Objective To describe an intelligent three-dimensional technique for automatic visualization of the fetal cranial mid-sagittal view to allow for the differential diagnosis of fetal midline anomalies.Methods Two hundred and twenty pregnant women with singleton pregnancies were imaged to display the mid-sagittal view of fetal head using a new 3D program (Smart MSP) developed by our team.Results The mid-sagittal view of the fetal head was successfully visualized in 190 normal cases (95％) and 18 abnormal cases (90％) by Smart MSP program.The total successful rate was 94.5％ (208/220).Conclusions Smart MSP is a novel and feasible method for the automatic visualization of fetal cranial midsagittal plane and may become a potential tool for routinely screening the fetal midline anomalies.

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.

Objective To study the mechanism of pregnancy immune tolerance induced by adoptive transferring of FasL gene-modified dendritic cells(DC). Methods The mouse models of spontaneous abortion(CBA/J ? DBA/2) and normal pregnancy(CBA/J ? BALB/c) were established.Five different experimental groups were included: mice of normal pregnancy(CBA/J?BALB/c)(n=17),served as control group;mice of spontaneous abortion without treatment(CBA/J?DBA/2)(n=37),mice injected with DC culture medium(DCCM)(n=25);mice immunized with empty plasmid pcDNA3.1-DC(n=6);and mice immunized with pcDNA3.1-FasL-DC(n=5).Embryo resorption rates of pregnant mice in each groups were observed.Annexin V-FITC was used to detect the apoptosis of T cells.Immunohistochemical staining(SABC) was used to detect the expression of FasL in decidual membranes of pregnant mice. ResultsThe embryo resorption rate of mice immunized with FasL-DC was decreased significantly as compared with that of mice of spontaneous abortion without treatment,DCCM group and immunized with pcDNA3.1-DC(P0.05). Conclusion The decreased apoptosis rate of peripheral T cells and the reduced expression of FasL in decidual membranes may be an important mechanism for the pathogenesis of abortion.Adoptive transfer of FasL gene-modified DC may induce pregnancy immune tolerance by increasing FasL expression of maternal-fetal interface and decreasing embryo resorption rate.

ObjectiveTo summarize the echocardiographic diagnosis, clinical classification and prognosis of different types of fetal congenital cardiac malformation (FCMH).MethodsThe echocardiography sonogram characteristics for 429 cases with FCMH were summarized and analyzed by pathological findings and postnatal following-up.ResultsThe incidence of FCMH was 1.3% (429/33 800). In one hundred and seventy-seven caese of single structure malformation, there were 5 cases of Atrial septal defect and 55 cases of interventricular septal defect (34.5%, 61/177). The others including (116 cases): 10 cases of single atrium and 34 cases of single ventricle, 20 cases of Ebstein’s anomaly, 11 cases of tricuspid atresia and 6 cases of pulmonary atresia with intact ventricular seprum, 20 cases of pulmonary stenosis, 10 cases of coarctation of aortic arch and 4 cases of interruption of aortic arch, 1 case of pulmonary artery sling. In two hundred and thirty-three cases of symphysic teratism, there were 41 cases of double-outllet right or left ventricle (17.5%, 41/233) and Tetralogy of Fallot (40 cases, 17.2%, 40/233). The others (152 cases) including: 16 cases of complete and 18 cases of corrected transposition of great arteries, 38 cases of atrioventricular septal defect, 30 cases of truncus arteriosus persistens, 8 cases of total and 10 cases of partial abnormal pulmonary venous drainage, 14 cases of hypoplastic right heart and 6 cases of left heart syndrome, 9 cases of pulmonary artery atresia with ventricular septal defect, 2 cases of plysplenia and 1 case of plenia syndrome. Nineteen cases of instructure cardiac anomalies including 16 cases of heart tumor and 3 cases of endocardial ifbroelastosis. Nine cases were missed diagnosis and 7 cases were misdiagnosis. A total of 136 cases couldn′t be cured with an unfavorable outcome. Nighty three cases with severe FCMH could be cured. Fifty four cases needed emergent treatment postnatal, and 146 cases with mild abnormality.ConclusionsFetal congenital malformation of heart diagnosed by antenatal echocardiography is valuable for guiding the clinical decision in prevetion and treatment it can also reduce perinatal mortality with congenital malformation of heart.

