Objective To estimate the value of neck circumference in diagnosis of metabolic syndrome. Methods We analyzed the neck circumference of 523 volunteers and the occurrence of metabolic syndrome among them. Then we updated and revalued their data after follow-up for 1.5 years, meanwhile, we evaulated the value of Body Mass Index (BMI) and neck circumference in predicting metabolic syndrome. Results The increase of neck circumference was closely related to the occurrence of metabolic syndrome , and this tendency continued in the follow-up. Compared with BMI , neck circumference was sensitive in identifying the patients of metabolic syndrome. Conclusion Neck circumference has great value in diagnosis and treatment of metabolic syndrome.

Objective To explore the value of miniprobe sonography (MPS) in differentiating Crohn??s disease (CD) and ulcerative colitis (UC). Methods 46 patients with active inflammatory bowel disease (IBD) were included into the patient group (16 patients with CD and 30 cases with UC). 20 healthy cases ( underwent physical examination in outpatient department) were recruited as the control group. All cases underwent MPS and high sensitive C-reactive protein (Hs-CRP) test.The MPS measurement index include thetotalwallthickness(TWT), mucosal thickness (MT), submucosal thickness (SMT), muscularispropria thickness (MPT), and the number of enlarged colic and paracolic lymph nodes. Results TheTWT, M, SM, MP(mm)and Hs-CRP(mg/L)in CD, UC and control group are 5.84 ± 1.42, 1.48 ± 0.23, 1.88 ± 0.28, 2.31 ± 0.85, 40.58 ± 19.33, 4.74 ± 1.01, 1.79 ± 0.35, 1.41 ± 0.25, 1.32 ± 0.34, 22.41 ± 15.25,2.86 ± 0.23, 0.97 ± 0.13, 1.06 ± 0.11, 0.64 ± 0.0 and 1.70 ± 0.65. TWT, MT, SMT, MPT and Hs-CRP in UC group has significant different with those in controp group(P<0.05). The mean value of TWT, MT, SMT, MPT and Hs-CRP in CD group are higher than those in UC group. M in UC group is higher than that in CE group. The difference is significant(P<0.05). 5 cases in CD and 2 cases with UC had enlarged colic or paracolic lymph nodes. Conclusions The MPS can distinctly observe the changesof different colonic tissue layers and the surrounding tissue structures in IBD patients,which helps for distinguishing active CD from UC.

Objective To evaluate efficacy and safety of intravenous chemotherapy combined with TACE in the treatment of gastric cancer with hepatic metastasis.Methods In this study 60 gastric cancer patients with hepatic metastasis were divided into two groups randomly,the trial group (30 cases) took intravenous chemotherapy consisted of docetaxel 60 mg/m2 intravenous drip d1,oxaliplatin 80 mg/m2 intravenous drip d1 followed by 5-fiuorouracil 500 mg/m2 intravenous drip d1-5 after TACE.The control group (30 cases) took the same chemotherapy protocol and one treatment cycle covering 4 weeks.Results The overall response rate in trial group was 53％ and the increase rate of Karnofsky was 70％ while that was 37％ and 40％ respectively in the control group (P ＜ 0.05).The median overall survival of trial group was 13 months and which was 8 months in the control group (P ＜ 0.05),meanwhile the toxicities and side reactions of trial group didn't increase notably.Conclusions Intravenous chemotherapy combined with TACE is safe and more effective in the treatment of gastric cancer with hepatic metastasis.

Objective To studythe labor analgesia effect incombination of water acupuncture andremifen-tanil patient-controlled intravenous analgesia (PCIA) and impact on mother and baby. Methods 90 Ninety sin-gle birth primiparous women were randomly divided into three groups (n = 30), groupⅠ, groupⅡ, groupⅢ. Content of β-endorphin, stress hormone levels,VAS scores were recorded at T0 and T1; adverse circumstance, Apgar score of newborn and neonatal behavioral neurological assessment were recorded. Results Comparing with groupⅢ or T0, at T1 β-EP in the groupⅠwas gone up, while ACTH、 COR and VAS scores were lower in the groupⅠand groupⅡ; adverse circumstance in the groupⅠreduced than that in the groupⅡ. The VAS scores inThe groupⅠand groupⅡand Apgar score and NBNA assessment in three groups were not significantly different. Conclusion Combination of water acupuncture and remifentanil patient-controlled intravenous analgesia iseffec-tive. Ithas no adverse effects on mother and baby. It is an ideal method of labor analgesia.

