Child ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell

Objective To summarize the characteristics of fetal hand deformity in prenatal two-and three-dimensional u1trasonography. To analyze the causes of missed diagnosis of prenatal u1trasonography in detecting fetal hand deformity. Methods Systematic continuous sequence approach was performed with two-and three-dimensional u1trasonography in 11 854 cases to detect the fetal hand development, deformity and accompanied malformations. Prenatal sonographic features of fetal hand deformities (59 cases) were correlated with the morphology and X-ray characteristics of the delivered fetuses. Results Fifty-nine cases of fetal hand deformity were diagnosed out of 11 854 fetuses by prenatal u1trasonography:44 cases of abnormal wrist posture,1 case of full-ifnger absence, 2 cases of metacarpal and phalanx absence, 3 cases of clinodactyly, 2 cases of forearm and hand absence, 1 case of syndacty, 1 case of polydacty, 5 cases of lethal bone dysplasia. The detection rate was 0.50%(59/11 854). Eight cases were missed:3 cases of partial ifnger absence, 2 cases of clinodactyly, 1 case of syndacty, and 2 cases of polydacty. The rate of missed diagnosis is 11.90%(8/67). Abnormal wrist posture showed a hook-shaped hand in the wrist. Full-finger absence showed that one or multiple ifngers were absent. Metacarpal and phalanx absence showed no fetal hands. Clinodactyly showed that four ifngers were not in the same plane. Forearm and hand missing showed that ulna, metacarpal and phalangeal were absent. Syndacty showed a beak-like hand. Multi-ifnger indicated six ifngers in one hand. Lethal bone dysplasia showed very short limbs. Conclusions Prenatal u1trasonography played an important role in detecting and diagnosing severe type of fetal hand deformity. The detection rate of fetal hand deformities can be greatly improved by appropriate use of the scan-time, fetal position, systematic continuous sequence approach and real three-dimensional u1trasonography.

AIM: To evaluate the safety, efficacy and stability of posterior chamber phakic intraocular lens ( ICL ) implanation and clear lens extraction for the correction of high myopia.
METHODS: The study enrolled 56 cases ( 100 eyes ) of high myopia. Group I comprised 32 cases ( 58 eyes ) receiving ICL implantation and Group II comprised 24 cases (42 eyes) undergoing clear lens extraction. In this study, we evaluated the two groups of subject's the visual and refractive results, intraocular pressure ( IOP ) , endothelial cell density ( ECD ) , anterior chamber depth ( ACD) , lens transparency, the surgical complications as well as visual adverse symptoms before and after surgery.
RESULTS: The postoperative subjects in group I and group II were followed, uncorrected vision acuity ( UCVA)>0. 5 were 69. 0% in group I and 71. 4% in group II after 3mo. UCVA>0. 5 were 72. 4% in group I and 73. 8% in group II after 1a. Predictability of the manifest spherical equivalent refraction within±1. 00D was achieved in 62. 1%of eyes in group I and 57. 1% in group II after 1a. The central vault of the ICL ( distance from posterior surface of ICL to the crystalline lens ) measured with anterior segment optical coherence tomography ( AS-OCT ) was 0. 35-0. 54 (0. 40±0. 16) mm. Twelve point one percent of eyes in group I and 7. 1% of eyes in group II had transient mild increase in IOP. Here were statistically significant differences between preoperative and postoperative ECD (P<0. 001 ). Complications of surgery: 1 eye had ICL spontaneous rotation, 2 eyes had anterior subcapsular cataract, 4 eyes noticed halos around lights at night in group I. Three eyes had posterior capsule mild opacification, 3 eyes noticed halos around lights at night, 12 eyes had difficulty in near vision in group II.
CONCLUSION: ICL implantation and clear lens extraction are effective, safe and predictable surgical option for the management of high myopia. No severe complications occurred, but its long time effect and safety still need more time to prove.

