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BACKGROUND:There is an internal relationship between hyperhomocysteinemia and vascular calcification.However,the pathogenesis of hyperhomocysteinemia promoting vascular calcification is still unclear. OBJECTIVE:To investigate the role of bone morphogenetic protein-2 in hyperhomocysteinemia-induced vascular calcification. METHODS:Human carotid wax samples were divided into a calcified group(n=29)and a non-calcified group(n=13)according to the presence or absence of calcified plaque.Sixteen ApoE-/-mice were randomly divided into a control group and a hyperhomocysteinemia group,with 8 mice in each group.Bone morphogenetic protein-2 vector was used to transfect rat thoracic artery smooth muscle A7r5 cells,and gradient concentration of homocysteine(50,100,200,and 400 μmol/L)was utilized to treat A7r5 cells.Calcification was detected by alizarin red staining and hematoxylin-eosin staining.The interaction of bone morphogenetic protein 2 with Runt-related transcription factor 2 was detected by immunofluorescence,and the expressions of bone morphogenetic protein 2,Runt-related transcription factor 2,and α-smooth muscle actin were detected by immunohistochemistry and western blot assay. RESULTS AND CONCLUSION:(1)Human carotid artery tissue staining revealed that compared with the non-calcification group,inflammatory cells increased and calcification positive rate increased in the calcification group(P<0.05).Compared with the non-calcification group,the expressions of bone morphogenetic protein-2 and Runt-related transcription factor 2 were up-regulated,and the expression of α-smooth muscle actin was decreased in the calcification group(all P<0.05).(2)The staining of mouse arterial specimens exhibited that,the positive rate of calcified area in the hyperhomocysteinemia group was significantly higher than that in the control group(P<0.05);serum homocysteine level in the hyperhomocysteinemia group was significantly higher than that in the control group(P<0.05).Compared with the control group,the expressions of bone morphogenetic protein-2 and Runt-related transcription factor 2 were up-regulated,and the expression of α-smooth muscle actin was decreased in the hyperhomocysteinemia group(all P<0.05).(3)A7r5 cell culture analysis demonstrated that with the increase of homocysteine concentration gradient,the degree of calcification,the content of bone morphogenetic protein-2 and Runt-related transcription factor 2 protein in A7r5 cells increased(P<0.05),and the content of α-smooth muscle actin protein decreased(P<0.05).(4)The A7r5 cell culture analysis of overexpressed bone morphogenetic protein 2 showed that the calcification degree of the overexpressed bone morphogenetic protein 2 group was increased compared with the corresponding control group,the β-sodium glycerophosphate group,and the homocysteine group.RUNt-related transcription factor 2 expression up-regulated(P<0.05)and α-smooth muscle actin expression down-regulated(P<0.05).(5)The expression of bone morphogenetic protein 2 increased in A7r5 cells cultured with homocysteine in calcified medium,and the expression of Runt-related transcription factor 2 increased with the increase of bone morphogenetic protein 2 expression.(6)The results confirm that bone morphogenetic protein-2 is a key target gene in the regulation of smooth muscle cell phenotypic transformation resulting in vascular calcification by hyperhomocysteinemia.Targeted regulation of bone morphogenetic protein-2 reduces hyperhomocysteinemia-induced vascular calcification.
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【Objective】 To study the changes in related parameters after secondary preparation of blood components, in order to further improve the quality of blood components. 【Methods】 Different centrifugation conditions were selected for the preparation of primary blood component red blood cells in additive solution leukocytes reduced, and the quality was tested. Then, using the red blood cells in additive solution leukocytes reduced as the initial blood for secondary preparation, and the red blood cells were washed through the Haemonetics ACP 215 device, and the quality was tested. The preparation parameters of blood components were observed, compared and optimized. 【Results】 Under comparable centrifugation effects of different centrifugation conditions, the quality control items, which of primary blood components of red blood cells in additive solution leukocytes reduced and frozen plasma prepared by the separation, such as volume, hemoglobin, hematocrit and residual white blood cells met the relevant national standards. And the quality control items of secondary blood components of washed red blood cells such as the hemoglobin and superalbumin content both met the relevant national standards, while volume exceeded the standard by 7-14 mL, which can be operated to the standard range. In addition, the recovery rate of red blood cells and the clearance rate of plasma protein could reach 75% and 99% respectively. 【Conclusion】 There is a certain correlation between primary and secondary preparation of blood components, but the relevant parameters of secondary preparation of blood components can be flexibly adjusted according to the actual situation to ensure that the quality of prepared blood component products meet the national standards, thus ensuring clinical treatment effect and safety.
