Objective To explore the impact of Toxoplasma gondii infection on pregnancy outcomes in early pregnancy wom-en. Methods Toxoplasma gondii IgM and IgG antibodies in the peripheral blood of 2 993 early pregnant women were detected by using enzyme-linked immunosorbent assay(ELISA). According to the test results,the infected ones were divided into an acute in-fection group,a previous infection group,and an active infection group,and 200 pregnant women without Toxoplasma infection were randomly chosen as a control group,and the pregnancy outcomes of the four groups were followed up and the results were compared. Results There were 286 women infected with Toxoplasma gondii,with the infection rate of 9.56%(286/2 993),in which 43 cases were diagnosed as acute infection,156 were previous cases,and the other 87 were active infection ones. The inci-dences of adverse pregnancy outcomes in the above 3 groups and the control group were 13.95%(6/43),1.92%(3/156),5.75%(5/87)and 1.50%(3/200),respectively. The incidences of adverse pregnancy outcomes in the acute infection group and active in-fection group were both higher than that in the control group,the differences were statistically significant(both P<0.05),while there was no significant difference between the previous infection group and control group(P>0.05). Conclusion Acute and ac-tive Toxoplasma gondii infections are closely associated with the occurrence of adverse pregnancy outcomes in early pregnant wom-en;therefore,Toxoplasma gondii IgM antibody should be included in the routine inspection items of the pre-pregnancy physical examination for child-bearing age women.

Objective To investigate the clinical efficac y of internal fixation with Titanium Alloy(TIA)reconstruction plate in treatment o f clavicular midpiece fracture.Methods 37cases of clavicular midpiece frac-ture underwent open reduction and in ternal fixation with TIA.All the 37c ases were followed up and their clini cal efficacy were analyzed.Results All the clavicle fractures achieved clinical union and satisfactory fun ctional re-covery.Conclusion Open reduction and internal fixatio n with TIA reconstruction plate is on e of the best choices for clavicular midpiece fractures,for it can free the patients from distress of reoperation.[

Objective To discuss the test efficiency of three methods for detecting Toxoplasma IgG antibody. Methods To-tally 304 specimens were detected parallelly for Toxoplasma IgG antibody by using the gold marked method,indirect hemagglutina-tion test(IHA),and enzyme-linked immunosorbent assay(ELISA),and the sensitivity,specificity and Youden index of these methods were compared. Results The detection sensitivities of gold marked method,IHA,and ELISA for Toxoplasma IgG anti-body were 85.5%,89.8%and 91.9%respectively(χ2=4.12,P>0.05);the specificities were 92.4%,96.6%and 97.5%respec-tively(χ2=4.06,P>0.05). The detection efficiency and Youden index of ELISA were 94.1%and 0.89 respectively,being high-er than those of IHA and gold marked method. Conclusion The sensitivity and specificity of the ELISA method for Toxoplasma IgG antibody are higher,and in addition,it can be automated. Therefore,it is suitable for large-scale Toxoplasma IgG antibody screening.

Objective To evaluate percutaneous injection of hemostatic agents under the guidance of contrast-enhanced sonography(CEUS) in controlling hemorrhage from severe splenic trauma. Methods Eight patients with splenic traumas of grade Ⅲ, Ⅳ were consecutively enrolled in this study. Percutaneous injection of hemocoagulase atrox and α-cyanoacrylate was performed by CEUS-guidance in all patients. Ultrasound examination was performed at 1,3,7 and 14 days after focal injection. Vital signs and hemoglobin (Hb) level were recorded. Results After the injection,immediate CEUS demonstrated that active bleeding from the injury sites disappeared. From 30 minutes after the injection arterial blood pressure began to ascend ( P <0. 05), and heart rate decreased to the normal level after the treatment ( P <0.05). Hb decreased at first and then gradually increased to the normal level. Conclusions Pereutaneous injection of hemoeoagulase atrox and α-cyanoacrylate under the guidance of CEUS can effectively control bleeding from a severe splenic trauma. CEUS can be helpful to the diagnosis of the suspected splenic trauma and to ensure hemostatic materials to be injected exactly into injury sites.

