Comparison of the efficacy of three types of Kirschner wire tension bands for ulnar olecranal fracture / 中国骨伤

OBJECTIVE@#To compare the clinical effect of three types of Kirschner wire tension band for olecranon fracture.@*METHODS@#The clinical data of 64 patients with olecranon fracture treated by Kirschner wire tension band fixation from March 2016 to May 2020 were retrospectively analyzed. Among them, 19 patients were treated with intramedullary K-wires fixation(group A) including 8 males and 11 females with an average of (48.2±18.3) years old, 3 patients were typeⅠ, and 16 patients were typeⅡ according to Mayo classification;20 patients were treated with transcortical K-wires fixation (group B) including 13 males and 7 females with an average of (43.5±20.4) years old, 3 patients were typeⅠand 17 patients were typeⅡ according to Mayo classification;25 patients were treated with perforated Kirschner wire(group C) including 15 males and 10 females with an average of (55.2±17.5) years old, 4 patients were typeⅠand 21 patients were typeⅡ according to Mayo classification. The operative time, intraoperative blood loss, times of Intraoperative fluoroscopy, fracture healing time and complications of 3 groups were compared. At the final follow-up, elbow function was assessed using the Mayo Elbow Function Scale.@*RESULTS@#There were differences in operative time, intraoperative fluoroscopy times, postoperative VAS and soft tissue irritation among the three groups(P<0.05). The operative time, intraoperative fluoroscopy times in group A and C was better than that in group B. The postoperative VAS score, skin irritability in group C was better than that of group B. The difference was statistically significant on Mayo elbow function score at the final follow-up among three groups(P<0.05), the scores of group A and C were higher than that of group B.@*CONCLUSION@#Compared with transcortical K-wires screw fixation, both intramedullary K-wires screw fixation and perforated Kirschner wire fixation, which can significantly reduce the occurrence of soft tissue irritation, reduce surgical complications and shorten the operation time.

Prenatal ultrasound diagnosis of fetal microphthalmia / 中华超声影像学杂志

Objective@#To analyze the ultrasonic features, associated malformations and combined genetic abnormalities of microphthalmia .@*Methods@#The characteristics of 15 cases of fetal microphthalmia were retrospectively analyzed. And the proportion of fetal microphthalmia associated malformations were further assessed according to the different organ system.@*Results@#All the orbital diameters of affected eyes of the 15 cases were less than the 5th centile of normal fetal orbital diameter corresponding to gestational age. In which, 26.67%(4/15) fetuses had additional ocular defects, and 66.67%(10/15) were diagnosis with extrocular defects, including 20.00%(3/15) with central nervous system defects, 13.33%(2/15) with orofacial defects, 26.67% (4/15) with cardiac defect, 13.33%(2/15) with limb defect, 33.33% (2/15) with urogenital defect and 40.00%(6/15) with abnormal ultrasonographic soft markers. And the proportion of fetal microphthalmia associated extrocular defects showed no significant difference(P=0.502).@*Conclusions@#Fetal microphthalmia is frequently associated with random and sporadic occurrence of extrocular defects

Prenatal ultrasound diagnosis of fetal microphthalmia / 中华超声影像学杂志

Objective To analyze the ultrasonic features ,associated malformations and combined genetic abnormalities of microphthalmia . Methods The characteristics of 15 cases of fetal microphthalmia were retrospectively analyzed . And the proportion of fetal microphthalmia associated malformations were further assessed according to the different organ system . Results All the orbital diameters of affected eyes of the 15 cases were less than the 5th centile of normal fetal orbital diameter corresponding to gestational age . In which ,26 .67% ( 4/15 ) fetuses had additional ocular defects ,and 66 .67% ( 10/15 ) were diagnosis with extrocular defects ,including 20 .00% ( 3/15) with central nervous system defects ,13 .33% ( 2/15) with orofacial defects ,26 .67% ( 4/15) with cardiac defect ,13 .33% ( 2/15) with limb defect ,33 .33% ( 2/15) with urogenital defect and 40 .00% ( 6/15 ) with abnormal ultrasonographic soft markers . And the proportion of fetal microphthalmia associated extrocular defects showed no significant difference ( P ＝ 0 .502 ) . Conclusions Fetal microphthalmia is frequently associated with random and sporadic occurrence of extrocular defects

Chromosomal anomalies in fetuses with structural malformation detected by ultrasonography at 11-13+6 gestational weeks / 中华围产医学杂志