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Objective To evaluate the feasibility of secondary transplantation for patients with acute leukemia after failure of the first haploidentical hematopoietic stem cell transplantation. Methods Two acute leukemia patients underwent the first haploidentical hematopoietic stem cell transplantation from two donors with thalassemia, and the number of collected CD34+ cells was 2.57×106/kg and 1.99×106/kg per donor, respectively. The first haploidentical hematopoietic stem cell transplantation failed. Secondary transplantation was performed from two non-thalassemia donors, and the number of collected CD34+ cells was 4.28×106/kg and 5.75×106/kg per donor, respectively. A reduced-intensity conditioning regimen consisting of fludarabine (Flu), busulfan (Bu) and antithymocyte globulin (ATG) was adopted for the secondary transplantation. Results For two recipients, the time of secondary transplantation of neutrophil and platelet was +12 d and +10 d, +10 d and +10 d, respectively. Up to the final follow-up (+1 062 d and +265 d after secondary transplantation), the primary diseases of both two recipients have been completely relieved without evident post-transplantation complications. Conclusions Secondary transplantation with reduced-intensity conditioning regimen may successfully treat acute leukemia after failure of the first haploidentical hematopoietic stem cell transplantation.
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【Objective】 To investigate the preparation quality and clinical application effect of pooled platelets with leukocytes reduced. 【Methods】 The quality and clinical effect of the buffy-coated method prepared pooled platelets leukocytes reduced (experimental group, n=40) and apheresis platelets leukocytes reduced (control group, n=40) were compared. 【Results】 The platelet volume (mL), platelet count (×1011), red blood cell contamination (×108) and residual white blood cell (×106) of the experimental group and control group were 278.90±7.92 vs 276.52±8.01, 2.66±0.09 vs 2.66±0.83, 0.54±0.42 vs 0.83±0.84, 0.29±0.54 vs 0.27±0.51, respectively, with no significant difference. The results of bacterial culture were negative, all met the requirements of relevant national standards. In addition, the CCI (×103, 24 h) and PPR (%) were 15.11±9.86 vs 14.61±12.55 and 54.23±18.70 vs 61.41±19.09 respectively, with no significant difference, indicating a certain degree of therapeutic effect. 【Conclusion】 The quality and clinical therapeutic effect of pooled platelets leukocytes reduced were consistent with that of apheresis platelets leukocytes reduced.
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Objective@#To explore the relationship between myopia and nutritional status among upper elementary students in Shanghai.@*Methods@#A stratified cluster sampling method was used to select 5 576 fourth and fifth grade students from 16 districts in Shanghai, vision test, physical examination and questionnaire survey were administered. Two level multivariate Logistic regression and mixed linear models were used to analyze the relationship between myopia, spherical equivalent (SE) and nutritional status.@*Results@#The detection rates of overweight and obesity were 17.0%(949) and 18.7%(1 042), respectively. There was a statistical difference in the proportion of the nutritional status in boys and girls( χ 2=210.94, P <0.01), with overweight and obesity in boys higher than those of girls. The overweight boys were more likely to have myopia (univariate analysis: OR=1.23, P =0.04; multivariate analysis: OR=1.21, P =0.06) than the normal weight boy. Overweight students tended to had more negative refractive than those with normal weight in both boys and girls(multivariate analysis, boys: β =-0.19, girls: β=-0.24, P <0.05). Myopia risk and refractive power in obese students showed no statistical difference with normal weight students( P >0.05).@*Conclusion@#Overweight students have lower SE than the normal weight among upper elementary students of Shanghai, more researches are needed to confirm this finding and to provide theoretical bases for myopia prevention and control.