Objective To investigate the diagnostic value of prenatal ultrasound for fetal structural abnormalities.Methods The clinical data of 3 101 fetus with structural malformations, diagnosed by prenatal ultrasound and confi rmed after induced labor, and 856 cases of missed diagnosis were analyzed. All these data were collected in Maternal and Child Health Hospital of Tangshan City from January 2010 to June 2014. The types and number of fetal structural abnormalities were recorded. The rates of detection and missed diagnosis for the fetal structural abnormalities were calculated and the reasons for missed diagnosis were analyzed.ResultsA total of 3101 cases (4 171 positions) were diagnosed as fetal structural abnormalities by prenatal ultrasound. The detection rate was 11.51‰ (3 101/269 501). There were 856 cases (947 positions) of fetal structural abnormalities were missed, and the missed diagnosis rate was 3.18‰ (856/269 501). The incidence of fetal structural abmormalities was 14.68‰ (3 957/269 501). In terms of anatomy systems, the top five were cardiovascular system abnormalities (851 cases), the central nervous system abnormalities (691 cases), facial abnormalities (562 cases), urinary system abnormalities (476 cases), and respiratory system abnormalities (134 cases). In terms of single abnormalities, the top five were cleft lip and palate (549 cases), ventricular septal defect (519 cases), hydronephrosis (331 cases), spina bifi da (212 cases), and atrial-ventricular septal defect (163 cases). The top five of missed deformities were polydactylia/symphysodactylia (285 cases), ear deformities (108 cases), hypospadias (93 cases), foot abnormalities (92cases), and ventricular septal defect (52 cases).Conclusions There is a high detection rate for fetal structural abnormalities with prenatal ultrasound. Prenatal ultrasound is an indispensable means for the diagnosis of fetal malformation, but it also has some limitations. There is a high rate of missed diagnosis for polydactylia/symphysodactylia, microtia, and hypospadias.

OBJECTIVE:To provide reference for strengthening drug regulation in drug administration department. METH-ODS:Drug regulatory statistical yearbooks during 2011-2015 were collected. Literature analysis,content analysis,comparative analysis and secondary analysis were conducted to analyze and explore the drug production license,business license,advertising ap-proval,protection of TCM varieties,drug complaints,investigation and punishment of drug cases,etc. in statistical yearbook. RE-SULTS & CONCLUSIONS:The number of drug manufacturers and operating enterprises had been increasing year by year,while the retail chain stores in certified enterprises showed tendency to go beyond the single retail pharmacy. Compared with the down-ward trend of number of approved drug advertisements,the number of protected varieties of TCM decreased more obviously. The increase in number of drug complaints did not cause the number of investigated and punished drug cases at the same time,which showed a downward trend. It is suggested to further improve the quality and efficiency of drug regulatory work in China by strict drug production license approval,reforming drug advertising regulation and TCM varieties protection system,intensifying efforts to investigate and punish drug complaints and cases,and playing the supervision of public opinion role of the media and the masses.

Objective:To observe the feasibility of magnetic resonance (MR)-guided stereotactic body radiotherapy (SBRT) for non-small cell lung cancer, and analyze the dosimetric differences in the presence or absence of magnetic field.Methods:Three patients with non-small cell lung cancer were prospectively treated with MR-guided linac (MR linac) for SBRT, and the dose was calculated with or without magnetic field models. The differences of dose distribution with or without magnetic field models were compared. At the same time, the target coverage, plan pass rate and treatment time were described, and the complexity of the conventional accelerator backup plan and the magnetic field model were compared.Results:The treatment time of 3 patients was (36.67±6.11) min, and the average time of online adaptive planning was (14.4±1.7) min, which was basically tolerated by patients. The treatment plan pass rate (3%/3 mm) was 98.9%, the Gamma pass rate (3%/3 mm) of the online plan during treatment was 98.5% and the target coverage was 99.1%, which met the clinical needs. The dose in the low dose area of the lung was slightly lower than that in the case without magnetic field, whereas the dose in ribs and skin was slightly higher than that in the plan without magnetic field. The number of machine unit (MU) for online adaptive plan was slightly higher than that of the reference plan, and the number of MU for the conventional accelerator standby treatment plan was significantly lower than that of the MR linac plan under the same target coverage. The follow-up results showed that there was no adverse reaction, and the short-term efficacy was partially relieved.Conclusions:In the case of considering the influence of magnetic field, the treatment plan meeting the clinical needs can be obtained. It is proven that SBRT radiotherapy for lung cancer guided by magnetic resonance accelerator is feasible, whereas the treatment time and process are complex.

