Objective:To investigate the risk factors of birth weight discordance in dichorionic diamniotic (DCDA) twins.Methods:This study retrospectively analyzed 1 757 cases of DCDA twin pregnancies from 11 Chinese hospitals from January 1, 2014, to December 31, 2017. Birth weight discordance was defined as ≥ 20% difference between the twins. All cases were divided into two groups: the concordant group ( n=1 520) and discordant group ( n=237). General information was compared and the high-risk factors of birth weight discordance were analyzed. Mann-Whitney U test, Chi-square test or Fisher's exact test, and logistic regression analysis were used as statistical methods. Results:Compared with the concordant group, the discordant group showed a higher incidence of hypertensive disorders of pregnancy [24.5% (58/237) vs 12.8% (194/1 520), χ2=22.882, P<0.05], fetal structural malformations [4.2% (10/237) vs 1.0% (15/1 520), χ2=15.160, P<0.05], fetal distress [6.3% (15/237) vs 1.4% (21/1 520), χ2=22.602, P<0.05], umbilical cord abnormalities [3.8% (9/237) vs 1.2% (18/1 520), χ2=7.607, P<0.05] and abnormal placental cord insertion [3.8% (9/237) vs 1.4% (21/1 520), χ2=34.904, P<0.05], but lower incidence of premature rupture of membranes [11.0% (26/237) vs 16.5% (250/1 520), χ2=4.645, P=0.034]. Logistic regression analysis showed that the independent risk factors of birth weight discordance in DCDA twins were hypertensive disorders of pregnancy ( OR=2.258, 95% CI: 1.620-3.184, P<0.001), fetal structural malformations ( OR=4.268, 95% CI: 1.892-9.631, P<0.001), umbilical cord abnormalities ( OR=2.889, 95% CI: 1.245-6.705, P=0.014) and abnormal placental cord insertion ( OR=2.318, 95% CI: 1.012-5.311, P=0.047). Conclusions:Hypertensive disorders of pregnancy, fetal structural malformations, umbilical cord abnormalities and abnormal placental cord insertion may be the risk factors of birth weight discordance in DCDA twins.

Objective To explore the value of three-dimensional ultrasound (3D-US) gray scale median (GSM) in quantitative evaluation of the drug treatment of carotid plaques.Methods Eighty-one patients with 93 carotid plaques were enrolled from May 2015 to October 2015.Patients were received 3D-US,3.0T MRI and blood lipid examination including total cholesterol(TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),and high-density lipoprotein cholesterol(HDL-C) before drug treatment.After atorvastatin therapy with a daily dose of 20mg for 6-12 months,3D-US and blood lipid examination were repeated,and 55 patients were followed successfully with a total of 62 plaques obtained.According to data acquired by MRI and 3D-US before treatment,the patients were divided into low-risk group,medium risk group,and high-risk group.The differences of GSM value and blood lipid levels were compared among groups and the changes of these parameters before and after the treatment in each group were compared.Results There was no significantly difference in serum TC,TG,LDL-C and HDL-C levels among the groups before treatment.After treatment,the serum TC and LDL-C levels were significantly lower than those before(P ＜0.05),the differences of TG and HDL-C levels were not significant,and the LDL-C level in high-risk group was significantly lower than those in other groups(P ＜0.05).The GSM values in of high-risk and medium-risk group were significantly increased after drug treatment than those of before (33.87 ± 6.53 vs 27.50 ± 7.82,47.35 ± 5.42 vs 44.56 ± 4.36,P ＜0.05),and had no significantly change in low risk group(62.01 ± 10.68 vs 63.13 ± 10.41,P ＞0.05).The difference of GSM between before and after treatment in each group was negatively correlated with the difference of LDL-C (r =-0.28,P =0.03).Conclusions Three-Dimensional ultrasound (3D-US) gray scale median (GSM) can be a reliable parameter in clinic quantitative evaluation drug treatment of carotid plaques,and has a better value especially for high-risk and medium-risk plaques.

