Objective To assess the application of automated four-dimensional (4D) volume color Doppler ultrasonography in normal fetal heart screening. Methods Four-dimensional volume color Doppler was acquired at the level of four chamber view level in 120 fetuses from 18 to 23 weeks of gestation. Three diagnostic planes including color Doppler information were retrieved by automated multiplanar imaging from the 4D volumes. The left ventricular outflow view (cardiac plane 1), the right ventricular outflow view (cardiac plane 2) and ductal arch view (cardiac plane 3) were acquired. Tomographic ultrasound imaging (TUI) was added to display all the three diagnostic planes. The data were then analyzed to determine whether cardiac planes 1-3 were displayed correctly in each volume. Results Automated 4D volume color Doppler ultrasonography displaying rate of cardiac plane 1, cardiac plane 2, cardiac plane 3 were 100%, 96.67% and 91.67%, respectively. Cardiac plane 1 was displayed at least three TUI plane, cardiac plane 2 was displayed at least two TUI plane, and cardiac plane 3 was displayed at least two TUI plane. Conclusion It is possible to acquire important planes of the fetal heart with automated 4D volume color Doppler ultrasonography and the visualization rate of the three diagnostic planes is fine.

AIM: To investigate the mechanism of renal damage in chronic intermittent hypoxia (CIH) rat model.METHODS:The Sprague-Dawley rats were randomly divided into 2-week CIH group (2IH), 2-week simulated air control group (2C), 4-week CIH group (4IH) and 4-week simulated air control group (4C).HE staining, PAS staining and Masson staining were used for histological evaluation .Blood was collected for the measurement of superoxide dismutase (SOD).The mRNA expression of hypoxia-inducible factor-1α(HIF-1α), manganese superoxide dismutase (MnSOD), copper/zinc superoxide dismutase ( Cu/ZnSOD ) was detected by real-time PCR.RESULTS: ( 1 ) No significance difference of renal weight , body weight , and the ratio of renal weight to body weight was observed , while IH caused mor-phologic kidney damage , especially in 4IH group.Hypertrophy of epithelial cells in the kidney tubles and dilation in the glomeruli were observed under light microscope with HE and PAS staining , especially in 4IH group.Masson staining showed no significant fibrotic response in the kidney of the rats exposed to IH .(2) The SOD levels in the serum and kid-ney were decreased after CIH .Compared with the corresponding control groups , the levels of serum SOD were significantly lower in CIH groups, especially in 4IH group.The mRNA expression of Cu/ZnSOD and MnSOD in CIH groups decreased significantly as compared with control groups .The mRNA levels of HIF-1αwere significantly higher in CIH groups than those in the corresponding control groups .CONCLUSION: CIH induces abnormalities of glomeruli and convoluted tu-bules, while 4-week IH exposure has not led to fibrotic response .CIH participates in the process of renal oxidative stress damage by upregulating HIF-1αtranscription and downregulating Cu/ZnSOD and MnSOD transcription .

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common clinical disease that seriously threatens human health and life. Accurate location of the upper airway obstruction is the key to the diagnosis and treatment of OSAHS. Acoustic pharyngometry uses sound reflection to quickly assess the cross-sectional area and volume of the upper airway. Acoustic pharyngometry represents a simple, quick, non-invasive method for measuring upper airway dimensions which could predict sleep apnea risk. In this article we sought to introduce the application of acoustic pharyngometry in the diagnosis and treatment of OSAHS.
Acoustics ; Humans ; Larynx ; Pharynx ; diagnostic imaging ; Sleep Apnea, Obstructive ; diagnosis ; therapy ; Syndrome

ObjectiveTo compare the levels of sFas in the sera among Kawasaki disease (KD),incomplete Kawasaki disease (IKD),and normal control groups,and to analyze the relationship of sFas with IKD children.MethodsA total of 32 cases of acute KD and acute IKD children,and 20 cases of the control children were selected,respectively.The levels of serum sFas among three groups were measured using ELISA kits.Each child among the three groups was examined by echocardiography.Results(1)The levels of serum sFas among the three groups were[ (0.54±0.20)ng/L in KD,(0.55±0.16)ng/L in IKD,and (0.24 ± 0.04) ng/L] in control group,respectively.The overall means of sFas in the KD and IKD groups were higher than the control group,and the differences were statistically significant( F=29.276,P＜0.05 ).(2)The levels of serum sFas among echocardiography abnormal and normal groups were[ (0.65±0.19) ng/L and (0.49±0.10)ng/L],respectively; and the difference between two groups were statistically significant ( t=3.139,P ＜ 0.05 ).ConclusionsThe expression levels of sFas in the peripheral serum of IKD children were increased,and there was a close association of overexpression of sFas with the cardiovascular damage in IKD children.

