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The aortic isthmus (AOI) connects the blood circulation of fetal supraphrenic and subphrenic organs,reflecting fetal blood distribution directly and quickly.The waveform of AOI can demonstrate the fetal blood supply,the presence of intrauterine hypoxia and so on.Measurement of fetal AOI Doppler spectrum and related hemodynamic parameters may provide reliable indicators for early detection and positive intervention in fetal growth retardation,which is of great significance for increasing the detection rate of FGR and reducing the incidence and mortality of perinatal period.The research progresses of hemodynamics in AOI of fetuses during the second and third trimester were reviewed in this article.
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Objective To explore the effects of pregnancy and delivery on the anal sphincter complex (ASC) with 3D-US imaging technique.Methods Transperineal 3D-US images were obtained in 131 women,including 15 nulliparous women (nulliparous group),31 women in middle pregnancy (middle pregnancy group),31 women in late pregnancy (late pregnancy group),24 underwent cesarean section (cesarean section group) and 30 underwent natural childbirth (natural childbirth group).In the resting and anal shrinking state,external anal sphincter (EAS) thickness was measured at 3,6,9 and 12 o'clock positions at distal plane,internal anal sphincter (IAS) thickness was measured at the same four positions at proximal,middle and distal planes,and at the 4 and 8 o'clock positions,the bilateral puborectails muscle (PRM) at middle plane were measured.Results In resting state,at 12 and 9 o'clock positions on the proximal plane,and 3 and 9 o'clock positions on middle plane,the thickness of IAS of cesarean section group was thicker than those in nulliparous group and natural childbirth group (all P＜0.05).On the distal plane,the thickness of EAS at 4 positions of caesarean section group and the natural childbirth group was thinner than those in the late pregnancy group (all P＜0.05).In anal shrinking state,the thickness of IAS at 12 and 9 o'clock positions on the proximal plane,and the thickness of EAS 12 o'clock position on the distal plane,which later pregnancy and cesarean section group were thicker than those in natural children group (all P＜0.05).In resting and anal shrinking state,the thickness of left and right PRM in natural childbirth group were thinner than those in late pregnancy group and cesarean section group (all P＜0.05).In resting and anal shrinking state of nulliparous group,anal shrinking state of middle pregnancy group,and resting state of late pregnancy group,the thickness of left PRM was thicker than those of right PRM (all P＜0.05).Conclusion ASC changes occur in varying degrees in women in middle pregnancy and [ate pregnancy,also in women after cesarean section and natural childbirth.ASC thickening is a protective mechanism for women during pregnancy.
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Placental implantation (PI) is a serious complication of obstetrics and gynecology,which threatens the safety of the mothers and children.Prenatal ultrasound has become the preferred imaging method due to its universality,ecnomic ly and high sensitivity,but the diagnostic efficacy of the indicators is still controversial.The diagnostic value and advantages of various indicators of prenatal ultrasound in the diagnosis of PI were reviewed in this article.
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Placental implantation (PI) is a serious complication of obstetrics and gynecology,which threatens the safety of the mothers and children.Prenatal ultrasound has become the preferred imaging method due to its universality,ecnomic ly and high sensitivity,but the diagnostic efficacy of the indicators is still controversial.The diagnostic value and advantages of various indicators of prenatal ultrasound in the diagnosis of PI were reviewed in this article.
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Objective To better understand the relationship between the maximum tumor diameter and the most distant micrometastases in different types of non-small cell lung cancer (NSCLC) and to provide histological evidence for the delineation of clinical target volume (CTV) from gross tumor volume.Methods We retrospectively studied the pathological specimens from 113 surgically treated NSCLC patients (44 squamous cell carcinoma patients and 69 adenocarcinoma patients) who were admitted to our hospital from 2014 to 2015.The maximum tumor diameter was determined by a combination of gross and microscopic measurements.Micrometastases were microscopically determined.The distances between the tumor edges and micrometastases outside the tumor boundaries were measured by an ocular micrometer followed by a calculation.Quantitative data were analyzed by t test, and qualitative data were analyzed by logistic regression.Results The regression relationship between the maximum tumor diameter and micrometastases was significant in the adenocarcinoma group, but not significant in the squamous cell carcinoma group (P=0.151).The association between the presence or absence of lymph node metastasis and the most distant micrometastasis was significant in the adenocarcinoma group, but not significant in the squamous cell carcinoma group (P=0.597).No association between the degree of tumor differentiation and the most distant micrometastasis was observed in either group (P=0.113).The average measurement of the most distant micrometastases was 2.94 mm in the adenocarcinoma group, with 7.5 mm as the distance to cover 95% of the most distant micrometastases.To reach the same coverage, 4 mm was needed for tumor size smaller than 3 cm, 6 mm for those between 3 cm and 5 cm, and 7.5 mm for those larger than 5 cm.The average measurement of the most distant micrometastases was 2.69 mm in the squamous cell carcinoma group, with 6 mm as the distance to cover 95% of the most distant micrometastases.Conclusions For NSCLC, the most distant micrometastasis of adenocarcinoma is associated with the maximum tumor diameter and presence or absence of lymph node metastasis, and the CTV should thus be adjusted accordingly;no relevance between the most distant micrometastasis and maximum tumor diameter is observed in squamous cell carcinoma;there is no relationship between the most distant micrometastasis and the degree of tumor differentiation in adenocarcinoma and squamous cell carcinoma.
