Objective: To investigate the current basic situation of the staff of ultrasound departments in Shanghai′s medical institutions, for providing references in making management policy of these professionals. Methods: Questionnaire surveys on human resource and service ability were made to all the ultrasound departments of medical institutions in Shanghai in December 2013 and November 2018 respectively. Data of the two surveys were compared and analyzed, and were descriptively analyzed by mean and percentage. Results: The number of ultrasound professionals per 10 000 people in Shanghai was 1.04 in 2018. Tertiary hospitals had advantages in the number of the professionals, and the proportion of professional qualification, age, education background and professional title of the professionals. Compared to those data in 2013, the number of ultrasound professionals had increased 31.8% in 2018. The proportion of medical practitioners with medical imaging specialty was 95.6%(2 063/2 158), and had increased by 4.7 percent. The medical services workload of ultrasound was 19.82 million person-time, and had increased 45.8%. Conclusions Development of ultrasound departments was rapid, but the development of professionals was unbalanced with the development of medical services. It is suggested to strengthen training of ultrasound professionals and improve the system of hierarchical medical system.

Objective: To establish a functional antibody detection method for acellular pertussis vaccines in order to conveniently and effectively evaluate the production consistency and potency of acellular pertussis vaccine bulks and final products. Methods: Chinese hamster ovary (CHO) cell clustering assay was optimized and used to measure titers of neutralizing antibodies against pertussis toxin in mouse immune serum samples. Results: Vaccine samples were determined to be immunized intraperitoneally with 1/5 the human dose to ten female NIH mice (20-24 g, 5-week-old). Four weeks after immunization, blood samples were collected to isolate serum. Serially diluted serum samples were used to neutralize 0.1 IU/ml of pertussis toxin national reference product for 2 hours. Results of clustering were determined after 48 hours of incubation in pre-cultured CHO cell wells. The geometric mean of the serum dilution of the final unclustered wells was the neutralizing antibody titer of vaccine sample. There were significant differences in the titers of neutralizing antibodies elicited by acellular pertussis vaccines prepared with different manufacturing processes. Vaccine samples succeed or failed the modified intracerebral challenge assay (MICA) were easily distinguishable by neutralizing antibodies. Conclusion The method of detecting neutralizing antibodies to pertussis toxin greatly reduces the amount of animals used in research. CHO cell clustering assay that has better repeatability and precision can be used for monitoring and initial evaluation of the consistency and potency of the bulks and final products of pertussis vaccines prepared with different manufacturing processes.

OBJECTIVE: To establish a non-invasive method for beta-thalassemia by detecting parental CD41-42 mutation in cell-free DNA derived from maternal plasma with droplet digital PCR (ddPCR). METHODS: Beta-actin gene and beta-thalassemia gene CD41-42 mutation were respectively set as the reference and target sequences. A novel method was established based on Bio-Rad ddPCR technique with specific primers and TaqMan probes for the two genes. The accuracy, sensitivity and detective linearity range of the developed method were evaluated by detection of the target gene gradient concentration samples. The applicability was also evaluated by testing 20 maternal plasma samples. RESULTS: The ddPCR method could accurately detect the beta-thalassemia CD41-42 mutation in cell-free DNA derived from maternal plasma. Within the target sequence concentration ratio of 5.00%-0.50%, the relative errors were all < 0.05, the linear regression equation was Y=1.0101-X-0.0071 and R=0.9994. The results of 20 maternal plasma cell-free DNA samples were all consistent with those of the follow-up testing. CONCLUSION A ddPCR method for detecting parental CD41-42 mutation in cell-free DNA from maternal plasma was developed. The method is simple, rapid, accurate, and can be applied for non-invasive prenatal diagnosis for couples simultaneously carrying the CD41-42 mutation.
Cell-Free Nucleic Acids ; DNA ; blood ; Female ; Humans ; Mutation ; Polymerase Chain Reaction ; Pregnancy ; Prenatal Diagnosis ; methods ; beta-Thalassemia ; diagnosis ; genetics

