Study on Sulfated Modification and Anti-psoriasis Activity of Polysaccharide from Dictamnus dasycarpus / 中国药房

OBJECTIVE： To conduct sulfated modification of polysaccharide from Dictamnus dasycarpus （DDP-Ⅲ）， and to compare structure characteristics and anti-psoriasis activity of DDP-Ⅲ before and after sulfated modification. METHODS： DDP-Ⅲ was separated and purified with DEAE-52 anion exchange cellulose column and Sephadex G-100 column. After derived with 1-phenyl-3-methyl-5-pyrazolone， HPLC was used to determine the composition of its monosaccharide. SDDP-Ⅲ was synthesized using esterification reagent （anhydrous pyridine+chlorosulfonic acid） to modify DDP-Ⅲ. The degree of sulfate substitution was determined by barium chloride-gelatin turbidimetric method. The structures were compared by IR， Raman spectrum and SEM before and after modification. The male ICR mice were randomly divided into normal group， model group， positive group （tripterygium glycosides， 20 mg/kg） and DDP-Ⅲ/SDDP-Ⅲ low-dose， medium-dose and high-dose groups （56， 112， 224 mg/kg）. Except that normal group was given vaseline for external use， and other groups were given Imiquimod cream for external use to induce psoriasis model. At the same time， administration groups were given relevant medicine intragastrically 0.4 mL， and both normal group and model group were given constant volume of water intragastrically， once a day， for consecutive 14 d. Two hours after last medication， the serum contents of IL-17 and IL-23 were determined by ELISA. The skin scales near the tail were observed by HE staining， and the number of scales with granular layer was recorded. RESULTS： DDP-Ⅲ was composed of mannose， rhamnose， glucuronic acid， galacturonic acid and glucose. The degree of sulfate substitution was 0.65 for SDDP-Ⅲ. IR and Raman spectrum showed that the characteristic absorption peaks of sulfate radical group appeared near 1 255 cm－1 and 823 cm－1， 1 240 cm－1 and 815 cm－1 for SDDP-Ⅲ， except for same characteristic absorption peak as DDP-Ⅲ. SEM analysis showed that DDP-Ⅲ was flaky， smooth and tightly arranged； SDDP-Ⅲ was massive or granular with porous structure and loose arrangement. Animal experiment showed that compared with normal group， the epidermis of skin lesion was significantly thickened and the granular layer was significantly reduced； serum contents of IL-17 and IL-23 were increased significantly， while the number of scales with granular layer was decreased significantly （P＜0.05 or P＜0.01）. Compared with model group， above symptoms of administration groups were improved to different extent， and serum contents of IL-17 and IL-23 in positive group， DDP-Ⅲ high-dose groups， SDDP-Ⅲ medium-dose and high-dose groups were decreased significantly； the number of scales with granular layer was increased significantly， and above indexes of SDDP-Ⅲ medium-dose and high-dose groups were significantly better than corresponding DDP-Ⅲ group （P＜0.05 or P＜0.01）. CONCLUSIONS： DDP-Ⅲ contains five monosaccharide components such as mannose， etc. Both DDP-Ⅲ and SDDP-Ⅲ possess anti- psoriasis effects， and SDDP-Ⅲ exhibits stronger anti-psoriasis effect than DDP-Ⅲ. Its mechanism may be associated with inhibiting IL-23/IL-17 signaling pathway.

Application of ultrasound medical imaging workstation in quality control of ultrasonic reports issued by resident doctors / 中华医学超声杂志（电子版）

Objective To explore the application value of ultrasound medical imaging workstation in quality control of ultrasound reports issued by resident doctors.Methods The pancreatic ultrasound reports of outpatients provided by resident doctors with 6 months and 12 months of training were derived from the ultrasound medical imaging workstation as 6-month group (G6M) and 12-month group (G12M),respectively.There were 1582 ultrasound reports in the G6M,including 420 for males and 962 for females,with 1318 for patients ＜ 65 years old and 264 for patients ≥ 65 years old.There were 2723 ultrasound reports in the G12M,including for 760 males and 1963 for females,with 2323 for patients ＜ 65 years old and 400 for patients ≥ 65 years old.Frequency of"unclear tail of the pancreas" in the report,standard image,and body markers were recorded.The chi-square test was used to compare patient gender,age,and the quality of resident reports between the two groups.Results The chi-square test showed that there was no significant difference in sex or age composition between the two groups (all P ＞ 0.05).The number of cases of"unclear tail of the pancreas" reported in the G6M and G12M was 554 (35.02％) and 734 (26.96％),respectively,and there was a statistical difference between the two groups (x2=31.029,P ＜ 0.001).In the reports with "unclear tail of the pancreas",the number of reports with "no map" was 8 (1.44％) and 14 (1.91％) in the G6M and G12M,respectively,and there was no significant difference between the two groups (P ＞ 0.05).As to "map without marker" and "map with marker",there were 337 (60.83％) vs 209 (37.73％) and 308 (41.96％) vs 412 (56.13％) in the G6M and G12M,respectively,and the chi-square test showed that there were significant differences between the two groups (x2=44.960 and 42.834,all P ＜ 0.001).Conclusion Ultrasound medical imaging workstation can be used for periodic spot check,evaluation,and feedback of resident reports,which has a positive role in promoting the quality control of ultrasound reports.