Objective To quantitatively evaluate the vulnerability of carotid plaques in patients with acute ischemic cerebral infarction by using Gray-scale median (GSM) based on Three-dimensional ultrasound (3D-US).Methods Totally 207 patients were examined with carotid plaques in the PLA Army General Hospital from December 2015 to August 2016,including 102 patients with acute cerebralischemic stroke (cerebral infarction group) and 105 patients without cerebral infarction (control group).The Vascular plaque quantification (VPQ) software was applied to acquire GSM value of carotid plaques automatically.Results The GSM value of carotid plaques in cerebral infarction group was significantly lower than that in control group (44.78± 11.58 vs 54.36± 11.99,t=7.70,P ＜ 0.01),and the low density lipoprotein in the cerebral infarction group was significantly higher than that in the control group [(3.51 ± 1.20) mmol/L vs (3.10± 1.07) mmol/L,t=1.58,P ＜ 0.05].There was no significant difference between the two groups in age,gender,body mass index,smoking,drinking,history of diabetes,history of hypertension,systolic blood pressure,diastolic blood pressure,triglyceride,total cholesterol,high density lipoprotein,plaque thickness,plaque area stenosis rate and plaque volume (all P ＞ 0.05).Conclusion The GSM value of carotid plaques based on 3D-US-VPQ technology can effectively reflect the vulnerability of carotid plaques,and may be valuable in the risk assessment of carotid plaques.

OBJECTIVETo identify and characterize the Brucella strains from Guizhou province in 2010-2013.

METHODSA total of 12 strains of Brucella suspicious bacteria were isolated in Guizhou province from 2010 to 2013. Four strains (GZLL3, GZLL4, GZLL11 and SH2) were isolated from goat blood samples and eight strains (SH4, GZZY, GZSQ, GZZA, BR13001, BR13004, BR13005 and BR13006) were isolated from blood samples of patient 12 Brucella suspicious strains were identified and characterized using conventional methods. Brucella genus specific gene BCSP31-based PCR (BCSP31-PCR) was used to identify the genus of Brucella and IS711 insert sequence-based PCR (AMOS-PCR) was applied to identify the species of Brucella strains. Goats and patients originated Brucella strains were comparatively analysed using Pulse-field Gel Electrophoresis (PFGE).

RESULTSBoth of conventional methods and PCR identified the 12 Brucella suspicious strains as B. melitensis biotype 3. BCSP31-PCR identification results showed that a specific DNA bands (223 bp) were detected in all the 12 strains and positive control samples with no DNA band in negative samples. AMOS-PCR amplified a 731 bp-DNA bands in all the 12 strains, with 731 bp, 498 bp and 275 bp in M5, S2 and A19 strains, respectively, and no DNA band was detected in the negative control samples. PFGE analysis showed that 12 Brucella isolates from patients and goats showed consistent PFGE patterns with the digestion of restriction enzyme Xba I.

CONCLUSIONThe epidemic species/type of Brucella in both human and animal in Guizhou province was B. melitensis biotype 3 and goat was the main animal source of infection of brucellosis in Guizhou province.

Animals ; Bacterial Typing Techniques ; Brucella ; classification ; Brucellosis ; epidemiology ; China ; epidemiology ; DNA, Bacterial ; Goats ; Humans ; Molecular Typing ; Polymerase Chain Reaction