Objective To investigate the clinical performance of ultrasound screening for fetal structural anomalies at 11-13+6 weeks of gestation and to evaluate the relation of structural anomalies with karyotypes and copy number variations. Methods A retrospective analysis was conducted on fetuses with structural anomalies detected by ultrasound examination at 11-13+6 gestational weeks in First Affiliated Hospital of Sun Yat-Sen University from January 2013 to December 2017. Karyotype and chromosomal microarray analysis(CMA) were offered to these fetuses and ultrasound scans were repeated at 16-18 gestational weeks. All fetuses were followed up to termination or birth. Fisher's exact test was used for statistical analysis. Results A total of 362 fetuses with structural anomalies were studied including 101 (27.9%) fatal malformations, 253 (69.9%) major malformations and eight (0.2%) minor malformations. Cardiac malformation (32.6%, 118/362), central nervous system anomalies (24.9%, 90/362) and anterior abdominal wall defects (20.9%, 76/362) were the three most common abnormalities. Invasive prenatal test was performed in 107 cases including 25 fatal, 79 major and three minor malformations. Thirty (28%) out of the 107 cases had abnormal karyotypes, which were chromosomal aneuploidies (n=28) and chromosomal fragment abnormalities (n=2). Among the 99 cases received CMA, 25 had abnormal karyotypes, and copy number variations were identified in eight [three (4.05%) were pathogenic variations] out of the rest 74 with normal karyotypes. The incidence of chromosomal abnormalities in fetuses with major malformations was higher than that of fetuses with fatal malformation [32.9% (26/79) vs 12.0% (3/25), P=0.045]. Altogether, 117 cases repeated second-trimester ultrasound among which 16 (13.7%) were normal; 19 (16.2%) had cardiac defect which was discordant with the first-trimester evaluation and five (4.2%) were found to have additional malformations. Diagnosis of the other 77 cases were consistent with the first-trimester ultrasound findings. After the second-trimester ultrasound scanning, 49 pregnancies were terminated; 39 twin pregnancies and four triplet pregnancies underwent selective fetal reduction; 25 continued to delivery with good neonatal outcomes. Out of the 23 699 cases without abnormal ultrasound findings at 11-13+6 gestational weeks, 20 182 (85.2%) were successfully followed up, among which structural abnormalities were found in 178 during the second trimester and in 31 after birth. Conclusions A detailed ultrasound examination at 11-13+6 weeks of gestation is important to identify fetal structural defects. However, it could not replace the second-trimester ultrasound. There is a high risk of chromosomal abnormalities in fetuses with early-detected structural defects. CMA is able to identify pathogenic copy number variations with a relatively low detection rate.

Application of Single Nucleotide Polymorphism Microarray Analysis for the Investigation of Fetuses with Conotruncal Heart Defects / 中山大学学报(医学科学版)

@#【Objective】This study aimed to explore copy number variations（CNV）in fetuses with conotruncal heart defect （CTD）. 【Methods】 Fetuses with ascertained CTD were investigated for chromosomal aberrations including copy number variations with chromosomal microarray analysis（CMA）and QF-PCR. Based on clinical significance of CNV，Fetuses were divided into two subgroups：non- benign CNV group ［（pathogenic CNV and CNV of unknown significance（VOUS）］and benign CNV group. Data on fetal structural malformations，copy number variations，and pregnancy out? comes were collected and compared.【Results】Among 128 cases without chromosomal aneuploidies ，pathogenic CNV ， CNV of VOUS ，and benign CNV were identified in 5.5% ，4.7% ，and 3.9% ，respectively. Compared with cases in benign CNV group（n=115），fetuses in non- benign CNV（n=13）had a significantly higher rate of overall extra- cardiac anomalies（76.9% vs. 43.5%，P=0.037），structural extra-cardiac anomalies（61.5% vs. 24.2%，P=0.022），softer mark? er anomalies（61.5% vs. 20.9% ，P=0.004），and thymus anomalies（30.8% vs. 0.87% ，P=0.000），whereas，no significant difference in that of intra- cardiovascular anomalies was noted（53.9% vs. 53.9%，P=1.000）excepted for that of persistent left superior vena cava（46.2% vs. 13.9% ，P=0.010）. The incidence of natural death in non- benign group was higher than but not statistically different from that of benign group.【Conclusions】Pathogenic CNV contributed to the pathogenesis of CTD. The presence of associated extra-cardiac anomalies including thymus abnormalities correlated with a higher probability of non-benign CNV.

