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【Objective】 To retrospectively investigate the antibody distribution and pregnancy outcome of pregnant women with Rh alloantibody in Guangzhou, and summarize the prevalence, diagnosis and treatment experience of hemolytic disease of newborn (HDN) caused by Rh alloantibody, so as to provide data for the prevention, diagnosis and treatment of Rh-HDN. 【Methods】 A total of 17 345 pregnant women in Guangzhou from January 2014 to December 2020 were selected for irregular antibody screening test.Those with Rh antibody were followed up for delivery, and the clinical and laboratory examination results of pregnant women and newborns were analyzed. 【Results】 A total of 71 cases (0.41%, 17/17 345) with Rh alloantibodies were detected.Among them, anti-D, anti-E, anti-Ec, anti-C, anti-Ce, anti-c, anti-e accounted for 26.76% (19/71), 46.48% (33/71), 9.86% (7/71), 7.04% (5/71), 5.63% (4/71), 2.82% (2/71) and 1.41% (1/71), respectively.Among the 71 pregnant women, 34 gave birth to children with HDN, with the total prevalence rate of 47.89%, among whom 100%, 78.94% and 42.42% were anti-c, anti-D and anti-E, respectively.And 71.43% (5/7) of the children who underwent transfusion were with anti-D.Although the yield rate of anti-E was the highest, it involved low morbidity and mild symptoms, which preferred to occur in the first fetus.No significant difference in gestational age, birth weight and the occurrence time of jaundice was notice between the anti-D group and anti-E group, but the total bilirubin of the anti-E group was lower while the Hb level were higher than those of the anti-D group (P<0.05). Two children died, and others were cured by phototherapy, albumin, IVIG and blood transfusion. 【Conclusion】 The publicity of Rh-HDN for early prevention and treatment should be strengthened to improve the cure rate and the prognosis.
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Objective To assess right ventricular (RV) regional and global volume and systolic function in patients with right coronary artery disease by real time three-dimensional echocardiography(RT-3DE).Methods RT-3DE images were acquired in 20 normal controls (Group A),30 patients with right coronary artery stenosis(Group B) and 10 patients with RV myocardial infarction(Group C).Volumetric RT-3DE images were analyzed by use of TomTec software,which provided regional (inflow,body and outflow) and global end diastolic volume(EDV),end systolic volume(ESV),stroke volume(SV) and ejection fraction(EF).RT-3DE quantitative data were analyzed to test repeatability.Results Compared with group A and group B,EDV and ESV of body and global were larger in group C;ESV of inflow and outflow were larger (P ＜0.05).EDV of group C was larger than group B(P ＜0.05).Compared with group A and group B,the EF of inflow,outflow and global in group C were lower(P ＜0.05).The EF of body in group C were lower than group B(P ＜0.05).There was no significant difference in regional and global volume and EF between group A and group B(P ＞0.05).The intra-observer and inter-observer's variability was low and consistency was high.Conclusions In patients with RV myocardial infarction,RV regional and global volumes were enlarged and systolic function was impaired.Evaluating right ventricular regional and global volume and function in patients with right coronary artery disease by RT-3DE has high repeatability.
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Objective To evaluate the accuracy of methods in echocardiographic measurements of right ventricular (RV) volume.Methods Forty-six healthy volunteers were examined by two dimensional echocardiography (2-DE),real time three-dimensional echocardiography (RT-3DE) and cardiac magnetic resonance imaging (cMRI) within 24 hours.2 DE adopts three methods to measure RV volume,the first is Simpson,the second is the half ellipsoid method,and the last is biplane area-length method.In RT 3DE,RV volume were calculated respectively by tri-plane method and TomTec 4D RV-function CAP software.In cMRI,RV volume was calculated by Argus software.Right ventricular end diastolic and end-systolic volume (RVEDV,RVESV) were measured respectively.Then the echo measurement were compared to cMRI.Consistency of two methods was evaluated by Bland-Altman analysis.Results ①As compared to cMRI,Simpson,the half ellipsoid method and tri-plane method underestimated RV volume,with statistical significance(P ＜0.05).Biplane area-length method and TomTec 4D RV-Function CAP had no significant statistical difference (P ＞ 0.05).② The result of correlation analysis was as follows:RV volumes from Simpson and tri-plane method had bad correlation with those from cMRI (r =0.3-0.4).RV volumes from TomTec,half ellipsoid method and biplane area length method correlated highly with those from cMRI(r =0.7-0.8).③The Bland-Altman analysis of echo methods with cMRI showed that each measurement by TomTec and biplane area-length method had a smaller limit of the agreement and a smaller difference average.Conclusions Tom-Tec 4D RV-Function CAP in RT-3DE and biplane area length method in 2-DE can measure RV volumes accurately.
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ystolic LS and RS are equal in the indentification of the infarcted segments.