Objective To study the possibility of fetal cardiac rhabdomyoma diagnosed by ultrasonography,and the relationship between the fetal cardiac rhabdomyoma and family tuberous sclerosis. Methods High resolution ultrasonic equipment with fetal cardiac software was used. The main cross section of four chamber view was studied mainly. The location, the number of the tumor and the outflow tract of left and right ventricular cordis were scanned carefully, the maternal abdominal scan was performed as well. Results Five cases of fetal cardiac rhabdomyoma were found by routine prenatal ultrasonography, and were confirmed by autopsy. Among them, one case were associated with maternal tuberous sclerosis. Conclusions Fetal cardiac rhabdomyoma associated with tuberous sclerosis. Fetus with cardiac rhabdomyoma frequently die of cardiac failure; since the prognosis of the tuberous sclerosis with neural sclerosis was very poor, when the fetal cardiac rhabdomyoma was detected prenatally, the possibility of tuberous sclerosis should be considered, also relative examination must be performed to the mother to decrease the perinatal mortality.

Objective The clinical value of ifrst-trimester standard ultrasound views in screening for fetal structural abnormalities. Methods From September 2008 to March 2011, transabdominal sonographic screening by standard ultrasound views was performed in 3 134 viable singleton pregnancies during the ifrst trimester at Beijing Obstetrics and Gynecology Hospital. Used the following views:(1) Fetal proifle;(2) Neck sagittal;(3) Skull and brain;(4) Thorax;(5) Abdomen;(6) Bladder;(7) Upper limbs, and (8) Lower limbs. The women underwent 20-to 24-week and 28-to 32-week ultrasound examination if the anatomical survey was normal during the ifrst trimester. Follow-up was obtained by reviewing of the birth records from hospital charts. Results Sixteen prenatal abnormalities were detected at 11-to 13-week scan (including one case of encephalocele and meningoceles, one case of endothelial cushion defect and single umbilical artery, one case of ectopia cordis, gastroschisis, and spinal abnormalities, two cases of exencephaly, one case of anencephaly, one case of gastroschisis and lower limb malformation, two cases of omphalocele, one case of encephalocele, ectopia cordis, and gastroschisis, one case of single ventricle, one case of endothelial cushion defect, four cases of hyhrop). All of the 13 women decided on termination of pregnancy. Three suspected structural abnormalities (hydrops) detected at the ifrst-trimester scan were found as normal after birth. Seven cases were diagnosed at 20-to 24-week scan (including one case of dextrocardiac and double outlet right ventricle;two cases of endothelial cushion defects;one case of trisomy 21 with VSD;one case of omphalocele, one case of short ulna and radial with wrist distortion, and one case of club foot). One case of diaphragmatic hernia was detected at 32-week scan. Two cases (one case of cardiac defects and one case of ear deformity) were identified after birth. Of all the 3 134 fetuses, follow-up was obtained in 2 822 cases, 312 cases were excluded from the analysis because the outcome of their pregnancy could not be traced. Twenty-three fetuses with at least one major structural defect detected by prenatal ultrasonography were confirmed by follow-up. The sensitivity of the standard first-trimester ultrasound views was 56.5%(13/23), speciifcity was 99.9%(2 796/2 799), CR was 99.6%(2 812/2 822), and the false negative rate was 43.5%(10/23). Conclusions The standard views of the ifrst trimester are feasible and effective in screening the major fetal abnormalities including exencephaly, anencephaly, gastroschisis, omphalocele, ectopia cordis and single ventricle. However, ultrasound screening in early pregnancy still has some limitations, continuous scanning in different stages of pregnancy is necessary.

