Twenty cases of clinically diagnosed dilatation cardiomyopathy (DCM) were examined with the Model XJY-6 ultrasound instrument to determine the anatomical changes of their hearts and the changes of their left ventricular diastolic function (LVDF) . Twenty healthy individuals were also examined as control. The following results were observed.Most patients exhibited dilatation of all the chambers and the increase of the left ventricular weight, however, dilatation was the main manifestation. Cardiac dilatation and hypertrophy present the similar pictures on radiograph or ECG, differentiation of the two conditions can hardly be made with either of the above methods, but must depend on ultrasound especially in cases complicated with left atrial dilatation and fibrillation.The changes of LVDF of DCM patients revealed by ultrasoundfwere the abnormalities of the amplitude and rate of the posterior wall movement and of the dias-tolic filling volume and filling rate of the left ventricle. It was found that the PWE, DPWV, RFF, RER/ESV of the patients were much lower than those of the control (P

The left ventricular function of 103 normal subjects in the age range of 17 to 48 were examined with three echocardiographic methods, the Pombo's method (Method I), Fortuin's method (Method II) and Lalani's method (Method III), in order to evaluate their relative efficiency. The results were as following:( 1 ) The value of left ventricular end diastolic volume determined with Method II was larger than that determined with Method 1(123. 9?22.6vsl05. 43?26.0 ml, P0. 05).( 2 ) The values of stroke volume, stroke index, cardiac output, and cardiac index were the largest as determined with Method II, the second with Method I and the smallest with Method III. For instance, the value of cardiac index was 4.66 ?1.21 /m2/min wita Method 11,3.81?1.0 with Method I, and 2.96?0.8 with Method III(P0. 05).( 4 ) All the parameters obtained from Methods I and II were correlated with each other closely (r = 0.72 - 0.96, P0.05).( 5 ) Methods I and II are simple to operate and easy to reproduce and there have been a lot of parameters obtained with these two methodds. However the systolic mitral closure slope of Method III is rather difficult to determine and the parameters obtained with Method III are comparatively less in number.It is concluded that Methods I and I of the echocardiographic technique are the methods of choice in determining the left ventricular function of a normals-sized or nearly normal-sized heart since they are simple, effective and accurate.

Objective To reduce the misdiagnosis of the inpatients admitted to digest department with abdominal pain through analyzing the consultation undertaken by surgeon.Method The causes and the constituent ratio according to the case records of those inpatients admitted to digest department because of abdominal pain were analyzed.Results The obstruction of hollow viscus was the first cauge(51.07%),and the tumor of digestive tract(17.78%)was the second cause for invitation for consultation to surgeon of the inpatients with abdominal pain in digest department wards.The ultrasound 32.78%,CT 26.67% and gastroenterological endoscope 13.89% were definite diagnosis,and should shorten the time of consultation.Conclusion Whether inpatient or outpatient with abdominal pain should be planned to be examined by ultrasound,CT or gastroenterological endoscope,obgerve the changes of the symptom and sign so that the misdiagnosis can be avoided.

Objective To investigate several related problems possibly affecting the measurement results in the experiment of 125I-FSH in vitro cells uptake by domestic GC-1200 gamma RIA counter.Methods Before entering the measuring room,the sample was performed the background measurement.CPM measured in the different locations of same measurement frame and the different locations in unmeasured area were performed the statistical comparison.Results In high count,the influence of single sample reaching 1.9 ×106CPM on the adjacent low counting tube count was 7%;its influence on low counting tube count in adjacent detector was 7.33%;all samples were arranged from high to low order and the high count sample holder was placed on the measured location close to the detector,its influence on low counting tube count was 5.33%.Conclusion The domestic GC-1200 γ RIA counter is suitable for the measurement of the in vitro cell uptake experiment of 125I nuclear labeling.

