Objective:To establish the reference value of the angle between the left ventricular inflow and outflow tract (LIOA) in normal fetuses in the second and third trimesters, and observe the correlation between fetal LIOA and gestational age, cardiac axis, cardiac size, and estimated fetal weigh (EFW).Methods:Fetal LIOA in normal fetuses with gestational age from 16 weeks to 39 + 6 weeks were obtained prospectively by two-dimensional ultrasound in the Second Xiangya Hospital from November 2022 to April 2023. Pearson′s correlation coefficient was used to analyze the correlation between fetal LIOA and gestational age, cardiac axis, cardiovascural size and EFW. Results:The LIOA range of 651 normal fetuses was (44.39±7.67)°, and it was found that LIOA was not related to gestational age. LIOA mildly positively correlated with the cardiac axis ( r=0.22, P<0.05) while not correlated with gestational age, cardiovascural size or EFW (all P>0.05). Conclusions:The range of LIOA in normal fetuses were established. Fetal LIOA is constant in the second and third trimesters and it is mildly positively correlated with the cardiac axis. Evaluating fetal LIOA may also provide information for future research on the fetal aortic hemodynamic development.

Objective: To examine the effects of parental rearing style and its consistency on sleep problems of preschool children and to provide theoretical basis for making early family intervention measures. Methods: A questionnaire survey was conducted among 2 744 children and their parents in 19 kindergartens in Anqing city. Parental Behavior Inventory (PBI) was used to investigate the rearing style of parents, and Chinese version of Children s Sleep Habit Questionnaire (CSHQ) was used to evaluate the incidence of sleep among preschoolers. Results: Preschool children s overall rate of sleep disorder was 15.5%, and accompanied by sleep duration disorder (70.0%), sleep resistance (64.2%), sleep latency (38.7%), anxiety (15.5%), daytime sleepiness ( 10.1 %). Living in urban areas, parents smoking and drinking behaviors, and parents parenting style all affected preschoolers sleep ( P <0.05). Multivariate Logistic regression analysis showed that fathers active rearing style was negatively correlated with preschool children s sleep problems such as delayed sleep impedance and short sleep duration, while mothers active rearing style was negatively correlated with preschool children s sleep problems such as sleep resistance and night wake up ( P <0.05). There was a positive correlation between father s severe rearing style and preschoolers sleep resistance, sleep duration, short sleep disordered breathing, daytime sleepiness and total sleep problems, and mother s severe rearing style and preschoolers sleep duration, short sleep anxiety, night wakefulness, daytime sleepiness and total sleep problems ( P <0.05). Consistent rate of negative rearing patterns was a risk factor for short sleep duration in preschoolers ( OR =2.19，95% CI =1.12-4.28， P =0.02). Conclusion The detection rate of sleep problems in preschoolers is high. Parental supportive involvement has a positive effect on preschoolers sleep, while parental coercion hostile parenting has a negative effect on preschoolers sleep. The consistent rate of rearing styles affects the sleep duration of preschoolers.