Objective: To investigate the current status of depression and anxiety among female staff in a maternal and child health hospital, and to provide a basis for developing related prevention and intervention measures and promoting the mental health of female staff. Methods: The female staff from a provincial maternal and child health hospital completed a psycho-health questionnaire survey on Internet from June to October, 2016. The questionnaires used in the survey consisted of Patient Health Questionnaire (PHQ-9) , Generalized Anxiety Disorder Scale (GAD-7) , and Symptom Checklist-90 (SCL-90) . The distribution features of mental health problems such as depression and anxiety were analyzed according to the results: of the questionnaire survey. Results Of all female staff surveyed, 42.04% showed depression symptoms, 28.90% showed anxiety symptoms, and 26.12% showed comorbid symptoms of depression and anxiety. Moderate or severe depression (anxiety) was mainly distributed among the female staff with comorbid symptoms (90.63% and 97.01%, respectively) . There were significant differences in the distribution of moderate or severe anxiety symptoms between the medical staff and nursing staff (χ²= 5.81, P=0.05) and between those with intermediate and junior professional titles (χ²=7.99, P=0.018) . As for SCL-90 results, the total score, total average score, and scores on factors of somatization, compulsion, interpersonal sensitivity, depression, and anxiety in the female staff with comorbid symptoms, moderate or severe depression, and moderate or severe anxiety were significantly higher than the national norm (P<0.01) , while the scores on paranoid and psychotic factors were significantly lower than the national norm (P<0.01) . The numbers of cases of positive factors were significantly higher in the female staff with comorbid symptoms than in the female staff with a single symptom and asymptomatic female staff (both P<0.01) , and positive cases were mainly distributed in depression, interpersonal sensitivity, compulsion, anxiety, and somatic factors. Conclusion The prevalence of depression and anxiety is high among female staff in the maternal and child health hospital, mainly characterized by comorbid symptoms of moderate or severe depression and anxiety. Comorbidity is accompanied by mental health problems such as interpersonal sensitivity, obsessive compulsion, and physical discomfort. Corresponding measures are needed for the prevention and intervention of mental health problems among female staff in the maternal and child health hospital.

Objective To evaluate the diagnostic value of multi-slice three-dimensional computed tomographic angiography(MS 3D-CTA)for vertebrobasilar dolichoectasia(VBD).Methods MS 3D-CTA of 10 patients with VBD were retrospectively analysed.Source images were got by GE Lightspeed pro scanner.Volume rendering(VR)and maximum intensity project (MIP) were adopted to reconstruct 3D images in all cases.Twenty patients were selected as the control group by suspected cerebra[vascular diseases and underwent MS 3D-CTA at the same period.Enumeration data between the patient group and the control group was assessed by Wilcoxon.test.Results There were 2 types of 10 cases with VBD,including simple type(n=4)and saddle type(n=6).Compared with the control group of the length of the basilar artery(B 1,25.60 mm),the deviant degree(Bc,1.20 mm),the height(Bh,1.90 am),the length of the vertebral artery (V1,17.55 mm),the deviant degree(Vc,2.05 mm),and the diameter of BA and/or VA (Bw/Vw,3.05 mm),there is significant difference in the B1 30.20 mm,Bc 7.10 mm,Bh 8.80 mm,V1 23.00 mm,Vc 5.95 mm,and Bw/Vw 5.05 mm(P＜0.01,all).Conclusion The clinical performances of VBD is different,MS 3D-CTA is a very effective method for the diagnosis of VBD.

Objective: To investigate the current status of reproductive health among the female medical staff in a provincial maternal and child health hospital and analyze the occupational influencing factors for reproductive health, particularly the effects of high-intensity work, work shift, chemical poisons, and physical and biological factors on reproductive health, and to provide a scientific basis for developing related intervention measures and promoting the reproductive health of professional females. Methods: A reproductive health questionnaire was designed in terms of age, type of work, professional title, education level, working hours, working strength, and the reproductive health of female staff to analyze the current status of reproductive health, working strength, and occupational hazardous factors. The female medical staff in the provincial maternal and child health hospital completed the questionnaire on the internal network of the hospital voluntarily. Results: Of all respondents, 19.46% had a history of miscarriage, 5.90% visited the hospital due to infertility, 21.31% had irregular menstruation within the last 3 months, and 30.57% had reproductive system disease; 72.28% of the investigated medical staff often worked at night, 47.25% often worked overtime (more than 3 days a week) , and 22.27% worked over 8 hours daily. The respondents who often worked overtime had a significantly higher prevalence of reproductive system disease than those who did not often work overtime (χ²= 58.65, P<0.01) . The respondents who often worked at night had a significantly higher rate of miscarriage than those who did not work at night (χ²=41.57, P<0.01) . In all respondents, 87.08% were often exposed to chemical injuries such as disinfectants, and 78.15% had contact with noise, radiation, and other physical injuries; the medical staff exposed to chemical and physical injuries had a significantly higher proportion of individuals with a history of miscarriage than the unexposed staff (χ²=10.04, P<0.01; χ²=13.30, P<0.01) . Conclusion Much attention should be paid to the reproductive health of female medical staff in the provincial maternal and child health hospital, who have high working strength. The occupational hazard factors can be avoided by reasonably arranging the work schedule and creating a supportive environment to improve the reproductive health of female medical staff.