Objective To evaluate the clinical significance of prenatal ultrasonography in diagnosis of retroaortic left innominate vein ( LINV ) . Methods Thirty fetus with retroaortic LINV were involved , including 17 cases of isolated retroaortic LINV and 13 cases of complicated retroaortic LINV . Three-vessel and trachea ( 3VT ) view was focused in the routine second trimester ultrasound screening to observe whether LINV existing or not . And then the transducer was rotated to the fetal sagittal view to assess the relationship between LINV and aortic arch and the convergence of left subclavian vein and left internal jugular vein into the LINV . Results The characteristic feature of retroaortic LINV was the LINV converge into right superior vena cava ( SVC) under the aortic arch ,not above the aortic arch . The most important plane to detect the retroaortic LINV was the 3VT view ,which revealed the abnormal vein lying to the left of pulmonary artery . The abnormal vein then could be traced and revealed its connection with the right SVC beneath the aortic arch on the transverse plane inferior to the 3VT view and on the fetal sagittal plane . Conclusions The whole course of retroaortic LINV can be revealed by ultrasound prenatally ,which can not only account for the abnormal vein to the left of pulmonary artery on 3VT view ,but also play an important role in surgery decision and future cardiac intervention treatment .

OBJECTIVETo investigate the comprehensive treatment of stage-IIIb testicular non-seminomatous germ cell tumor (NSGCT) based on the chemotherapy with cisplatin, etoposide and bleomycin (BEP) and nerve-sparing laparoscopic retroperitoneal lymph node dissection (nsLRPLND).

METHODSWe reported a case of stage-IIIb testicular NSGCT, analyzed the clinical data and treatment methods and reviewed the relevant literature.

RESULTSThe patient underwent chemotherapy with etoposide (0. 18 g/d for the first 3 days), cisplatin (30 mg/d for the first 5 days), and bleomycin (30 mg/d on day 2, 9 and 16) for 3 cycles, followed by nsLRPLND. Both chemotherapy and surgery were successfully performed. The operation time was 175 min, with intraoperative blood loss of 50 ml, but no severe perioperative complications. No recurrence and distant metastasis were found during the 6-month follow-up after surgery.

CONCLUSIONThe comprehensive treatment based on BEP chemotherapy and nsRPLND can be used as an option for stage-IIIb testicular NSGCT.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Combined Modality Therapy ; Humans ; Lymph Node Excision ; methods ; Male ; Retrospective Studies ; Testicular Neoplasms ; therapy

Objective To investigate the features of chronic prostatitis during puberty(CPP)and the effects of pelvic floor biofeedback therapy.Methods Totally,25 CPP children (mean age,16 years) and 15 children (mean age,16 years) with normal lower urinary tract as controls were included.In CPP group,NIH-CPSI scores were evaluated,expressed prostatic secretions (EPS) were examined,and bacterial culture was done;and CPP patients were categorized based on the definitions of NIH types.In both groups, urodynamic examination was performed,including evaluation of uroflow curve,maximum flow rate (Q_(max)), post-voiding residual urine (PVR),detrusor-sphincter dyssynergia (DSD),maximum detrusor pressure (P_(det,max))and maximum urethral closure pressure (MUCP).CPP patients underwent biofeedback therapy, and 10 weeks later the effects were assessed.Results In CPP group,NIH typing showedⅡ,ⅢA andⅢB in 1,3 and 21 cases,respectively.Before treatment in CPP and control groups,the incidence of staccato voiding (20 cases vs 1 case),DSD (22 cases vs 1 case),Q_(max)(10.7?3.7 vs 15.0?4.3ml/s),PVR (7.7?4.1vs 3.2?2.6ml),P_(det,max)(115.1?33.6vs 76.8?16.6cm H_2O)and MUCP(176.5?45.7 vs 86.2?28.5cm H_2O)all showed significant differences between the 2 groups(P＜0.05).In CPP group,the differences in pain(4.6?2.2 vs 2.1?1.6),urination (7.9?2.0vs 2.2?1.7),life impact (9.4?2.2vs 2.6?2.1)and total scores(22.0?5.2vs 7.0?4.2) of NIH-CPSI and Q_(max)(10.7?3.7 vs 14.9?5.6) between pre-and post-biofeedback were significant (P＜0.05).Conclusions The main type of CPP is categoryⅢB.The primary symptom is voiding disorder,which leads to greater psychological stress in patients.Children with CPP have pelvic floor dysfunctions and multiple abnormal urodynamic param- eters.The short-term effect of biofeedback strategies for CPP is satisfactory.

