Objective To evaluate the diagnostic value of magnetic resonance imaging (MRI) on fetal ventriculomegaly identified through prenatal ultrasonography and the outcomes of these newborns were followed up. Methods From March 2006 to July 2008, MRI was performed on 135 pregnant women whose fetuses diagnosed as fetal ventriculomegaly at an average of 32 gestational weeks in Shengjing Hospital Affiliated to China Medical University. Mild ventriculomegaly was defined when the width of unilateral or bilaeral fetal cerebral ventricle triangle was 10-15 mm, moderate ventriculomegaly 16-20 mm and severe ventriculomegaly >20 mm. We introduced the Denver developmental screening test(DDST) to follow-up the mild ventriculomegaly and normal babies, confirmed by MRI, at 6-12 months after birth and a case-control study was conducted. The intelligence and growth of these infants were analyzed. Results (1) Diagnostic rate of fetal ventriculomegaly through MRI: Among the 135 gravidas, 60 (44.4%) showed isolated ventriculomegaly, 5 (3.7%) complicated with ventricular hemorrhage; 12 (8.9%) complicated with agenesis of corpus callosum (ACC) and 2 (1.5%) complicated with cerebellar hypoplasia, while 56 (41.5%) were normal. Seventy-nine cases had fetal ventriculomegaly on MRI and 15.2% (n=12) of them complicated with ACC. (2) Degree of fetal ventriculomegaly on MRI: Among the 60 isolated ventriculomegaly cases, 55 (91.7%) were mild and 5 (8.3%) moderate ones. Among the 5 cases complicated with ventricular hemorrhage, one was mild ventriculomegaly, and 4 moderate or severe cases. Among the 12 cases with ACC, 8(66.7%) were moderate ventriculomegaly and 4 (33.3%) severe cases. The 2 cases with cerebellar hypoplasia were both moderate ventriculomegaly fetuses. (3) Follow-up at 6-12 months after birth : thirty out (case group) of the 55 isolated ventriculomegaly cases, 38 out of the 56 normal babies and 42 babies with normal MRI results were followed up, and the later 80 cases were taken as control. Four infants (13.3%) in the case group and 10 (12.5%) in the control group showed abnormal or suspected results in DDST (P>0.05), the rest babies were all normal. (4) Clinical outcomes of the 79 ventriculomegaly fetuses diagnosed by MRI: thirty mild ventriculomegaly babies and 5 moderate ones were born at term and showed normal at follow ups. However, 7 gravidas were not compliant, 6 pregnancies were terminated, and 12 were last. Three of the 12 cases with ACC continued the pregnancy, and postnatal MRI of the babies showed the same with the prenatal MRI, 8 pregnancies were induced and one was lost. All of the 5 fetuses with ventricufar hemorrhage were induced and the prenatal diagnosis was confirmed by autopsy. One of the 2 fetuses with cerebellar hypoplasia was term delivered and diagnosed as cerebral palsy at the age of 6 months, and the other one was induced. Conclusions MRI is an indispensable complementary diagnostic method for fetal ventriculomegaly diagnosed through ultrasound. The development of intelligence and growth of babies born with mild isolated ventriculomegaly is the same as normal ones.

Objective To evaluate the diagnostic value of MRI in the cases suspected of ventriculomegaly by prenatal uhrasonography.Methods 104 patients of suspected fetal ventriculomegaly (VM) diagnosed by uhrasonography were included from the Shengjing Hospital,China Medical University from March 2006 to October 2007.All cases were divided into 4 groups based on the standard of Gaglioti:10-12 mm(66 cases),13-15 mm(22 cases),16-20 mm(14 cases),and 21-25 mm(2 cases);they included 75 eases of single intracerebroventricular expansion and 29 eases of double intracerebroventricular expansion.All of them were subjected to MRI scan within 48 h of uhrasonographic examination to determine the prenatal diagnosis by MRI pregnancy outcomes.Results Among the 26 072 cases who received prenatal uhrasonography,104 cases (0.39%) were VM. (1) MRI detected 3 cases (5%) in 10-12 mm group:one ease of cerebellar hypoplasia,vascular malformation,chest and abdominal anomalies each; 5 cases(23%)in 13 -15 mm group:one case of agenesis of corpus callosum (ACC),cerebral hemorrhage,cerebral hemorrhage with cerebral meningocele,cerebral meningocele,intracranial mass meningocele each; 6 cases(43% )in 16 -20 mm group:4 cases of ACC,one case of intraventricular hemorrhage and ACC combined with ventricular hemorrhage each; 2 cases in 21-25 mm group:one case of ACC and intraventricular hemorrhage each.(2) MRI detected 4 eases(5%) among 75 unilateral VM cases and 12 eases (41%) among 29 bilateral VM eases.The differences were significant (P＜0.01).MRI diagnosis rate was 15.38% (16 cases).Follow-up of the outcomes of the pregnancy showed induction of 0labor in 15 cases (14%) all of which were the same as MRI results on autopsy,full-term delivery of 88 cases,of which all the neonates were healthy.Conclusions When the expansion width is above 16 mm or bilateral VM is suspected by ultrasonography,we suggest MRI examination to determine fetal central nervous system disease.

