Objective To investigate the application of the ultrasonic guidance-assisted neonatal internal jugular vein catheterization.Methods Sixty two newborns (including low birth weight infants) receving thoracic/abdominal operation or resection of malignant tumor on the body-surface were randomly assigned to ultrasound guidance (UG) group or surface mark landmark(S) group.Newborns in both groups were all punctured with 22G venous indwelling needles to place the external casing,followed by the steel wire guidance-assisted implantation of ARROW 4F dual chamber central venous catheter.Then we compared the rate of successful insertion attempt,rate of malpositioning,complications and average operation time between the two groups.Results The rate of successful insertion attempt was 96.8%(30/31) in the UG group,significantly higher than that in the S group (32.3%,10/31),there was significant difference between the two groups(χ2=28.182,P=0.000).Malpositioning happened in 2 cases in the UG group,but 25 cases in the S group.Rate of complications was higher in the S group compared to the UG group (64.5% vs 3.2%,χ2=25.99,P=0.000).Most importantly,the average operation time was (4.366±1.137)min in the UG group,significantly shorter than that of the S group [(13.70±5.34)min,t=5.463,P=0.028)].ConclusionUltrasound guidance-assisted catheterization for neonatal internal jugular vein is safe and feasible and can dramatically improve the success rate and prevent complications.

Considering the present condition of nuclear medicine experiment teaching and management model,this paper proposes some reform measures:reforming teaching model,adjusting teaching content,enhancing lab management.

Genetic Predisposition to Disease ; Genome-Wide Association Study ; Humans

Accidents, Occupational ; Adolescent ; Adult ; Ammonia ; poisoning ; Female ; Humans ; Male ; Young Adult

Objective To discuss the ultrasound imaging of acardia twin before and after spontaneously blood blocked in twin reversed arterial perfusion sequence (TRAP), and to analyze the inlfuence factor for the prognosis of pump twin. Methods Seven TRAP with pump twins and acardia′s blood lfow blocked were diagnosed by US and autopsy in Hubei Women and Children′s Hospital between 2001 January to 2012 September. The ultrasound images, clinical data and pump twin’ outcome were analyzed. Results Ultrasound images showed skin edema, acardia, spine and lower limbs in seven acardia cases before blood blocked, among which 4 were acardius acephalus, 3 were acardius anceps. Single umbilical artery were detected in 7 cases with reversed umbilical artery perfusion toward fetus. Four cases had rare blood lfow (UA-PI ratio<0.7. Five acardia cases had slower growing rate than the pump twin. Ultrasound images showed no growing, no blood lfow in the acardia, the acardia twin became vagued in the second and third trimester, and ifnally developed into a paper fetus. A linear umbilical cord extend from umbilical region to placenta were found in 7 cases whose blood lfow were spontaneously blocked. Pump twin′s outcome:3 pump twins survived, 3 died in uterus, and 1 was induced labor due to hydrocephalus and cardiac failure. The most important factors that affected the prognosis of pump twin included:faster growing in acardia twin with less blood supply, abnormal brain and heart function in pump twin, chromosome abnormalities, abnormal amniotic fluid and cord entanglement. Conclusions Less blood flow and slow growth speed prompt in acardia twin suggested spontaneously acardia blood block. It is mandatory to monitor the pump twin after the spontaneous block of acardiac’s blood lfow.

Objective To explore the factors relating to serum lutein level in elderly patients with early age-related macular degeneration (AMD).Methods 102 early AMD patients diagnosed by international diagnostic criteria were selected.The level of serum lutein was measured by HPLC,and dietary intake was estimated by food-frequency questionnaire (FFQ).The factors relating to serum lutein level were analyzed by Pearson correlation and multiple regression analysis models.Results Serum lutein level was higher in female AMD patients than in male AMD patients [(0.33±0.31) μmol/L vs.(0.21 ±0.19) μmol/L,t=2.21,P＜0.05].Serum lutein level was positively correlated with dietary lutein (r=0.49,P＜ 0.001),but not correlated with age,BMI,and other nutrient intake after adjustment for caloric intake.Dietary lutein was mainly from corn,spinach,leeks,eggs,chrysanthemum,pumpkin,broccoli,lettuce,asparagus and peas.Intakes of spinach,pumpkin,asparagus were significantly associated with serum lutein level.Conclusions Elderly patients with AMD should increase the intakes of lutein-rich vegetables to increase the serum lutein level.