Cause analysis and treatment of reoperative metabolic and bariatric surgery:A report of 54 cases / 中国实用外科杂志

OBJECTIVE: To explore the cause and treatment of bariatric and metabolic surgery reoperation. METHODS: A retrospective analysis was conducted on the clinical data of 54 patients underwent reoperative metabolic and bariatric surgery in Department of Bariatric and Metabolic Surgery,the First Affiliated Hospital of Jinan University from November 2000 to December 2018, and the reasons and surgical techniques of reoperation were analyzed. RESULTS: Causes of reoperation included inadequate weight loss/weight regain in 22 cases(40.7%),adhesive intestinal obstruction in 5 cases(9.3%),mesenteric hernia in 5 cases(9.3%),gastroesophageal reflux in 4 cases(7.4%),anastomotic leakage4 cases(7.4%),anastomotic ulcer bleeding in 3 cases(5.6%),anastomotic stenosis in 3 cases(5.6%),postoperative intraabdominal bleeding in 3 cases(5.6%),recurrent diabetes in 2 cases(3.7%),severe dumping syndrome in 2 cases(3.7%),anastomotic error in 1 case(1.9%). Reoperation methods mainly included Roux-en-Y gastric bypass in 30 cases(55.6%),sleeve gastrostomy in 10 cases(18.5%),hernia repair in 5 cases(9.3%),exploratory laparotomy hemostasis in 4 cases(7.4%),gastroscopic balloon dilatation in 2 cases(3.7%),restoration surgery in 1 case(1.9%),revisional banded gastric bypass with GaBP ring in 1 case(1.9%), hiatal hernia repair in 1 case(1.9%). A total of 54 patients underwent reoperation with a follow-up period of 1 to 102 months. Among them, 42 patients were followed up,and 12 patients were lost to follow-up(follow-up rate of 77.8%). Among the 42 patients who were followed up, 41 of them achieved good results after surgery, and the symptoms and signs were relieved to various degrees. CONCLUSION: The most common cause of reoperative metabolic and bariatric surgery is inadequate weight loss/weight regain.The choice of reoperation method depends on the primary surgical procedure, the cause of failure, and the intraoperative condition.

Prenatal ultrasound diagnosis and clinical outcomes of fetal hepatohilar cystic occupying lesions / 中华超声影像学杂志

Objective To explore the prenatal ultrasound diagnosis and postnatal clinical outcomes of fetuses with hepatohilar cystic occupying lesions . Methods T his was a retrospective study that included all fetuses found to have hepatohilar cystic occupying lesions diagnosed by ultrasound in the First Affiliated Hospital of Sun Yat‐sen University between January 2008 and December 2017 . According to the morphology of the cyst and max diameter ,the cases were divided into four groups . Cases with polygonal cysts and max diameter over 30 mm were assigned to group 1 ,non‐polygonal cysts and max diameter over 30 mm to group 2 ,polygonal cysts and max diameter under 30 mm to group 3 ,non‐polygonal cysts and max diameter under 30 mm to group 4 . T he birth status ,ultrasound review image ,surgical treatment and pathological findings were tracked to analyze the prognosis of these fetuses . Results Among 47 cases of fetal hepatohilar cystic occupying lesions ,38 fetuses were born and 9 were terminated with only 1 case taking pathological examination . T here were 39 cases with pregnancy outcomes . T wenty‐seven cases ( 69 .2% ,27/39) were diagnosed as congenital biliary dilatation ( CBD) ,5 cases ( 12 .8% ,5/39) were found cysts resolved in postnatal ultrasound examinations . Biliary atresia was diagnosed in 3 cases ( 7 .8% ,3/39 ) by operation ; M esenteric cysts ( 5 .1% ,2/39) were diagnosed in 2 cases by ultrasound . One ( 2 .6% ,1/39) was diagnosed as double‐gallbladder by ultrasound . 1 ( 2 .6% , 1/39 ) was diagnosed as teratoma by operation . M ost cases were in the group 3 ,but there was no significant difference compared with other groups ( all P ＞ 0 .05) . Conclusions More than half of hepatohilar cystic occupying lesions diagnosed in prenatal ultrasound are proved to be CBD with good prognosis . T he cysts in few cases can be resolved after born . 7 .8% of cases are biliary atresia with poor prognosis ,w hich give messages to prenatal clinical consultation .