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Objective@#To analyze the trends of Internet addiction among adolescents in Shanghai, so as to provide theoretical evidence for the prevention and control of Internet addiction in adolescents.@*Methods@#A multistage stratified cluster random sampling method was conducted, and 92 171 junior and senior high school students in Shanghai were selected for questionnaire survey in 2004-2019. Evaluation of Internet addiction, loneliness, academic pressure and depression among middle school students.@*Results@#In 2004-2019, the rate of Internet addiction among middle school students in Shanghai was 4.3%, which without significant differences by year( t =1.8, P >0.05). The detection rate of Internet addiction in boys (5.3%) was higher than that in girls (3.4%) ( χ 2=186.8, P <0.01), and was highest in secondary vocational school (7.7%), followed by senior high school (4.6%) and junior middle school students (2.8%) ( χ 2=746.5, P <0.01). The prevalence of Internet addiction in girls, senior high school students, secondary vocational school students, students aged 16-20, students with loneliness or high academic pressure showed an increasing trend in 2004-2019, with the average annual increase rate ( APC ) of 6.62%, 5.45%, 2.13%, 3.36%, 4.09% and 3.60% respectively ( P <0.05).@*Conclusion@#Internet addiction among adolescents in Shanghai showed an increasing trend in some groups from 2004-2019, but without significant differences by year in the overall groups. Comprehensive prevention and control programs are needed for adolescent Internet addiction, especially for those with mental health problems.
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Acute undifferentiated leukemia (AUL) is a clinically rare subtype of acute leukemia (AL). AUL lacks the serial specific antigen expressions, and the blasts have no morphological features of myeloid differentiation. Due to the rarity of AUL in clinic, there is no unified understanding of clinical and biological characteristics. It′s difficult to diagnose and choose the optimal treatment for AUL patients. And the prognosis of patients with AUL is poorer compared with other types of AL. Thanks to the big development of biotechnology in recent years, the related researchers have a better understanding of this rare disease. This article reviews the progress of diagnosis and treatment in AUL.
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Objective:To investigate the effect of hemoglobin (Hb) volatility on cardiovascular prognosis in peritoneal dialysis (PD) patients.Methods:Retrospective cohort study was designed. Patients undergoing stable PD for more than 3 months and followed up regularly for at least 1 year were enrolled from May 1, 2013 to October 31, 2014 in the General Hospital of Ningxia Medical University. According to the Hb variation based on the mean changes in Hb standard deviation at 1 month, 3 months, 6 months, 12 months over baseline Hb, all patients were divided into low volatility group (≤10 g/L), moderate volatility group (>10-20 g/L) and high volatility group (>20 g/L), and baseline information were compared among these groups. Kaplan-Meier survival analysis and Cox regression equation were used to analyze the relationship between Hb variation and cardiovascular mortality and all-cause mortality. Besides, the patients were divided into qualified group (Hb≥110 g/L) and substandard group (Hb<110 g/L) by the Hb level at the study endpoint (cardiovascular death and all-cause death) according to KDIGO guidelines and relevant literature. Cox regression analysis was used to analyze the relationship between Hb variation and cardiovascular death in qualified group or substandard group. Multivariate linear regression analysis was used to analyze the related factors of Hb fluctuation in PD patients.Results:A total of 267 patients were enrolled. There were 160 males (59.93%) in this study. The age was (52.66±13.72) years old, and the median dialysis age was 37(21, 61) months. The patients' baseline Hb (before dialysis) was (80.16±14.89) g/L and at the end of the study Hb was (105.34±22.08) g/L. Body mass index and baseline Hb levels in the high volatility group were lower than those in low volatility group and moderate volatility group (all P<0.05). Both moderate and high volatility groups had lower estimated glomerular filtration rate than that in low volatility group, and high volatility group had higher urea nitrogen level than that in low volatility group (all P<0.05). The amount of erythropoietin usage in the high volatility group was higher than that in moderate volatility group ( P<0.05). The Kaplan-Meier survival analysis results showed that there was no significant difference in survival rate for all-cause death (Log-rank χ2=0.735, P=0.693) and