Objective To investigate the status of the plague natural focus and assess the risk of plague in regions with large scale engineering construction project,in order to provide a basis for plague prevention and control.Methods The survey was carried out in 14 regions with large scale engineering construction project of 40 counties in Guizhou Province in 2000-2011,2-3 towns were selected in each county and 2-3 villages in each town,the plague hosts and flea vectors in the residential houses and outdoors were investigated,the sera of 5 animals were collected in each village.The capture rate of hosts and flea index were calculated.Then the samples were cultured and serological tested for plague.Results The density of rodents was 1.14％-3.87％ in the reservoir region' residential building of hydro power station (Tianshengqiao,Pingban,Silin,Guangzhao,Sanbanxi,Dongqing,Qianzhong,Shatuo) and Xingyi airport,and Rattus flavipestus was the dominant species.The density of rodents was 0.00％-0.84％ in the reservoir region of hydro power station (Hongjiadu,Yingzidu,Goupitan,Longtan) and Jinyang district; the total flea index in Yinzidu,Pingban,Longtan reservoir regions of hydro power stations were 3.16,2.00,1.06,3.47 and 1.99,respectively.A total of 21 rodent and flea samples from Tianshengqiao hydro power station were tested positive for F1 antigen of the plague.Three strains of Yersiniapestis were isolated.Nine rat filter paper blood samples and 7 sera of indicative animals were tested plague F1 antibody positive.Other regions with large scale engineering construction project were tested negative.Conclusions The reservoir region of Tianshengqiao hydro power station is endemic areas of the plague,where belong to high risk areas.The density of Rattus flavipestus is higher than the controlling standard of the country in the reservoir region of hydro power station (Pingban,Silin,Guangzhao,Sanbanxi,Dongqing,Qianzhong,Shatuo),where belong to potential risk areas.The plague prevention and monitoring should be continually strengthened to reduce the risk of plague.

Objective To survey the major host animal and media fleas of plague in Beipanjiang Basin,to gain insights into plague foci and to provide a basis for prevention and control of plague.Methods According to the epidemiological site survey methods,from 2008 to 2010 five villages in five townships (towns) in coastal watershed of Beipanjiang were selected.The methods of cage trapping and 5 meters thread clamp were used to capture rodents indoor and outdoor,respectively.After rats were anesthetized with ether anesthesia,rat body flea were combed and stored in sterile tubes.The liver and spleen of rodents were collected and stored in the test tube with preservation solution,and free body fleas on rats were collected with flea sticky paper and stored in sterile tubes.Blood specimens (5 ml) of indicating animal and normal people were collected,serum was separated and sent for laboratory test.The four-step method was utilized to isolate Yersinia pestis from rodents and fleas,the indirect hemagglutination (IHA) was used to test F1 antibodies on the blood of rodents filter,blood serum of humans and rodents.Results Totally 243 rodents were captured,202 indoor and 41 outdoor,the capture rate was 4.90％ and 1.15％,respectively.Rodents captured belong to 9 species,4 genera,1 family and 1 order,Rattus flavipectus and Mus pahari were dominant species.Five rodents had body flea,the dyed flea rate was 2.06％;53 fleas were captured,total flea index was 0.218 1.Rat fleas were classified in 2 families,2 genera and 2 species,and Cheopis was the dominant species.Yersinia pestis and plague F1 were not detected.Conclusion The epidemic indication has not been found in Beipanjiang Basin,but the nurturing conditions for Rattus flavipectus plague foci along the coast are exist.

Objective:To explore the characteristics of somatic symptoms and their dynamic changes after treatment in elderly inpatients with depression,so as to give supported data in differential diagnosis and management of somatic symptoms in the elderly patients.Methods:Totally 69 consecutively hospitalized depression patients(≥60 years)were enrolled in the study,and 62 of them completed the 12-month follow-up.The diagnoses were made according to International Statistical Classification of Diseases and Related Health Problem-10th revision(ICD-10) criteria.The Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)and Somatic Symptom Self-rat-ing Scale-Somatic factor(SSS-S)were used to assess the severity of depression,anxiety and somatic symptoms, which were evaluated at baseline,2 weeks,4 weeks and the end of 12-monthr espectively.The Minimum Mental State Examination(MMSE)were used to evaluate cognitive function,and Global Assessment Function(GAF)were used to evaluate social function at the end of 12-month follow-up.Result:Somatic symptoms presented in the all patients at the stages of depressive episode.The most common ones were gastrointestinal symptoms(91%),dizzi-ness or headache(66%),cardiovascular symptoms(59%).SSS-S scores at 2 weeks and 4 weeks of antidepressant treatment were significantly improved compared with those of baseline,[(13.6 ±3.2),(12.4 ±2.8)vs.(17.1 ± 4.8),analyzed by repeated measures of ANOVA,P <0.05].The changes of SSS-S scores were positive associated to the changes of anxiety symptoms and the effect of physical diseases,analyzed by hierarchical linear model analy-sis.At the stages of rehabilitation,residual somatic symptoms were positive associated to the degree of anxiety symptoms(OR =2.132,P <0.05),and unrelated to the level of HAMD,MMSE and GAF scores analyzed by logis-tic regression analysis.Conclusion:Somatic symptoms are various in elderly inpatients with depression during the a-cute phase,which are improved greatly as effective antidepressant treatment,and still have residual somatic symp-toms at the stage of rehabilitation.The effect of physical diseases and anxiety symptoms have influence on somatic symptoms.

