Congenital diaphragmatic hernia (CDH) is one of the most common congenital malformations and the most deadly types of congenital disease.Pulmonary hypertension (PH) and pulmonary hypoplasia are the most important causes of determining the prognosis of CDH.The prenatal evaluation indicators and management of PH is a difficult point and hot issue of present international study.This article reviewed the new progress of pathogenesis,prenatal evaluation predictor,clinical diagnosis and treatment of CDH complicated with PH.

A rat model of metabolic syndrome was induced by high glucose plus high fat diet and treated by tea polyphenols for 10 weeks.The results showed that the levels of fasting blood glucose,triglyceride,cholesterol,low-density lipoprotein cholesterol,and free fatty acid in tea polyphenols treatment group were significantly lower than those in control group(all P＜0.05),along with decreased TNF-α,IFN-γ,iNOS mRNA and protein expressions,and IL-1β protein expression in pancreatictissue (all P＜0.05).Under electron microscope,more secretory granules in islet beta cells and impoveddisorganization of cellular organ were shown in tea polyphenols treatment group compared with metabolic syndrome group.The results suggest that tea polyphenols are able to protect islet β cells against oxidative damage via inhibiting the production of inflammatory cytokines.

Objective To compare real -time tissue elastography (RTE)and ultrasound in the diagnosis of papillary thyroid carcinoma (PTC)with cervical lymph node (LN)metastasis.Methods A retrospective analysis was carried out on the clinical data of 72 patients with PTC.Eighty -four LNs of them were performed with ultrasound-guided fine -needle aspiration biopsy.Patients were divided into two groups:with cervical lymph node metastasis group and without cervical lymph node metastasis group.All patients were reviewed their B -mode ultrasonography (BUS)on cervical lymph node and RTE on thyroid.RTE elasticity indices (EI)of mean (Emean),minimum (Emin),maximum (Emax)and the ratio of Emean in LNs and surrounding muscle (Emean -m)were measured at the thyroids.The performances of RTE and BUS in predicting of PTC with LN metastasis were compared and ana-lyzed.Results The sensitivity and specificity of BUS on diagnosis of the cervical lymph nodes metastasis were 84.0% and 90.0%.The RTE Emea,Emax,Emin and SI in meta -static LNs were significantly higher than those in benign LNs(P =0.001,0.002,0.001,0.007).The RTE results of PTC patients with lymph node metastasis was ana-lyzed by ROC curve.The largest area was Emin.AUC was 0.918,the critical value was 0.240.AUC of SI was 0.896, AUC of Emean was 0.718,AUC of Emax was 0.670.The sensitivity and specificity were 94.0% and 99.4%,respec-tively.Conclusion Co -operation of RTE and BUS was more accurate than simple BUS in diagnosis of PTC with lymph node metastasis.SI and Emin has a high diagnostic value.

Adult ; Anesthesia, General ; Bronchoalveolar Lavage ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; surgery ; Ventilators, Mechanical

Objective To compare the internal fixation methods for treatment of intertrochanteric fractures in elderly patients.Methods One hundred and sixty four elderly patients with intertrochanteric fractures were treated from June 2006 to September 2011.The fractures were fixed with dynamic hip screws (DHS,n =42),locking proximal femur plate (LPFP,n =40),Gamma nails (n =36) or proximal femoral nail anti-rotation (PFNA,n =46),respectively.The clinical data were collected and the operative time,blood loss,time of clinical healing,postoperative complications and Harris hip scores of 6 months after surgery were compared among groups.Results All patients were followed-up for 6 to 36 months.The operative times of DHS,LPFP,Gamma nails and PFNA groups were (103 ± 15),(90 ± 13),(79 ± 11)and (65 ±9)min,respectively(F =2.87,P ＜0.05).The blood loss of 4 groups was (202 ±23),(181 ±23),(98 ± 13) and (87 ± 11) ml,respectively (F =3.21,P ＜ 0.05).The times of clinical fracture healing were (16.1±1.9),(14.6±1.8),(12.9±1.7) and (11.5±1.4) weeks,respectively(F=2.66,P＜0.05).The postoperative complications of 4 groups were 4/42,3/40,2/36 and 1/46,respectively (x2 =5.67,P ＜0.05).The Harris hip scores of 6 months after surgery of 4 groups were 81％ (34/42),85％ (34/40),89％ (32/36)and 93％ (43/46),respectively(H =20.03,P ＜0.05).Conclusions In treatment for intertrochanteric fractures in elderly patients,the efficacy of intramedullary fixation (Gamma nails and PFNA) is better than extramedullary fixation DHS and LPFP).PFNA is more effective than other 3 methods and should be preferentially chosen.