Objective To introduce a novel technique of intracolonic shunt procedure used in the anus - preserving operation for acute intestinal obstruction resulted from cancer at low and middle portions of rectum and assess the clinical significance. Methods In total, 81 patients with acute obstruction of low and middle portion of rectum caused by cancer were randomly ( random number) divided into control group and study group. In control group, 42 patients were operated with preventive transverse colonostomy or terminal ileum stoma after low proximal resection of rectum involved in cancer, while 39 patients were operated with intracolonic shunt procedure by using a biodegradable anastomosis ring and a condom placed 5 cm above anastomosis for protection in study group. Results There were no significant differences in sex, age, tumor site, tumor size and the distance from anstomosis to anal-edge between two groups. In both groups, the bowel movement resumed in 2 ~ 5 days after operation (P > 0.05). In study group, the rate of anastomosis leakage was 7.7% (3/39), and leakages were treated with drainage for 7.1 days in average to be healed, and the biodegradable anastomosis ring detached and were discharged in 14 -23 days (17 days in average), and there were no complications of drainage happened. The anastomotic stenosis occurred in three patients (7. 7% ) within 6 months after operation. In control group, 11.9% patients (5/42) had anastomosis leakage and they treated with drainage for 18.2 days in average to get the leakage healed, and 35. 7% patients (15/42) had stoma complications, and anastomotic stenosis happened in 28.6% patients (12/42) within 6 months after operation, and 7. 1% patients need another operation because of severe anastomosis stenosis. There were no significant differences in rate of anastomosis leakage between tow groups ( P > 0. 05), but there were significant differences in drainage days after anstomosis leakage happened and 6 - months anastomosis stenosis between two groups (P<0.05). Conclusions In the anus -preserving operation for acute intestinal obstruction at low and middle portions of rectum caused by cancer , the intracolonic shunt procedure is convenient and safty, and reduces the hazard incurred by anastomosis leakage and anastomosis stenosis compared with classic stoma operation.

Objective To evaluate the outcome of living donor liver transplantation(LDLT)for hepatocellular carcinoma(HCC).Methods We retrospectively analyzed the clinical data of 180 patients,who had received LDLT(n=34)or deceased donor liver transplantation(DDLT,n=146)for HCC,compared overall and recurrence-free survival between LDLT and DDLT,and identified the risk factors of tumor recurrence and prognosis by univariate and multivariate analysis.Results The 5-year overall survival and recurrence-free survival rate were 53 % and 58 %,respectively,in DDLT group,and 60 % and 60 %,respectively,in LDLT group.There was no significant difference in overall (P=0.85)and recurrence-free(P=0.89)survival between these two groups.The tumor recurrence rate was 26.5 % in LDLT group,and 17.8 % in DDLT group,respectively(P=0.25).Multivariate COX regression model analysis identified vascular invasion(relative risk 2.118,95 % confidential interval 1.201-4.353,P=0.032)and tumor beyond UCSF criteria(relative risk 3.490,95 % confidential interval 1.862-8.207,P=0.015)as independent risk factors of tumor recurrence,and tumor beyond UCSF criteria(relative risk 8.573,95 % confidential interval 3.016-18.261,P=0.006)as independent predictors of prognosis.Conclusion LDLT is a safe and effective procedure for patients with HCC,but further studies are required for selection criteria of recipients and higher HCC recurrence rate after LDLT.

