Objective To investigate the value of prenatal ultrasound in diagnosis and treatment of twin reverse arterial perfusion (TRAP) syndrome. Methods A retrospective study was performed in 5 TRAP cases, including ultrasound images, clinical data and pregnancy outcomes. The sonographic characteristics were summarized. Results Five TRAP cases were diagnosed during 13 to 28 weeks' gestation and confirmed after birth. Color Doppler unltrasonography revealed retrograde umbilical artery perfusion towards acardiac twin. Two of 5 cases ended up in induced abortion, 1 in spontaneous abortion, 1 was delivered at 37 weeks' gestation after ultrasound-guided feticide of the acardiac twin and 1 was monitored closely with ultrasound and delivered alive at 32~(+4) weeks' gestation. Conclusion Prenatal ultrasonography has great applicative value for TRAP syndrome in early diagnosis, choosing optimal treatment and prognosis assessment.

Objective To investigate the testing capabilities of clinical transfusion laboratories in medical institutions in Beijing for the regulatory authorities to formulate administrative policies in this regard.Methods Experts assigned by Beijing Clinical Transfusion Quality Control Center made on-site inspections at the transfusion laboratories in medical institutions using quality control products.They recorded the complete testing process of the operators as well as the instruments,detection reagents in use and the testing results,with statistics and analysis made to the data so collected.Results The pass rate of these on-site inspections was lower than that of the external quality assessment.Some laboratories failed to complete the testing of the quality control products in time and the actual operations in some laboratories were inconsistent to the guidelines.55.9％ of level Ⅰ hospitals and 25.6％ of level Ⅱ hospitals were found with insufficient and inadequate instruments and process layout to meet the needs of clinical blood transfusion.Some of the technicians were found without sufficient trainings in their professional knowledge and basic skills,resulting in their poor competence against emergency cases and weakness in independent problem solving.In addition,the records of detection process and results were found to be substandard.Conclusions Transfusion laboratories in Beijing need to improve their testing capabilities in general.

In recent years, with being gradually developed, three-dimensional (3D) reconstruction based on pathology and medical imaging technology has shown certain value in the diagnosis and treatment of breast cancer. And with its advantages of providing the spatial location, morphological structure and 3D structure relationships with the surrounding tissues and organs, 3D reconstruction technology has played a key role in the early diagnosis, surgical treatment, and accurate evaluation of the treatment effect after surgery of breast cancer. Although the application of 3D reconstruction technology based on pathology and medical imaging is still inadequate, with the continuous development of science and technology, 3D reconstruction technology will play an increasingly important role in the diagnosis, personalized treatment and prognosis assessment of breast cancer.

Objective To evaluate the effects of compound glycyrrhizin on the percentage of Th17 cells and expression of interleukin(IL)-17A in peripheral blood of patients with psoriasis vulgaris, and to explore their relationship with therapeutic effects. Methods A total of 30 patients with mild to moderate progressive psoriasis vulgaris were randomly and equally divided into two groups:group 1 treated with compound glycyrrhizin injection, antihistamines and topical drugs, group 2 treated with antihistamines and topical drugs. Twelve healthy human subjects served as the control group. Blood samples were collected from the patients 1 day before start of treatment and after 3 weeks of treatment, and from the control group. Flow cytometry and enzyme-linked immunosorbent assay (ELISA)were performed to determine the percentage of Th17 cells and expression level of IL-17A respectively in the peripheral blood samples. Results Before the treatment, the percentage of Th17 cells and expression level of IL-17A were both significantly higher in the two patient groups than in the control group (all P<0.05). After the treatment, group 1 showed significant decreases in the percentage of Th17 cells and expression level of IL-17A compared with those before the treatment (both P<0.05), while no significant differences were observed in group 2 between pre-and posttreatment IL-17A expression level or Th17 cell percentage (both P>0.05). Furthermore, both Th17 cell percentage and IL-17A expression were significantly different between the two patient groups after the treatment (both P< 0.05). Conclusion Compound glycyrrhizin may treat psoriasis vulgaris by regulating Th17 cell percentage and IL-17A expression in peripheral blood.

The dynamic changes of immunoreactive dynorphin1-13 (ir-Dyn1-13) contents in 18 burned patients were studied by radioimmunoassay. It was found that ir-Dyn began to increase gradually at the onset of burn and remained at a relatively high levels by the time of preliminary wound healing. Plasma ir-Dyn increased gradually after bum and decreased abruptly before death in one severely burned patient who died of respiratory failure at the third week. The results suggest that Dyn may have a protective effect on the burned patients.