Objective To investigate contents of serum free fatty acid(FFA)in old patients with metabolic syndrome(MS)and to analyze its correlation with the components of MS.Methods Among 1 372 over 60-year-old people undergoing physical examination,169 patients with MS and 89 healthy subjects were selected as MS group and control group.The blood pressure,height,weight,waist circumference,and hip circumference were measured.Levels of fasting blood glucose,insulin,blood lipid,and serum FFA were measured.Waist-hip ratio(WHR),body mass index(BMI),and insulin resistance index(HOMA-IR)were calculated.Results The levels of waist circumference,WHR,BMI,fasting blood glucose and insulin,HOMA-IR,blood lipid,and serum FFA in MS group were significantly higher than those in control group.The levels of HDL-C were lower in MS group(P

Humans ; Neoplasms, Muscle Tissue ; congenital ; diagnosis

Objective To share our experiences on integrated services in providing fetal diagnosis and postnatal treatment for congenital diaphragmatic hernia(CDH).Methods A retrospective analysis was conducted on 25 pregnancies diagnosed as CDH by both prenatal ultrasound and MRI in Maternal and Children Hospital of Guangdong Province from January 2012 to January 2014.All of the subjects received integral medical management including prenatal management (prenatal diagnosis and consultation), perinatal management (prenatal care and delivery) and neonatal treatment.Results Among the 25 CDH fetuses, 11 were mild, nine were moderate, and five were severe.One severe case, who was diagnosed at 26 gestational weeks, was aborted on demand of the mother.The other 24 cases continued their pregnancy and all delivered after 35 weeks including 13 cesarean sections (one due to twin pregnancy and 12 due to maternal demand) and 11 vaginal birth.The mean gestational age when CDH was diagnosed was (24.5 ± 3.5) weeks, and the 24 women delivered at an average of (37.5 ± 1.4) gestational weeks.The eleven mild cases accepted mask oxygenation.For those 13 moderate or severe CDH cases, all received dexamethasone to promote fetal lung maturity at 32 gestational weeks, seven were intubated before clamp the cord, and the other six did after.These 13 babies accepted high-frequency oscillation ventilation, with a median duration of 58 hours, and some of them treated with inhaled nitric oxide on requirement with a median duration of 52 hours.Except two cases died before operation, the rest 22 cases underwent neonatal surgery.One moderate case died at 48 hours after surgery due to pulmonary hypertension and respiratory failure.Another one severe case withdrew treatment at two months old.The other 20 infants recovered fully.Conclusions Integrated management including prenatal diagnosis and postnatal treatment, provides an effective and streamlined mode for diagnosis and treatment of CDH.Therefore,it might minimize potential medical risks.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common clinical disease that seriously threatens human health and life. Accurate location of the upper airway obstruction is the key to the diagnosis and treatment of OSAHS. Acoustic pharyngometry uses sound reflection to quickly assess the cross-sectional area and volume of the upper airway. Acoustic pharyngometry represents a simple, quick, non-invasive method for measuring upper airway dimensions which could predict sleep apnea risk. In this article we sought to introduce the application of acoustic pharyngometry in the diagnosis and treatment of OSAHS.
Acoustics ; Humans ; Larynx ; Pharynx ; diagnostic imaging ; Sleep Apnea, Obstructive ; diagnosis ; therapy ; Syndrome

Objective To identify the polyreactivity of a monoclonal natural anti-keratin autoantibody 3B4 and to analyze its possible molecular me chanism.Methods enzyme-linked immunosorbent assay (ELISA)and immunohistoche mistry were applied to test the binding reactivity of 3B4 against different anti gens and tissues.The variable region genes and their amino acid composition wer e sequenced.Results 3B4 could reacted with a range of antigens and tissues,i n addition to keratin and skin.The variable region genes of its light chain and heavy chain showed high homology with germline genes VK1 am4 and VH1 J558.42.H CDR3 region,which mainly composed of short side chain amino acids(from 294 to 324 nucleotides around the heavy chain),was the only motif that differs from ot her highly homologous immunoglobulin genes.Conclusions The monoclonal natural anti-keratin autoantibody 3B4,with its variable region genes highly homologo us to germline genes,is highly polyreactive.The flexibility of HCDR3 may contr ibute to the polyreactivity.