Objective To explore the value of transvaginal ultrasound five-view method for diagnosing fetal congenital heart disease(CHD)in early pregnancy of high-risk pregnancy.Methods Totally 428 singleton fetuses at 11-13+6 weeks of gestation in high-risk pregnancies were prospectively enrolled.Fetal cardiac examinations were performed using two-dimensional grey scale imaging combined with CDFI via transabdominal ultrasound method,transvaginal ultrasound five-view method(upper abdominal transverse view,four-chamber view,three-vessel and trachea[3VT]view,ventricular outflow tract view and bilateral subclavian artery view)and transvaginal ultrasound two-view method(four-chamber view and 3VT view).Taken results of pregnant metaphase or late pregnancy fetal echocardiography,post-abortion pathology or postnatal neonatal echocardiography as gold standards,the diagnostic performances of the above 3 methods for diagnosing fetal CHD in early pregnancy were compared.Results CHD was diagnosed in 120(120/428,28.04％)fetuses.Transvaginal ultrasound five-view method made 11 false positives and 19 false negatives,with sensitivity,specificity,positive predictive value and negative predictive values for diagnosing fetal CHD in the first trimester of high-risk pregnancy of 84.17％,96.43％,90.18％and 93.99％,respectively,which were all significantly higher than of transvaginal ultrasound two-view method(70.83％,91.88％,77.27％and 88.99％)and transabdominal ultrasound method(72.50％,91.23％,76.32％and 89.49％;all P＜0.05).Conclusion Transvaginal ultrasound five-view method could be used to effectively diagnose fetal CHD in the first trimester of high-risk pregnancy.

Pancreatic cancer is characterized by high malignancy and poor prognosis.Surgical treatment remains a cruci-al method for achieving clinical cure and extending patient survival.However,the complexity of pancreatic anatomy,the variabil-ity in resection extent and digestive tract reconstruction techniques,combined with inconsistent surgical terminology used by clini-cians,often leads to inaccuracies in the coding of pancreatic tumor surgeries.This article provides an analysis of five common surgical procedures for pancreatic cancer,including Whipple procedure,pylorus-preserving pancreaticoduodenectomy,central pancreatectomy,radical resection of pancreatic body and tail cancer,and total pancreatectomy.By analyzing five surgical cases,this study aims to enhance the scientific accuracy and precision of coding for common pancreatic cancer surgeries.

Objective To explore the value of transvaginal ultrasound five-view method for diagnosing fetal congenital heart disease(CHD)in early pregnancy of high-risk pregnancy.Methods Totally 428 singleton fetuses at 11-13+6 weeks of gestation in high-risk pregnancies were prospectively enrolled.Fetal cardiac examinations were performed using two-dimensional grey scale imaging combined with CDFI via transabdominal ultrasound method,transvaginal ultrasound five-view method(upper abdominal transverse view,four-chamber view,three-vessel and trachea[3VT]view,ventricular outflow tract view and bilateral subclavian artery view)and transvaginal ultrasound two-view method(four-chamber view and 3VT view).Taken results of pregnant metaphase or late pregnancy fetal echocardiography,post-abortion pathology or postnatal neonatal echocardiography as gold standards,the diagnostic performances of the above 3 methods for diagnosing fetal CHD in early pregnancy were compared.Results CHD was diagnosed in 120(120/428,28.04％)fetuses.Transvaginal ultrasound five-view method made 11 false positives and 19 false negatives,with sensitivity,specificity,positive predictive value and negative predictive values for diagnosing fetal CHD in the first trimester of high-risk pregnancy of 84.17％,96.43％,90.18％and 93.99％,respectively,which were all significantly higher than of transvaginal ultrasound two-view method(70.83％,91.88％,77.27％and 88.99％)and transabdominal ultrasound method(72.50％,91.23％,76.32％and 89.49％;all P＜0.05).Conclusion Transvaginal ultrasound five-view method could be used to effectively diagnose fetal CHD in the first trimester of high-risk pregnancy.

Pancreatic cancer is characterized by high malignancy and poor prognosis.Surgical treatment remains a cruci-al method for achieving clinical cure and extending patient survival.However,the complexity of pancreatic anatomy,the variabil-ity in resection extent and digestive tract reconstruction techniques,combined with inconsistent surgical terminology used by clini-cians,often leads to inaccuracies in the coding of pancreatic tumor surgeries.This article provides an analysis of five common surgical procedures for pancreatic cancer,including Whipple procedure,pylorus-preserving pancreaticoduodenectomy,central pancreatectomy,radical resection of pancreatic body and tail cancer,and total pancreatectomy.By analyzing five surgical cases,this study aims to enhance the scientific accuracy and precision of coding for common pancreatic cancer surgeries.