Analysis of copy number variation by CMA in fetus with increased nuchal translucency / 中华妇产科杂志

Objective To investigated the clinical value of chromosomal microarray analysis (CMA)in fetuses with increased nuchal translucency(NT). Methods Totally 101 cases out of 19261 singleton fetuses who underwent the first trimester(11-13+6 weeks)ultrasound examination from January 2015 to June 2017 at First Affiliated Hospital of Sun Yat-sen University were diagnosed with NT ≥2.5 mm and underwent invasive prenatal test for fetal karyotype and CMA. According to the combination of other ultrasound abnormalities,the cases were divided into isolated group(67.3％, 68 / 101)and complicated group(32.7％, 33/101). In addition, the cases were divided into 5 groups according to the thickness of NT,2.5-2.9 mm(borderline thickening;16.8％, 17/101), 3.0-3.4 mm(33.7％, 34/101), 3.5-4.4 mm(16.8％, 17/101),4.5-5.4 mm(15.8％, 16/101),and ≥5.5 mm(16.8％, 17/101). Chi square test was used to detect the different rates of other combined ultrasound abnormalities and abnormal chromosome between 5 groups. Results The median thickness of NT was 3.4 mm(2.5-8.5 mm). And 32 cases(31.7％, 32/101)had abnormal karyotype. There was a significant difference in the frequency of abnormal karyotype between the isolated and the complicated group(20.6％ vs 54.5％, P<0.01). Among 69 cases(68.3％,69/101) of normal karyotype, 3 cases(4.3％, 3/69)were detected with pathogenic copy number variation(CNV) by CMA. Thirty-five cases with chromosomal abnormalities(include abnormal karyotype and pathogenic CNV), there was a significant difference in the frequency of chromosomal abnormalities between the isolated and the complicated group(23.5％ vs 57.6％, P=0.001). The median age of pregnant women in 5 groups was 35 years(24-39 years),33 years(23-46 years),31 years(21-46 years),33 years (21-41 years) and 35 years (21-43 years). The rates of chromosomal abnormalities increased with the increase of NT thickness. There was significant difference in the incidence of associated chromosomal abnormalities among 5 groups(P<0.05). Comparative analysis within the 5 groups, the incidence of associated chromosomal abnormalities between NT 2.5-2.9 mm and ≥5.5 mm was significantly different (P=0.005), while the differences between the other groups were not significant(P>0.05). Conclusions There is a high risk of fetal chromosomal abnormalities in borderline NT thickening (2.5-2.9 mm)at advanced maternal age, but the pathogenic CNV is not detected. Chromosomal microdeletion or microduplication could be further detected in the NT thickening(≥3.0 mm)fetuses with normal karyotype by chromosome microarray analysis, while the positive rate is relatively low, and the variants of unknown significance might be detected.

Clinical effects of loading doses of rosuvastatin in treatment of acute cerebral infarction and influence on cere-bral hemodynamics / 局解手术学杂志

Objective To observe the effects of loading doses of rosuvastatin in treatment of acute cerebral infarction and influence on cerebral hemodynamics.Methods One hundred and twenty-six patients of acute cerebral infarction who were admitted into hospital from January 2014 to June 2016 were selected and randomly divided into the observation group(63 cases,loading doses of rosuvastatin,40 mg per day at the first time,and then 20 mg per day)and the control group(63 cases,routine doses of rosuvastatin,10 mg per day),and one course lasted for 3 months.The NIHSS scores and Barthel index before treatment,1 month and 3 months after treatment were compared,as well as the clinical effects and cerebral hemodynamics changes 3 months after treatment.Results The NIHSS scores of the observation group at 1 month and 3 months after treatment were respectively lower than those of control group with statistical significance(P<0.05),and scores of the Barthel index of the observation group were higher than those of the control group with statistical significance(P<0.05).The total effective rate in the observation group was 88.89%,which was higher than that of the control group(77.78%),but the difference was not statistically significant(P>0.05).After the treatment,bilateral pulsation index(PI)of the observation group were lower than those of the control group (P<0.05).Systolic blood flow velocity(Vs)and mean blood flow velocity(Vm)were higher than those in the control group(P<0.05). The difference of adverse reaction between 2 groups was not statistically significant(P>0.05).Conclusion Loading doses of rosuvastatin can achieve better curative efficacy in treatment of patients with acute cerebral infarction and better improvement of cerebral hemodynamics.

