Objective:To compare the pregnancy outcomes of surviving fetuses in monochorionic diam-niotic(MCDA)twin pregnancies after selective feticide or spontaneous single intrauterine fetal demise(sIUFD),and to explore the influencing factors of prognosis.Methods:A total of 219 cases of intra-uterine death of one fetus in MCDA twin pregnancies admitted to Peking University Third Hospital from September 2010 to August 2021 were collected.According to the mode of fetal death,they were divided into the spontaneous sIUFD group(120 cases)and the selective feticide group(99 cases).Data on the maternal conditions during pregnancy,the situation of the intrauterine-dead fetus,and pregnancy out-comes were collected for retrospective case-analysis.Results:The live-birth rates of surviving fetuses in the spontaneous sIUFD group and the selective feticide group were 85.0％and 81.8％respectively,and the total perinatal survival rates of surviving fetuses were 73.3％and 81.8％respectively,and there were no statistically significant differences.Compared with the spontaneous sIUFD group,the selective feticide group had a greater gestational week at delivery,and lower rate of preterm birth before 37 weeks,neonatal asphyxia,and early neonatal mortality.Using the gestational week at delivery as the outcome variable,Cox regression analysis showed that the mode of fetal death was not a risk factor affecting the gestational week at delivery of the surviving fetus,while gestational hypertension and the gestational week of fetal death were independent risk factors affecting the gestational week at delivery of the surviving fetus.Using preterm birth before 37 weeks,intrauterine death of the surviving fetus,and abnormal neonatal cranial ultrasound as outcome variables respectively,unconditional logistic regression analysis showed that the mode of fetal death,the gestational week of fetal death,the position of the dead fetus,and fetal complications were independent risk factors affecting the outcomes of the above-mentioned survi-ving fetuses.According to the results of the univariate analysis,the above risk factors were included in the multivariate regression analysis,and the results were the same as those of the univariate analysis.Conclusion:For MCDA twin pregnancy patients with severe twin-related complications,the prognosis of surviving fetuses after selective feticide is better.The proactive intrauterine intervention and treatment are of great significance for improving the prognosis of surviving fetuses.

Objective:To compare the pregnancy outcomes of surviving fetuses in monochorionic diam-niotic(MCDA)twin pregnancies after selective feticide or spontaneous single intrauterine fetal demise(sIUFD),and to explore the influencing factors of prognosis.Methods:A total of 219 cases of intra-uterine death of one fetus in MCDA twin pregnancies admitted to Peking University Third Hospital from September 2010 to August 2021 were collected.According to the mode of fetal death,they were divided into the spontaneous sIUFD group(120 cases)and the selective feticide group(99 cases).Data on the maternal conditions during pregnancy,the situation of the intrauterine-dead fetus,and pregnancy out-comes were collected for retrospective case-analysis.Results:The live-birth rates of surviving fetuses in the spontaneous sIUFD group and the selective feticide group were 85.0％and 81.8％respectively,and the total perinatal survival rates of surviving fetuses were 73.3％and 81.8％respectively,and there were no statistically significant differences.Compared with the spontaneous sIUFD group,the selective feticide group had a greater gestational week at delivery,and lower rate of preterm birth before 37 weeks,neonatal asphyxia,and early neonatal mortality.Using the gestational week at delivery as the outcome variable,Cox regression analysis showed that the mode of fetal death was not a risk factor affecting the gestational week at delivery of the surviving fetus,while gestational hypertension and the gestational week of fetal death were independent risk factors affecting the gestational week at delivery of the surviving fetus.Using preterm birth before 37 weeks,intrauterine death of the surviving fetus,and abnormal neonatal cranial ultrasound as outcome variables respectively,unconditional logistic regression analysis showed that the mode of fetal death,the gestational week of fetal death,the position of the dead fetus,and fetal complications were independent risk factors affecting the outcomes of the above-mentioned survi-ving fetuses.According to the results of the univariate analysis,the above risk factors were included in the multivariate regression analysis,and the results were the same as those of the univariate analysis.Conclusion:For MCDA twin pregnancy patients with severe twin-related complications,the prognosis of surviving fetuses after selective feticide is better.The proactive intrauterine intervention and treatment are of great significance for improving the prognosis of surviving fetuses.