cardiovascular death (Log-rank χ2=2.961, P=0.228) in different Hb volatility groups. Cox regression analysis showed that after adjusting for age, sex, serum creatinine, and blood albumin, higher Hb volatility was associated with a lower risk of cardiovascular death ( HR=0.972, 95% CI 0.947-0.999, P=0.040). After adjusting for related confounding factors, higher Hb volatility was still a protective factor for cardiovascular death in the substandard group ( HR=0.946, 95% CI 0.903-0.992, P=0.022), but there was no significant correlation between Hb fluctuation and all-cause death. Multivariate linear regression analysis results showed that the fluctuation level of Hb was positively correlated with Kt/V ( B=4.682, 95% CI 2.480-6.884, P<0.001) and erythropoietin dosages ( B=0.001, 95% CI 0-0.001, P=0.003), and negatively correlated with baseline Hb ( B=-0.554, 95% CI -0.651--0.457, P<0.001). Conclusions:High Hb variability is a protective factor for cardiovascular death in PD patients with lower Hb level (substandard Hb). Adopting a reasonable program to correct anemia timely to reach the standard level has a greater impact on reducing risk of cardiovascular death in PD patients than Hb variation in anemia treatment.
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Human motion control system has a high degree of nonlinear characteristics. Through quantitative evaluation of the nonlinear coupling strength between surface electromyogram (sEMG) signals, we can get the functional state of the muscles related to the movement, and then explore the mechanism of human motion control. In this paper, wavelet packet decomposition and : coherence analysis are combined to construct an intermuscular cross-frequency coupling analysis model based on wavelet packet- : coherence. In the elbow flexion and extension state with 30% maximum voluntary contraction force (MVC), sEMG signals of 20 healthy adults were collected. Firstly, the subband components were obtained based on wavelet packet decomposition, and then the : coherence of subband signals was calculated to analyze the coupling characteristics between muscles. The results show that the linear coupling strength (frequency ratio 1:1) of the cooperative and antagonistic pairs is higher than that of the nonlinear coupling (frequency ratio 1:2, 2:1 and 1:3, 3:1) under the elbow flexion motion of 30% MVC; the coupling strength decreases with the increase of frequency ratio for the intermuscular nonlinear coupling, and there is no significant difference between the frequency ratio : and : . The intermuscular coupling in beta and gamma bands is mainly reflected in the linear coupling (1:1), nonlinear coupling of low frequency ratio (1:2, 2:1) between synergetic pair and the linear coupling between antagonistic pairs. The results show that the wavelet packet- : coherence method can qualitatively describe the nonlinear coupling strength between muscles, which provides a theoretical reference for further revealing the mechanism of human motion control and the rehabilitation evaluation of patients with motor dysfunction.
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Adult , Humans , Algorithms , Electromyography , Movement , Muscle Contraction , Muscle, Skeletal , Physiology , Range of Motion, ArticularABSTRACT
Objective:To investigate the clinical application of salvianolate for injection in Tongde Hospital of Zhejiang Province and evaluate its rationality of injection.Methods:From March 2018 to November 2018, 560 patients treated with salvianolate for injection in Tongde Hospital of Zhejiang Province were selected by random sampling method.The indications, usage and dosage, route of administration, choice of vehicle, concentration of vehicle, course of treatment, compatibility, contraindications and adverse reactions of salvianolate for injection were analyzed retrospectively.Results:Totally 560 inpatients received salvianolate for injection were collected, about 26.96%(151/560) was consistent with the indication, 99.82%(559/560) with a correct administration dosage and frequency, 100.00%(560/560) with right administration route, 95.00%(532/560) with a right solvent selection, 67.86%(380/560) with correct solvent concentration, 61.07%(342/560) with a correct treatment course, 100.00%(560/560) with a right medicine combination, about 94.46%(529/560) was consistent with coagulation function contraindication, about 90.18%(505/560) was consistent with liver function contraindication.The incidence of adverse reactions was 1.61%(9/560).Conclusion:In the clinical application of salvianolate for injection, a high rate of unreasonable usage is found in indication, treatment course and solvent selection.Because of the serious problems in the use of salvianolate injection, it should be used strictly to ensure clinical medication safety.