Humans ; Mitochondrial Diseases ; genetics ; Molecular Biology ; Oxidoreductases ; chemistry ; deficiency ; genetics

Objective To screen out the PI3K/Akt pathway related genes in vascular smooth muscle cells (VSMCs) subjected to cyclic strain. Method VSMCs of rat aorta were subjected to cyclic strain (10 %, 1 Hz) by using a FX-4000T system. Phosphorylation of Akt was examined by Western blotting. Suppression subtractive hybridization (SSH) method was employed to analyze the differently expressed cDNA sequence between the strained VSMCs pretreated with and without wortmannin, a specific inhibitor of PI3K. These fragments were ligated with T vectors, screened through the blue-white screening system to establish cDNA library, and was sequenced and analyzed in GenBank with BLASTN search.Result Level of Akt phosphorylation of VSMCs was significantly enhanced by the mechanical strain compared with the control. Ten different expressed sequence tags (EST) were gained after sequencing 30 clones randomly selected from 54 white clones. There may be six genes related with the mechanical strain and cell signal PI3K/Akt, such as High mobility group box 1 (HMGB1), Neural precursor cells expressed (Nedd4a), Cyclin-dependent kinase 5 (CDK5), Histone deacetylase 3 (HDAC3), Ubiquitin-like 1 (Uble1a) and Heterogeneous nuclear ribonucleoprotein H1 (hnRNP). Conclusion SSH is an effective and reliable approach to screen out the genes related with the mechanical strain and PI3K/Akt pathway in VSMCs.

Objective To investigate the value of nuchal translucency(NT) thickening in the fetal chromosome abnormality screening.Methods The 14 881 pregnant women received NT measurement in 11-13 +6 weeks at Beijing Obstetrics and Gynecology Hospital from January 2010 to August 2012.The 118 fetuses whose NT≥2.5 mm were recruited.One hundred and eight (91.5％,108/118)of them accepted invasive procedure and karyotype analysis.Results (1) Chromosome karyotype analysis:113 singleton pregnancies (95.8％) and 5 twin pregnancies (4.2％) whose NT thickened from 2.5 mm to 11.0 mm were advised karyotype analysis.The 108 pregnant women accepted karyotype analysis.Among them,88 had normal chromosome karyotype,and 20 had chromosome abnormalities.The detection rate was 18.5 ％ (20/108).(2) The sensitivity,specificity,false positive rate,false negative rate,total consistent rate,positive predictive value and negative predictive value of prenatal screening of chromosome abnormalities for NT ≥ 2.5 mm were 44％,99％,1％,56％,99％,19％ and 100％,respectively.(3) Among the 88 fetuses who had normal karyotype,72 (82％) had isolated thickened NT,while 16 (18％) had fetal structural malformation or intrauterine demise.(4) Among the 10 pregnant women who did not accept fetal karyotype analysis,8 terminated pregnancy because of fetal structural malformation,and the other 2 fetuses died in uterus.(5)All of the 5 twin pregnancies were dichorionic twins,and one of the twins had thickened NT.Among the 5 twin pregnancies,one fetus was trisomy 21 and others had normal karyotype.3 twin pregnancies who had normal chromosomes gave live birth.And the other had a gastroschisis and exstrophy deformity fetuse.This fetuse died in uterus and remaining fetuse had full-term live birth.(6) 35 (29.7％) pregnant women received second trimester Down's syndrome serum screening.One was high risk and was proved a trisomy 21 pregnancy.Thirty-four were low risk and had normal chromosome karyotype.Conclusion NT thickening may indicate fetal chromosome abnormalities or other structural malformations.It is a useful prenatal screening indicator.

Objective: To compare the efifcacy and safety of circumferential pulmonary vein antecourt isolation (CPVAI) ablation and stepwise linear (SL) ablation in treating the patients with atrial ifbrillation (AF) Methods: A total of 136 AF patients with catheter ablation under EnSite 3000 guidance in our hospital were retrospectively summarized. The patients included 93 paroxysmal AF and 43 persistent AF and divided into 4 groups. Paroxysmal AF with CPVAI ablation,n=45, Paroxysmal AF with SL ablation,n=48 and persistent AF with CPVAI ablation, n=18, persistent AF with SL ablation,n=25. The differences of left atrium diameter, ablation time, X-ray exposure time, the success rate and complication were compared among different groups. Results: For 12 months follow-up study, the success rate and complication were similar between 2 ablation methods for treating both Paroxysmal AF and persistent AF patients. For Paroxysmal AF patients, both ablation methods could effectively reduce left atrium diameter,P<0.01. The SL ablation had less procedural time than CPVAI ablation,P<0.01, while the X-ray exposure time was similar between 2 ablation methods. Conclusion: Both CPVAI and SL ablation methods were effective and safe for treating AF patients.