Bacteremia ; microbiology ; Female ; Humans ; Infant ; Pseudomonas Infections ; pathology ; Pseudomonas aeruginosa

OBJECTIVE:To provide reference for setting reasonable medicines insurance payment price in China.METHODS:We retrieved and analyzed academic articles formally published at home and abroad,official websites and government documents,summarized.medicines insurance payment pricing mechanism as well as fair solutions to high-cost medicines,so as to put forward the suggestions to formulate reasonable medicines pricing policy in China.RESULTS&CONCLUSIONS:The international medicines payment prices are usually determined by internal reference pricing method,incremental cost-effectiveness evaluation method and external reference pricing method.The sustainable and fair accessibility of high-cost medicines are promoted by fair medicines pricing program,medicines patent pool,open source medicines discovery znitiative and so on.After the goal of universal health care has been achieved in china,reasonable medical insurance payment price should be explored and formulated.It is necessary to adopt,intemal reference pricing method to determine the payment standard of completitive eneric products,external reference pricing method or incremental cost-effectiveness evaluation method to determine the reference price for price negotiation of the innovative patented medicines;the concept of fair pricing for high-cost medicines.

Objective To observe and compare the analgesic efficacy of femoral nerve block (FNB)and sufentanil for positioning patients with fractured hip.Methods Sixty patients scheduled for hip fracture surgery were randomized into three groups.Fifteen minutes before positioning for subarachnoid block,the FNB group received nerve ultrasound guided FNB using 20 ml ropivacaine 0.5% .Five minutes before positioning,the S group received a dose of IV sufentanil 0.15μg/kg,the C group didn't accept any intervention.The visual analog scale(VAS)following positioning (T2 ),OAA /S scale before positioning (T1 ),MAP,HR,SpO2 entering operating room (T0 )and T1 ,T2 ,adverse reactions were recorded.The plasma concentration of noradrenaline(NA)and cortisol(Cor)by T0 and T2 were measured.Results MAP,HR,the level of NA,Cor by T2 in group C increased significantly by comparing with T0 (P <0.05),while there were no obvious change in group F,and the same to group S except NA.The obvious change of SpO2 couldn't be found at each time point in every group(P >0.05).There were no significant differences in MAP,HR,the level of NA,Cor in all instances among the three groups(P >0.05).The OAA /S of S group was higher than the other groups(P <0.05).Compared with group C,group F and S showed markedly lower VAS at T2 (P <0.05),there were no significant differences between the two group.Side effects of group S included respiratory depression in 3 patients,nausea vomiting in 1 and dizzy in 1,no adverse reaction were found in other groups.Conclusions Both FNB and intravenous sufentanil can reduce the pain of positioning patients with fractured hip,showing almost the same analgesic efficacy,FNB can more inhibit stress reaction caused by pain.

Objective To investigate the risk factors that worsened the pathologic course of acute ischemic stroke .Methods The clinical data of 264 patients with acute ischemic stroke treated in Shijitan hospital were analyzed retrospectively .According to the outcome ,the patients were divided into deterioration group (70 cases) and improved group(194 cases) .The clinical data ,labora-tory examination results of the patients were collected through self-made survey and compared between the two groups .The risk factors that worsened the pathologic course of acute ischemic stroke were analyzed by multiple linear regression .Results There were 42 .86% patients with hyperlipidemia history and 70 .00% with diabetes history in the deterioration group ,which were signifi-cantly higher than the improved group(P<0 .05) .The levels of glucose ,glycosylated hemoglobin ,fibrinogen ,serum ferritin ,C reac-tive protein ,low density lipoprotein cholesterol in the deterioration group were significantly higher than those in the improved group (P<0 .05) .Multiple linear regression analysis showed that hyperlipidemia history ,high level of C reactive protein ,and high level of low density lipoprotein cholesterol were the independent risk factors that worsened the pathologic course of acute ischemic stroke . Conclusion Hyperlipidemia history ,high level of C reactive protein ,and high level of low density lipoprotein cholesterol were the independent risk factors that worsened the pathologic course of acute ischemic stroke .According to these factors ,patients were e-valuated and targeted measures were made to improve the prognosis of the patients .

Objective:To investigate effects of depside salt from salvia miltiorrhiza(DSSM)on the dental pulp of rats under repeated exposure to +Gz acceleration.Methods:27 male SD rats were randomly divided into 9 groups(n =3).The rats in negative control group was only fixed with rats kept-keeling device,in positive control group were exposed to +5 Gz and +10 Gz respectively for 30 s each time,5 times per day,4 days per week,for 3 consecutive weeks.The rats in other groups were respectively given DSSMat 2,6 and 18 mg/kg respectively 30 min before each +Gz exposure.The rats in negative and positive control groups were injected with 0.9%sodium chloride solution 30 min prior to +Gz exposure.After the experiment,The pulp changes were observed by HE staining.Real time qPCR was applied to determine the relative expression of heat sheck protein(HSP70)mRNA.Results:+Gz exposure decreased the activity degree of the rats,and resulted in damage of rat dental pulp.With the increase of +Gz value,the relative expression of HSP70 mRNA was increased(P ＜0.05).HSP70 mRNA expression in drug groups was less than that in their own positive control groups,but showed statistical significance only in the 18 mg/kg and +10 Gz group(P ＜0.05).Conclusion:+Gz exposure may dam-age dental pulp.DSSMhas certain protective effect under +Gz exposure.