Objective To explore the relationship between ileocolonic lesions and perianal fistulas of Crohn's disease as sessed by CT enterography (CTE).Methods Totally 28 patients with initial diagnosis of active ileocolonic lesions of Crohn 's disease were collected,16 with perianal fistula and 11 without perianal fistulas.All patients underwent CTE and pelvic MRI.Total number of lesions,minimum length between every two lesions in colon wall and maximum length of colonic le sions were calculated.The rank sum test was performed respectively.Results Lesions of 14 patients (14/16,87.50％) in perianal fistulas group located in left colon or rectum,while lesions of 6 patients (6/12,50.00 ％) in non-perianal fistulas group located in left colon or rectum,the difference was statistically significant (Z=-2.135,P＜0.05).The mean number of lesions in patients with perianal fistulas was 3.06,while in patients without perianal fistulas was 2.91,there was no statistical difference (P＞0.05).The maximum length of colonic lesions in patients with perianal fistulas was (12.79± 8.30)cm,while in patients without perianal fistulas was (7.04± 3.09)cm,and there was no statistical difference(P＞ 0.05).The minimum length hetween every two lesions in patients with perianal fistulas was (5.23±2.98)cm,while in pa tients without perianal fistulas was (8.44 ± 2.87) cm,the difference was statistically significant (Z =-2.095,P＜ 0.05).Conclusion Crohn's disease complicated with perianal fistulas has relationship with lesion location and smaller length intervals between two lesions in colon wall,and has no relationship with total number of lesions and maximum length of colon lesions.

Objective To analyze retrospectively the impact of different heart rates on image quality and radiation dose of coronary angiography using 640-slice dynamic volume CT.Methods A total of 461 patients with suspected coronary artery disease or referred to health check underwent coronary angiography with 640-slice dynamic volume CT.Two groups were created according to their heart rates:Group A had heart rate < 65 beats per minute (n=337)and Group B had heart rate between 65 to 122 beats per minute (n=124).Image quality was assessed by analyzing the 1 5 segments of the main coronary branches using 3-grade scale (grade I-good,grade Ⅱ-acceptable,grade Ⅲ-poor).Effective radiation dose was also evaluated.Results Patients in both A group and B group performed successful CT coronary angiography with a total of 6 91 5 coronary segments.Among them,coronary segments that could be evaluated reliably accounted for 94.5% (6 535/6 91 5)while 5.5% (380/6 91 5)were too small (≤1.5 mm)to be assessed. For the image quality,Group A and Group B had grade I in 90.5% (305/337)vs 74.2% (92 /124),grade Ⅱ in 9.5% (32/337)vs 21.0% (26 / 124)and grade Ⅲ in 0 % (0 / 337 )vs 4.8% (6 / 124),respectively.Image quality was significantly different be-tween Group A and Group B (P <0.001).In addition,32 patients (9.5%)in Group A had slight cardiac motion artifacts but with-out affecting image quality,whereas 26 patients (21.0%)in Group B had higher degree of cardiac motion artifacts thus graded as grade Ⅱ.Stair-step artifacts were not found in all patients.The effective radiation dose was higher in Group B than in Group A by 32.05%(7.91±0.34 mSv vs 5.99±0.17 mSv).Conclusion Coronary angiography using 640-slice dynamic volume CT can guarantee excellent image quality when heart rate < 65 beats per minute.Although the image quality would decrease in some extent it is still diagnostic when heart rate is between 65 to 122(include 65 and 122)beats per minute.