Objective To explore the status of iodine nutrition in 8～10 years children after universal salt iodization(USI)in the iodine deficiency area.Methods Probability proportion to size method(PPS)or simple random sampling methods were used to sample children aged 8～10 years in iodine deficiency area in the vear 1995,1997,1999,2002 and 2005, respectively.Goiter were detected by palpation and B-ultrasound, iodine concentration in salt was detected by direct titration method and that in urine by the method of As3+-Ce4+catalytic spectrophotometry.Results After USI has been implemented,the median of salt and urinary iodine tended to mcreaseand the goiter rate tended to decrease year by year.In 2005,the coverage rate of iodinated salt was elevated to 97.2%,qualified iodize salt rate was 97.1%and edible qualified iodinated salt rate was 94.3%in the whole iodine deficiency areas.The median of urinary iodine Was 227.7 μg/L 89.7%(323/360)of the population had a level of the urinary iodine over 100μg/L Goiter rate of 8～10 years children Wag decreased from 22.3%(282/1267)to 4.4%(53/1200) from 1995 to 2005.Conclusion After 10-year USI,the status of iodine nutrition in ShaJldong Province has been promoted obviously and it is in a suitable iodine nutritional status.

Adult ; Biomarkers ; blood ; Case-Control Studies ; Female ; Granzymes ; blood ; Hepatitis B ; blood ; immunology ; Humans ; Male ; Middle Aged ; Perforin ; blood ; T-Lymphocytes, Cytotoxic ; metabolism

OBJECTIVETo analyze the origin of the feeding artery of the retroperitoneal invasion caused by massive hepatocellular carcinoma (HCC) and the characteristics of DSA. To explore the approaches to completely embolize the tumor blood supply and to assess the technical success rates, the safety and effectiveness with a purpose of improving the patients survival rates and living quality.

METHODSAfter complete ultraselective arterial embolization via hepatic artery for the 75 patients with retroperitoneal invasion led by massive HCC, those showing lipiodol deposition inconsistance compared with CT or MRI underwent the ultraselective catheterization to find potential tumor feeding arteries and then the subsequent chemoembolization. 3-6 months after operation CT or MRI was used to evaluate the efficacy. RETURNS: Retroperitoneal lesions were supplied by the posterior branch of right inferior phrenic artery (64%, 48/75), the right adrenal artery (33.3%, 25/75) and the right-side first lumbar artery (2.7%, 2/75), respectively. The success rates of ultraselective catheterization to tumor feed arteries was 100% (75/75). 3-6 months after embolization, the cases of complete and most-part iodine oil filling in the lesions were 72 (96%) and 3 (4%) respectively. The sizes of the lesions showed significant reduce (55, 73.3%), reduce (15, 20%) and no change (5,6.7%). Survival rates of 6, 12, 24 and 36 months after TACE were 90.7% (68/75), 81.3% (61/75), 49.3% (37/75) and 40% (30/75) respectively.

CONCLUSIONThe supply arteries of retroperitoneal invasion led by massive HCC come from the posterior branch of right phrenic artery, the right adrenal artery and the right first lumbar artery. Ultraselective TACE has high technical success rates, hight safety, and excellent effectiveness. The complete embolization of tumor feed artery can significantly increase the survival rates and living quality of these patients.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; blood supply ; pathology ; therapy ; Chemoembolization, Therapeutic ; Female ; Humans ; Liver Neoplasms ; blood supply ; pathology ; therapy ; Male ; Middle Aged ; Peritoneum ; pathology

Objective To explore the impact factors for post-thaw embryo survival rate and clinical pregnancy rate in frozen-thawed embryo transfer program. Methods The clinical data of 573 cycles of frozen-thawed embryo transfers were retrospectively analysed. Groups were divided according to the pre-freeze embryo quality, pre-freeze embryonic developmental stage, frozen-thawed embryo quality and cryopreservation technique, respectively, and post-thaw embryo survival rates and/or clinical pregnancy rates were compared among groups. Results The clinical pregnancy rate of high quality pre-freeze embryo was significantly higher than that of low quality pre-freeze embryo (31.8% vs 20.0%) (P< 0.05). There was no significant difference in the post-thaw survival rates and clinical pregnancy rates between embryos frozen at day 2 of ferrtilization and those frozen at day 3 of ferrtilization(79. 1% vs 82.9% and 25.5% vs 31.2%, respectively) (P>0.05). The clinical pregnancy rates of the transfer cycles only with fully intact embryos and with mixed embryos were significantly higher than that only with partially damaged embryos(36.7% vs 24.1% and 29.2% vs 24.1%, respectively)(P<0.05). The post-thaw survival rate and post-thaw high-quality embryo rate were significantly higher in those processed with modified cryopreservation technique than in those processed with original cryopreservation technique (82.0% vs 66.3% and 50.0% vs 27.5%, respectively)(P<0.05). Conclusion Pre-freeze embryo quality, post-thaw embryo survival rate and post-thaw embryo quality have a positive correlation to subsequent clinical pregnancy rate. Favorable cryopreservation technique may ensure the success of post-thaw embryo recovery and transfer.