Objective To study the therapeutic effect of rehabilitation exercise and cognitive-behavioral intervention on the patients with tinnitus. Methods 110 patients were divided into two groups, with 55 cases in each group. Conventional nursing was delivered to the control group, while the patients in the experimental group received conventional nursing as well as rehabilitation exercise and cognitive-behavioral intervention (6 months).The patients were evaluated by Tinnitus handicap inventory (THI),self-rating anxiety scale(SAS)and self-rating depression Scale(SDS)before the intervention,at 1 month and 6 months after the intervention. Results The levels of anxiety,severity of depression and tinnitus classification at 1 month and 6 months after the intervention in both groups were significantly different(all P<0.001).The levels of anxiety,depression and tinnitus in the experimental group were lower than those in the control group.The effect of tinnitus recovery at1 month and 6 months after the intervention in both groups was statistically significant (all P<0.05). The tinnitus recovery in the experimental group was better than that in the control group. Conclusion Rehabilitation exercise and cognitive-behavioral intervention can improve the therapeutic effect on tinnitus, reduce anxiety and depression in patients and deserve clinical application.

Objective To explore the application of change speed of lithotomy position in the patients with gynecological laparoscopic surgery.Methods A total of 120 gynecological laparoscopic surgery patients in our hospital were randomly divided into observation group and control group,pneumoperitoneum pressure of two groups was 11 mmHg.The change speed of lithotomy position in the control group was in 6 s,the observation group was ＞ 30 s,and the changes of hemodynamics and blood gas indexes were compared.Results SBP and DBP after pneumoperitoneum in the two groups were increased compared with that before pneumoperitoneum (P ＜ 0.05).The increase of DBP and SBP after pneumoperitoneum in the observation group was less than that in the control group (P ＜ 0.05).PETCO2 after pneumoperitoneum in the observation group showed no statistically significant compared with pneumoperitoneum before (P ＞ 0.05),but the control group had higher PETCO2 than that before pneumoperitoneum,there were statistically significant differences (P ＜ 0.05).The observation group and the control group had a tendency to rise in airway pressure after pneumoperitoneum,but no statistical significance between the two groups was found (P ＞ 0.05).Conclusion Prolonging change time of lithotomy position can reduce the influence of hemodynamics for the patients with gynecological laparoscopic operation,and it is beneficial to the recovery of lung function.

Objective To explore the application of change speed of lithotomy position in the patients with gynecological laparoscopic surgery.Methods A total of 120 gynecological laparoscopic surgery patients in our hospital were randomly divided into observation group and control group,pneumoperitoneum pressure of two groups was 11 mmHg.The change speed of lithotomy position in the control group was in 6 s,the observation group was ＞ 30 s,and the changes of hemodynamics and blood gas indexes were compared.Results SBP and DBP after pneumoperitoneum in the two groups were increased compared with that before pneumoperitoneum (P ＜ 0.05).The increase of DBP and SBP after pneumoperitoneum in the observation group was less than that in the control group (P ＜ 0.05).PETCO2 after pneumoperitoneum in the observation group showed no statistically significant compared with pneumoperitoneum before (P ＞ 0.05),but the control group had higher PETCO2 than that before pneumoperitoneum,there were statistically significant differences (P ＜ 0.05).The observation group and the control group had a tendency to rise in airway pressure after pneumoperitoneum,but no statistical significance between the two groups was found (P ＞ 0.05).Conclusion Prolonging change time of lithotomy position can reduce the influence of hemodynamics for the patients with gynecological laparoscopic operation,and it is beneficial to the recovery of lung function.

Objective To explore the hospitalization status of patients with chronic obstructive pulmonary disease ( COPD ) . Method In total, 12,838 COPD patients hospitalized from January 2008 to December 2014 were involved in the study and their hospitalization status were analyzed. Results Among the 12,838 patients, 2,499 were hospitalized for critical conditions (19.47%), 5,455 for acute attack (42.49%), 4,884 for acute exacerbation (38.04%). The ratio of male/female was 5.32:1. Those in 71 to 80 years old were at the highest risk. They were hospitalized at least for 1 time, at most for over 38 times, averaged (3.52 ± 4.05) times. Conclusions The COPD patients were hospitalized due to acute attack and acute exacerbation. The patients'age ranged from 71 to 80 years. The male patients had a predominant incidence than the female ones. The times of hospitalization were related with possible complications of other chronic diseases. Therefore, nursing staff should draw up individual continuing nursing strategies based on the patients′ hospitalization reasons to reduce the hospitalization rate of acute attack and acute exacerbation. Meanwhile, we should formulate the pre-hospital rescue plan for the hospitalized patients at the peak age and implement prospective nursing.

