Patent ductus venous is a kind of the congenital portosystemic shunts (CPSS). In recent years, the related case report increased gradually, but the domestic research is rare. In this article, we review the current diagnosis and treatment of neonatal patent ductus venous based on literature available.

Objective To investigate the prevalence of gastroeaophageat reflux disease(GERD)in the end stage renal disease patients(ESRD)with maintenance hemodialysis and the pathogenetic factors of GERD.Methods 60 cases who had heart burn and acid regurgitation symptoms were enrolled,31 cases of them were ESRD patients with maintenance hemodialysis,29 patients who were renal diseases free as control group.GERD was diagnosed by three methods:endoscopy,24h esophageal pH monitoring,endoscopic esophageal biopsy.GERD was established if any of these tests was positive.HP infection and serum gastrin were assessed too.Results (1)The prevalences of GERD in two groups were 83.9%,79.3% respectively and had no significant difference(P＞0.05).(2)The prevalence of HP infection in the ESRD group was significantly lower than control group(19 4% vs 51.7%,P＜0.05).(3)The concentration of serum gastrin in the ESRD group and control group was(102.61±30.80)ng/ml and (83.41±20.61)ng/ml,two group had significant difference(P＜0.05).Conclusion The prevalence of GERD inthe ESRD patients was higher than expected,and was correlated with absence of HP infection and hypergastinemia.

Objectives To summarize the maternal and fetal outcomes of patients with essential thrombocythemia (ET), and tentatively propose possible solutions for different clinical scenarios.Methods We retrospectively studied the clinical data, treatment, outcomes and follow-up status in 18 consecutive cases of young women with ET visited Peking University People's Hospital, among whom 22 pregnancies occurred from March 2005 to January 2015.Rank-sum test, Chi-square test or Fisher exact test were applied for statistics.Results (1) Out of the total 22 pregnancies, 17 (77％) were successful (term live births) and five (23％) ended in miscarriages, among which four were spontaneous abortion in first trimester.(2) Six pregnancies did not received any therapy, while 16 received various treatments before and/or during pregnancy, including oral Aspirin(single/joint), Hydroxyurea, Interferon-α (IFN-α) and platelet apheresis.(3) Treatments before/during pregnancy improved the live birth rate significantly (15/16 vs 2/6, P=0.009).Platelet (PLT) count of the newborns were all normal till the time at follow-up.(4) The median PLT count in those patients before Aspirin therapy was 761 × 109/L[(448-1 213) × 109/L, and 639× 109/L[(283-1 908) × 109/L] thereafter, which showed no significant difference (Z=-0.405, P=0.686).(5) The PLT counts in those patients before combination therapy of Aspirin and IFN-α was 989 × 109/L[(435-1 504) × 109/L], and 498 × 109/L[(186-559) × 109/L] thereafter, which decreased significantly (Z=-2.366, P=0.018).Conclusions (1) First-trimester spontaneous abortion is the most common complication of ET in pregnancy.(2) A specific treatment strategy may improve the pregnant outcomes without long-term harmful effect up to now.(3) IFN-α and/or Aspirin might be the first-line therapy in women with ET during pregnancy.

The therapy of acute promyelocytic leukemia (APL) with all-trans retinoic acid and arsenic trioxide was first discovered in China, which made a great contribution worldwide to APL treatment. However, foreign guidelines did not include the Chinese chemotherapy regimens, and our regimens were inconsistent with foreign guidelines. Therefore, it is necessary to interpret the home and international guidelines and to explore standard treatment of APL by analyzing APL guidelines of the China, Europe and the United States. Owing to several discrepancies between domestic and foreign APL guidelines, unifying the APL's diagnosis and treatment standard is desperately needed at present according to the evidence-based medicine. It is hoped that Chinese chemotherapy regimens will be more acceptable to other countries of the world, and would benefit the diagnosis and treatment of human APL.

