Objective To investigate the diagnosis judgment values of trimester ultrasound screening for simple single umbilical artery fetal malformation.Methods From January 2011 to January 2015,selected the 15-28 weeks pregnant singleton pregnancies in Shunyi Hospital of Beijing Chinese Medicine Hospital for system fetal ultrasound,in which the single umbilical artery group of 50 patients,50 cases of healthy pregnant women (control group),the two groups were carried ultrasound screening with single umbilical artery flow spectrum analysis,and observed the prognosis.Results The single umbilical artery fetal bladder after abdominal oblique horizontal cross-section of the umbilical artery bypass saw one side of the bladder,and there were 24 patients the malformations with the incidence rate was 48.0％.In the two groups can be clearly demonstrated umbilical artery condition,but the umbilical artery pulsation index(PI),arterial resistance index (RI) and peak valley ratio of umbilical artery blood flow velocity (S/D) value in the single umbilical artery group were 1.02±0.17,0.66±0.06 and 3.08 ±0.57,significantly higher than those of the control group (0.75 ± 0.21,0.53 ± 0.08,2.11±0.27;t=7.298,11.874,15.983,P＜ 0.05).In the single umbilical artery group,there were 32 patients of abortion,10 patients of birth were,8 patients ogpregnancy.Perinatal death in 8 cases,the mortality rate was 16.0％,the single umbilical artery fetal malformations of perinatal mortality was significantly higher than that of children with simple single fetal umbilical artery (x2 =9.333,P ＜ 0.05).Conclusion Trimester ultrasound screening for single umbilical artery combined with simple two-dimensional ultrasound and umbilical arteryblood flow velocity conditions can improve fetal malformations value judgment,provide a reliable detection method to reduce oerinatal mortality.

Objective To evaluate whether the forced expiratory volume in sixth scend(FEV6) was the optimal surrogate for forced vital capacity (FVC) in the diagnosis for chronic obstructive pulmonary disease (COPD).Methods Retrospectively analyzed the spirometric data of 142 COPD patients (7 cases with mild COPD,60 cases with moderate COPD,48 cases with severe COPD,27 cases with extremely severe COPD) admitted to Hebei Chest Hospital from October 2011 to October 2012 who had FEV6 data.FEV6,FEV5,FEV4 and FEV3 were measured on volume-time curves and the diagnostic value was analyzed.Results FEV6,FEV5,FEV4 and FEV3 were highly correlated to FVC (r =0.994,0.939,0.935 and 0.923 respectively,P ＜0.001).Assuming =70％ as the diagnostic standard for obstruction,FEV1/FEV6 had a diagnostic rate of 92.96％ with a false negative rate of 7.04％.FEV1/FEV5,FEV1/FEV4 and FEV1/FEV3 had higher false negative rates (9.86％,13.38％ and 27.46％ respectively) than FEV6.The value of FEV1/FEV6-FEV1/FVC had no statistical significance between the mild-moderate and the severe-extremely severe COPD groups(t =1.376,P =0.171).Conclusion There is a strong correlation between FEV6 and FVC.FEV6 may be the best surrogate for FVC in the diagnosis of chronic obstructive pulmonary disease.Elevating diagnostic critical value can reduce the false negative rate.

