Objective To evaluate the importance of the prenatal diagnosis to fetus with mild ventriculomegaly ( MVM) in pregnancy outcome and prognosis. Methods The ultrosonographic results of 51 pregnant women who were admitted to our hospital were collected in this study. In each case,a thorough evaluation of fetal anatomy was performed,karyotyping or MRI was done if needed,and follow-up was done un-til afterbirth. Results In 51 cases of lateral ventriculomegaly fetal:ultrasonography indicated there were 26 fetuses with mild ventriculomega-ly. The incidence of MVM complicated with other abnormities was 46. 0%,and that complicated with chromosome disorder was 11. 5%. Con-clusion Ultrasonography plays an important role in the detection of MVM. Chromosome analysis should be carried out for elder pregnant women when their fetuses are diagnosed as MVM and other complicating abnormities.

Non-motor symptoms are an important component of the manifestations of Parkinson's disease(PD);they usually include sleep disorder,neuropsychotic symptoms,autonomic dysfunction,pain,and so on.Non-motor symptoms are multifactorial and mainly involve various non-dopaminergic neurotransmitter systems.These symptoms are not only a result of disease progression,but also can appear in the early stage of the disease,and they can have a major impact on the quality of life.The early notice of these symptoms may lead to better therapeutic strategies and subsequently to the improvement of the quality of life in PD patients.

Objective To explore the latent class structure and heterogeneity of posttraumatic stress disorder(PTSD) in adolescent.Methods The Chinese PTSD Checklist-Civilian Version (PCL-C) was used to assess 560 adolescent from the Wenchuan earthquake area.Latent Class Model was employed to analyze the data.Results Latent Class Analysis revealed four classes of adolescent PTSD sample:pervasive disturbance (n=115,20.5％),no disturbance (n=165,29.5％),Intermediate Symptom with high Emotional Numbing (n=188,33.6％),as well as Intermediate Symptom with low avoidance (n=92,16.4％).The proportion of boys in each subsample were 55.7％,49.7％,50.5％ and 50.4％,respectively.In addition,there was no significant gender difference of prevalence within each class (x2=1.56,P=0.669).Conclusions Four-class model best fit the data for PTSD symptoms,and different clinical intervention should be adopted.

Objective To investigate the effect of madopar combined with entacapone administration on plasma homocystein ( Hcy) level in patients with Parkinson's disease ( PD) .Methods Thirty healthy person were selected as a control group, 20 PD subjects with no levodopa ( LD) taking were as no treatment group, 63 subjects with madopar were as madopar group and 49 subjects with madopar combining entacapone were as combination group. Meanwhile levodopa concentration in peripheral blood and Unified PD Rating Scale Ⅲ ( UPDRSⅢ) score were measured.The plasma Hcy levels of all the researchers were detected.Results The L-dopa concentration in plasma of combination group was statistically significantly higher than that of madopar group ( P<0.05 ) .The score of UPDRSⅢscale of madopar group and combination group were significantly lower than that of madopar group ( all P<0.05).Compared with control group, the Hcy concentration in non-treatment group, madopar group and combination group were significantly increased ( all P<0.05 ) .And the Hcy concentration in madopar group was significantly higher than those in none treatment group and combination group ( all P<0.05 ) .Conclusion Madopar combined with entacapone therapy can significantly reduce plasma Hcy levels in patients with PD, which may be beneficial to the treatment of PD.

ObjectiveTo explore the significance and the scheme of OSCE ( Objective structural clinical examination ) applied in clinical resident training and examination. MethodsOSCE were adopted to train and evaluate residents clinical skills. 180 residents were trained through OSCE for two weeks.Then a test on clinical skills of the residents by OSCE was conducted after training. 172 questionnaires of evaluation on the training effect were collected and analyzed. ResultsWith regard to the training and examination of clinical skill, 96.51％ residents considered that it was helpful for clinical work, 98.26％ considered that it would make their operation more standandized. ConclusionThe training through OSCE is an important way to improve and evaluate clinical skills of residents and may be widely applied.

Septic shock is the most serious stage of sepsis and the main cause of the high mortality.So far,the scientists have paid more attentions on biomarkers for the early diagnosis and therapy monitoring of septic shock.As a kind of acute phase proteins, heparin-binding protein (HBP)has functions with increasing vascular permeability, sterilization, chemotaxis and regulating cell apoptosis.When the level of plasma HBP is high, it suggests that the patient has severe sepsis with edema and vascular collapse and can beapplied as a valuable biomarker for early diagnosis and therapy monitoring of septic shock.This review focuses on common inflammatory biomarkers for clinical application of sepsis, as well the structure and function of HBP and its clinical application of septic shock.