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Objective To evaluate the performance of axial-pattern composite tissue flap in the repair of skin defects after lip cancer resection.Methods From July 2012 to December 2017,8 patients with lip cancer were enrolled from Department of Dermatology,the Second Hospital of Jilin University.After lip tumor resection,the full-thickness defects were as long as 1/3 to 1/2 length of the lip,and were repaired with axial-pattern composite tissue flaps based on labial arteries.Results All the axial-pattern composite tissue flaps survived after the surgery.During the follow-up of 6 months to 5 years,no tumor recurrence was observed in the 8 patients,the shape and function of lips were improved,and the patients were satisfied.Conclusion Skin defects after lip cancer surgery can be repaired with axial-pattern composite tissue flaps based on labial arteries,which can restore the anatomical structure and aesthetic function of the lip well.
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Objective To investigate the clinical value of fetal echocardiography in prenatal diagnosis , classification and outcome of abnormal origin of pulmonary artery from ascending aorta ( AOPA) . Methods From January 2014 to June 2018 ,18 cases of AOPA diagnosed by echocardiography in 43966 fetuses from Shaanxi Fetal Congenital Heart Disease Diagnostic Center were retrospectively analyzed . The echocardiographic features ,pathological and anatomical classification ,genetic characteristics and outcome of postnatal echocardiography were summarized . Results Abnormal origin of pulmonary artery branches could be demonstrated by color Doppler imaging system in 18 cases . Ten cases ( 55 .6％ ) of right pulmonary artery abnormalities originated from ascending aorta ( AORPA ) ,in which 6 cases ( 60％ ) were distal pulmonary artery abnormalities ,4 cases ( 40％ ) were proximal pulmonary artery abnormalities . Eight cases( 44 .4％ ) of left pulmonary artery abnormalities originated from ascending aorta ( AOLPA ) ,including 7 cases ( 87 .5％ ) of distal pulmonary artery abnormalities and 1 case ( 12 .5％ ) of proximal pulmonary artery abnormalities . Twelve AOPAs were associated with other intracardiac malformations with 6 right ventricular double outlet (DORV) accompanying with pulmonary stenosis ,3 tetralogy of fallots( TOF) ,2 atrioventricular septal defects( AVSD) ,1 single ventricle with single atrium ,and 1 Berry syndrome ,and no casese were associated with extracardiac malformations .Amniocentesis karyotype analysis and gene chip detection in 5 cases showed normal results . Four of 18 cases were born ,in which 3 cases died and 1 case was progressively suffered with right pulmonary artery atresia ,10 cases were inducted of labor ( 4 autopsy) and following-up was lost in 4 cases . Conclusions Incidence of AOLPA and distal type in fetal AOPA is higher than that in child and adult from references ,DORV is abnormal type mostly associated with intracardiac malformation . AOPA has no obvious genetic result for less cases . The main risk after AOPA birth is pulmonary infection . Echocardiography is of great value for AOPA in prenatal diagnosis , outcome observation and surgical planning after birth .