PurposeTo measure the areas and diameter lines of bronchi at acute exacerbation and at remission period in patients with chronic obstructive pulmonary disease (COPD) using CT, and to explore the correlation between the two periods and evaluate the comprehensive assessment in diagnosing COPD exacerbation.Materials and Methods Fifty-two COPD patients were scanned with 64-row spiral CT on chest and PFT at acute exacerbation and at remission period. The areas and diameter lines of apical segmental and the sub-segmental bronchi of the right upper lobe in the patients were measured at the two periods, including indicators such as wall thickness (WT), thickness-diameter ratio (TDR), wall area (WA), percentage of wall area (WA%). The differences of those indicators at the two periods were compared with such factors of COPD comprehensive assessment as forced expiratory volume at the first second% (FEV1%), percentage of forced expiratory volume in first second to forced vital capacity (FEV1/FVC), COPD assessment test (CAT), modified medical research council questionnaire (mMRC) for assessing the severity of breathlessness, 6-minute walking distance (6MWD). Results The patients had significant differences between acute exacerbation period and remission period in the indicators of COPD comprehensive assessment like FEV1%, FEV1/FVC, CAT, mMRC and 6MWD (t=-4.119,-2.583, 4.012, 3.321 and-3.892,P<0.05). Compared with those at remission period, the WT, TDR, WA and WA% of sub-segmental bronchi were all higher at acute exacerbation period (t=3.025, 2.341, 2.204 and 2.124, P<0.05); only TDR of segmental bronchi showed significant difference between the two periods (t=2.990,P<0.05). The correlation of sub-segmental bronchi with FEV1%, FEV1/FVC, CAT, mMRC and 6MWD was more significant than that of segmental bronchi with those indicators at the two periods.Conclusion The COPD comprehensive assessment can help diagnose COPD at acute exacerbation period; MSCT shows the remodeling of segmental and sub-segmental bronchi and the changes on the airway wall, and the quantitative measurement of sub-segmental bronchi has correlation with the differences of indicators in the comprehensive assessment; COPD comprehensive assessment seems to be more valuable than PFT in the estimation of COPD at acute exacerbation.

Objective To explore the curative effect of percutaneous cavity injection for the treatment of drug resistant pulmonary tuberculosis guided by color Doppler ultrasound.Methods Ninety-six bacterial culture positive patients with drug resistant pulmonary tuberculosis were randomly divided into treatment group(n =48) and control group (n =48).Patients in both groupswere given systemic anti tuberculosis therapy,and those who in the treatment group were given extra percutaneous cavity injection guided by color Doppler ultrasound.Results After 3 months of treatment,the sputum negative conversation rate,X-ray absorption rate,cavity closure rate,and cavity efficiency rate of the treatment group were 56.3％ (27/48),81.3％ (39/48),58.3％ (28/48) and 75.0％ (36/48) respectively,higher than those of the control group 35.4％ (17/48),62.5％ (30/48),37.5％ (18/48) and 50.0％ (24/48) respectively),and the differences were statistically significant(x2 =4.20,P =0.02 4 ; x2 =4.17,P =0.041; x2 =9.58,P =0.004 ; x2 =6.40,P=0.020).After 12 months of treatment,the sputum negative conversation rate,cavity closure rate,cavity efficiency rate of the treatment group were 93.8％ (45/48),83.3％ (40/48),95.8％ (46/48) respectively,higher than those of control group(77.1％ (37/48),62.5％ (30/48) and 81.3％ (39/48)),and there were significant differences between two groups (x2 =5.35,5.27,5.03 ; P =0.040,0.038,0.025) ; the X-ray absorption rate of the treatment group was 93.8％ (45/48),higher than that of ciontrol group (83.3％ (40/48)),but there was no significant difference between two groups(x2 =2.56,P =0.199).Conclusion It is very effective to treat drug resistant pulmonary tuberculosis using percutaneous cavity injection guided by Color Doppler Ultrasound.No obvious complications or adverse reactions have been observed so far.

Inflammation and lung function decline are the main pathophysiological features of chronic obstructive pulmonary disease (COPD). Acupuncture can improve lung function in patients with COPD, but the underlying mechanisms are not well understood. Orexins (OXs), which are found in peripheral plasma, are neuropeptides that regulate respiration and their levels are related to COPD. Therefore, we hypothesized that acupuncture might alter OXs, reduce lung inflammation and improve lung function in COPD.