Objective To investigate the methods and internal quality control ( IQC ) leucorrhea routine examinationin clinical laboratories of medical institutions in Guizhou Province.Methods In 2009, 97 clinical laboratories were randomly selected for the first investigation.At the same time, staffs in theinvestigated laboratories were educated on the importance of IQC.The second investigation of the same items was carried out in 2011 inthe same laboratories.The results of the two investigations were analyzed byChi-square test.Results 2009 and 2011 numbers of laboratories thoseonly used normal saline suspension method for leucorrhea examination were 17and 16 (χ2 =0.037, P >0.05 ) respectively, used bothnormal saline and 10%KOH suspension methodswere 16and 2(χ2 =12.003,P<0.01), used staining method were 64and 79(χ2 =5.488,P<0.05), both used suspension and staining methods were 60and 73(χ2 =4.041, P<0.05), used normal salinesuspension method combined with Wright stain and Gram staining methods were3and 28(χ2 =23.996,P<0.01) respectively.Numbers of Laboratoriespracticing IQC were 2and 88in 2009 and 2011 respectivly(χ2 =153.293,P <0.01).Conclusions Currently, the most common used method for leucorrhea routine examination is suspension.Through the investigations and education, the quality ofleucorrhea routine examination was improved in Guizhou Province.

Objective To report our first clinical experience with a novel modified culotte technique for the treatment of true coronary bifurcation lesions. Methods The novel modified culotte technique (the mono-ring culotte) stenting was done in which the side branch (SB) stent was deployed firstly followed by ex vivo wiring of a most proximal cell of SB stent with the hard end of main branch (MB) wire. Secondly, the MB stent was deployed through the most proximal cell of SB stent. The procedure was ended with kissing balloon dilation. From June 2014 to March 2015, 15 patients with true coronary bifurcation lesion were treated with mono-ring culotte stenting in our center. Results The procedures were successful in all cases without procedural complication and in-hospital major adverse cardiovascular events. The procedural time was (34. 3 ± 9. 6) min, fluoroscopic time was (18. 1 ± 3. 8) min, and contrast volume was (112. 0 ± 24. 5) ml, respectively. Post-procedurally, the residual stenosis of the main and the side branch were (10. 0 ± 2. 5)% and (10. 2 ± 5. 3)% , respectively. Conclusions The mono-ring culotte stenting is safe and feasible for treatment of true coronary bifurcation lesions, and may be superior to the conventional culotte stenting.

Objective To explore the curative effect and influencing factors of percutaneous radiofrequency ablation(PRFA)for benign thyroid nodules in order to improve the effect of thyroid benign nodule ablation treatment.Methods The study included 482 benign thyroid nodules.The largest diameter of benign thyroid nodules ranges from 0.7 to 9.2 cm.Two hundred and fifty-eight nodules were solid nodules,224 nodules were cystic-solid nodules,and 96 thyroid nodules combined with the background of Hashimoto's thyroiditis.The patients of this study included 356 females and 126 males,the ages of the study population ranged from 14 to 82 years old.In order to observe the local pain,swelling,skin infection,hoarseness and other complications of the thyroid nodules with PRFA,we conducted conventional ultrasound and contrast-enhanced ultrasound immediately and followed up in 1,3,6,12,18 and 24 months after the treatment.Besides,the nodule volume reduction ratio was calculated,and the effects of gender,age,nodule size,cystic proportion,and the background of Hashimoto's thyroiditis on the treatment were analyzed.Results The volume of benign thyroid nodules after the PRFA treatment was significantly reduced after 1,3,6,12,18,24 months,and their nodule volume reduction ratio(VRR)was(51.2±5.7)%(1 months),(69.7±4.3)%(3 months),(84.6±3.7)%(6 months),(89.3±2.9)%(12 months),(93.7±1.6)%(18 months)and(94.9±1.4)%(24 months),respectively.The thyroid nodules were divided into 3 groups according to the cystic portion,significant differences were found in the volume reduction rate at 1,3,6,12,18 and 24 months after PRFA(F=66.858,69.101,19.410,49.559,146.653 and 309.950 respectively,all P＜0.001),the more cystic portion was,the faster the lesion shrinked.The nodules with the cystic portion ＜ 20%were grouped according to the maximum diameter(≤3 cm/＞3 cm),and the background of Hashimoto's disease; and significant differences were found in the volume reduction rate at 1,3,6,12,18 and 24 months after PRFA(the t values for different size groups were 9.710,8.925,9.899,12.734,17.226 and 42.580,respectively,the t values for whether there is a background of Hashimoto's disease were 66.858,69.101,19.410,49.559,146.653,309.950,respectively,all P ＜ 0.001).The VRR of nodules of which the maximum diameter ≤ 3 cm,or without Hashimoto's thyroiditis was larger after radiofrequency ablation.The nodules of which the maximum diameter≤3 cm and with the cystic portion ＜20%were grouped according to different genders(male or female)and different ages(≤40 or＞40 years old),and the mean VRR of the nodules between different gender and age groups are not significantly different(P＞0.05).Conclusions Ultrasound guided PRFA is a safe and effective minimally invasive therapy for benign thyroid nodules.