospectively analysis of clinical data of 160 cases of liver trauma, including 96 cases of blunt trauma and 64 cases of open trauma, was made.Results Among the 160 cases, one case with stage IV trauma and severe thoracic injury died 30min after admission. Among the other 159 cases, 45cases (9 cases of stage Ⅰ, 31 cases of stage Ⅱ and 5cases of cases Ⅲ) received nonoperative treatment, and 114cases (7 cases of stage Ⅱ, 67 cases of stage Ⅲ and 50 cases of stage Ⅳ) received operative therapy. In non-operative treatment group, the cure rate was 100 %(45/45). In operation treatment group the cure rate was 98.2 %(112/114), the mortality rate was 1.8 %(2/114), 1 case died of hemorrhage after operation and 1 case died of ARDS. Five patients with postoperative complications were cured, including hepatic abscess in 2 cases, biliary fistula in 2 cases, and hemorrhage after operation in 1 case. Conclusions B-ultrasound is the method of choice for diagnosis of liver trauma, and CT can be used if conditions permit. Cases of lives truma of stages Ⅰ and Ⅱ and some cases of stage Ⅲ that have stable hemodynamics, can receive nonoperative treatment under close observation. Some cases of stage Ⅱ, most cases of stage Ⅲ and all cases of stages Ⅳ to Ⅵ injury should preferably undergo surgical treatment.

Objective To observe the effects of paeonol on collagen induced arthritis (CIA) and investigate its mechanisms. Methods The tentative arthritis mice model was created by injecting type Ⅱ collagen. The severity degree of RA was scored according to the rating criteria after treatment with paeonol. ELISA method was employed to detect the levels of IL-12, TNF-2, IFN-γ and anti-type Ⅱ collagen autoantibody. The efficacy of paeonol was compared with that of MTX (the positive control) and PBS was used as the negative control. Results We found that paeonol could alleviate severe RA, inhibit the expression of inflammatory cytokines such as IL-12, TNF-2, IFN-γ and reduce the level of anti-type Ⅱ collagen autoantibody in serum, which was similar with MTX. Conclusion The results show that paeonol has a reliable therapeutic effect for RA. This study has provided a good clue for the future research and development of medications for the treatment of RA.

Objective To summarize the clinical characteristics and therapeutic approaches of Kasabach-Merritt syndrome (KMS).Methods The data from 17 KMS patients that had been definitely diagnosed from December,2007 to January,2012 in our tertiary center were collected retrospectively.Results We described 17 patients,13 of whom were male and 4 of whom were female,with an age range of 17 hours to 28 days.Of the 17 cases,4 cases had hemangioma of internal organs,13 on the surface of the body.All of them had thrombocytopenia and coagulation dysfunction.Seventeen cases were initially treated with corticosteroids.The responses were varied:excellent and rapid improvement (n =6),failure (n =11),recurrence (n =3).Then the cases of failure and recurrence accepted artery embolization:excellent and rapid improvement (n =8),failure (n =4),recurrence (n =1),with 1 giving up.At last,the cases resistant to artery embolization therapy accepted vincristine therapy.Four cases had rapid improvement,and 1 died from disseminated intravascular coagulation.In this study,a response rate to corticosteroids was 35.3％,and the recurrent rate was 50％.The response rate to artery embolization was 61.5％.Five patients unresponsive to hormone therapy and artery embolism were treated with vincristine,and the effective rate was 80％.Conclusion In the therapy of neonatal KMS,the resistant to corticosteroids is common.Combinative therapy of corticosteroids with artery embolization is recommended as the first-line therapy.Vincristine is suggested as a therapy when there is resistance to the other therapy.

Objective To investigate the effect and mechanism of human amniotic epithelial cells (hAECs) transplantation in treatment of cerebral hemorrhage in rabbits.Methods Thirty New Zealand white rabbits were used to induce cerebral hemorrhage.Animals were divided into hAECs group and isotonic saline group according to random number table,with 15 rabbits per group.Before transplanted to rabbits,hAECs were transfected with the retrovirus carrying green fluorescent protein (GFP).Morphologic and behavioral changes in both groups were noted periodically.Survival of transplanted hAECs and expressions of glial fibrillary acidic protein (GFAP) and microtubule-associated protein 2 (MAP-2)in focal cerebral tissues were observed.Results In hAECs group,the rabbits obtained progressive recovery in walking,supporting and coordinated motion.Restoration period mostly ranged from 2-3 weeks.Most of the rabbits in hAECs group had limb motor function recovered to grade Ⅱ-Ⅲ,while the recovery is slow in isotonic saline group with most ranging from grade Ⅰ-Ⅱ.According to Tarlov score,limb motor function presented significant difference between hAECs group and isotonic saline group (P ＜ 0.05).Immunohistochemical staining showed positive expressions of GFAP and MAP-2 in hAECs group,but no expressions in isotonic saline group (P ＜ 0.05).Conclusion hAECs transplantation effectively improves neural behavior and reduces nerve function impairment in treatment of cerebral hemorrhage in rabbits.

Objective To observe the effects of repetitive transcranial magnetic stimulation (rTMS) combined with abdominal muscle electrical stimulation on the pulmonary ventilation of patients with cervical spinal cord injury.Methods Twenty-five patients with cervical spinal cord injury were randomized into an experimental group (n =13) and a control group (n =12).The control group was given comprehensive rehabilitation treatment,including upper limb movements,standing training and training of respiratory function,while the experimental group was given repetitive transcranial magnetic stimulation and abdominal muscle electrical stimulation in addition to the comprehensive rehabilitation treatment.The patients' maximum lung capacity (VC),forced expiratory volume for 1 second (FEV1),peak expiratory flow rate (PEF) and tidal volume (VT) were measured at the outset and after 3 months of treatment.Results The lung function indexes increased in both groups after treatment,but each index improved significantly more in the experimental group,on average,than in the control group.Conclusion As a supplement to routine respiratory function training,repetitive transcranial magnetic stimulation combined with abdominal intermediate frequency electrical stimulation can improve the pulmonary ventilation function of patients with middle and lower cervical spinal cord injury.

Objective To explore the clinical characteristics of neonatal congenital cystic lung lesions. Methods Between January 2008 and June 2014,total 28 cases diagnosed congenital cystic lung lesions in neonatal center of Guangzhou Women and Children's Hospital were collected.The clinical data were analyzed including manifestations,lesion characteristics,imaging,diagnosis,treatment and prognosis,and the related literature were reviewed.Results There were 20 male and 8 female,16 cases of lobar emphysema,7 cases of pulmonary seques-tration,4 cases of congenital cystic adenomatoid malformation and 1 case of bronchogenic cyst.Main symptoms were dyspnea(78.57%),cyanosis (39.29%),wheezing cough (17.86%),feeding difficulties (14.29%),fever (10.71%),asymptomatic(21.43%).Two cases combined with congenital heart disease,4 cases combined with other malformations(such as diaphragmatic hernia,laryngeal stridor,funnel chest,polycystic kidney).There were lesions in chest CT image,4 cases underwent lobectomy,other cases underwent conservative treatment.Seventeen cases got better and discharge,3 cases dead.Conclusion The most common type of congenital cystic lung lesions in neonate is lobar emphysema.Main manifestations are dyspnea,cyanosis.If we suspect congenital cyst-ic lung lesions,we should do chest CT or MRI scan soon ,also do echocardiography and ultrasound to exclude other malformations.The treatment effect is satisfactory,and the outcome need long time to follow up.