Objective To observe the effect of propofol of dento-anaesth dosage on prevention of emergence ngitatian(EA). Methods Forty ASA Ⅰ-Ⅱ patients, aged 32-56 years old and undergoing elective laparoscopic cholecystectomy, were randomly divided into two groups, propofol group (group P, 20 cases) and control group (group C, 20 cases). Anesthesia was induced intravenously with 0.1 mg/kg midaxolam, 1.0 mg/kg propofol, 2 μg/kg fentanyl and 0.15 mg/kg vecuronium. Anesthesia was maintained by intravenous and inhalation combined anesthesia. Vecuronium was discontinued about 15 min before the end of sur gery. After entered the postoperative care unit, patients in group P received propofol (0.5 mg/kg) and those in group C were administrated with normal saline (0.05 ml/kg). Time to recovery of spontaneously breathing, duration of opening eyes on verbal command, extubation time were recorded. Incidence of EA in both groups was calculated. Results Time to recovery of spontaneously breathing, duration of opening eyes on verbal com-mand and extubatian time in group P [(15.6±4.5), (18.2±6.5), (22.6±5.5) min, respectively] were sig-nificantly longer than those in group C[(13.2±5.4), (15.7±6.2), (18.4±6.8) min, respectively ]. In-cidence of EA in group P(5% ) was significantly less than that in group C(30%). Conclusion The propofol of dento-anaesth dosage can obviously decrease the incidence of EA in patients undergoing elective laporo-scopic cholecystectomy.

Objective To study the changes of parameters of platelet (Pt), mean platelet volume( MPV ), platelet constrict volume ( PCT ), and platelet distribution width (PDW) in child idiopathic thrombocytopenic purpura (ITP) before and after anti-virus treatment. Methods Pt,MPV,PCT and PDW were determined in 110 cases with child ITP, including slight group ( 16 cases), medium group(38 cases ), serious group (30 cases) and more serious group (26 cases) before and after treatment with anti-virus as well as in 110 normal controls with XT-1800i auto blood cell analysis instrument. Results There were significant differences on MPV, PDW and PCT between the patients of slight group and medium group, and so on medium group and serious group, serious group and more serious group (P<0.01 ).There was significant difference on PCT between the patients of slight group and more serious group (P<0.01 ). Before treatment, in the patients the MPV, PDW were significantly higher and the Pt, PCT were significantly lower than those in the controls and after treatment (P<0.01 ). After treatment,the levels of Pt and PCT were lower in the patients than those in the controls (P<0.05), but , MPV, PDW were no difference. Conclusion Dynamic changes of parameter of platelet could reflect the progress of ITP and could guide clinical treatment.

Objective:To explore the value of current indications for fetal pulmonary valvuloplasty (FPV) by summarizing the postnatal diagnosis, treatment, and prognosis of fetuses with pulmonary atresia with intact ventricular septum (PA/IVS) and right ventricular hypoplasia (RVH).Methods:This prospective study was conducted at the Heart Center of Women and Children's Hospital, Qingdao University from September 2018 to March 2021, which included pregnant women who were (1) with fetal PA/IVS and RVH; (2) unable to receive FPV due to fetal position or gestational age despite the indications; (3) given integrated pre- and postnatal management. Prenatal fetal echocardiography assessment, postnatal diagnosis, treatment, and follow-up were summarized using Wilcoxon matched-pair signed-rank test.Results:A total of 35 singleton pregnant women were diagnosed with fetal PA/IVS and RVH by ultrasonic cardiogram and admitted during the study period. Among the 28 fetuses meeting the FPV indications, 18 underwent FPV, while the other 10 did not due to inappropriate fetal position or gestational age. After excluding four terminated pregnancies, the rest six cases were enrolled. The median gestational age at the initial prenatal fetal echocardiography diagnosis was 28.9 weeks (28.3-30.4 weeks). Compared with the initial evaluation, the fetal right ventricular to left ventricular length/diameter ratio [0.8 (0.6-0.9) vs 0.6 (0.5-0.8)] and tricuspid regurgitation velocity [4.7 m/s (3.2-5.1 m/s) vs 4.1 m/s (3.3-4.8 m/s)] were increased, while tricuspid valve Z value [－0.8(－1.6-0.8) vs 0.4 (－0.3-1.9)] and single-ventricular predictive score [0.5 (0.0-2.0) vs 2.0 (1.0-3.0)] were decreased when re-evaluated six weeks later ( T were－2.21, 2.00,－2.20, and 2.00; all P<0.05). All of the six fetuses were born alive with a median gestational age of 38.9 weeks (37.3-40.1 weeks). The median weight was 3 425 g (3 100-4 160) g after being transferred to cardiac intensive care unit. The median age was 12.5 d (0.0-20.0 d) at the first surgical intervention. The median follow-up duration was 15 months (11.8-18.5 months). At initial diagnosis, the single-ventricular predictive score was 1-2 points in four fetuses, and =3 points in two fetuses. There was no death during follow-up. Four patients achieved anatomical biventricular circulation, one achieved clinical biventricular circulation, and one still needed further follow-up, with single-ventricular predictive score at initial diagnosis of 1-3, 3, and 2 points, respectively. Conclusions:The prognosis is good in fetuses with PA/IVS and RVH who have FPV indications but do not receive intrauterine intervention, which suggests that the current FPV indications may be too broad, and a more suitable FPV indication need to be further explored given the difficulty of implementing FPV.