Objective To identify and characterize the Brucella strains from Guizhou province in 2010-2013. Methods A total of 12 strains of Brucella suspicious bacteria were isolated in Guizhou province from 2010 to 2013. Four strains (GZLL3, GZLL4, GZLL11 and SH2) were isolated from goat blood samples and eight strains (SH4, GZZY, GZSQ, GZZA, BR13001, BR13004, BR13005 and BR13006) were isolated from blood samples of patient 12 Brucella suspicious strains were identified and characterized using conventional methods. Brucella genus specific gene BCSP31-based PCR (BCSP31-PCR) was used to identify the genus of Brucella and IS711 insert sequence-based PCR (AMOS-PCR) was applied to identify the species of Brucella strains. Goats and patients originated Brucella strains were comparatively analysed using Pulse-field Gel Electrophoresis (PFGE). Results Both of conventional methods and PCR identified the 12 Brucella suspicious strains as B. melitensis biotype 3. BCSP31-PCR identification results showed that a specific DNA bands (223 bp) were detected in all the 12 strains and positive control samples with no DNA band in negative samples. AMOS-PCR amplified a 731 bp-DNA bands in all the 12 strains, with 731 bp, 498 bp and 275 bp in M5, S2 and A19 strains, respectively, and no DNA band was detected in the negative control samples. PFGE analysis showed that 12 Brucella isolates from patients and goats showed consistent PFGE patterns with the digestion of restriction enzyme Xba I. Conclusion The epidemic species/type of Brucella in both human and animal in Guizhou province was B. melitensis biotype 3 and goat was the main animal source of infection of brucellosis in Guizhou province.

Objective To identify and characterize the Brucella strains from Guizhou province in 2010-2013. Methods A total of 12 strains of Brucella suspicious bacteria were isolated in Guizhou province from 2010 to 2013. Four strains (GZLL3, GZLL4, GZLL11 and SH2) were isolated from goat blood samples and eight strains (SH4, GZZY, GZSQ, GZZA, BR13001, BR13004, BR13005 and BR13006) were isolated from blood samples of patient 12 Brucella suspicious strains were identified and characterized using conventional methods. Brucella genus specific gene BCSP31-based PCR (BCSP31-PCR) was used to identify the genus of Brucella and IS711 insert sequence-based PCR (AMOS-PCR) was applied to identify the species of Brucella strains. Goats and patients originated Brucella strains were comparatively analysed using Pulse-field Gel Electrophoresis (PFGE). Results Both of conventional methods and PCR identified the 12 Brucella suspicious strains as B. melitensis biotype 3. BCSP31-PCR identification results showed that a specific DNA bands (223 bp) were detected in all the 12 strains and positive control samples with no DNA band in negative samples. AMOS-PCR amplified a 731 bp-DNA bands in all the 12 strains, with 731 bp, 498 bp and 275 bp in M5, S2 and A19 strains, respectively, and no DNA band was detected in the negative control samples. PFGE analysis showed that 12 Brucella isolates from patients and goats showed consistent PFGE patterns with the digestion of restriction enzyme Xba I. Conclusion The epidemic species/type of Brucella in both human and animal in Guizhou province was B. melitensis biotype 3 and goat was the main animal source of infection of brucellosis in Guizhou province.

Adult ; Aged ; Aged, 80 and over ; Echocardiography, Transesophageal ; methods ; Female ; Foramen Ovale, Patent ; diagnosis ; Humans ; Male ; Middle Aged