Objective To evaluate the therapeutic effects of somatostatin(stilamin)and rhubarb for severe acute pancreatitis(SAP).Method A total of 42 patients with SAP received traditional treatment in combination with somatostatin(stilamin)and rhubarb,and compared with 40 SAP patients with routine treatment.The changes of acute physiology and chronic health evaluationⅡ(APACHEⅡ),serum amylas,serum creatinine,blood calcium,blood glucose,white blood cell count,the duration of abdominal pain,abdominal bulge,fast and hospital stay,complications,morlality and operation rate on the fist day,third day and fifth day were compared between two groups.Results Somatostatin and rhubarb reduced the complications,operation rate and mortality, and shortened the duration of abdominal pain,abdominal bulge,fast and hospital stay.Conclusions Combination of somatostatin and rhubarb is effective in the treatment of SAP patients.

Objective To investigate predisposing factors for early infection in patients with severe acute pancreatitis.Methods The clinical and laboratory data including age、gender、APACHE Ⅱscore on admission、hemodiastase、mechanical ventilation、blood calcium、mean arterial blood pressure、blood glucose、 alanine aminotransferase、aspartate aminotransferase、total bilirubin、necrosis of the pancreas、hypoxemia、 entero-functional disturbance、etiological factor、serum albumin、serum creatinine、urea nitrogen and haematocrit were analyzed by multiple linear regression in relation with the infection incidence in the 86 SAP patients hospitalized from Jan 2002 to Mar 2007.Results The fasting time、hiliary panereatitis、 hypoxemia、necrosis of pancreas、entero-functional disturbance、serum creatinine、urea nitrogen and haematocrit were positively correlated with the incidence of pancreatic infection(all P

Objective:To explore the relationship between the severity of cardiovascular disease with the expression of apolipoprotein(a) [apo(a)] and apolipoprotein B(apoB) in peripheral blood and their location in peripheral blood cells.Methods: In this report,we selected 4 patients with angiography which indicated that three coronary arteries were narrowed and 5 control patients with normal angiography.Arterial blood was collected and analyzed for lipid parameters in plasma.The mRNA expression of apo(a) and apoB in peripheral white blood cells and platelets were determined by RT-PCR and their protein expression by western blot.Moreover,the expression and location of apo(a) and apoB in white blood cells were determined by confocal microscopy and computer 3D analysis.Results: In plasma,levels of high density lipo-protein-cholesterol(HDL-C) and apolipoprotein A-Ⅰ(apoA-Ⅰ) in cardiovascular disease(CVD) patients were significantly less than those in the control patients[(0.62?0.05) mmol/L,(0.78?0.08) mmol/L vs(0.81?0.15) mmol/L,(0.9?0.07) mmol/L,P0.05).Studies with confocal microscopy indicated that proteins of apo(a) and apoB were co-expressed by a few cells of leukocytes and the ratio of apoB/apo(a) in cardiovascular disease patients was significantly less than that in the control patients(optical density value 1.60?0.12 vs 4.40?0.35,P