Objective:To review the clinical outcomes following perinatal multidisciplinary diagnosis and treatment of fetal D-transposition of great arteries (D-TGA).Methods:This retrospective analysis involved 37 fetuses (two fetuses were one of the twins) with D-TGA that were diagnosed by prenatal ultrasound at the Women and Children's Hospital, Qingdao University from January 2016 to December 2020. All the subjects received perinatal multidisciplinary diagnosis and treatment, from the Departments of Fetal Medicine, Genetics, Obstetrics, Ultrasonography, Pediatric Cardiology, Neonatology, etc., and the outcomes were described and summarized.Results:The detection rate of D-TGA was 0.059% (37/62 413), among which intact ventricular septum with D-TGA accounted for 56.8% (21/37) and ventricular septal defect with D-TGA for 43.2% (16/37). All the 37 cases were observed with normal nuchal translucency and four of them were at high risk in fetal Down syndrome screening. All the 31 cases who received non-invasive cell-free fetal DNA screening had normal results and two of 26 cases who received amniocentesis for karyotype analysis and chromosome microarray analysis were abnormal. In terms of pregnancy outcome, 19 pregnancies (51.4%) were terminated, of which 10 cases were terminated for medical reasons and others for non-medical reasons, and 18 cases gave birth to alive body (48.6%, 18/37). Postnatal ultrasound re-examination of one neonate revealed D-TGA with ventricular septal defect, patent ductus arteriosus, and bicuspid pulmonary valve malformation and severe hypoxia and acidosis occured. The patient was discharged after withdrawing treatment and was lost to follow-up. The other 17 neonates all underwent successful surgical treatment with a mean age of (10.2±6.0) d and length of hospital stay of (26.3±9.3) d. Postoperative follow-up (3.3±1.2) years showed all with good cardiac function.Conclusion:Perinatal multidisciplinary diagnosis and treatment of D-TGA can improve the success rate of postnatal treatment and prognosis.

OBJECTIVETo detect the concentration of serum hepcidin and the mRNA expression level of ferroportin1 (FPN1) in the placenta membrane from full term pregnant women with different degree of iron deficiency, and explore their roles for iron transport in placental.

METHODSThe concentration of HGB, serum iron (SI) and serum ferritin (SF) of mothers and infants were detected in 55 full term pregnant women and neonates. The expression level of FPN1 mRNA in placental was detected by the RT-PCR technique. The concentration of serum hepcidin was detected by double antibody sandwich biotin avidin enzyme-linked immunosorbent assay. The serum hepcidin level and the FPN1 mRNA expression in the full term placenta from different maternal iron status were compared in three groups.

RESULTSThere were no significant differences in the cord blood HGB, SI and SF of newborns from pregnant women with different iron status (P>0.05). The concentration of serum hepcidin of pregnant women among normal, iron deficiency and mild iron deficiency anemia were (193.637±52.219), (176.523±43.875), and (147.623±37.768) μg/L respectively, with statistical significance (F=3.872, P=0.027). The expression levels of FPN1 mRNA among three groups were 0.462±0.077, 0.507±0.074 and 0.551±0.104 respectively, with statistical significance (F=4.767, P=0.013). A negative correlation between maternal serum hepcidin and placental FPN1 mRNA (r=-0.383, P=0.004) was identified.

CONCLUSIONThere were no significant differences in the iron status of corresponding newborns from pregnant women with different iron status. With the severity of maternal iron deficiency, the concentration of serum hepcidin was down-regulated, while the expression of FPN1 mRNA in placenta was up-regulated.

Anemia, Iron-Deficiency ; Cation Transport Proteins ; Enzyme-Linked Immunosorbent Assay ; Female ; Fetal Blood ; Hepcidins ; Humans ; Infant, Newborn ; Iron ; Mothers ; Placenta ; Pregnancy ; RNA, Messenger