Objective To evaluate the efficacy of emergency endoscopic intervention in acute obstructive suppurative cholangitis (AOSC) complicated with septic shock.Methods A total of 54 patients with AOSC and septic shock who underwent therapeutic emergency ERCP were included in this retrospective study,and were evaluated by the shock index (SI).Results ERCP was performed for all patients in 24hours after hospitalization,and the average ERCP operation time was 23.8 ± 12.5 min.All 54 patients underwent EST,46 of whom received ENBD,7 biliary stenting and 1 transferred to surgery due to bleeding.The post-ERCP mortality rate was 0,and the complications included 1 case of pancreatitis and 2 cases of pneumonia.The positive rate ofGram-Negative bacillus before ERCP was 46.9％ (15/32).The SI before ERCP was 1.250 ±0.200,which decreased to 0.950 ±0.119 at 2hr after the procedure (P ＜0.001 ),and decreased further to 0.598 ± 0.099 ( P ＜ 0.001 ) at 24 hours after ERCP.Conclusion Therapeutic emergency ERCP is of great importance in the treatments for AOSC complicated with septic shock.

ObjectiveTo investigate the efficacy of co-infusing cord blood (CB) as the third party cells on graft versus host disease (allo-GVHD) prophylaxis after unrelated or haploidentical donor allogeneic hematopoietic stem cell transplantation (allo-HSCT).MethodsFrom 2007 to 2011,41 patients receiving unrelated or haploidentical donor allo-HSCT were analyzed retrospectively.Twenty-five patients received one unit of HLA 4/6-6/6 matched CB one day before SCT as CB group,and median MNC dose was (1.64 ± 0.49) × 107/kg.Sixteen cases not receiving CB served as control group.All patients received antithymocyte globulin,cyclosporine,methotrexate,and mycophenolate mofetil as GVHD prophylaxis.The incidence and severity of aGVHD,and treatment-related mortality were compared between two groups.ResultsThe main clinical characteristics in both groups were comparable.The cumulative incidence of aGVHD in CB group and control group was 44.0％ versus 68.8％ respectively (x2 =2.403,P＞0.05).The cumulative incidence of grades Ⅲ to ⅣV aGVHD in CB group and control group was 16.0％ and 37.5％ respectively (x2 =2.445,P＞0.05).The 100-day treatment-related mortality in CB group and control group was 12.0％ and 12.5％ respectively (x2 =0.002,P＞0.05).ConclusionCord blood as the third party cells might reduce the incidence and severity of aGVHD in unrelated or haploidentical donor HSCT.The efficacy and the mechanism of this strategy need to be further explored by prospective randomized controlled trials.

Objective To investigate the off-label use status in obstetrics ward so as to provide references for carrying out obstetrics pharmaceutical care and promoting safe medication use in pregnant and parturient women. Methods The prescriptions for pregnant and parturient women from January to June, 2015 in obstetrics ward were investigated. According to drug instructions, the off-label drug use of prescriptions of all selected patients was analyzed in the following aspects:the category of off-label drug use, and drugs use information. In addition, a logistic regression was conducted that modeled the odds of receiving an off-label prescription as a function of the following possible risk factors:pregnant, parturient women and the rank of doctors. The clinical results including the unreasonable drug application, abortion rate and birth defect were compared between the off-label drug use and on-label drug use groups. Results Total of 384 patients were selected, and 5330 prescriptions involving 50 drugs were analyzed. The rate of off-label drug use was 68. 5%, 27. 7% and 24. 0% in patients, prescriptions and drug categories, respectively. The main categories of off-label drug use were super solvent use ( 76. 6%) and indication (14. 3%). The top 3 drugs of off-label use were those for urinary and reproductive (56. 2%), alimentary tract (46. 9%) and traditional Chinese medicine (43. 4%). In addition, there was no significant correlation between the risk of off-label drug use and maternal status and the level of doctors. And no significant difference between the two groups in the unreasonable drug application, abortion rate and birth defect was detected. Conclusion The off-label drug use in obstetrics ward is common in this hospital and most of them are supported by clinical evidence. Due to the lack of more authoritative evidence-based medication, the doctors are suggested to use the drug according to provisions of the drug instructions. When off-label drug use is really needed, it should be based on the surpport of evidence basde medicine,so as to ensure the drug safety for pregnant and parturient women and avoid professional risks.