Objective To explore the relationship between prospective memory (PM), retrospective memory (RM) and social function in old patients with schizophrenia. Methods 54 old patients with schizophrenia and 54 healthy controls were evaluated with logical memory (LM)IQ, LMIIQ of Wechsler Memory Scale-Fourth Edition (WMS-IV), Chinese Cambridge Prospective Memory Test (C-CAMPROMPT), University of California at San Diego (UCSD) Performance- based Skills Assessment- brief (UPSA- B), and Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Results The scores of LMIQ, LMIIQ, event-based prospective memory (EBPM), time-based prospective memory (TBPM), IQ, and UPSA-B were poorer in the patients than in the controls (P<0.001). The score of UPSA-B was positively correlated with LMIQ (r=0.524, P<0.001), LMIIQ (r=0.427, P<0.001), EBPM (r=0.437, P<0.001), TBPM (r=0.479, P<0.001) and IQ (r=0.709, P<0.001). Linear regression analysis indicated that TBPM (β=0.811, P=0.007), IQ (β=0.610, P<0.001) were contributing factors for the score of UPSA-B. Conclusion Schizophrenics may complicate the impairment of PM and RM, and the former may be independent fluence to their social function.

Objectives To investigate the clinical profile and prognosis of hemophagocytic syndrome (HPS). Methods A retrospective study was carried out to analyze the clinical features and laboratory findings in 28 children with HPS. Fisher's exact probability method and Logistic multivariate regression were used to explore the prognostic risk factors.. Results HPS was clinically characterized by prolonged fever (100%), hepatomegaly (64.29%),and other minor features including respiratory symptoms (53.57%), splenomegaly (50%), hydrops of multiple serous cavity (42.86%), lymphadenectasis (32.14%), jaundice (17.85%), skin rash (14.29%), central nervous system involvement (14.29%), and alimentary tract hemorrhage (10.71%). Labo-ratory data showed that 1iver dysfunction, pancytopenia, coagulation abnormalities, disseminated intravascular coagulation, hy-pertriglyceridemia, decreased number of natural killer cells and hyponatremia were prominent. The etiological analysis indicated that infection associated hemophagocytic syndrome was most common (60.71%), in which EB virus associated HPS was pre-dominant, accounting for 64.71%. Significant difference was observed in the difference of albumin,blood urea nitrogen and acti-vated partial thromboplastin time between death and survival cases (P<0.05). The Logistic regression multivariate analysis showed that hypoalbuminemia was an independent prognostic factor. Conclusions There are various underlying diseases and clinical manifestations for HPS. The lower level of serum albumin is an independent prognostic factor. A prompt diagnosis and treatment is very important for HPS prognosis due to the rapid progression and high mortality.

OBJECTIVE:To establish a method for simultaneous determination of rutin,quercetin and nuciferine in Heye gran-ule. METHODS:HPLC was performed on the column of Hypersil ODS2 with mobile phase of acetonitrile-water(containing 0.3%phosphoric acid and 0.4% triethylamine)(gradient elution)at a flow rate of 1.0 ml/min,the detection wavelength was 256 nm,the column temperature was 25 ℃,and the injection volume was 10 μl. RESULTS:The linear range was 0.012-0.240 μg for rutin(r=0.999 9),0.010 4-0.208 μg for quercetin(r=0.999 9)and 0.015-0.300 μg for nuciferine(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries were 98.5%-101.3%(RSD=1.1%,n=6),99.1%-101.6%(RSD=1.0%, n=6)and 98.9%-101.7%(RSD=1.2%,n=6). CONCLUSIONS:The method is simple,accurate and reliable,and can provide ref-erence for quality control of Heye granule.