Objective To investigate the clinical characteristics,risk factors and prognosis of patients with persistent inflammation,immune-suppression and catabolism syndrome(PICS)secondary to sepsis in medical intensive care unit(MICU)in initial stage,in order to increase the understanding of PICS and provide the reference experience for the early screening of high-risk patients.Methods A total of 298 elderly patients diagnosed as sepsis admitted into MICU from Aug.2013 to Dec.2016 were retrospectively studied.Of them,97 patients meeting inclusion criteria were ultimately enrolled and separated into the PICS group and the non-PICS group.General and clinical data and laboratory indexes at first day admitted into MICU were compared between the two groups.The indexes between the two groups were analyzed statistically by multivariate logistic regression analysis.The survival-time distributions were estimated by Kaplan-Meier model,and the difference in prognosis was compared between the two groups.Results Of 97 patients,36 patients (37.1％)met the diagnosis of PICS.The acute physiological function and chronic health evaluation Ⅱ (APACHE Ⅱ) score had a significant difference between the two groups(27.7±5.8 vs.22.9±6.0,P＜0.01).The grade of acute gastrointestinal injury(AGI)were significantly higher in the PICS group than in the non-PICS group(P ＜0.05).Platelet counts,helper T cell counts and CD4+/CD8+ ratios were significantly lower in the PICS group than in the non-PICS group[(164.39 ± 84.29) × 109/L vs.(235.16 ± 126.89) × 109/L,(238.97± 181.11)/μl vs.(385.93±308.22)/μl,(1.58 ± 1.13) vs.(2.12± 1.23),all P ＜0.05)].Multivariable logistic regression analysis revealed that APACHE Ⅱ score was an independent risk factor for PICS and its optimal cut-off value for predicting PICS was 26.5.Kaplan-Meier analysis showed that the overall survival was poorer in the PICS group than in non-PICS group in the whole observation phase.The further Kaplan-Meier analysis on survival time of subdivisions showed that the survival of patients at 90-day and 180-day after admission and in stage 1-3 during one year had significant differences between the two groups (P ＜ 0.05).While the survival of patients at 28-day after admission had no significant difference between the two groups(P＞0.05).Conclusions The elderly patients with persistent inflammation,immune-suppression,and catabolism syndrome(PICS) secondary to sepsis in medical intensive care unit(MICU)show the higher levels of APACHE Ⅱ score and AGI grade,and lower values of platelet counts,CD4+ T cell counts and CD4+/CD8+ ratio in initial stage.And APACHE Ⅱ score is an independent risk factor for PICS in elderly sepsis patients,and the optimal cut-off value of APACHE Ⅱ score for predicting PICS is 26.5.The prognosis for advanced stage and long term prognosis are poor.It is essential to use APACHE Ⅱ and so on,to timely identify and intervene PICS.

Objective To evaluate the changes in anterior chamber structure of pelvic floor before and after total hysterectomy with transperineal ultrasonography.Methods Forty-five patients who would receive total hysterectomy were enrolled.The structures of the anterior pelvic floor were observed with transperineal ultrasonography 1 day pre-operation and 1,3 and 6 months after operation.The parameters at rest and max Valsalva were recorded and calculated,including the bladder neck-symphyseal distance (BSD),bladder neck descent (BND),urethral rotation angle (UR) and posterior urethrovesical angle (PUA).The changes of the parameters at different time were analyzed statistically.Results BSD at max Valsalva,BND,UR and PUA at max Valsalva at different time were significantly different (all P＜0.05).Compared with those preoperative,BSD at max Valsalva decreased (H=2.627,P=0.009) and BND increased (q=-3.095,P=0.002) 3 months after operation,BSD at max Valsalva decreased (H=4.379,P＜0.001),BND (q=-4.379,P＜ 0.001),UR (H=-2.861,P=0.004) and PUA at max Valsalva (q=-2.686,P=0.007) increased 6 months after operation.The remaining parameters were not significantly different between every two time points (all P ＞ 0.05).Conclusion The changes of BSD,BND at max Valsalva,UR and PUA at max Valsalva occur at the initial period after the total hysterectomy.The total hysterectomy can damage the pelvic floor and early pelvic floor rehabilitation need to he provided.

Objective To explore the value of ultrasound-guided balloon control technique in abdominal aorta for reducing intraoperative hemorrhage in high-risk placenta previa undergoing cesarean section.Methods From Aug 2013 to Oct 2017,40 cases were admitted,among them,16 cases were treated with ultrasound-guided towed balloon prophylactic control technique of abdominal aorta (the study group) before cesarean,and 24 cases did not receive balloon occlusion (the control group) during the cesarean.Clinical data were compared between the two groups.Results The time used for uterine suture (t =10.34,P =0.01),the amount of intraoperative blood loss (t =9.51,P =0.01) and blood transfusion (t =3.41,P=0.005)in the two groups were all statistically different.While the differences in PT (t =1.02,P =0.32),ALT (t =0.54,P =0.59),AST(t =0.91,P =0.37),creatinine(t =0.75,P =0.46) were not statistically significant between the two groups.Conclusion Ultrasound-guided abdominal aortic balloon control technique can reduce the blood loss significantly in cesarean section with high-risk placenta previa.