Design, synthesis and evaluation of a novel MEK protein inhibitors / 药学学报

This study was conducted to design and synthetize highly efficient, specific, non-resistant small MEK inhibitors. Based on active small molecules which have been reported, we studied the action mode with MEK protein using Autodock 4.2, generated innovative and feasible design method, designed novel small MEK protein inhibitors with a reference to molecular modeling and docking. The anti-tumor activities of four kinds of cells including MCF-7, PANC-1, SY5Y, A549 were tested with MTT method in vitro. The structure of 10 new small molecules has been determined with 1H NMR and 13C NMR. The compounds 4, 6, 7, 8, 10 had high antitumor activities, the compounds 1, 3, 5 also showed good activity, and the compounds 2, 9 showed cell selectivity in killing tumor.

Pharmaceutical inactivation of Erk1/2 does not affect function of FGF21 to regulate glucose and lipid metabolic hemostasis / 中国病理生理杂志

AIM: To investigate whether inactivation of extracellular signal-regulated kinase 1/2 ( Erk1/2 ) will affect the function of fibroblast growth factor 21 (FGF21) to regulate glucose and lipid metabolism .METHODS:Male db/db mice (8 weeks old) were treated with U0126 (an inhibitor of Erk1/2 kinase) for 1 week, and then treated with re-combinant human FGF21 protein and adenovirus-mediated FGF21 (Ad-FGF21).The profile changes of blood glucose and blood lipid were evaluated at 120 min or 4 weeks after FGF21 administration.Meanwhile, the molecular mechanism was ex-plored by in vitro study.RESULTS: Treatment of db/db mice with recombinant human FGF21 protein significantly re-duced blood glucose and triglyceride levels at 120 min after FGF21 administration , but these changes were comparable in U0126-treated mice .Furthermore , abnormal glucose and triglyceride levels , and glucose and insulin tolerance were strong-ly improved in db/db mice as accompanied with decreasing body fat content after 4 weeks of ad-FGF21 administration .In-terestingly, treatment with or without U0126 did not influence these effects of FGF21.Mechanically, treatment with Ad-FGF21 significantly upregulated the protein levels of p-Erk1/2 and peroxisome proliferator-activated receptor γ( PPARγ) as well as the expression of adiponectin at mRNA and protein levels in adipose tissues .However , treatment with or without U0126 did not change the profiles .On the other hand , in vitro experiments also indicated that treatment of adipocytes with recombinant human FGF 21 protein significantly activated Erk 1/2 phosphorylation , and upregulated the expression levels of PPARγand adiponectin (P<0.05).However, pre-administration of U0126 did not affect the profiles.CONCLUSION:Pharmaceutical inactivation of Erk 1/2 by U0216 does not affect the biological function of FGF 21 to regulate blood glucose balance and improve abnormal blood lipids in vivo.

Prenatal Sonographic Characteristics of Clubfoot and Relationship with Chromosomal Abnormalities / 中山大学学报(医学科学版)

[Objective]To evaluate the incidence of chromosomal abnormalities and associated abnormalities in prenatally diag?nosed clubfoot,and to determine the prognostic factors as well.[Methods]A total of 89 fetuses with clubfoot diagnosed during Janu?ary 2010 to October 2015 in prenatal ultrasound scan and confirmed postnatally or by autopsy,were selected,within which 16 (18.0%)cases were without other abnormalities and 73(82.0%)cases were with other abnormalities. The associated abnormalities were identified ,the correlation with chromosomal abnormalities were analyzed with Fisher analysis and the factors affecting the outcomes were determined with Logistic regression analysis.[Results]Among associated abnormalities ,the skeletal abnormalities besides the clubfoot were the most frequently associated anomalies (35 ,47.9%),and the central nervous abnormalities followed secondly(30,41.1%). A chromosomal abnormality,with trisomy 18 being the most frequently detected,was identified in 34%(17/49)of the clubfoot fetuses with other anomalies ,whereas none of chromosomal abnormality was identified in 11 fetuses without other anomalies,a significant different rate of aberrant chromosome noted(P < 0.001). The survival rate of clubfoot fetuses without other anomalies was higher than that of clubfoot fetuses with other anomalies(50.0%vs 1.3%,P=0.03). The conditions of with or without associated anomalies were the independent prognostic factors (P = 0.01),the clubfoot fetuses associated with other anomalies had poor outcomes[OR=11.9(95%CI:1.8,80.1)].[Conclusion]Skeletal abnormalities besides the clubfoot were the most frequently associated anomalies. The condition of with or without associated anomalies is the independent prognostic index for fetuses with clubfoot. Aneuploidy were more commonly in clubfoot fetuses with associated abnormalities than in those without other abnormalities. No indication for karyotyping suggests for the clubfoot fetuses without other abnormalities due to the low incidence of associate chromo?somal anomalies.