Objective To investigate the transiliac-transsacral screw insertion pathway (TSIP) so as to provide an anatomical basis for clinical surgical practice.Methods CT scanning data of normal pelvis in 90 Chinese adults were selected by random number table.There were 45 males and 45 females,aged from 21 to 82 years (mean,53.88 years).After computed tomography scan,pelvic data of the 90 subjects were entered into Mimics software 16.0 for three-dimensional reconstruction.The outer frames of sacrum and ilium at sagittal plane were depicted.Maximum inscribed circle method was applied to determine the screw insertion pathways which traversed 1st (S1) and 2nd (S2) sacral segments,respectively.The diameters and lengths of screw pathways,the distances from screw insertion points to both anterior superior iliac spine and posterior superior iliac spine,as well as the angles between pathways and anatomic surface were measured.Results Most subjects had the condition of a trans-S1 TSIP (male 78％,female 76％),and all the tested pelvis had the condition of trans-S2 TSIP.There was no statistically significant difference between the left and right side parameters in male group,and so was in female group (P ＞0.05).TSIP radius:there was no statistically significant difference among male S1 [(5.52 ± 1.91)mm],male S2 [(5.35 ± 1.05)mm],and female S1 [(5.49± 1.34)mm] (P＞0.05),but each of them was greater than female S2 [(4.79 ± 1.40) mm] (P ＜ 0.05).TSIP length:male S1 [(158.25 ±9.84) mm] was larger than male S2 [(138.94 ± 9.75) mm],and female S1 [(154.91 ± 9.40) mm] was larger than female S2 [(141.01 ±8.60)mm].The screw insertion point was located at the outer ilium side.The distances from S1 to anterior superior iliac spine and to posterior superior iliac spine were (96.49 ±6.91)mm and (68.22 ±6.35)mm in males but (100.48 ±8.15)mm and (61.57 ±6.84) mm in females.The distances from S2 to anterior superior iliac spine and to posterior superior iliac spine were (114.43 ±8.77)mm and (49.62 ±8.54)mm in males but (114.75 ± 10.19)mm and (44.52 ±8.36)mm in females.Compared with those with a condition of TSIP in S1,a pelvis without a condition of an S1 TSIP had larger S2 TSIP radius.The S2 TSIP radius in one with such condition in male was (5.10 ±0.84)mm and that in one without such condition in male was (6.22 ± 1.27) mm.The corresponding female data was (4.37 ± 0.92)mm and (6.11 ± 1.84)mm (P ＜ 0.05).Both S1 and S2 TSIP were almost vertical to sagittal plane and parallel to coronal plane.Conclusions Anatomically,a S1 or S2 transiliactranssacral screw is available in most Chinese adults for sacroiliac joint fixation on both sides.Mimics software can be helpful to ensure the pathway of screw fixation,which provides reference for transiliactranssacral screw fixation technique.

Objective To report a pedigree with X?linked dominant protoporphyria(XLDPP), and to detect 5?aminolevulinic acid synthetase 2(ALAS2)gene mutations in this pedigree. Methods A clinical investigation was performed in a pedigree with XLDPP, and relevant data were collected from family members. A next?generation sequencing method was applied to screen possible mutation sites, and Sanger sequencing was performed to determine pathogenic gene mutations. Dermoscopy was conducted to observe skin lesions in the patients with XLDPP, and the Fotofinder system and very high frequency (VHF) ultrasound system were utilized to assess the severity of photodamage. Liver and gallbladder ultrasonography as well as blood examination were performed for all the family members. Results A deletion mutation, c.1706?1709ΔAGTG, was detected in the ALAS2 gene on the X chromosomes of all the patients in this family, which led to replacement or loss of 19-20 C?terminal residues through transcriptional frameshifting, and eventually caused an increase in ALAS2 activity. In the patients with XLDPP, skin photodamage was relatively severe;protoporphyrin?induced hepatobiliary damage was observed and aggravated with age;anemia and iron deficiency occurred sometimes. Conclusion The deletion mutation c.1706?1709ΔAGTG of the ALAS2 gene may be the underlying cause of XLDPP in this pedigree.

Objective To analyze the prognostic impact of Ikaros family zinc finger 1(IKZF1)mutation on adult Philadelphia chromosome (Ph1) positive acute lymphoblastic leukemia (ALL) patients.Methods IKZF1 mutation was detected in 63 adult Phi positive ALL patients at diagnosis using capillary electrophoresis.Recruited patients were treated in our center and other three hospitals in Ningbo from January 2014 to January 2017.Clinical data were collected and retrospectively analyzed.Results Thirty-nine (61.9％) patients were positive IKZF1 mutation in this cohort.The white blood cell (WBC) count in IKZF1 mutation group was significantly higher than that of mutation negative group [(64.6±11.3)× 109/L vs.(33.7±5.6)×109/L,P＜0.05].Patients with WBC count over 30×109/L accounted for 56.4％ in IKZF1 mutation group.Complete remission (CR) rate in the IKZF1 mutation group was also lower than that of negative group after induction chemotherapy (64.1％ vs.75.0％,P＞0.05).IKZF1 was a negative prognostic factor but not independent factor for survival by univariate and multivariate analyses.Patients were divided into chemotherapy and allogeneic transplantation groups.The 3-year overall survival (OS) rate and 3-year leukemia-free survival (LFS) rate in IKZF1 mutation group were significantly lower than those of negative group in both transplantation group (42.3％ vs.59.3％;31.2％ vs.50.0％;respectively,both P＜0.05) and chemotherapy group (24.8％ vs.40.0％;19.0％ vs.34.3％;respectively,both P＜0.05).Conclusion IKZF1 mutation is a poor prognostic factor for adult Ph1 positive ALL patients.