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To better analyze the problem of abnormal neuromuscular coupling related to motor dysfunction for stroke patients, the functional coupling of the multichannel electromyography (EMG) were studied and the difference between stroke patients and healthy subjects were further analyzed to explore the pathological mechanism of motor dysfunction after stroke. Firstly, the cross-frequency coherence (CFC) analysis and non-negative matrix factorization (NMF) were combined to construct a CFC-NMF model to study the linear coupling relationship in bands and the nonlinear coupling characteristics in different frequency ratios during elbow flexion and extension movement. Furthermore, the significant coherent area and sum of cross-frequency coherence were respectively calculated to quantitatively describe the intermuscular linear and nonlinear coupling characteristics. The results showed that the linear coupling relationship between multichannel muscles was different in frequency bands and the overall coupling was stronger in low frequency band. The linear coupling strength of the stroke patients was lower than that of the healthy subjects in different frequency bands especially in beta and gamma bands. For the nonlinear coupling, the intermuscular coupling strength of stroke patients in different frequency ratios was significantly lower than that of the healthy subjects, and the coupling strength in the frequency ratio 1∶2 was higher than that in the frequency ratio 1∶3. This method can provide a theoretical basis for exploring the intermuscular coupling mechanism of patients with motor dysfunction.
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Humans , Case-Control Studies , Electromyography , Muscle, Skeletal , Stroke , Stroke RehabilitationABSTRACT
Objective The aims of this study were to investigate the correlation between the early stage of severe granulocy-topenia and the curative effect on clinical prognosis of chemotherapy in the first-line EP regimen of small cell lung cancer(SCLC). Methods A retrospective study analysis of 82 cases of first-line EP chemotherapy in patients with SCLC was collected clinical da-ta,according to the time of patients with severe neutropenia.Patients were divided into two groups i.e.early-onset group(the first two cycles appeared Ⅲ-Ⅳ neutrophil decline)and non-early-onset group(Ⅲ~Ⅳneutropenia did not appear or three cycles and lat-er).The main indicators for the observation were objective response rate(ORR),disease control rate(DCR),time to progression (TTP)and overall survival(OS).Kaplan-Meier method and Log-rank test were used to analyze univariate survival and Cox propor-tional hazards model to analyze multivariate survival.Results The effective rates of chemotherapy were 81.8% and 75.5%(P=0.499),and DCRs were 97.0% and 95.9% in early-onset and non-early-onset groups,respectively(P>0.05).The median survival time was 10.4 months and 6.9 months in early-onset and non-early-onset groups,respectively(P=0.001).The median OSs were 22.4 months and 16.0 months in early-onset and non-early-onset groups,respectively(P=0.023).Multivariate surviv-al analysis revealed that smoking index,number of chemotherapy cycles,chest radiotherapy and early-onset severe neutropenia were independent prognostic factors for SCLC(P<0.05).Conclusion Chemotherapy-related loss of early severe neutropenia correlates with the efficacy of chemotherapy in SCLC and is an independent predictor of prognosis in SCLC.
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Objective To compare the learning outcomes of team-based learning (TBL) and traditional pedagogy in gastroenterological clinical teaching.Methods Sixty students on eight-year program of clinical medicine were randomly divided into TBL group and tradition group.The two groups adopted TBL and traditional pedagogy respectively in gastroenterological clinical teaching.The scores for Individual Readiness Assurance Test-baseline (IRAT-baseline),Group Readiness Assurance Test (GRAT) and Individual Terminal Test (ITT) in TBL group were compared.The scores for IRAT-baseline,ITT and clinical practice in TBL group were contrasted with those in tradition group.Besides,students in TBL group were investigated by questionnaire after the experiment.Results Compared with tradition group,TBL group spent more time on self-study before clinical teaching [(85.70 ± 11.43) vs.(35.00 ± 9.47),P=0.000].In addition,the form of self-study was more diversified in TBL group than that in tradition group.Students in TBL group achieved higher scores in IRAT-baseline [(17.78 ±5.07) vs.(12.57±4.26),P=0.000],ITT [(23.66 ±5.36) vs.(18.52 ± 4.54),P=0.000] and clinical practice test [(16.53 ± 5.10) vs.(12.24 ± 4.59),P=0.001] when contrasted to tradition group.TBL group gained higher scores in GRAT than those in IRAT-baseline [(27.82 ± 3.12) vs.(17.78 ± 5.07),P=0.000].After the teaching intervention,the scores for ITT were higher than those for IRAT-baseline in both TBL group and tradition group [(23.66 ± 5.36) vs.