Treatment of pediatric distal femur fractures by external fixator combined with limited internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the clinical effects of external fixator combined with limited internal fixation in the treatment of pediatric distal femur fractures.</p><p><b>METHODS</b>From January 2008 to June 2014, 17 children of distal femur fractures were treated by external fixator combined with limited internal fixation. There were 12 males and 5 females, aged from 6 to 13 years old with an average of 10.2 years, ranged in the course of disease from 1 h to 2 d. Preoperative diagnoses were confirmed by X-ray films in all children. There were 11 patients with supracondylar fracture , and 6 patients with intercondylar comminuted fracture. According to AO/ASIF classification, 9 fractures were type A1, 5 cases were type A2,and 3 cases were type C1. The intraoperative and postoperative complications, postoperative radiological examination, lower limbs length and motion of knee joints were observed. Knee joint function was assessed by KSS score.</p><p><b>RESULTS</b>All the patients were followed up from 6 to 38 months with an average of 24.4 months. No nerve or blood vessel injury was found. One case complicated with the external fixation loosening, 2 cases with the infection of pin hole and 3 cases with the leg length discrepancy. Knee joint mobility and length measurement (compared with the contralateral), the average limited inflexion was 10 degrees (0 degrees to 20 degrees), the average limited straight was 4 degrees (0 degrees to 10), the average varus or valgus angle was 3 degrees (0 degrees to 5 degrees). KSS of the injured side was (96.4 +/- 5.0) points at final follow-up, 16 cases got excellent results and 1 good. All fractures obtained healing and no epiphyseal closed early was found.</p><p><b>CONCLUSION</b>External fixator combined with limited internal fixation has advantages of simple operation, reliable fixation, early functional exercise in treating pediatric distal femurs fractures.</p>

Radiofrequency ablation and bipolar umbilical cord coagulation for complicated monochorionic twins / 中华围产医学杂志

Objective To assess the effects of radiofrequency ablation (RFA) and bipolar cord coagulation (BCC) on the prognosis and complication rate of complicated monochorionic twins.Methods A retrospective review was undertaken in 58 cases of complicated monochorionic twins treated with RFA or BCC at the First Affiliated Hospital of Sun Yat Sen University,from January 2008 to August 2013.Non-parametric Wilcoxon test,Chi-square test,Fisher exact test or multi-variant Logistic regression analysis were used for statistical analysis.Results Indications for selective termination in the 58 cases were:twin reversed arterial perfusion sequence in 12,severe twin to twin transfusion syndrome in 28,discordance of fetal anomalies in 10,selective intrauterine growth restriction in 7 and twin anemia-polycythemia sequence in 1.Forty-three cases were managed with BCC and 15 with RFA.Preterm labor was more common in the BCC group than in the RFA group [86.0％(37/43) vs 9/15,respectively; x2=4.598,P=0.032).Premature rupture of the membranes occurred in 48.8％(27/43) of the BCC group vs.4/15 of the RFA group (x2=2.229,P=0.135).The median procedure-todelivery time was 48 (1-150) days for the BCC group vs.101(14-138) days for the RFA group (Z=-2.245,P=0.025).Overall survival rate was 62.8％(27/43) in the BCC group vs 11/15 in the RFA group (x2=0.547,P=0.460),which was not significantly different.Neurodevelopmental delay was detected in two neonates in BCC group and in one neonate in RFA group.Logistic regression analysis showed that delivery before 28 gestational weeks was an independent risk factor for the poor prognosis of the co-twins (OR=192.720,95％CI:18.610-994.000,P ＜ 0.01).Conclusion Compared with BCC,RFA does not improve the prognosis of complicated monochorionic twins significantly.