Objective To investigate the distribution characteristics and clinical features of familial aggregation hemangioma to improve the level of the diagnosis and treatment.Methods Total 1202 cases of vascular disease were treated in this department from June 2006 to June 2011.The clinical data and family distribution characteristics in 36 cases of familial aggregation hemangioma were analyzed and their effects of laser treatment were evaluated.Results 36 cases were familial aggregation hemangioma,whose incidence was 2.99 ％ in 1202 cases of vascular disease cutis; and the ratio of male to female was 1 ∶ 1.There were 9 cases of parents suffering from hemangioma.But the incidenceof the next generation suffering from vascular disease was 28.5 ％.Among these 36 cases of familial aggregation hemangioma,33 cases underwent the long pulse 1064 nm Nd ∶ YAG laser and optimized pulse light combination therapy.The effective rate was 100 ％.Conclusions There may be a genetic predisposition in hemangioma.The application of long pulse 1064 nm Nd ∶ YAG laser and optimized pulsed light treatment to hemangioma cutis can obtain satisfactory results.The intervention should be taken in early stage.

ObjectiveTo investigate the value of combined four-chamber view,left and right ventricular outflow tract view and three-vessel view of two-dimensional echocardiography (2DE) in prenatal screening for fetal congenital heart disease (CHD). MethodsFour combined views of 2DE were used to detect fetal hearts in 2419 fetuses at 21～ 25 gestational weeks.The echocardiograms were performed on all 2382 live-birth infants.Chi-square test was applied for statistical analysis.Sensitivity,specificity,positive predict value and negative predict value were calculated. Results The prevalence of fetal CHD was 11.62％ (281/2419).Among the 281 CHD fetuses,87.18％ were simple CHD (n=245) and 12.82％ were complex CHD (n=36).No difference was found in the positive rate of fetal CHD between the high-risk group and non-high-risk group [13.60％(34/250) vs 11.39％(247/2169),x2=1.069,P＜0.05].Thirty-six cases of CHD could be detected by the four combined views in prenatal screening with the sensitivity,specificity,positive and negative predictive value of 12.8％,99.8％,90.0％ and 89.7％,respectively.However,the diagnostic sensitivity of four combined views for simple CHD was 2.9％(7/245) and 80.6％(29/36) for complex CHD.The prevalence of neonatal CHD was 10.58％ (252/2382),including 241 with simple CHD and 11 complex ones. ConclusionsFour combined views of 2DE for prenatal screening is less sensitive in detecting simple CHD than complex CHD.Most of the complex CHD could be diagnosed by four combined views of 2DE before birth,but the misdiagnosis rate is high in simple CHD.The echocardiograms performed on newborns might make up for the lack.

Objective To understand serotype and fimbriae-genotype of B. pertussis vaccine strains and isolates from different periods in China. Methods Serotype of eighty isolates and three vaccine strains were determined using anti-fim2 and fim3 monoclonal antibodies compared with polyclonal antisera. Fim2 and fim 3 genes were amplified by PCR and the amplified products were sequenced and analyzed . Results The serotype of three vaccine strains and all isolates but only one tested by the slide agglutination and micro-plate assay of anti-fim2 and fim3 monoclonal antibodies were the same in comparison with that of the slide agglutination of polyconal antisera. In this study, seventeen isolates and vaccine strains CS and P3S10 were fim2&3 serotype, and forty-eight isolates were tim2 serotype while fifteen isolates and vaccine strain 18530 were fim3 serotype. The predominant serotypes were fim2 and fim2&3 before Expanded Program on Immuni-zation in 1978, while the find became the most popular serotype after nation-wide pertussis vaccination in China. The fim2-1 and fim3-A genotype was the most common type, which was identified in 92.5% and 95.0% of the isolates, respectively. The genotype of vaccine strain 18530 was fim2-2 and fim3-A while oth-er vaccine strains were fim2-1 and fim3-A. The isolates contained fim3-B and fim3-D subtypes were found since 2000. These data indicated that the serotype and fimbriae genotype of B. pertussis isolates have been changed for immune environment of national-wide pertussis vaccination in China. Conclusion The validity and specificity of anti-fim2 and fim3 monoclonal antibodies have been validated for serotyping of B. pertussis strains. The information of serotype and fimbirae genotype of B. pertussis vaccine strains and isolates from dif-ferent time periods have been obtained. These data can facilitate the studies on quality control of vaccine strain, epidemiology and the evolution of B. pertussis in China.