(17.78 ± 5.07),P=0.000;(18.52 ± 4.54) vs.(12.57 ± 4.26),P=0.000].However,there was no statistical difference in the growth of scores from IRAT-baseline to ITT between TBL group and tradition group [(5.69 ± 2.76) vs.(5.36 ± 2.00),P=0.754].The result of the questionnaire showed that a majority of students in TBL group (＞70％) approved of "I was actively involved in TBL" "TBL is helpful for self-study I've benefited from teacher's explanation in TBL" "I have benefited from group discussion in TBL" and "TBL is more attractive than the traditional pedagogy".Nevertheless,more than half of students in TBL group also indicated "Knowledge learned in TBL is more fragmented than that in traditional pedagogy" and "TBL increased my course load".Conclusions TBL contributes to improving abilities of autonomous learning,clinical thinking,teamwork,communication and knowledge application.This teaching mode could arouse students' learning interests and enhance clinical teaching outcomes.TBL is worth popularizing in gastroenterological clinical teaching.
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Objective To explore the detection rate ,types ,accompanying abnormalities and prognosis of fetal congenital heart disease(CHD) in a single center in northwest China ,in order to set up a foundation for further studying the epidemiological characteristics of fetal CHD and integrated management of fetal CHD in the prenatal and postnatal . Methods A total of 2725 CHD in 45015 fetus diagnosed by fetal echocardiography were enrolled . The fetal CHD detection rate and the composition ratio were calculated . Follow-up results between the simple CHD and complex CHD were analyzed . Results The detection rate of fetal CHD in our center was up to 6 .1％ . There were 1589 cases of complex CHD ,accounting for 58 .3％ in all the fetal CHD ,of which the most common type was single ventricle ,followed by tetralogy of Fallot , atrioventricular septal defect and double outlet right ventricle ;Simple CHD 1136 cases ,accounting for 41 .7％ in all the fetal CHD ,the most common type was ventricular septal defect . The number of abortion cases ,intrauterine and postnatal natural deaths of fetal CHD accounted for 60 .3％ ( 1357/2251) of the total follow-up ,of which complex CHD and chromosomal abnormalities accounting for the majority . 68 cases of CHD underwent surgical treatment after birth ,of which complex CHD were predominant . 37 cases of simple CHD spontaneous closure and 27 cases of simple CHD genetic test results were abnormal . Conclusions The detection rate of CHD in this group is relatively high ,which is related to the prenatal diagnosis consultation center . Fetal complex CHD is more common while the prognosis is worse than simple CHD . Prenatal and postnatal integrated management of fetal CHD has important clinical value in early treatment of complex CHD .
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Objective To investigate the relationship between the severity of white matter lesions (WMLs) and the hematoma volume in patients with spontaneous intracerebral hemorrhage. Methods Patients with intracerebral hemorrhage (age ≥40 years) who were included in the Image Registration Center, Drum Tower Hospital, Nanjing University School of medicine from June 1, 2012 to May 31, 2017 were enrolled retrospectively. The head CT and baseline head MRI data were collected within 12 h after onset. The volume of hematoma on the baseline CT was calculated using ITK-SNAP software. The WMLs volume was semi-automatically segmented and calculated in the WMLs area by MRIcron software and ITK-SNAP software. According to the Fazekas score, the severity of WMLs was divided into mild ( 0-2), moderate (3-4) and severe (5-6). According to the median volume of hematoma, the patients were divided into smaller hematoma volume group and larger hematoma volume group. The baseline data in patients of both groups were compared. Multivariate logistic regression analysis was used to determine the independent related factors of hematoma volume. Results Age, National Institutes of Health Stroke Scale (NIHSS) score, and hematoma volume increased with the severity of WMLs, while the total cholesterol and low-density lipoprotein cholesterol levels decreased with the severity of WMLs. Hematoma volume was significantly associated with the NIHSS scores, apolipoprotein A1, D-dimer, WML volume, and intracerebral hemorrhage site. Multivariate logistic regression analysis showed that high WML score (odds ratio [OR] 1.001, 95% confidence interval [ CI] 1.002-1.008; P=0.049), intracerebral hemorrhage site ( OR 1.441, 95% CI 1.090-1.911; P=0.010), and NIHSS score (OR 1.081, 95% CI 1.011-1.152; P=0.031) were the independent risk factors for larger hematoma volume. Conclusion The severity of WMLs was significantly positively correlated with the baseline hematoma volume in patients with spontaneous intracerebral hemorrhage.