Comparison between the aorta and pulmonary artery dimensions z-score in fetus with tetralogy of Fallot and normal fetus / 中华超声影像学杂志

Objective To establish z-score model for fetal aorta (Ao) and pulmonary artery (PA) dimensions base on fetal femur length (FL),then to evaluate them in prenatal diagnosis of tetralogy of Fallot (TOF).Methods Three hundred twenty-nine normal fetuses and 43 fetuses with TOF were involved,Ao and PA dimensions were measured for all cases offline after cardio-spatiotemporal image correlation (STIC) volume acquisition,and PA to Ao ratio (PA/Ao) was calculated.Normal Ao and PA dimensions z-score models were constructed by using first standard regression analysis using FL as independent variable.Subsequently,the three parameters between normal and TOF fetuses were compared.Results The models use to calculate z-score for Ao and PA dimensions were constructed,FL had close correlation with fetal Ao and PA dimensions.Compared with normal fetuses,the mean z-scores of Ao,PA and PA/Ao ratio were statistical different in TOF fetuses.All Ao z-scores were ＞ + 2 z-scores and all the PA/Ao ratio were ＜ the 95％ CI in TOF group,however,only 48.84％ (21/43) PA z-scores of TOF cases were ＜-2 z-scores.Conclusions The Ao and PA dimensions z-score can provide quantitative evidence in prenatal diagnosis of TOF.Aortic dilatation and abnormal PA/Ao ratio are the main performances in fetal TOF and would be markers for prenatal diagnosis of TOF.

Association between fetal ventricular septal defects and chromosomal abnormalities / 中华妇产科杂志

Objective To evaluate the association between fetal ventricular septal defects (VSD)and chromosomal abnormalities.Methods The 214 fetuses diagnosed VSD in the First Affiliated Hospital of Sun Yat-sen University from January 2008 to September 2011 were included.The VSD were categorized into 3 types:perimembranous,muscular and mixed (the defect could not be classified because the dimensions were larger than 5 mm) type.The perimembranous defect was subdivided into inlet and outlet subtypes.Complicated with other cardiac abnormalities/extracardiac abnornalities or not,the cases were divided into isolated VSD group,VSD complicating cardiac anomalies group (other cardiac and/or great vessels malformation),VSD complicating extracardiac anomalies group (include organ malformation and sonographic soft markers) and VSD with both cardiac and extracardiac anomalies group.G-banding chromosome analysis was advised for all cases.In cases that no karyotype was obtained,the phenotype of the newborns was examined by the pediatricians.And those appeared normal were defined as normal karyotype.Results (1) There were 134 (62.6％,134/214) perimembranous defects,including 91 (42.5％,91/214) inlet lesions and 43 (20.1％,43/214) outlet lesions.There were 35 (16.4％,35/214) muscular defects and 45 (21.0％,45/214) mixed type lesions.(2) Among the 214 VSD fetuses,46 (21.5％) were isolated VSD,34 (15.9％) were cases with other cardiac anomalies,87 (40.6％) were cases with extracardiac anomalies and 47 (22.0％) were cases with both cardiac and extracardiac anomalies.(3) The chromosomal karyotypes were obtained in 105 cases,and 21 cases were considered as normal according to the phenotype.Of all these 126 cases,46 (36.5％,46/126) had chromosomal abnormalities.(4) Inlet defects had the highest risk of chromosomal abnormalities (28/55,50.9％),while the muscular defects had the lowest risk (2/25,8.0％).The incidence of chromosomal abnormalities in outlet and mixed type was 33.3％ (9/27) and 7/19,respectively.The types of VSD were significantly correlated with chromosomal defects (P ＜ 0.01).(5) The incidence of chromosomal abnormalities in the 4 groups were 3.4％ (1/29),2/14,53.6％ (30/56) and 48.1％ (13/27),respectively.The risk of chromosomal abnormalities in the cases complicating extracardiac or both extracardiac and cardiac anomalies was significantly higher than the isolated VSD group (P ＜ 0.01).Conclusion Fetal VSD had a highest risk of chromosomal abnormalities,especially the inlet type and VSD with extracardiac abnormalities,and then the fetal karyotype should be recommended.

Novel derivatives of diosgenin: design, synthesis and anti-tumor activity / 药学学报

Diosgenin can inhibit the growth of A375 and K562 cell lines and induce their apoptosis with an effect on pro-apoptotic members of Bcl-2 family. To study the SAR of diosgenin derivatives, and to improve the anti-tumor activity of diosgenin, a series of novel diosgenin derivatives were designed and synthesized. Their anti-tumor activities in vitro were evaluated. The results revealed that most of the new derivatives had potent effects against K562, A375 and A549 (three tumor cell lines) in vitro, and had no or less effect against H293 and L02 (two normal cell lines). Particularly, some compounds (e.g. 1, 6-8) showed excellent activities on K562 with IC50 values ranging from 1.96 to 4.35 micromol x L(-1).