Objective To investigate the metabolite changes in the preschool children with autism spectrum disorder (ASD) using MR spectroscopy (MRS) and explore the associations between image findings and clinical variables, which may provide a noninvasive brain biochemical method for the early diagnosis and prevention of autism. Methods Twenty one cases of preschool ASD children (3-6 years old) and age-and sex-matched 20 preschool healthy controls underwent single voxel short (SVS) short TE (TE=30 ms) MRS. The absolute metabolite concentrations in the anterior cingulate cortex (ACC) , anterior middle anterior cingulate cortex (aMCC) and posterior cingulate (PCC) were quantitatively analyzed using LCModel software. Two independent sample t tests were used for analysis. The relationships between metabolite concentrations and diagnostic and statistical manual of mental disorders (DSM-IV) , childhood autism rating scale (CARS) and autism behavior checklist (ABC) were analyzed by Pearson correlation analysis. Results Compared to control subjects, ASD patients had significantly lower N-acetylaspartate (NAA) values (4.35 ± 0.80, 6.34±0.82, 8.04±0.97 mmol/L respectively) in ACC, aMCC and PCC (t=2.640, P=0.012;t=2.182, P=0.035;t=3.343, P=0.002) , had significantly lower choline (Cho) 1.32±0.22 mmol/L (t=2.905, P=0.006) and glutamine and glutamate complex (Glx) 10.02 ± 0.88 mmol/L (t=2.090, P=0.043) in PCC. Cho, total creatine (tCr) , myo-Inositol (MI) and Glx levels did not differ between groups in other aforementioned regions (P>0.05). Negative correlations between the NAA ualues in the PCC and CARS (r=-0.504, P=0.020) were detected, and no significant correlation among DSM-IV, CARS, ABC and other metabolite values (P>0.05). Condnsions The biochemical changes in the preschool children with ASD in cingulate reflect the neuronal loss, structural or functional damage and cell membrane enzyme metabolic dysfunctions, may reveal the pathological basis of ASD. These results may provide noninvasive and quantitative methods for the diagnosis and prognosis evaluation of ASD child.

Objective To explore the clinical value of two-dimensional speckle tracking imaging (2DE-STI) by measuring global longitudinal strain (GLS) in normal children.Methods Totally 176 normal children underwent cardiac ultrasound examination,the left ventricular GLS were measured,and the difference of GLS between gender was analyzed.And the changes of GLS with body surface area (BSA) and age were discussed.Results GLS had no significant difference between male and female ([-24.90 ± 2.06]％ vs [-24.93 ± 2.01]％,t =0.83,P =0.934).GLS had significant differences among different BSA groups (F=3.84,P =0.003),and the differences of GLS in BSA＞ 1.0 group and the other five groups were statistically significant (all P＜0.05).GLS had statistically significant differences among different age groups (F=4.81,P=0.001),and the differences of GLS in ＞9 years old group and the other four groups were statistically significant (all P＜0.05).Conclusion Left ventricular GLS presents certain regularity with children's growth.

Objective:To explore the feasibility of artificial intelligence ultrasound to diagnose of biliary atresia (BA) based on deep learning.Methods:A total of 531 gallbladder ultrasound images in 177 cases of BA patients (BA group) and 585 gallbladder ultrasound images in 195 cases of Non-BA patients (Non-BA group) were collected in Hunan Children′s Hospital from September 2018 to October 2020. For the BA and Non-BA groups, all images were divided into training set and test set according to the ratio of 2∶1. The Mask R-CNN model was trained by training samples, and then the model was tested, according to patient and image as a unit respectively, to evaluate the gallbladder organ detection rate and the diagnostic accuracy of BA. In addition, the images of the test set were randomly numbered.Four sonographers were invited to interpret the images to calculate the diagnostic accuracy individually. Last, the diagnostic accuracy of the Mask R-CNN model was compared with that of sonographers.Results:In terms of the automatic detection of gallbladder organs, the detection rate in both BA and Non-BA group reached 100%, but there were 17 false alarms in 372 test images, with a false alarm rate of 4.57%. In terms of the diagnostic rate of gallbladders, when taking patient as a unit, the total diagnostic accuracy of the model in the test set was 95.97%, which was higher than that of the sonographers in other hospitals and the sonographer with intermediate professional title in our hospital, and the difference was statistically significant ( P<0.005). It was slightly higher than that of sonographer with senior professional title in our hospital (91.94%), but the difference was not statistically significant ( P=0.183). When taking picture as a unit, the total diagnostic accuracy of the model was 97.04%, which was higher than that of the sonographers in other hospitals and the sonographer with intermediate professional title in our hospital, and the difference was statistically significant ( P<0.001). It was slightly higher than that of sonographer with senior professional title in our hospital (94.09%), but the difference was not statistically significant ( P=0.05). Conclusions:The artificial intelligence technology based on Mask R-CNN can automatically and accurately detect gallbladder organs and diagnose BA, which is worthy of further study.