Objective To report a pedigree with X?linked dominant protoporphyria(XLDPP), and to detect 5?aminolevulinic acid synthetase 2(ALAS2)gene mutations in this pedigree. Methods A clinical investigation was performed in a pedigree with XLDPP, and relevant data were collected from family members. A next?generation sequencing method was applied to screen possible mutation sites, and Sanger sequencing was performed to determine pathogenic gene mutations. Dermoscopy was conducted to observe skin lesions in the patients with XLDPP, and the Fotofinder system and very high frequency (VHF) ultrasound system were utilized to assess the severity of photodamage. Liver and gallbladder ultrasonography as well as blood examination were performed for all the family members. Results A deletion mutation, c.1706?1709ΔAGTG, was detected in the ALAS2 gene on the X chromosomes of all the patients in this family, which led to replacement or loss of 19-20 C?terminal residues through transcriptional frameshifting, and eventually caused an increase in ALAS2 activity. In the patients with XLDPP, skin photodamage was relatively severe;protoporphyrin?induced hepatobiliary damage was observed and aggravated with age;anemia and iron deficiency occurred sometimes. Conclusion The deletion mutation c.1706?1709ΔAGTG of the ALAS2 gene may be the underlying cause of XLDPP in this pedigree.

Objective:To evaluate the effectiveness of Minqing Ao dental desensitizer in the treatment of early childhood caries (ECC).Methods:41 0 teeth with ECC in 1 1 0 cases were divided into 3 groups.Minqing Ao dental desensitizer,fluoride toothpaste and ordinary toothpaste without fluoride were respectively used in group A,B and C.The laser fluorescence value(LFV)was meas-ured and compared before treatment,2,4,6 weeks and 6 months after treatment.Results:2 weeks after treatment,the LFV was not significantly changed in the 3 groups.4 weeks after treatment LFV in group A was decreased(P<0.01 ),the LFV in group A was lower than that in group B(P<0.05)and in group C(P<0.01 ).While there was no significant difference between group B and C(P>0.05).6 weeks after treatment LFV in group A and B was decreased(P<0.01 and P<0.05),there was significant difference be-tween each 2 groups(P<0.05).6 weeks and 6 months after treatment LFV in group A was lower than that in group B(P<0.01 ),and in group B was lower than that in group C(P<0.01 ).Conclusion:Minqing Ao is effective for treatment of early childhood caries.

Adult ; Epstein-Barr Virus Infections ; diagnosis ; Humans ; Male ; Pityriasis Rubra Pilaris ; diagnosis

OBJECTIVEOnly a few clinical reports in the treatment of early mycosis fungoides (MF)(IA, IB, IIA stage) are available in the literature. The purpose of this study was to compare the efficacy and safety of narrow-band UVB and psoralen plus ultraviolet A (PUVA) photochemoterapy in 24 patients with early-stage MF, and explore a new approach for the treatment of early mycosis fungoides.

METHODSA total of 24 identified early mycosis fungoides patients received PUVA, NB-UVB and a combined therapy of PUVA followed by NB-UVB (n = 9/6/9) irradiation. A retrospective study was carried out to analyze the sex, age of onset, TNM stage, treatment, and duration of treatment, and times of treatment, duration of maintenance treatment, effective and recurrence in these patients. The data were analyzed using SPSS 17.0 and a two-sided test at the α = 0.05 level of significance was conducted.

RESULTSOf the 24 patients studied, the average treatment was 104.5 (95% CI, 75.71-133.29) times. The average duration of treatment was 12.88 (95% CI, 9.90-15.85) months. The average maintenance treatment time was 11.08 (95% CI, 2.13-20.04) months. The effective rate (CR+PR) of PUVA treatment was 88.9%, recurrence rate was 11.1% (n = 9). In the NB-UVB treatment group, the effective rate was 100.0%, and the recurrence rate was 33.3% (n = 6). In the PUVA followed by NB-UVB (combination therapy) treatment group, the effective rate was 77.8% and the recurrence rate was 55.6% (n = 9). There were no significant differences among the three groups in terms of number of treatments, treatment duration, maintenance treatment duration, effective rate and recurrence rate (P > 0.05).

CONCLUSIONSPUVA and NB-UVB are effective and safe in the targeted therapy of early stage mycosis fungoides. The combined therapy of PUVA followed by NB-UVB can reduce the total PUVA dose and risk of developing skin cancer.

Combined Modality Therapy ; methods ; Ficusin ; Humans ; Mycosis Fungoides ; therapy ; Neoplasm Recurrence, Local ; PUVA Therapy ; Photochemotherapy ; Physical Examination ; Retrospective Studies ; Treatment Outcome ; Ultraviolet Therapy

Arthritis, Rheumatoid ; complications ; diagnosis ; Female ; Humans ; Middle Aged ; Pleurisy ; complications ; diagnosis ; Sweet Syndrome ; diagnosis ; etiology