Objective To explore the clinicopathological features ,diagnosis and differential diagnosis of pleuropulmonary blasto-ma(PPB) .Methods A case of PPB was reported by light microscopic observation ,immunohistochemistry and molecular pathology study with review of related literature .Results A 45-year-old female was admitted to the hospital because of cough and dyspnea . Chest radiogram revealed a solid mass in the left lung .Grossly ,the tumor was described as a firm lesion with lumina or multicystic components and well-circumscribed margins .Microscopically ,the tumor was composed of sheets of malignant primitive small cells and fascicles of embryonal rhabdomyosarcoma-like cells with foci hyalinized stroma .Beneath the benign epithelium ,the primitive mesenchymal cells showed as mixed blastematous and sarcomatous characteristics that plump spindle shaped cells presented poor differention with abundant eosinophilic cytoplasms and brisk mitotic activities .Immunohistochemically ,vimentin and MyoD-1 were positive in malignant small cells but some epithelial markers are negative .Meanwhile ,K-RAS extron 3 mutation was detected by high resolution melting analysis(HRMA) .Conclusion Pleuropulmonary blastoma(PPB) is a rare malignant tumor with unique clinicopathological features .It should be distinguished from some mimics such as pulmonary blastoma and embryonal rhabdomyo-sarcoma .

BACKGROUND:Studies have shown that the finite element method could preferably simulate the biomechanical analysis for the object with complicated structures and irregular shapes. The similarities for the finite element model have great influences on the results of the analysis. However, to construct an ideal model is the most time-consuming and complicated portion for the finite element analysis. OBJECTIVE:To construct a finite element model for the maxilary first molar and the periodontal tissue, and to provide a basis of biomechanical researches of the maxilary first molar. METHODS: A volunteer with complete mandibular dentition and healthy periodontal tissue was selected in this study. Cone-beam CT was scanned. The images were saved as DICOM format. These images were imported to the medical modeling software Mimics. The surface model for the maxilary first molar and the alveolar bone was constructed. The model was then imported to GiD for pre-processing. Thus, the complete three-dimensional finite element model for the maxilary first molar and the periodontal tissue was constructed. RESULTS AND CONCLUSION:A finite element model for bilateral maxilary first molar, periodontal ligament and maxilary alveolar bone was constructed, including 896 035 nodes and 4 881 067 elements. This model has restored the geometric shape and the structure of the research object. This study successfuly constructed finite element models of maxilary first molar and the periodontal tissue, which can be a basis of biomechanical researches for the maxilary first molar and the periodontal tissue under the effect of different clinical orthodontic forces.

Objective To assess the efficacy of combination therapy with all-trans-retinoic acid (ATRA ) and arsenic trioxide (ATO) in treating patients with acute promyelocytic leukemia (APL) .Methods A retrospective study was conducted to evaluate the efficacy of combining ATO with ATRA based induction therapy ,followed by 3 courses of consolidation chemotherapy and 2-year sequential ATO/ATRA maintenance therapy in newly diagnosed APL ,and the efficacy between high risk group and low/inter-mediate risk group ,also between different PML-RARa isoform sub-group were compared .Results In high risk group and low/in-termediate risk group ,the complete remission(CR)rates were 70 .0% and 96 .9% (P=0 .04) ,respectively ;the 3 years overall sur-vival rates(OS) and disease free survival rates (DFS) were(70 .0 ± 14 .5)% ,(96 .9 ± 3 .1)% ,P= 0 .01 and(66 .7% ± 19 .2)% , (93 .8 ± 6 .1)% ,P=0 .08 ,respectively .In BCR1 group and BCR3 group ,the CR were 78 .6% and 95 .6% (P=0 .14) ,respectively ;the rates of 3 years OS and DFS were(95 .7 ± 4 .3)% ,(78 .6 ± 11 .0)% ,P=0 .18 ,and(92 .9 ± 6 .9)% ,(87 .5 ± 11 .7)% ,P=0 .24 , respectively .Conclusion The results indicate that ATO based first-line protocol is highly effective for treatment of newly diagnosed APL ,especially for the PML-RARa BCR3 isoform APL .

Objective To investigate the changes of brain volumes in neuromyelitis optica (NMO)patients using voxel-based morphometry (VBM) method, and preliminarily explore the pattern of cerebral anatomical impairment. Methods Twenty-three clinically defined NMO patients and 15 gender and age matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 3.0 Tesla MR systen. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Whole brain volumes included grey matter volume (GMV), white matter volume (WMV), total intracranial volume (TIV), grey matter fraction (GMF), white matter fraction (WMF),brain tissue fraction (BTF) and regional brain volumes between the two groups were compared by independent samples t-test and an Pearson were performed to compare the regional brain volumes and the ages. Results GMV of NMO group[(610. 2 ± 55.0) ml] was significantly decreased comparing to healthy control group[(657. 2 ± 36. 3) ml] (t = - 2. 915, P ＜ 0. 05). The age of NMO patients [(40 ± 9) years old] showed negative correlation with GMF [(42. 5 ± 2. 6) %] (r = - 0. 673, P ＜ 0. 05). Regional brain volume analysis showed decreased GMV in left insula and bilateral posterior cingutates in NMO patients,while decreased WMV was found in left frontal and left parietal white matter. Conclusion VBM could detect brain volume changes sensitively. Total grey matter volume in NMO patients was decreased comparing to HC group. Regional grey matter atrophy in NMO patients occurred in left insular and bilateral posterior cingutates, regional white matter atrophy occurred in left frontal and left parietal lobe.