Objective To investigate dynamically characteristics of apparent diffusion coefficient (ADC) of MR diffusion-weighted imaging (DWI) in the rabbit VX-2 tumor model.Methods Forty New Zealand rabbits were included in the study and forty-seven rabbit VX-2 tumor models were raised by implanting directly and intrahepatically after abdominal cavity was opened.DWI was carried out periodically and respectively on seventh,fourteenth,and twenty-first day after implantation.Part samples of VX-2 tumors were studied by pathology.The distinction of VX-2 tumors on DWI was assessed by their ADC values.The statistical significance between different time groups,different area groups,or different b-value groups was calculated using SPSS12.0 software,respectively.Results ADC values of 47 VX-2 tumors in the area of tumor periphery,tumor center,and normal parenchyma around tumor were greater when b-value was 100 s/mm2 than those when b-value was 300 s/mm2 and the distinction of VX-2 tumor ADC in the area of tumor periphery,tumor center,and normal parenchyma around tumor between different b-value groups was significant,respectively( F =17.964,P ＜0.01 ; F =13.986,P ＜0.01 ; F =128.681,P ＜0.01 ).The ADC values in the area of normal liver parenchyma around tumor were greater than those in the area of VX-2 tumor periphery and tumor center when the b-value was 100 or 300 s/mm2.When b-value was the same( 100 or 300 s/mm2),the distinction of VX-2 tumor ADC between different areas was significant( F =176.586,P ＜0.01 ; F =55.089,P ＜0.01 ).The ADC of VX-2 tumor in the area of tumor periphery and tumor center became gradually low from seventh to fourteenth or twenty-first day after implantation and the distinction of ADC between different time groups but the area same (?) was significant( b =100 s/mm2,F =48.211,P ＜0.01 ;b =300 s/mm2,F =20.955,P ＜0.01 ).There were not obvious cellular necrosis in VX-2 tumors on seventh and fourteenth day after implantation but ADC of VX-2 tumor decreased unobviously because of cellular edemata in or around tumors.There were obvious cellular necrotic areas in VX-2 tumors on the twenty-first day after implantation.ADC of viable tumor cells in VX-2 tumors were lower on DWI than that in the area of normal liver parenchyma around tumor and ADC of dead tumor cells in VX-2 tumors were unequal,including high values,equal values,and low values but they were higher than that in the area of normal liver parenchyma around tumor after dead tumor cells had been liquified or had become cystic.Conclusions ADC is able to reflect objectively the diffusion of water molecules in the tumor and to reflect indirectly the degree of the growth and liquified necrosis of a tumor.ADC has an important and potential value in monitoring dynamical tumor growth and in evaluating malignant degree and therapeutic effect.

Consensus ; Hirschsprung Disease ; diagnosis ; Humans

Objective To compare the accuracy of endoscopic ultrasound (EUS) with double contrast enhanced ultrasound ( DCUS) in the preoperative staging of gastric malignancies. Methods This study included 162 patients with biopsy proven gastric cancer who underwent surgical resection as primary management of their malignancies. All patients underwent DCUS and EUS prior to surgical intervention with the results of the ultrasound findings compared with the pathological stages of the resected specimen. Results Among the 162 gastric cancer patients, there were 42 cases of T1, 49 cases of T2, 56 cases of T3, and 15 cases of T4 tumors. The overall accuracy of DCUS and EUS for the determination of loco-regional tumor infiltration ( T Staging) was 77. 2% and 74. 7% , (χ2 = 0. 273, P = 0. 603). Comparison of ultrasound techniques revealed that DCUS was superior to EUS only for a tumor depth of T3 (χ2 =5. 009, P = 0.025). Lymph nodes were correctly staged with DCUS and EUS in 78.4% and 57. 4% of cases, respectively ( χ2 = 16. 370,P =0.001). Using DCUS, the sensitivity of the technique was 78. 4% with a specificity of 78. 5%. In comparison, EUS had a sensitivity of 49. 5% with a specificity of 69. 2%. DCUS also detected a higher incidence of positive lymph nodes than EUS for poorly differentiated (81. 5% vs. 42. 6% ,χ2 =17. 338, P < 0. 01) and overall tumor types (78.4% vs. 49. 5% , χ2 = 17.523, P < 0. 01). Conclusions Double contrast-enhanced ultrasonography offers another noninvasive approach for the preoperative evaluation of gastric cancer. DCUS was comparable to EUS in tumor depth evaluation. DCUS offers an advantage in the detection of lymph node metastases, especially in poorly differentiated tumors.