Patent ductus arteriosus (PDA) is a frequent congenital heart disease .Incidence rate of PDA accounts for 10% ~21% of total incidence rate of congenital heart disease .In recent years ,along with the continuous deepening understanding of anatomical structure and pathology of PDA ,there were a variety of treatment methods ,including drug therapy ,interventional therapy and operation .The present article made a review about indications ,contraindi‐cations ,advantages and disadvantages of above three treatments .

Adult ; Aged ; Female ; Humans ; Lymphoma ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Splenic Neoplasms ; pathology

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Spondylosis ; therapy ; Treatment Outcome

Objective To investigate the MRI features of urethral sphincter in female with stress urinary incontinence(SUI) by the study of the indexes of the thickness of middle urethral sphincter, the function urethral length and bladder neck funnel . Methods Forty patients of female patients diagnosed as SUI by clinical were retrospectively as SUI group, and 40 asymptomatic female volunteers were recruited as reference group. All of the subjects were tested by pelvic MRI scanning both in static status and in the condition of Valsalva. The thickness of middle urinary sphincter was measured in the horizontal axis plane. In the midsagittal plane, the function urethral length was measured from the internal orifice to perineal fascia. The bladder neck funnel whether exist was observed from the midsagittal plane. For the comparison of the urinary sphincter thickness and urethral length of the two groups, independent sample t test was adopted. For urethral length in static status and under the condition of Valsalva, paired t test was done. For comparison of positive rate of the bladder neck funnel, Chi?squared test has been done. Results The value of the middle urinary sphincter thickness in the groups of SUI and reference were (2.23±0.68) mm and (2.69± 0.75) mm, respectively. Thus the differences of the two groups had statistical significance (t=-2.839, P<0.01 ). In the static status, the urethral length in SUI and reference group were (2.72±0.51) cm and (2.94± 0.34) cm respectively, wheras in Valsalva condition, the value were (2.33 ± 0.49) cm and (2.43 ± 0.43) cm respectively. The differences of the two groups had statistical significance in static status (t=-2.322, P=0.023), wheras there had no statistical significance in the two groups in Valsalva condition (t=-1.049,P=0.297). For SUI and reference group, both in static status and Valsalva condition, the difference of function urethral length had statistical significance (P< 0.01). The positive rate of bladder neck funnel for SUI was 72.5% (29/40), and for reference was 22.5% (9/40), the difference of the two groups had statistical significance(χ2=20.050, P<0.01). Conclusion For female SUI patients, urinary sphincter muscle is much thinner, function urethral length is much shorter and has higher positive rate of bladder neck funnel.

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Objective To investigate the dynamic changes in each radical line of pelvic floor levator hiatus in female with stress urinary incontinence(SUI). Methods A retrospective analysis of MR images was performed in 30 female patients with clinically diagnosed SUI and 30 asymptomatic female volunteers recruited as reference group. All of the subjects underwent pelvic MRI scanning both in static statusand Valsalva maneuver, respectively, Valsalva was performed by attempt to forcibly urinate while holding her breath, respectively. Area of pelvic diaphragm hiatus (LHA), ntero-posterior length (LHL) and tmixmum width (LHW) were measured in horizontal axis plane of the obtained images.H line distance was measured in the midsagittal plane. Independent sample t test was performed to compare the difference in LHA, LHL and LHW between two groups. Paired t test was used to compare difference in LHA, LHL and LHW between two groups in static status and Valsalva maneuver, respectively. Results In static status, the values in LHA, LHL, LHW and H line distance for SUI groups were(28.7±19.3) cm2, (7.1±2.2) cm, (4.7± 1.6 ) cm and (5.7±1.1) cm, respectively. The parameters for the reference group were(13.1±3.7)cm2, (5.3± 0.8) cm, (3.4 ± 0.5) cm and (5.7 ± 0.9) cm, respectively. The difference in LHA, LHL, LHW between two groups was statistically significant (t=4.33, 4.36, 4.23, and P<0.01 for all indexes), whereas the difference in H line distance between two groups was no statistically significanct because of P> 0.05. In Valsalva
maneuver, LHA, LHL, LHW and H line distance were (40.0±26.0) cm2, (8.0±2.3) cm, (6.0±2.5) cm and (6.1± 1.5)cm for SUI group, and were (16.2±6.2) cm2,(5.5±1.0) cm, (3.6±0.8) cm and (6.0±1.0) cm for the reference group, respectively. The difference in LHA, LHL and LHW between two groups was statistically significant, (t=4.88, 5.36, 4.91 respectively, and P<0.01), whereas the differencein H value between two groups was no statistically significant (P< 0.05). For SUI group , the difference of LHA, LHL and LHW between static status and Valsalva maneuver had statistically significant with P<0.01. For reference group, the difference of LHA and LHL between static status and Valsalva maneuver had statistically significant(P<0.05). Conclusion Dynamic and static pelvic MRI can evaluate the morphology and variation of pelvic floor levator hiatus much intuitively and accurately. pelvic floor levator hiatus becomes enlarged in female with SUI.