Objective:To observe the clinical characteristics and treatment prognosis of patients with ocular toxocariasis (OT).Methods:A retrospective clinical trial. From March 2018 to September 2021, 40 eyes of 40 OT patients diagnosed by ophthalmic examination in the First Affiliated Hospital of Zhengzhou University were included in the study. All patients underwent best corrected visual acuity (BCVA) and scanning laser ophthalmoscope (SLO) examination. Color Doppler ultrasound flow imaging (CDFI), fluorescein fundus angiography (FFA) and optical coherence tomography (OCT) were performed in 25, 26 and 26 eyes, respectively. Among the 40 patients, there were 23 males (57.5%, 23/40) and 17 females (42.5%, 17/40). All patients were monocular. Thirty patients (75.0%, 30/40) were younger than 18 years old, with the mean age of (9.60±0.60) years. Ten patients (25.0%, 10/40) were great than or equal to 18 years old, with the mean age of (34.60±4.52) years. Thirty-three patients (82.5%, 33/40) lived in rural areas for a long time. There were 27 patients (67.5%, 27/40) with a history of contact with dogs and cats. In 40 eyes, peripheral granuloma (peripheral type), posterior pole granuloma (posterior pole type), vitreous opacity similar to endophthalmitis (turbid type) and hybrid type were 18(45.0%, 18/40), 11(27.5%, 11/40), 6(15.0%, 6/40) ang 5(12.5%,5/40), respectively. All patients were treated with drugs and/or surgery after definite diagnosis. There were 28 eyes of peripheral type, posterior pole type and hybrid type, 17 eyes were treated with surgery and 11 eyes with drug treatment, respectively. Five eyes with turbid type were only treated with drugs. In 40 patients, 33 patients participated in follow-up. The follow-up time after treatment was (18.78±9.44) months. The improvement of BCVA was observed. The number of eyes with different BCVA before and after treatment was compared by χ2 test or Fisher's test. Results:At the first visit, the BCVA ranged from light perception to 0.6, including 20 eyes with BCVA <0.1, 13 eyes with BCVA 0.1-0.3, and 7 eyes with BCVA >0.3. The posterior vitreous anterior limiting membrane was thickened in 24 eyes (60.0%, 24/40). There were 27 eyes (67.5%, 27/40) with lamellar vitreous opacity and 22 eyes (55.0%, 22/40) with peripheral/posterior pole granulomas. Among 25 eyes examined by CDFI, 14 eyes (56.0%, 14/25) showed characteristic stratified or diffuse opacity in vitreous body. Of the 26 eyes examined by FFA, 15 eyes (57.7%, 15/26) had "fern-like" leakage of retinal capillaries, and the lesion had a patchy non-perfused area. In 26 eyes examined by OCT, epiretinal membrane, cystoid macular edema and vitreoretinal traction were 8 (30.8%, 8/26), 5 (19.2%, 5/26) and 2 (7.7%, 2/26) eyes, respectively. At the last follow-up, compared with before treatment, the BCVA of 5 eyes with turbid type increased, and the difference was statistically significant ( P<0.05). In 28 eyes with peripheral type, posterior pole type and hybrid type, 17 eyes with surgical treatment improved BCVA, and the difference was statistically significant ( χ2=6.258, P<0.05). In 11 eyes only treated with drugs, BCVA remained unchanged, and the difference was not statistically significant ( χ2=0.594, P>0.05). Conclusions:OT patients are mostly children; retinal granulomas, gray-white hyperplastic membrane behind lens or vitreous stratified opacity are specific characteristics. OT is mainly treated by glucocorticoid drugs and vitrectomy.