Haemangioma of the retroperitoneal space is a rare benign capillary malformation, which can grow significantly in pregnancy due to the multiple associated cardiovascular changes. We herein describe the case of a pregnant woman with an extensive right retroperitoneal haemangioma extending from the level of the renal hilum, across the lateral anterior abdominal wall and into the thigh. We also highlight the challenges faced in the management of the patient's delivery process. To the best of our knowledge, this is the first case of such nature and severity described in the English literature.
Adult ; Cesarean Section ; Female ; Gestational Age ; Hemangioma ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Pregnancy ; Pregnancy Complications, Neoplastic ; Retroperitoneal Neoplasms ; diagnosis ; surgery

Objective To find out iodine nutritional status of pregnant women in the third trimester and the relationship between pregnant women and their neonates thyroid function in a high iodine area.Methods From April to June 2010,210 copies of fasting morning urine and venous blood,and their neonatal umbilical cord blood samples were collected in Haixing Hospital,Cangzhou city,Hebei province.Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry.The levels of free triiodothyronine(FT3),free thyroxine (FT4) and sensitive thyroid-stimulating hormone (sTSH) in serum were measured by chemiluminescence.Results Median urinary iodine of 210 pregnant women(average age 27.69 ± 4.73 years) in the third trimester was 1240.70 μg/L,84.3％(177/210) of them was in excessive iodine nutrition,and only 0.5％(1/210) of them was in adequate iodine nutrition.The prevalence rate of thyroid diseases was 19.5％ (41/210),and the spectrum of diseases were subclinical hypothyroidism(16.2％,34/210),subclinical hyperthyroidism(0.9％,2/210),hypothyroidism(2.4％,5/210) and hyperthyroidism (0,0/210).The number of newborns with sTSH 5 - ＞ 10 mU/L were 104 persons (49.5％); 10 - ＞ 20 mU/L were 44 persons(21.0％),and ≥20 mU/L were 16 persons(7.6％).Of pregnant women suffer from thyroid disease,the ratio(50.0％,24/48 ) of sTSH equal to 10.18 mU/L and ＞ 10 mU/L of their neonates was higher than that of their corresponding non-ill pregnant women(6.78 mU/L,Z =- 2.867,P ＜ 0.05; 22.2％,36/162,x2 =14.000,P ＜ 0.05).There was a positive correlation between neonates' and their mothers' sTSH levels (r =0.278,P ＜ 0.05).There was also a positive correlation between neonates' (sTSH ＞ 10 mU/L) and their mothers' abnormal sTSH levels (r =0.240,P ＜ 0.05).Conclusions Most of the pregnant women in high iodine areas are iodine excess.The level of neonates' sTSH is higher,and it is due to their mothers' abnormal sTSH and suffering from thyroid diseases to some extent.As a result,the monitoring of pregnant women's iodine nutrition and thyroid function and sTSH level of their neonates should be strengthened.

OBJECTIVEThe history of clinical application of extracorporeal membrane oxygenation (ECMO) has been more than 30 years. But in China, there were only a few ECMO centers with limited successful cases reported by the end of twentieth century. The high morbidities and mortalities in current pediatric ECMO practice are noted in China. Therefore, it is necessary to review the experience on rescue use of ECMO in critically ill pediatric patients.

METHODA retrospective analysis was done for patients who had been receiving ECMO treatment to rescue refractory cardiorespiratory failure from different causes in a hospital between July 2007 and May 2011.

RESULTA total of 12 patients were treated with ECMO; 7 of them were male and 5 female, they aged 6 days to 11 years, weighed 2.8 - 35 (17.21 ± 11.64) kg. The underlying causes of cardiorespiratory failure were as follows: two cases with acute respiratory distress syndrome (ARDS) leading to respiratory failure, 4 with failure of weaning from cardiopulmonary bypass, 3 with fulminant myocarditis, 1 with right ventricular cardiomyopathy leading to repeated cardiac arrest, 1 with preoperative severe hypoxemia, and 1 with anaphylactic shock complicated with massive pulmonary hemorrhage and severe hypoxemia. Of the 12 cases, 3 were established ECMO (E-CPR) while underwent chest compression cardiopulmonary resuscitation (CPR). The mean ECMO support time was 151.75 (15 - 572) h. Seven patients (58.33%) were weaned from ECMO, 6 patients (50.00%) were successfully discharged. Six cases had bleeding from sutures, 2 cases with severe bleeding underwent thoracotomy hemostasis, 2 presented with acute renal failure. Infection was documented in 3 cases, hyperbilirubinemia in 2 cases, lower limb ischemia in 1 case, hyperglycemia in 3 cases, disseminated intravascular coagulation in 1 case, membrane lung leakage in 2 cases, systemic hemolysis in 3 cases, oxygenator failure in 2 cases and oxygenator thrombosis in one case. During the follow-up between 6 months and 4.5 years, 5 patients survived with good quality of life, without any documented central nervous system disorders. One case survived with the right lower extremity disorder from ischemic damage. His motor function has been improved following orthopedic operation at one year after discharge.