BACKGROUND:With the development of science and technology and improvement in living quality, telemedicine has played an important role in daily life, in particular in disease diagnosis and treatment as wel as rescue process for elderly people. OBJECTIVE: Based on Web of Science and ClinicalTrials.gov databases, to analyze the international telemedicine and elderly disease development so as to provide referential basis for the related study in China. METHODS: An online retrieval of Web of Science and ClinicalTrials.gov databases was performed with the key words “telemedicine” and “geriatric diseases” for papers regarding telemedicine for geriatric diseases published from 2003 to 2013. RESULTS AND CONCLUSION: (1) 239 papers regarding telemedicine for geriatric diseases were retrieved in Web of Science from 2003 to 2013. As per distribution by country for publications, USA published the highest number of papers (n=93, 38.912%). As per distribution by institute for publications (2003-2013), University of Washington was most prolific, folowed by Columbia University, The University of Queensland and The University of Western Australia (Australia). Among the included journals,Journal of Telemedicine and Telecare published the greatest number of papers (n=20, 8.368%). The number of included papers gradualy increased over the 10-year study period. Among these 239 papers, only 4 of them were from China, indicating that Chinese scholars paid relatively little attention in this research field, and the number and quality of Chinese papers on telemedicine for geriatric diseases need to be improved. (2) 18 studies regarding telemedicine for geriatric diseases were registered in ClinicalTrials.gov database from 2003 to 2013. Interventional studies (n=15) accounted for the largest proportion, folowed by observational studies.

Objective To monitor intra-abdominal pressure (IAP) in critically ill patients.Methods A prospective cohort study was conducted.IAP was measured through the bladder technique.Patients were screened for intra-abdominal hypertension (IAH,IAP ≥ 12 mmHg,1 mmHg=0.133 kPa) upon ICU admission.The patients with IAH/abdominal compartment syndrome (ACS) were given appropriate treatment and management for IAH and/or ACS.Mean arterial pressure (MAP),IAP,abdominal perfusion pressure (APP),filtration gradient (FG) and serum creatinine (Cr) were determined in patients with or without IAH,as well as in survivors and non-survivors.Results The entire protocol of IAP measurement was completed in 88 patients.Number of IAH and ACS patients was 25 (28.4％) and 2 (2.3％),respectively.The number of survivors was 80 (90.9％),with 8 (9.1％) non-survivors.Compared with non-IAH patients,IAP and SCr were increased in IAH patients [IAP (mmHg):14.16 ± 2.43 vs.8.13 ± 2.28,t=10.984,P=0.000; SCr (μmol/L):126.72 ± 83.02 vs.73.41 ± 37.59,t=3.087,P=0.005],with a lower FG (mmHg:59.32 ± 17.08 vs.70.24 ± 15.03,t=-2.956,P=0.004).There were no significant differences in MAP and APP between IAH group and non-IAH group [MAP (mmHg):79.18 ± 12.33 vs.88.71 ± 17.34,t=-1.368,P=0.190; APP (mmHg):73.40 ± 16.11 vs.78.37 ± 14.32,t=-1.415,P=0.161].Compared with survivors,non-survivors showed significantly lower APP and FG [APP (mmHg):60.88 ± 14.58 vs.78.56 ± 14.06,t=3.382,P=0.001 ; FG (mmHg):50.38 ± 16.18 vs.68.81 ± 15.44,t=3.208,P=0.002],and higher SCr (μmol/L:129.12 ±83.62 vs.84.36 ± 55.15,t=-2.082,P=0.040).There was no significant difference in IAP and MAP between survivors and non-survivors [MAP (mmHg):71.00 ± 25.46 vs.84.38 ± 13.53,t =1.224,P=0.238 ; IAP (mmHg):10.62 ±5.34 vs.9.76 ± 3.40,t=-0.647,P=0.519].Conclusions Earlier IAP measurements in critically ill patients are essential for the detection of IAH/ACS and renal injury.With appropriate management of IAH/ACS,significant decrease in morbidity and mortality of patients has been achieved.

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Hospitalized ; statistics & numerical data ; Child, Preschool ; Drug Utilization Review ; statistics & numerical data ; Female ; Hospitalization ; statistics & numerical data ; Humans ; Infant ; Male ; Respiratory Tract Infections ; drug therapy