Objective To determine whether color doppler ultrasonography (CDU),thyroid function or thyroid autoimmune antibodies could identify Graves' disease in pregnancy(GDP) in pregnant patients with newly diagnosed thyrotoxicosis.Methods It is an observational study.Sixty-eight pregnant patients with newly diagnosed thyrotoxicosis including gestational hyperthyroidism (GHT) subjects (GHT group,n =33) and GDP subjects (GDP group,n =35),and 62 age-and sex-matched healthy subjects (C1 group:pregnant,n =32,C2 group:non-pregnant,n =30) were recruited.Thyroid function,human chorionic gonadotropin(HCG),thyroid autoimmune antibodies were detected.Peak systolic velocity of the superior thyroid artery (STA-PSV) and diastole inner diameter(STA-D) of the superior thyroid artery were measured by CDU.A ROC curve was used to evaluate STA-PSV,STA-D,thyroid function and thyroid autoimmune antibodies for identification of GDP.Results The area under the ROC curve of STA-PSV,STA-D and thyroid stimulating hormone (TSH),free T4 (FT4) for GDP were 0.905,0.887,0.803 and 0.786,respectively.The optimal cut-off points of STA-PSV,STA-D,TSH and FT4 for GDP were 40 cm/s,2.0mm,0.03 mIU/L and 30 pmol/L with the sensitivity of 82.9％,72.1％,81.8％,76.2％ and specificity of 81.8％,87.9％,75.2％,80.3％,respectively.Conclusions Detection of STA-PSV and STA-D by CDU,as well as thyroid function,is useful in screening GDP in pregnant patients with thyrotoxicosis.

Objective To pay attention to screening family disease and gene examination in patient with congenital adrenal hyperplasia (CAH). Method In this study, we investigated clinical data and performed gene sequencing of the pedigree and his family members with CAH. Results Based on clinical data, 3 of 6 family members were diagnosed CAH. Bone age of two boys nearly reach the maximum value. Genetic sequencing result indicated a T>A mutation of 1 004 position in CYP21A2 gene, which induced protein change I172N. Conclusion Disease screening and gene examine should be actively executed in patient with CAH in order to obtain diagnosis and start treatment as early as possible.

Abstrac:Objective To analyze the efficacy and safety of medpor-coated tear drain in lacrimal bypass surgery without skin incision. Methods The data of 7 patients(7 eyes) who underwent no skin incision of lacrimal bypass surgery with medpor-coated tear drain were ret-rospective reviewed. The operation result and complications were observed. Results All patients were followed up for 5~17 months. Com-plete or significant improvement of epiphora was achieved in 5 cases at the last follow-up. Complications included conjunctival granulation hy-perplasia (3 eyes),nasal mucosal granulation hyperplasia (2 eyes),and discomfort (4 eyes). Conclusion The lacrimal bypass surgery with medpor-coated tear drain could be expected to improve epiphora of refractory lacrimal obstruction. The main complications are granulation hyperplasia and discomfort.

Objective To evaluate the efficacy of ultrasound for placement of laryngeal mask airway (LMA) in comparison with fiberoptic bronchoscope in adult patients.Methods Fifty-eight ASA physical status Ⅰ or Ⅱ patients,aged 18-57 yr,weighing 50-70 kg,with body mass index 20-30 kg/m2,scheduled for gynecological operation under general anesthesia,underwent standard general anesthetic technique with 4 # LMA-ClassicTM.After clinical assessment of correct placement of LMA,the position of the LMA was confirmed by transverse neck ultrasound,and reconfirmed using fiberoptic bronchoscopy.The peak airway pressure and oropharyngeal leak pressure were recorded.Results When the outcome of clinical assessment of correct placement of LMA was considered as satisfactory,the rate of ideal anatomic placement assessed by ultrasound evaluation was 69 %,and the rate of ideal anatomic placement assessed by fiberoptic bronchoscopy was 59 %,and it showed that there was no significant difference in detecting the ideal placement of the LMA (P ＞ 0.05).The oropharyngeal leak pressure was significantly higher when ultrasound was used for confirmation of the correct placement of LMA than that when fiberoptic bronchoscope was used (P ＜ 0.05).Conclusion Ultrasound provides better efficacy for placement of LMA in indicating sealing of LMA than fiberoptic bronchoscope and is helpful in improving ventilation conditions in adult patients.