Objective To investigate the feasibility of a small amount of water intake at the early stage after general anesthesia in children.Methods Five hundred and seventy children underwent operations under general anesthesia were randomly divided into 2 groups:control group ( n =288) and early postoperative drinking group ( n =282).The children received routine water deprivation after operation in control group.After recovery from anesthesia and recovery of coughing and swallowing reflexes,the children were allowed to drink a small amount of water in early postoperative drinking group.The incidences of crying,bucking,aspiration and hyoxemia were recorded before water intake and at 5 min after water intake.Results Compared with control group,the incidence of crying was significantly decreased and no significant change was found in the incidence of bucking in early postoperative drinking group.No patients exhibited aspiration and hyoxemia in the two groups.Conclusion It is feasible that children drink a small amount of water at the early stage after general anesthesia.

Objective To discuss the psychology and behavior of elderly hypoglycemia patients with symptomatic carotid artery stenosis, and compare the differences in psychology and behavior between groups.Methods Measurement and assessment with fall efficacy scale on psychology towards prevention of fall among 408 elderly hypoglycemia patients (＞ 60 years old) with symptomatic carotid artery stenosis were taken; They were divided for hypoglycemia history, carotid artery stenosis and ischemia sympton, and fall history; SPSS 17.0software was applied to do statistical analysis. Results There is significant difference on fall efficacy scale score between groups with and without hypoglycemia, carotid artery stenosis and ischemia sympton, and fall history (P ＜0. 0 1). Conclusions Subdividing symptomatic groups, applying preventive intervention procedure on prevention of fall, education on psychology and behavior towards prevention of fall are the effective psychological intervention measures on prevention of fall.

Objective To investigate perioperative antimicrobial prophylaxis in thyroid operation at all levels of hospitals in a province.Methods From January 1 ,2011 to December 31 ,2013,all kinds of thyroid operation in a province were conducted targeted monitor,investigated results were analyzed.Results A total of 1 304 cases of thy-roid operation were investigated,1 294 (99.23%)were elective operation;duration of operation of 1 051 cases (80.60%)were ≤2 hours;antimicrobial use rate was 96.70%;196 patients (15.45%)were administered 30 mi-nutes before operation,887 patients (70.34%)used antimicrobial agents for >48 hours;19.53% of patients used the first generation cephalosporins and clindamycin.Conclusion There are some problems in antimicrobial use in thyroid operation in this province,such as inappropriate choice of antimicrobial agents,improper administration time,long time use of antimicrobial agents,and use antimicrobial agents without indications.Management of anti-microbial agents should be strengthened,so as to promote the rational use of antimicrobial agents.

ObjectiveTo understand condition about cost and economic burden of outpatients in countries and townships medical institutions in Xinjiang.MethodsThirty-one medical institution were selected and the cost and income of one-day outpatients were investigated,then the cost of different diseases,age groups and payment methods and the later disease cost burden were analyzed.ResultsOut-patient expenses of top ten common diseases was pneumonia100.12 yuan,injury 85.18 yuan,hypertension and coronary heart disease(CHD) 69.13 yuan,examination and diseases related to pregnancy 49.60 yuan,disease of the genitourinary system 41.71 yuan,enterogastrtis 34.80 yuan,bronchitis 30.72yuan,osteoarthrosis 24.60 yuan,upper respiratory infection ( URI ) 23.63 yuan,scytitis 21.14yuan;The outpatient expenses of those taking part in Neotype Countryside Cooperative Medical Care Insurance,whose family-month-income was less than 250 yuan,was 18.07 yuan,which disease cost burden was 25.56％.ConclusionThe expenses of infectious diseases in country and township hospitals was in the top ten.The cost of chronic non-communicable diseases was rising significantly;For those participating Neotype Countryside Cooperative Medical Care Insurance,the outpatient expenses was low and the disease economic burden was higher.