Ultrasonographic indicators predicting the outcomes of monochorionic twins with selective fetal growth restriction / 中华围产医学杂志

ObjectiveTo investigate the ultrasonographic indicators predicting the outcomes of selective fetal growth restriction (sFGR)fetusesin monochorionic twinsunder expectant management. MethodsMonochorionic twins with sFGR diagnosed in the First Affiliated Hospital of SUN Yat-sen University from Jan.2005 to May 2010 were included into this study.All patients underwent expectant treatment.Ultrasound appearances of monochorionic twins were documented in detail when sFGR was diagnosed.At the initial evaluation,presence or absence of the following abnormalities were documented, including abnormal Doppler flowin theumbilical artery,polyhydramnios in the larger twin,oligohydramnios,fetal weight discordance and velamentous cord insertion in sFGR fetuses; gestational age at diagnosis was recorded as well.The relationship between these ultrasound characteristics and mortality of sFGR fetus was analyzed with Logistic regression.ResultsOf 51 sFGR fetuses,11 (21.6％) suffered from fetal death,including four intrauterine demise and seven neonatal deaths both twins were dead in 3 cases. Logistic regression analysis demonstrated that oligohydramnios (OR=22.80,95％CI:3.58-145.31,P=0.001) and abnormality of diastolic flow in the umbilical artery (OR=6.51,95％CI:1.16-36.53,P=0.033) were independent risk factors of mortality of sFGR fetuses. Conclusions Both oligohydramnios and abnormal Doppler flow in the umbilical artery suggest poor prognosis of sFGR fetuses in monochorionic twins.

Comparison of the prenatal ultrasonic features between left and right isomerism / 中华超声影像学杂志

Objective To compare the prenatal ultrasonic characteristics between left and right isomerism as referring to autopsy outcomes.Methods Between November 2007 and July 2010,fetuses with isomerism that were confirmed by autopsy,were identified from 1200 prenatal ultrasonic scans.Their abnormal spectrums and ultrasonic features were analyzed and comparied between left and right isomerism.Results A total of 18 fetuses with right isomerism and 4 fetuses with left isomerism were detected and confirmed.The major findings of the right isomerism were;viscerocardiac heterotaxy (17,94%),anomalous pulmonary venous connection (16,89%),complete atrioventricular septal defect (15,83%),juxtaposition of the descending aorta and inferior vena cava(12,67%),left persistent superior vena cava (11,61%),right aortic arch (10,56%) and univentricle (10,56%).As for the left isomerism,all had viscerocardiac heterotaxy and interruption of inferior vena cave,three of them had heart block,complete atrioventricular septal defect and hypoplasia of aorta,two of them had univentricle.Conclusions Viscerocardiac heterotaxy,complete atrioventricular septal defect,univentricle are the most common anomalies detected.Right isomerism cases usually exist with anomalous pulmonary venous connection,juxtaposition of the descending aorta and inferior vena cava as well as right aortic arch.The left isomerism cases usually have interruption of inferior vena cave,heart block and hypoplasia of aorta.

Structure-activity relationship of diosgenin derivatives as Bcl-2 antagonists / 药学学报

The purpose of this paper is to clarify the structure-activity relationship of anti-tumor activity of diosgenin derivatives in vitro. Study has found that diosgenin can inhibit the reproduction of tumor cells by inducing apoptosis and the main target spot of this effect is Bcl-2. Based on the characteristics of pharmacophoric points' of the three-dimensional pharmacophore for Bcl-2 inhibitors, we have docked lots of diosgenin derivatives with Bcl-2, then synthesized 31 compounds of them, finally assessed the anti-tumor activity of the diosgenin derivatives in vitro against A375, A549, HepG-2 and K562. Preliminary studies of SAR have indicated that the aliphatic esters, and aromatic esters of diosgenin without F ring have no anti-tumor activity in vitro. The triazole bromides of diosgenin all achieve fairly good anti-tumor activity in vitro, and those with larger hydrophobic group have the better activity. The stronger is the hydrogen bonding interaction and dipole-dipole interaction of the heterocyclic of diosgenin and diosgenin without F ring and the acid ester of diosgenin without F ring, the better is the activity of derivatives.