Humans ; Muscular Dystrophy, Duchenne/epidemiology* ; Prevalence ; Myocardium

Multiple sclerosis is a severe autoimmune inflammatory disease mainly involving the central nervous system. In recent years, the exploration of the mechanism of nerve injury in multiple sclerosis has made great progress. At the same time, disease-modifying therapeutic drugs with different targets are also emerging. Understanding of the mechanisms of nerve injury in multiple sclerosis can help clinicians comprehensively understand the evolution of disease-modifying therapeutic targets of this disorder. Here, the mechanisms of nerve injury in multiple sclerosis and the relationship with the evolution of disease-modifying therapeutic targets are reviewed.

Objective To analyze the clinical features of intestinal infection in patients with acute leukemia (AL) after chemotherapy. Methods The data of 103 cases of AL patients after chemotherapy from January 2014 to April 2016 were retrospectively analyzed, and categorical variables were compared by using chi-square test. Results A total of 364 cycles of chemotherapy was conducted among 103 patients, of which 66 times (18.13 %) in 59 cycles occurred intestinal infections, including twice intestinal infections in one cycle of chemotherapy in 7 cases. The incidence of intestinal infection was 27.48%(36/131) in group without complete remission (CR), and 9.87%(23/233) in CR group. There was a statistical difference between the two groups (P<0.01). Repeated intestinal infections were found in 46.67%of the patients who accepted multiple cycles of chemotherapy. In the same cycle of chemotherapy, the probability of recurrence of intestinal infection after chemotherapy was 3.7 times than patients without intestinal infection occurred during chemotherapy. The incidence of intestinal infection of patients with acute lymphoblastic leukemia (ALL) after primary inducing chemotherapy was higher than that of patients with acute myelogenous leukemia (AML) (P= 0.019). The incidence of intestinal infection combined with neutropenic was 9.89 % (36/364), and the incidence of intestinal infection was 8.24 % (30/364) in neutrophils > 0.5 × 109/L. There was no significant difference (P> 0.05). After chemotherapy, some patients with intestinal infection occurred acute abdomen, with high mortality rate. Conclusions Intestinal infection may occur in the procession of chemotherapy and myelosuppression. Special attention should be paid on intestinal infection, including reduction of blood stream infection and risk factors, as well as timely intervention.

Objective To observe the effect of epidermal growth factor receptor (EGFR)sig-nal transduction inhibitor RG-14260 (RG)alone or combined with mTOR signal transduction inhibitor rapamycin (RA)on the proliferation and expression of decorin (DCN)in Ishikawa cells in vitro. Methods After treated with RG alone or combined with RA for 24 hours,immunohistochemical meth-od was used to detect the expression of proliferating cell nuclear antigens (PCNA).Reverse tran-scriptase-polymerase chain reaction (RT-PCR)and Western blot method were used to detect the ex-pression changes of DCN genes and proteins in cells respectively.Results RG alone or combined with RA were able to decrease the expression rate of positive PCNA cells in Ishikawa cells,promote the ex-pression of DCN genes and proteins,but the efficacy of combined application was more significant. Conclusion Single and combined applications of EGFR and mTOR signal transduction inhibitors can up-regulate the expression of DCN in Ishikawa cells at the levels of genes and proteins,and meanwhile the increased DCN can reinforce the inhibitory effect of signal transduction inhibitors on the cell prolif-eration.

Objective To observe the effect of epidermal growth factor receptor (EGFR)sig-nal transduction inhibitor RG-14260 (RG)alone or combined with mTOR signal transduction inhibitor rapamycin (RA)on the proliferation and expression of decorin (DCN)in Ishikawa cells in vitro. Methods After treated with RG alone or combined with RA for 24 hours,immunohistochemical meth-od was used to detect the expression of proliferating cell nuclear antigens (PCNA).Reverse tran-scriptase-polymerase chain reaction (RT-PCR)and Western blot method were used to detect the ex-pression changes of DCN genes and proteins in cells respectively.Results RG alone or combined with RA were able to decrease the expression rate of positive PCNA cells in Ishikawa cells,promote the ex-pression of DCN genes and proteins,but the efficacy of combined application was more significant. Conclusion Single and combined applications of EGFR and mTOR signal transduction inhibitors can up-regulate the expression of DCN in Ishikawa cells at the levels of genes and proteins,and meanwhile the increased DCN can reinforce the inhibitory effect of signal transduction inhibitors on the cell prolif-eration.

Objective To discuss the teaching effects of PBL teaching approach applied in clinical practice of medical oncology.Methods Throush clinical practice of medical onclolgy with the PBL teaching approach and the traditional one.A contrast between two teaching modes was made.And the teaching results were investigated based on the questionaic.Results The PBL teaching approach is superior to the traditional one.Conclusion The PBL teaching approach has an obvious advantage in the teaching of clinical practice of medical oncology and can improve the teaching quality