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Objective To investigate the clinical efficacy and toxicity in the use of simultaneous integrated boost intensity modulated radiation therapy (SIB-IMRT) for inoperable locally advanced nonsmall cell lung cancer (LA-NSCLC).Methods Between February 2012 and July 2015,58 pathologically diagnosed inoperable LA-NSCLC patients treated with SIB-IMRT were analyzed.A radiation dose of 50-64 Gy was administered in 1.8-2.2 Gy/fraction (26-30 fractions) to the planning target volume (PTV).Simultaneously,60-70 Gy was administered in 2.0-2.35 Gy/fraction (26-30 fractions) to the planning gross tumor volume (PGTV).Results The median follow-up time was 28.0 months (ranging from 6.0 to 40.0 months).The median overall survival (OS) and progress-free survival (PFS) were 25.0 (95％ CI:23.8-26.2) and 15.0 (95％ CI:11.3-18.7) months,respectively.The 1-,2-year OS were 91.4％ and 51.7％,respectively.The 1-,2-year PFS were 56.9％ and 22.7％,respectively.None of the patients developed grade 4 or 5 pneumonitis and esophagitis.In addition,in the subgroup analysis,the patients with N3 have a higher incident of ≥ grade 2 esophagitis compared with N0-N2,the incident are 29.2％ and 20.6％,respectively (P ＜ 0.05).Conclusions SIB-IMRT is feasible and well-tolerated for inoperable LA-NSCLC patients.It remains to be further evaluated in a large sample size prospective clinical trial.
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Objective To explore the application value of fetal echocardiography for the diagnosis and prognosis assessment of anomalous pulmonary venous connection (APVC),by comparing the results of prenatal diagnosis of APVC by ultrasound and follow-up.Methods Eighty-one APVC fetuses diagnosed by fetal echocardiography were followed up regularly.These results were compared with postnatal ultrasound diagnosis,operation and anatomy.The main points of methodology and differential diagnosis were summarized.Results Eighty-one APVC fetuses included 68 cases of total APVC(31 cases of supracardiac type,15 cases of intracardiac type,22 cases of infracardiac type),13 cases of Partial APVC(2 cases of supracardiac type,10 cases of intracardiac type,1 case of infracardiac type);12 cases of isolated APVC,69 cases of complex APVC(combined with other cardiovascular abnormalities);6 cases were born(4 infants of isolated APVC survived after operation,2 infants of complex APVC died),2 cases were ongoing pregnancy,71 cases were aborted (30 cases were dissected),2 cases were lost to follow-up.Conclusions Fetal echocardiography has important application value in diagnosis and prognosis assessment of APVC and the ones with other cardiovascular abnormalities.
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Objective To investigate clinical effects of bio-feedback and pelvic electric stimulation on stress urinary incontinence (SUI).Methods Fifty-six patients with SUI were selected randomly.All the patients received one or two courses of treatment and the effects were observed.Results Forty-three patients finished the treatment and the symptoms were improved.Scores of ICI-Q-SF and rotational angle of bladder were found to be significantly different from those before the treatment.Conclusions Stress urinary incontinence could be treated by bio-feedback and pelvic electric stimulation.Both the combination of treatment and individualized treatment should be taken into account.