Objective:To study the influence of different culture conditions on charcic and inhibition activity of nature killer cells ( NK) ,whether to join the modified K562 cells with IL-6 cytokine.Methods:According to the 5′end of the human IL-6 cDNA sequence,PCR primers designed to amplificate,express and transfect K562 cells cDNA library as a template for DNA.Genetic modified K562 cells as stimulating cells were prepared by expressing IL-6.To extract peripheral blood mononuclear cells( PBMC) from human peripheral blood.PBMC were explanted by genetic modified K562 stimulated.The expansion was initiated by CO-culture of PBMC and irradiate genetic modified K562 cell.The number of NK cell increased by directed induced generation of genetic modified K562 cell.Immunophenotypic analysis of NK cell surface markers was performed by flow cytometry (FCM).51Cr release assay was employed to measure the specific lysis skilling of NK cell target K562 cells.Results:We have constracted genetic modified K562 cells by genetic engineering.As stimulated cell added into the PBMC,an average of 760 ±18 fold expansion of CD56+CD16+CD3-cells was observed after 3 weeks of co-culture system.The NK cells population could proliferated more 91%±2% after expansion comparing with 6%± 0.4%in PBMC before expansion by FCM.The cytotoxical activity of NK cells which was induced by genetic modified K562 cell was the strongest than induced by IL-6 cytokine alone.The expanded NK cells lysed 92%±2% of K562 targets in a 5∶1 effector to target ratio.In this case,the NK cells induced by genetic modified K562 cells against tumor cells was more lethal.Conclusion:PBMC based in vitro expansion of natural killer cells was set up by genetic modified K562 cells.The cytotoxicity of NK cells was the strongest induced by genetic modified K562 cell treated.These results had important guiding significance for the the NK large number of amplification and used in clinical.

Paraneoplastic neurological syndromes (PNS) are a rare group of immune-mediated disorders that affect the central and peripheral neuromuscular system in association with cancer.If the limbal lobe system of the brain is involved,it will show paraneoplastic limbal encephalitis(PLE).The discern of patients with PNS is challenging since tumors causing paraneoplastic neurologic disorders are often asymptomatic and sometimes occult.We report a case of PLE with double positive anti-Hu and Yo antibodies,and further analyze and discuss it in conmbination with relevant literature to improve the understanding of the disease.

Objective To explore the value of preoperative detection of soluble fragments of cytokeratin-19 (CYFRA21-1), carcinoembryonic antigen (CEA), and postoperative detection of nuclear proliferation associated antigen Ki67 in prognostic evaluation of non-small cell lung cancer patients. Methods The clinicopathological data and follow-up results of patients with non-small cell lung cancer treated in the Department of Thoracic Surgery of the First Affiliated Hospital of Xiamen University in 2017 were collected. CYFRA21-1>3.39 ng/mL was defined as positive, and CEA>5 ng/mL was defined as positive. The receiver operating characteristic curve (ROC curve) of Ki67 expression level was drawn. The maximum area under the curve (AUC) was the cutoff value of Ki67 expression level, and the Ki67 expression level greater than its cutoff value was defined as positive. Cox regression analysis was used to determine the independent risk factors for poor prognosis in patients with non-small cell lung cancer. Results Finally 248 patients were collected, including 125 males and 123 females, with a median age of 61 years (ranging from 30 to 81 years) at the time of surgery. Univariate analysis showed that positive CYFRA21-1, high expression of Ki67, positive CEA, age≥60 years at operation, distant metastasis, lymph node metastasis, maximum tumor diameter>3 cm, and TNM stage Ⅲ were associated with poor prognosis in patients with non-small cell lung cancer. When combined detection of preoperative tumor markers and postoperative Ki67, the prognosis of all negative patients was the best, and that of all positive patients was the worst. Cox regression analysis showed that positive CEA+positive CYFRA21-1+high expression of Ki67 was an independent risk factor for poor prognosis in patients with non-small cell lung cancer (P<0.05). Conclusion The combined detection of preoperative serum CYFRA21-1, CEA, and postoperative Ki67 has important value in evaluating the prognosis of non-small cell lung cancer patients.