CONCLUSIONECMO is a justifiable alternative treatment for reversible severe cardiopulmonary failure in critically ill children.

Cardiac Output, Low ; etiology ; therapy ; Cause of Death ; Child ; Child, Preschool ; Critical Illness ; mortality ; therapy ; Extracorporeal Membrane Oxygenation ; adverse effects ; Female ; Heart Failure ; etiology ; mortality ; therapy ; Hemorrhage ; epidemiology ; etiology ; Humans ; Infant ; Infant, Newborn ; Male ; Postoperative Complications ; mortality ; therapy ; Respiratory Insufficiency ; etiology ; mortality ; therapy ; Retrospective Studies ; Survival Analysis ; Thrombosis ; epidemiology ; etiology ; Treatment Outcome

Aims: Solanum trilobatum Linn., (Solanaceae) is one of the most widely used plants as food supplement in southern part of India and some parts of Southeast Asia. This plant is traditionally used for the treatment of respiratory illness. In animal studies, the extract of S. trilobatum showed significant antimicrobial, hepatoprotective and anticancer activities. The complete phytochemical profile, antimicrobial and mast cell stabilizing activities of S. trilobatum remains unclear. This study tests the antimicrobial, antihistaminic and mast cell stabilizing activities of ethanolic extract of leaves of S. trilobatum (EEST). Methodology and results: The phytochemical test was carried out using chemical and instrumental [Gas Chromatography Mass Spectrometry (GC-MS)] analytical methods. Antimicrobial effect of EEST was tested against Streptococcus pneumonia, Escherichia coli and Staphylococcus aureus. Intestinal mesentery of Sprague Dawley (SD) rats was used to study the peritoneal mast cell stabilization activity of EEST. The rat intestinal mesentery was exposed to 50, 100, 200, 300, 400 and 600 μg/mL of EEST and the peritoneal mast cell stabilization activity was compared with that of standards (pheniramine 20 μg/mL and ketotifen 20 μg/mL). The phytochemical test showed the presence of carbohydrates, saponins, flavonoids, alkaloids, tannins and phenolic compounds. GC-MS analysis indicated the presence of 45 fragmented compounds which included epoxylinalol, himachalol, illudol, epibuphanamine, baimuxinal and edulan IV. EEST exhibited antimicrobial activity at 10 mg/mL against S. aureus, S. pneumonia. Significant mast cell stabilizing activity was observed from the dose of 100 μg/mL to 600 μg/mL. Conclusion: Ethanolic extract of leaves of S. trilobatum possess significant antimicrobial and antihistaminic activity.

INTRODUCTION: Uterine rupture is uncommon but has catastrophic implications on the pregnancy. A scarred uterus and abnormal placentation are known contributory factors. The aim of our study was to review the contributing factors, clinical presentation, complications and management of uterine rupture in our population in light of the changing nature of modern obstetric practices. METHODS: A retrospective observational study was conducted at KK Women's and Children's Hospital by studying proven cases of uterine rupture in the period between January 2003 and December 2014. These cases were analysed according to their past history, clinical presentation, complications, management and outcome. RESULTS: A total of 48 cases of proven uterine rupture were identified. The incidence of uterine rupture was 1 in 3,062 deliveries. The ratio of scarred uterus rupture to unscarred uterus rupture was approximately 3:1. The most common factor was previous lower segment caesarean section for the scarred group, followed by a history of laparoscopic myomectomy. Abdominal pain was the common clinical presentation in the antenatal period, while abnormal cardiotocography findings were the most common presentation in intrapartum rupture. CONCLUSION There is a notable shift in the trend of uterine rupture cases given the increasing use of laparoscopic myomectomy and elective caesarean sections. While ruptures from these cases were few, their presentation in the antenatal period calls for diligent monitoring with informed patient involvement in their pregnancy care.

OBJECTIVETo compare the specificity and sensitivity of two genotyping approaches for human papillomavirus (HPV).

METHODHPV DNA was amplified and detected in clinical specimens by polymerase chain reaction in a pair of universal primers MY09/11, and then genotyped with either sequencing method or liquid chip hybridization method (luminex method).

RESULTSequencing method obtained precise genotyping results in single-type HPV infection, while luminex method obtained accurate genotyping results in multiple-type HPV infection.

CONCLUSIONA combined method using both sequencing and luminex method is suitable for the genotyping of HPV-infected specimens.

Base Sequence ; DNA, Viral ; genetics ; Female ; Female Urogenital Diseases ; virology ; Genotype ; Humans ; Oligonucleotide Array Sequence Analysis ; Papillomaviridae ; genetics ; isolation & purification ; Papillomavirus Infections ; virology ; Polymerase Chain Reaction