Purpose To investigate the genetic changes of ALK gene in sporadic neuroblastoma in China, and to explore its role in neuroblastoma. Methods Total 56 cases of NB with overexpressed ALK protein were studied by fluorescence in situ hybridization ( FISH) , using interphase Vysis LSI ALK dual-color and break apart rearrangement probes. Literature under the subject was searched through PubMed. Results Of the 56 cases, ALK gain was found in 9 (16%) cases, ALK amplification was found in 1 (1. 8%) case only. No alterations of ALK were detected in the remaining 46 cases. Conclusion As a major predisposition gene as well as a poten-tial therapeutic target for neuroblastoma, the frequency of aberrant copy numbers of ALK gene in Chinese NB patients is closely similar with previously published results.

Objective To survey the knowledge requested by patients with coronary artery disease (CAD) after stent implantation.Methods A survey on CAD and stent-related knowledge requested by CAD patients with stent implantation was conducted with a self-designed questionnaire from September 2013 to November 2013.Total 362 patients (235 males and 127 females) aged (67 ± 12) years participated in the survey in Yuetan Community Health Service Center and Fuxing Hospital in Beijing.Open questions and heuristic questions were used together during the survey.Results The knowledge requested by patients were:diet management(255,70.4％),side effects of medication(241,66.6％),management of physical activity (221,61.0％),prevention of CAD(181,50.0％),withdrawal of medication(176,48.6％),the life of stents (168,46.4％),post-operation check-up items (162,44.8％),the causes of CAD (156,43.1％)and drug mechanisms(134,37.0％).Patients with stent implantation less than one year requested more knowledge about the cause of CAD (x2 =37.4,P ＜ 0.001),life-time of stent (x2 =39.9,P ＜0.001),prevention of CAD (x2 =13.4,P =0.001),post-operation check-up items (x2 =21.2,P =0.001) and requested less knowledge about withdrawal of medication (x2 =9.56,P =0.008),diet management (x2 =6.49,P =0.04) than those with more than one year.Patients aged ＜ 70 years requested more knowledge about the cause of CAD (x2 =31.6,P ＜ 0.001),prevention of CAD (x2 =9.99,P =0.007),life-time of stent (x2 =79.1,P ＜ 0.001),side effects of medication (x2 =7.84,P =0.02) than patients aged ＞ 70 years.Patients with education higher than junior high school requested more knowledge about the cause of CAD (x2 =26.6,P ＜ 0.001),prevention of CAD (x2 =14.4,P =0.001) and life-time of stents (x2 =7.82,P =0.02) than those with education lower than junior high school.Patients with education higher than junior college requested more knowledge about the cause of CAD (x2 =26.6,P ＜ 0.001) and post-operation check-up items (x2 =10.7,P =0.005) than those with education lower than junior college.Conclusion Some factors affect the knowledge requested by patients with coronary artery disease (CAD) after stent implantation,which should be considered in health education for CAD patients.

Objective To evaluate the effects of sevoflurane postconditioning on mitophagy during myocardial ischemia-reperfusion (I/R) in rats.Methods Forty-two pathogen-free adult male SpragueDawley rats, weighing 250-300 g, were randomly divided into 3 groups (n=14 each) using a random number table: sham operation group (group S) , I/R group and sevoflurane postconditioning group (group SP).Myocardial I/R was induced by 30 min ligation of the left anterior descending branch of the coronary artery followed by 2 h of reperfusion.In group SP, 2.4％ sevoflurane was inhaled for 15 min starting from the onset of reperfusion, while 33％ oxygen was inhaled in group I/R.The rats were sacrificed at the end of reperfusion, and the hearts were removed for measurement of myocardial infarct size (by 1％ 2, 3, 5 triphenyltetrazolium chloride) , expression of LC3 Ⅱ/LC3 Ⅰ , Beclin-1, p62 and Parkin (by Western blot) ,and mitochondrial menbrane potential (by using JC-1 probe) , and for examination of the uhrastructure of cardiomyocytes (with transmission electron microscope).Results Compared with group S, the myocardial infarct size was significantly increased, mitochondrial membrane potential was decreased, the expression of LC3 Ⅱ/LC3 Ⅰ , Beclin-1 and Parkin was up-regulated, and the expression of p62 was down-regulated in group I/R.Compared with group I/R, the myocardial infarct size was significantly decreased, the mitochondrial membrane potential was increased, and the expression of LC3 Ⅱ/LC3 Ⅰ , Beclin-1, p62 and Parkin was down-regulated in group SP.Conclusion Sevoflurane postconditioning can mitigate I/R injury in rats, and inhibition of excessive activation of mitophagy may be involved in the nechanism.