Objective To investigate the effect of depression symptoms on surgical outcome of posterior decompression among cervical spondylotic myelopathy (CSM) patients. Methods Between October 2006 and October 2011 in our hospital, lami?nectomy or laminoplasty was performed in 396 cases that were enrolled in the study. There were 132 males and 264 females with an average age of 60.2 years(ranged,39-84 years). All patients were divided into depression group and non?depressed group by the 21?item Beck Depression Inventory (BDI). There were no statistically significant differences between groups in age, sex, smok?ing status, duration of symptoms, and employment status (whether in the current working). The Japanese Orthopedic Association (JOA) scores, Neck disability index (NDI) and visual analogue scale (VAS) were compared after 1.5 months postoperatively. Re?sults All of 396 cases were followed up. The mean follow up duration was 32 months (range,24-50 months). There were no statistically significant differences in the CCI decline (7.1%±2.1% versus 6.8%±1.5%), expansion degree[(130.9±7.0) mm2 versus (150.8 ± 5.2) mm2] and the drift?back distance of the spinal cord [(5.7 ± 1.2) mm versus (6.2 ± 0.8) mm]. However, pa?tients with continuous depression showed poorer improvement than non?depressed patients in the surgery outcome: JOA im?proved (1.42±0.56 versus 6.76±3.12); NDI declined (7.31±2.18 versus 21.11±11.36); and VAS lightened (16.08±19.76 versus 23.85±20.79). Conclusion Depression contributed a dissatisfied surgery outcome after posterior decompression on functional re?covery, disability index and pain scores among patients of the cervical spondylotic myelopathy.

OBJECTIVETo observe the effect of N-acetylcysteine (NAC) on intestine injury induced by cardiopulmonary bypass (CPB) in rats.

METHODSThirty-two rats were randomly divided into sham-operated group, NAC control group, CPB model group, and CPB plus NAC treatment group (n=8). In the latter two groups, the rats were subjected to CPB for 1 h. The rats received intraperitoneal injections of normal saline or NAC (0.5 g/kg) as appropriate for 3 successive days prior to CPB, and those in CPB plus NAC group were given NAC (100 mg/kg) in CPB prime followed by infusion at 20 mgsol;(kg·h) until the cessation of CPB. Intestinal and blood samples were collected 2 h after CPB for pathological analysis and measurement of intestinal concentrations of malondialdehyde (MDA), tumor necrosis factor (TNF)-α, interlukin (IL)-6 and activity of superoxide dismutase (SOD), glutathione (GSH), and glutathione peroxidase (GSH-Px) and serum levels of diamine oxidase (DAO).

RESULTSEvident oxidative stress and pathological damages of the intestines were observed in rats after CPB. NAC treatment obviously alleviated intestinal damages induced by CPB, decreased the levels of intestinal MDA, TNF-α, IL-6 and serum DAO and increased activity of SOD, GSH, and GSH-Px in the intestines.

CONCLUSIONPerioperative NAC treatment can alleviate intestinal injury induced by CPB in rats by suppressing oxidative stress and inflammatory response.

Acetylcysteine ; pharmacology ; Animals ; Cardiopulmonary Bypass ; adverse effects ; Glutathione ; metabolism ; Glutathione Peroxidase ; metabolism ; Inflammation ; drug therapy ; Interleukin-6 ; metabolism ; Intestines ; drug effects ; physiopathology ; Malondialdehyde ; metabolism ; Oxidative Stress ; drug effects ; Rats ; Superoxide Dismutase ; metabolism ; Tumor Necrosis Factor-alpha

Objective To evaluate the efficacy and safety of prostatic arterial embolization (PAE) and transurethral resection of prostate (TURP) in treatment of benign prostatic hyperplasia (BPH).Methods Totally 40 patients with BPH from Jan 2016 to Oct 2016 were selected.All patients were divided into PAE (n=20) and TURP (n=20) group by random number table method.The curative effect indexes (international prostate symptom score [IPSS],quality of life score [QOL],prostate volume [PV],postvoid residual [PVR],maximum urinary flow rate [Qmax] and prostate-specific antigen [PSA]),the complications and side effects,as well as the incidence of sexual dysfunction were analyzed and compared between the two groups.Results No statistical difference of IPSS,QOL,PV,PVR,Qmax nor PSA was found between the two groups before operation (all P＞0.05).IPSS,QOL,PV,PVR and PSA were significantly lower than those before operation 3,6 and 12 months after operation (all P＜0.05),while Qmax was obviously higher than that before operation (P＜0.05).Three months after operation,the curative effect indexes were statistically different between the two groups (all P＜0.05),while no statistical difference was found 6 and 12 months after operation (P＞0.05).The incidence of postoperative complications in TURP group was higher than that in PAE group (x2 =4.329,P=0.037).There was no statistical difference in the incidence of sexual dysfunction between the two groups (x2=2.105,P=0.147).Conclusion PAE and TURP can significantly alleviate clinical symptoms of patients with BPH.Three months after operation,the efficacy of TURP is better than PAE,but PAE is more minimally invasive and has fewer complications.