Objective To investigate the diagnostic value of prenatal ultrasound for fetal structural abnormalities.Methods The clinical data of 3 101 fetus with structural malformations, diagnosed by prenatal ultrasound and confi rmed after induced labor, and 856 cases of missed diagnosis were analyzed. All these data were collected in Maternal and Child Health Hospital of Tangshan City from January 2010 to June 2014. The types and number of fetal structural abnormalities were recorded. The rates of detection and missed diagnosis for the fetal structural abnormalities were calculated and the reasons for missed diagnosis were analyzed.ResultsA total of 3101 cases (4 171 positions) were diagnosed as fetal structural abnormalities by prenatal ultrasound. The detection rate was 11.51‰ (3 101/269 501). There were 856 cases (947 positions) of fetal structural abnormalities were missed, and the missed diagnosis rate was 3.18‰ (856/269 501). The incidence of fetal structural abmormalities was 14.68‰ (3 957/269 501). In terms of anatomy systems, the top five were cardiovascular system abnormalities (851 cases), the central nervous system abnormalities (691 cases), facial abnormalities (562 cases), urinary system abnormalities (476 cases), and respiratory system abnormalities (134 cases). In terms of single abnormalities, the top five were cleft lip and palate (549 cases), ventricular septal defect (519 cases), hydronephrosis (331 cases), spina bifi da (212 cases), and atrial-ventricular septal defect (163 cases). The top five of missed deformities were polydactylia/symphysodactylia (285 cases), ear deformities (108 cases), hypospadias (93 cases), foot abnormalities (92cases), and ventricular septal defect (52 cases).Conclusions There is a high detection rate for fetal structural abnormalities with prenatal ultrasound. Prenatal ultrasound is an indispensable means for the diagnosis of fetal malformation, but it also has some limitations. There is a high rate of missed diagnosis for polydactylia/symphysodactylia, microtia, and hypospadias.

Objective　To investigate the expression and clinical significance of α2-macroglobulin (α2MG) in cerebrospinal fluid of schizophrenia patients after cerebral infarction.Methods　One hundred and thirty-six psychotic disorder patients were selected from March 2015 to March 2019,including 53 patients with traumatic cerebral infarction (cerebral infarction group) and 83 patients with non-cerebral infarction (non cerebral infarction group).The levels of α2MG,interleukin-6 (IL-6),C-reactive protein (CRP),immunoglobulin M (IgM) and complement C3 were detected by enzyme-linked immunosorbent assay (ELISA),the correlations between α2MG and IL-6,CRP,IgM,C3 were analyzed;and the ROC curve was drawn to analyze the diagnostic value of serum α2MG level in schizophrenia after cerebral infarction.Results　The levels of α2MG,IL-6,CRP,C3 and IgM in cerebrospinal fluid of patients in cerebral infarction group were higher than those of patients in non-cerebral infarction group (P<0.05).Pearson analysis showed that the levels of α2MG in cerebrospinal fluid were positively correlated with the levels of IL-6,CRP,C3 and IgM (r=0.413,P=0.002;r=0.553,P=0.000;r=0.613,P=0.000;r=0.512,P=0.000).ROC curve showed that the area under the curve of α2MG level in cerebrospinal fluid for the diagnosis of psychotic disorder after cerebral infarction was 0.897,the cutoff value was 1.968 μg/ml,the sensitivity was 83.0%,the specificity was 94.0%,and the 95% CI was 0.828~0.967.Conclusion　The levels of α2MG in cerebrospinal fluid of psychotic disorder patients after cerebral infarction rises,which has certain clinical significance for the diagnosis of cerebral infarction psychotic disorder.