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Objective To obtain the fatal aortic isthmic systolic index(ISI)with prenatal ultrasound,and to establish reference ranges for normal live fatal aortic isthmic systolic index(ISI). Methods A total of 251 normal fetuses at 18?37 gestation weeks were collected and underwent Dop?pler ultrasound examination to obtain the fatal aortic isthmus waveforms. Peak systolic velocity(PSV)and systolic nadir(NS)were measured on the waveforms. ISI was derived from the ratio NS/PSV,and its relationship with gestational weeks was analyzed. Results ISI value was between 0.19 and 0.21,from 18 to 24 gestational weeks. As the gestational weeks increasing,PSV increased;however,NS decreased gradually. At about 28 weeks,a brief end?systolic deceleration wave was observed on the aortic isthmus waveforms,and this trend led to ISI towards a mean value of zero at about 30 weeks. At the end of pregnancy,ISI was about-0.33. The curve equations were established regarding the gestational age as the independent variable X,PSV,NS and ISI as the dependent variable Y respectively. Y∧=-69.116+9.542X-0.139X2,R2=0.96,P<0.001;Y∧=-99.881+10.331X-0.232X2,R2=0.99,P<0.001;Y∧=-0.671+0.086X-0.02X2,R2=0.99,P<0.001. Conclusion Prenatal ultrasound can measure the fetal aortic isthmic systolic index,which is helpful in the diagnosis of fetal cardiovascular anomalies and evaluation of fetal intrauterine status.
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The charge management of medical consumables is the difficulty and weakness of price management in medical institutions. The establishment and application of the secondary database management system has realized precise management for materials fees. It has positive significance in ensuring the quality of medical charge and proving awareness and ability of cost management for departments.
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Objective To analyze the prevention and control condition of infectious diseases of national health cities of prefecture and county level and non-national health cities in Shandong province according to the requirement to create national health cities.Methods To select 15 cities in Shandong province as the research object,including the 5 prefecture-level national health cities,5 county-level national health cities and 5 non-national health city closer to the national health situation.The survey status of infectious diseases,infectious morbidity and children′s vaccination status were analyzed,respectively.Results From 2005 to 2008,registration reporting rate,timeliness rate,accuracy rate and integrity rate of legal infectious diseases increased to 99％ or more.Direct reporting network coverage rate of 1infectious diseases and public health emergencies reached 100％.No type A and B infectious diseases outbreak occurred.The incidences of hepatitis B,dysentery and tuberculosis of national health city were all lower than the rates of non-state health cities and the national average level.The care rate of mobile children living more than 3 months and the immunization rate reached 100％ at county-level cities.Immunization rates of child 4 vaccines and hepatitis B vaccination were more than 99％ annually in the year 2007 and 2008.Conclusions The status of prevention and treatment of infectious diseases is effective.The national health city had a more powerful emergency response ability in Shandong province.
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Objective To study the causes, epidemiology and control measures of outbreak of MRSA nosocomial infections. Methods The epidemiologic survey was carried out for 7 cases infected with MRSA within short term in the department of neurosurgery. The risk factors and epidemiological trends was analyzed. Results Some measures, such as strengthening training of health worker with MRSA prevention and control knowledge, enhancing their awareness of infection prevention and control, and controlling patients infected with MRSA effectively using warning mechanisms of MRSA infection outbreaks, should be taken to control the outbreak and spread of MRSA promptly. Conclusions Nosocomial MRSA infection is preventable and controllable.
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Objective To judge the hospital crisis and to provide the approaches and strategies to avoid the hospital crisis. Methods To conduct specific diagnosis of important risk factors of hospitals using expert diagnostics and crisis identification. Results Combined with the index system and weight affecting public hospitals' crisis, to focus on preventing risk factors directly, which had severe affection and put great weight on hospital crisis. To raise up the containments, managing strategies and mechanisms for public hospitals' crisis. Conclusions It is an effective method to warn and prevent hospital crisis by the way of establishing public hospital crisis value with fuzzy comprehensive evaluation system.
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lusionsThe CEUS findings are different between benign and malignant gallbladder adenomas. The enhancement pattern and speed are useful for differentiating benign from malignant adenomas.
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OBJECTIVE To improve the compliance of medical institutions in the prevention and treatment of influenza A(H1N1) by introduction of game theory.METHODS Solving the mixed strategy Nash equilibrium with the application of game theory model.RESULTS There was inevitable relationship between the proportion of inspections,amercement amount and compliance of prevention and treatment.CONCLUSIONS If the health administration departments decrease the proportion of inspection,the probability will be reduced on the attitude of the medical staff;If the health administration departments increase the proportion of inspection,the probability will also be increased.
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Objective To explore the value of evaluating rat liver fibrosis using contrast enhanced sonography.Methods Carbon tetrachloride was used to induce liver fibrosis.Under the mode of pulse-inversion harmonic imaging,ultrasound contrast agent was bolus iniected through tail vein,hepatic artery arrival time(HAAT),portal vein arrival time(PVAT),hepatic vein arrival time(HVAT)was recorded,and their relationship with immunohistochemical results were analyzed.Results There was no statistical difference of HAAT,PVAT between two groups among S0-S4 stage.HVAT was shorter in S3 and S4 stage than in S0-S2 stage(P＜0.05).HVAT was negative correlated with the percentage of immunohistochemical positive area of C-Ⅳ,LN,the correlation coefficients were-0.680 and -0.639 respectively.Conclusions Contrast enhanced sonography is useful for the diagnosing liver fibrosis.
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Objective To study the correlation between the fetal liver volume and gestational age by three-dimensional ultrasound,and to evaluate its clinical significance.Methods Fetal liver volume from 173 normal fetuses,ranging between 22～39 weeks old,was individually measured by three dimensional ultrasound.Results ① The reproducibility of fetal liver volume measurement by three-dimensional ultrasound was well.② The relationship between fetal liver volume and gestational age was linear(r= 0.93,P