Objective To evaluate the feasibility of CEUS in Crohn discasc (CD) activity.Methods Thirty-nine patients with CD were analyzed.The clinical disease activity index of 18 cases were less than 150 (inactivity),and 21 cases were between 150 and 450 (activity).The thickness of intestinal walls were measured and Limberg classification were determined by power-Doppler results.The CEUS was performed,and the parameters including rise time,peak intensity,mean transit time,time from peak to one half,wash in slope and time to peak were statistical analyzed.Results The thickness of the lesions,peak intensity and wash in slope of activity CD were greater than those of inactivity CD,which had significant difference (all P＜0.05).The Limberg classification of type Ⅰ was 1 case,type Ⅱ was 4 cases,type Ⅲ was 10 cases and type Ⅳ was 6 cases in activity CD.The Limberg classification of type Ⅰ was 10 cases,type Ⅱ was 7 cases and type Ⅲ was 1 case.The Limberg classification were mainly type Ⅲ and type Ⅳ in activity CD,and type Ⅰ and type Ⅱ in inactivity CD,which had significant difference (P＜0.001).Conclusion CEUS can provide quantitative parameters in CD activity and has great clinical value.

Objective To analyze and compare the advantages and disadvantages in high-field MRI scan and LAVA enhanced in the display of hepatic carcinoma capsule,in order to improve the early diagnosis and differential diagnosis level of primary hepatic carcinoma by MRI.Methods MRI data of 233 patients of primary hepatic carcinoma were retrospective analysed by two radiologists. Results 233 cases of primary hepatic carcinoma,except for 18 cases of diffuse hepatocellular carcinoma,a total of 239 lesions (54 small hepatocellular carcinoma,76 nodular hepatocellular carcinoma,109 massive hepatocellular carcinoma )were found .Hepato-cellular carcinoma capsule display rate was 139/239(58.16%).119 T1 WI,87 cases were found in T2 WI,and 139 cases were found in LAVA enhanced scan.25 lisions showed complete capsule on T1 WI,12 lisions showed complete capsule on T2 WI,59 lisions showed complete capsule on LAVA enhanced scan.Small hepatocellular carcinoma displayed capsule 21/54 (38.9%),nodular hepa-tocellular carcinoma 53/76 (69.7%),massive hepatocellular carcinoma 65/109 (59.6%).Conclusion High-field MRI conventional scan and LAVA enhenced scan can display PHC capsule better,LAVA enhanced (portal phase + delay phase)showed PHC capsule better than T1 WI and T2 WI.

Objective To discuss the method and skill of prenatal diagnosis of fetal isolated pulmonary stenosis and thus to improve prenatal diagnostic ability. Methods The data of 18 fetuses diagnosed as isolated pulmonary stenois were reviewed and the ultrasonic characters of each section were analysised. Results Five of the 18 cases were confirmed as pulmonary stenosis by autopsy and 12 cases were confirmed by echocardiography after birth. One case was confirmed as pulmonary atresia by echocardiography after birth. Reversed blood flow in arterial duct was detected at the ductal arch section in all the cases and right atrial enlargement,right ventricular myocardial hypertrophy, tricuspid regurgitation, foramen ovale enlargement, reduced activity of foramen ovale valve were detected in partial cases. Conclusions It is important that reversed blood flow in arterial duct and in the two main artery could be observed at the ductal arch section and the three vessel section respectively. Ductal arch section,ventricular outflow tracts section and the three vessel section are very important in the diagnosis of fetal isolated pulmonary stenosis.