ObjectiveTo look into the distribution of “iodine suitable” region in iodine-deficient areas in Shandong province and to provide a scientific basis for guiding the redesignate of iodine-deficient areas and launch scientific supply of iodine.Methods One to 3 copies of water source samples were collected in 105 existing iodine-deficient counties by village.Water iodine content was detected by arsenic-cerium catalytic spectrophotometry.The areas with water iodine content below 10 μg/L was defined as iodine-deficient areas and among 10 - 150 μg/L were “iodine suitable areas” and greater than 150 μg/L were high iodine areas.Results The research was carried out in 14 cities,105 counties,and 1337 towns.We collected 65 716 water samples.Sample recovery efficiency reached 99.8％.The median of water iodine was 5.57 μg/L.In the 1337 towns surveyed,there were 82.05％(1097/1337) of the township with water iodine median ＜ 10 μg/L,17.43％(233/1337) between 10 - 150 μg/L,and 0.52％(7/1337) ＞ 150 μg/L.Conclusions In Shandong province,the water “iodine suitable” regions are distributed scattered with considerable proportion.In iodine-deficient areas,there are areas with high water iodine,and iodine-deficient regions should be redrawn.Emphasis should be put on iodine nutritional status of residents in “high iodine and iodine suitable” regions,and iodine supplementation should be carries out scientifically.

BACKGROUNDAn increasing incidence of Crohn's disease has been found in China in recent years. Our study has been focused on evaluating the diversity of the clinical manifestations of Crohn's disease in order to improve early diagnostic accuracy and therapeutic efficacy.

METHODSThirty patients with active Crohn's disease were enrolled and their clinical data, including diagnostic and therapeutic results, were analyzed. Endoscopy combined with histological examination of biopsy specimens provided characteristic features of the disease. Transabdominal bowel sonography (TABS) was used for detecting intestinal complications. Nutritional supportive therapy was given to 20 subjects with active cases of the disease.

RESULTSMost patients were young adults with a higher proportion of females to males (ratio: 1.14:1). The disease affects any segment or a combination of segments along with the alimentary tract (from the mouth to the anus). In this study, the colon and small bowel were the major sites involved. Recurrent episodes of abdominal pain in the right lower quadrant and watery diarrhea were the most common symptoms. Granulomas were identifiable in nearly one-third (30.8%) of all biopsy specimens. In moderate cases of the disease, remission was achieved more quickly through the use of oral prednisone therapy than with SASP or 5-ASA. Beneficial effects on the host's nutritional status were observed. Immunosuppressives were used on an individual basis and showed variable therapeutic effects. Sixteen patients had surgery due to intestinal obstruction or failure to respond to drug therapies. Rapid improvement after surgery was reported.

CONCLUSIONEndoscopy (with biopsy) and TABS were both crucial procedures for diagnosis. SASP (or 5-ASA) and prednisone were effective as inductive therapies. Azathioprine has demonstrable benefits after induction therapy with prednisone. Surgery, as an alternative treatment, provided another effective choice in selected patients.

Adolescent ; Adult ; Aged ; Azathioprine ; therapeutic use ; Biopsy ; Child ; Crohn Disease ; diagnosis ; diagnostic imaging ; therapy ; Endoscopy, Gastrointestinal ; Female ; Humans ; Male ; Mesalamine ; administration & dosage ; Middle Aged ; Prednisone ; administration & dosage ; Sulfasalazine ; administration & dosage ; Ultrasonography

OBJECTIVETo explore the safety and effectiveness of endoscopic mucosal resection (EMR) in the treatment of colorectal polyps.

METHODEMR was applied in the treatment of colorectal polyps.

RESULTSA total of 3578 polyps in 2609 patients were all completely resected except 2 cases and the integrated rate of samples was 99.6%. Intra- and post-operation complications occurred in 22 cases(0.8%), including 7 intraoperative bleeding, 5 postoperative bleeding, and 10 thermal burn, which were cured by symptomatic treatment. A total of 1530 (58.6%) cases were followed-up with 3-12 months and no relapse was found in former place of excision.

CONCLUSIONEMR can be applied in resection of colorectal polyps effectively and safely.

Aged ; Endoscopy, Gastrointestinal ; Humans ; Intestinal Mucosa ; surgery ; Intestinal Polyps ; surgery ; Postoperative Hemorrhage ; Recurrence