We reported a case of preeclampsia complicated by acute stress cardiomyopathy following cesarean section at 37 weeks of gestation. The patient presented with chest tightness and suffocation two days after the operation and was considered as acute stress cardiomyopathy. The patient recovered and was discharged nine days after the surgery after a series of management, including non-invasive ventilation, vasodilation, lowing blood pressure, maintaining a negative fluid balance, anti-infection, and anticoagulation. Stress-induced cardiomyopathy during pregnancy and postpartum is rare, and cesarean section and preeclampsia may be the risk factors.

Objective To analyze the clinical features, diagnosis and treatment of the primary omental torsion (POT).Method The clinical data of 12 patients with POT admitted to our hospital from May 2010 to May 2015 were retrospectively reviewed.The clinical manifestations, laboratory investigation, medical image, treatment and outcomes of patients were analyzed.Results Twelve cases were all males with median age of 50.The POT was diagnosed during surgical exploration and confirmed pathologically after operation.Right abdominal pain was the main complaint in 11 cases, and pain migration to right lower quadrant in 1 case.In physical examination, the local peritonitis signs were elicited, including right quadrant tenderness and rebound tenderness at same location.All cases had mal temperature except one presenting low fever of 37.5 ℃.White blood cell counts was 12×109/L in one case, and(4-10)109/L in other 11 cases.Abdominal solid mass was found in one case by ultrasonic scan, measured 7 cm×5 cm with unclear surrounding boundary.Mesenteric fat opacity and dropsy were shown in 10 cases on CT plain scan, while thickness and effusion of hepatic flexure of colon was found in one case;however, none of them were suggested as POT by these two image study before operation.All patients were gnosed as localized peritonitis or appendicitis clinically before emergent surgical exploration.The necrotic omentum was resected and all patients recovered smoothly.There were no complications in all cases during one-year follow-up.The CT images were reviewed after operation, which indicated that the mesentery of dropsy and the thickened hepatic flexure of colon should be the imaging signs of omental torsion;and also 9 of 12 cases had whirlpools sign.Conclusion The preoperative diagnosis of POT is difficulty, the typical whirlpools sign of abdominal mass on CT imaging is of highly value in diagnosis.The surgical removal of omental infarction is effective and the prognosis is good.

Humans ; Sarcoma ; diagnosis ; Skin Neoplasms ; diagnosis

Objective To investigate the prevalence of gout and its associated factors in populations in Beijing. Methods A cross-sectional study of gout was carried out in state-employees who had yearly health examination at Peking Union Medical College Hospital in Beijing,China from September to December 2005. The prevalence of gout was calculated in the population. Data were further analyzed by multivariate logistic regression models to find associated factors of gout. Results The prevalence of gout in the population was 1.0%,and were 1.5% and 0.3% for men and women respectively. Bivariate and multivariate logistic regression analysis found that male gender (OR 15.07,95%CI 1.79～127.19),hard liquor (OR 4.93,95%CI 1.41～17.31 for ≥7 beverages per week),diuretics (OR 6.72,95%CI 2.34～19.34),waist obesity (OR 4.38,95%CI 1.33～14.43),and hypercholesterolemia (OR 3.63,95%CI 1.23～10.67 for serum cholesterol 5.17～6.21mmol/L) were associated with increased prevalence of gout,whereas products of bean curd (OR 0.21,95%CI 0.07～0.59) were associated with reduced prevalence of gout. Conclusion Male gender,hard liquor,diuretics,waist obesity and hyperchol-esterolemia may be associated with the increased risk of gout,whereas products of bean curd may be associated with the reduced risk of gout.