In order to clarify the chemical constituents in Qiliqiangxin capsule, a rapid ultra-performance liquid chromatography/orthogonal acceleration time-of-flight mass spectrometry (UPLC-Q-TOF/MS(E)) method was established. Forty peaks were identified on line using this method. The herbal sources of these peaks were assigned. The results implied that triterpenoid saponins, flavonoid glycosides, C21-steroids and phenolic acids were included in the main components of Qiliqiangxin capsule. The method is simple and rapid for elucidation of the constituents of Qiliqiangxin capsule and the results are useful for the quality control of Qiliqiangxin capsule.
Capsules ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Flavones ; analysis ; Ginsenosides ; analysis ; Glycosides ; analysis ; Hydroxybenzoates ; analysis ; Plants, Medicinal ; chemistry ; Quality Control ; Saponins ; analysis ; Spectrometry, Mass, Electrospray Ionization ; Steroids ; analysis ; Tandem Mass Spectrometry ; Triterpenes ; analysis

Objective:To investigate the influencing factors of coronary slow flow (CSF) in relevant patients.Methods:A total of 1 530 patients received coronary angiography (CAG) in our hospital from 2008-01 to 2010-09 were retrospectively studied.According to corrected TIMI frame counts,2 groups were established:CSF group,n=139 patients without obvious coronary artery stenosis but with CSF and Control group,n=232 patients without obvious coronary artery stenosis and with normal coronary blood flow.Basic clinical condition,risk factors and routine laboratory tests were compared between 2 groups;the influencing factors of CSF were evaluated by multivariate Logistic regression analysis.Results:① The following parameters were different between 2 groups:age,gender,histories of smoking and diabetes;red blood cells (RBC),hemoglobin,mean hemoglobin concentration,hematocrit (HCT),mean RBC volume,RBC distribution width;neutrophils,monocytes,basophilic granulocyte,the ratios of lymphocytes/monocytes (LMR),neutrophils/monocytes (NMR),neutrophils/lymphocytes (NLR) and platelet/lymphocytes (PLR);glutamic oxalacetic transaminase,creatine kinase and total bile acid,P＜0.05.② Correlation analysis showed that RBC (r=0.191,P＜0.01),hemoglobin (r=0.184,P＜0.01),neutrophils (r=0.218,P＜0.01),mean hemoglobin concentration (r=0.151,P＜0.01),mean RBC volume (r=-0.138,P＜0.01),total bile acid (r=-0.172,P＜0.01),NLR (r=0.231,P＜0.01),LMR (r=-0.157,P＜0.01) and NMR (r=0.121,P＜0.01)were related to 3-branch mean flow frame.③ Multivariate Logistic regression analysis indicated that total bile acid (partial regression coefficient=-0.102,P＜0.01),LMR (partial regression coefficient =-0.381,P＜0.01) and NMR (partial regression coefficient =0.489,P＜0.01) were the independent influencing factors of coronary slow flow.Conclusion:Total bile acids,LMR and NMR were the influencing factors of coronary slow flow in relevant patients.

OBJECTIVETo reveal the iodine status of pregnant women and its impact on thyroid function of neonates in high iodine area.

METHODSA total of 210 pregnant women were chosen from a hospital in Haixing county, Hebei province. Pregnant women's random urinary and neonates' cord blood were collected. The urinary iodine concentration (UIC) was examined by arsenic-cerium catalytic spectrophotometry. The levels of free triiodothyronine (FT3), free thyroxine (FT4) and sensitive thyroid-stimulating hormone (sTSH) in serum were measured by chemiluminescence.

RESULTSThe age of 210 pregnant women was (27.69 +/- 4.73) years old, whose urinary iodine median (inter-quartile range ) was 1240.70 (1292.68) microg/L. 84.3% (177/210) of the pregnant women had excessive iodine intake (UIC > or = 500 microg/L), 13.8% (29/210) had more than adequate iodine intake( UIC within 250 - 499 microg/L), 0.5% (1/210) had adequate iodine intake (UIC within 150 - 249 microg/L) and 1.4% (3/210) had insufficient iodine intake (UIC < 150 microg/L). The average serum level of FT3, FT4 in neonates were (2.93 +/- 0.59), (15.03 +/- 1.92) pmol/L, respectively. The median (inter-quartile range) of serum sTSH in neonates were 7.33 (5.59) mU/L 78.1% (164/210) of the neonates' serum TSH were beyond 5 mU/L. There were no correlation between pregnant women's urinary iodine level and neonates' serum FT3 and sTSH level (P > 0.05), but there was a positive correlation between pregnant women's urinary iodine level and neonates' serum FT4 level (P < 0.01). Serum FT4 level of the neonates with whose mothers had insufficient iodine intake ((12.99 +/- 1.10) pmol/L) were statistically lower than those with their mothers had excessive iodine intake (15.16 +/- 1.83) pmol/L) (P < 0.05).

CONCLUSIONMost of the pregnant women in high iodine area were excessive for iodine nutrition, but still a few pregnant women had insufficient iodine nutrition. The level of neonates' serum sTSH were relatively high and monitoring of risk of hypothyroidism and subclinical hypothyroidism should be strengthened.

Adult ; China ; epidemiology ; Female ; Fetal Blood ; chemistry ; Humans ; Hypothyroidism ; epidemiology ; Infant, Newborn ; Iodine ; urine ; Nutritional Status ; Pregnancy ; Thyroid Function Tests ; Thyroid Gland ; Thyrotropin ; blood ; Thyroxine ; blood ; Topography, Medical ; Triiodothyronine ; blood ; Young Adult