Correlation and regression analysis of fetal facial angles at 11－38 weeks of pregnancy with gestational age / 中华超声影像学杂志

Objective To determine the fetal facial angles at 11 －38 weeks of gestation by three‐dimensional ultrasound ( 3DUS) and analyze the correlation between facial angles and gestational age( GA ) . Methods From 2013 April to 2014 February ,439 singleton fetuses ranged 11－38 weeks of gestation were enrolled in this study . T he details of mid‐sagittal plane of facial profile was confirmed with 3DUS . Four facial angels were measured in this plane ,including frontomaxillary facial angle ( FM F ) ,frontonasal angle ( FNA ) ,mandibulomaxillary facial angle( M M F) and maxilla‐nasion‐mandible angle( M NM ) . T he intra‐and interobserver reliability were calculated in first 30 cases ,intra‐class correlation coefficient( ICC) greater than 0 .75 indicated good reliability . Pearson′s correlation coefficient ( r ) ,curve estimation and polynomial regression models were used to evaluate the correlation of the fetal facial angles with GA . Results ICC of the same observer were 0 .968 ,0 .962 ,0 .974 and 0 .988 ,respectively . ICC of different observer were 0 .948 , 0 .905 ,0 .874 and 0 .889 ,respectively . T he fetal facial angles of FM F ,FNA ,M M F and M NM showed correlations with GA ( r ＝ －0 .369 ,0 .447 ,－0 .470 ,0 .386 ; all P ＝0 .000) . Using GA as the independent variable and the facial angles as the dependent variables , the best fit regressing equation was cubic polynomial :FM F＝135 .300－6 .473×GA+0 .235×GA2 －0 .003×GA3 ( R2 ＝0 .240 , P ＝0 .000 ) ;FNA＝58 .920+7 .452×GA －0 .274×GA2 －0 .003×GA3 ( R2 ＝0 .297 , P ＝0 .000 ) ;M M F＝132 .329 －5 .337× GA+0 .191× GA2 －0 .002× GA3 ( R2 ＝ 0 .304 , P ＝ 0 .000) ;M NM ＝ －24 .592+ 4 .653× GA －0 .173× GA2 + 0 .002 × GA3 ( R2 ＝ 0 .413 , P ＝ 0 .000 ) . Conclusions The development of fetal facial angles are related to GA . T he growing patterns of fetal facial angles fit with a cubic polynomial function .

Prenatal ultrasonic diagnosis and outcome of congenital dacryocystocele / 中华超声影像学杂志

Objective@#To explore the value of prenatal ultrasound in diagnosis of congenital dacryocystocele.@*Methods@#The ultrasonographic features of 16 fetuses with congenital dacryocystocele were retrospectively reviewed and the outcome of pregnancy were followed up.@*Results@#The median gestational week detected with prenatal ultrasound was 30.29 weeks, the mean diameter was (8.96±1.96)mm. Congenital dacryocystoceles were unilateral in 12 fetuses and bilateral in 4 fetuses, 10 were female and 6 were male. The typical ultrasonic feature was anechoic cystic mass with clear boundary in relation to the medial and inferior aspects of the fetal orbit. The dacryocystocele resolved spontaneously prenatally in 5 fetuses, resolved spontaneously after delivery in 10 fetuses. One fetus died in caesarean section due to complete placenta previa.@*Conclusions@#Congenital dacryocystitis has its characteristic ultrasonographic features, and most cases can disappear naturally in prenatal or early newborns.

Preliminary study on the application of prenatal ultrasound for fetal facial profile line / 中华医学超声杂志（电子版）

Objective To evaluate the fetal profile (FP) line with two-dimensional and three dimensional ultrasound, to explore the changes of fetal facial profile with gestational age,and to analyze the manifestation of FP line for abnormal chromosomal fetuses. Methods FP line, which was defined as the line that passes through the anterior border of mandible and the nasion, was test on the facial mid-sagittal plane. Firstly, from April 2013 to January 2014, FP line was analyzed in 439 normal fetuses of Peking Union Medical College Hospital at 11-38 weeks of gestation. According to the relationship between FP line and fetal frontal bone,it was divided into three types: the FP line passed anteriorly, across or posteriorly to the frontal bone, respectively. When the FP line passed posteriorly to the frontal bone, the distance (F distance) between the FP line with the frontal bone was measured. Secondly, 26 pathological fetuses (21 trisomy 21 fetuses with 13-33 weeks' gestation and 5 trisomy 18 fetuses with 21-31 weeks' gestation) were analyzed respectively. Results No cases with a FP line passed anteriorly to the frontal bone were found in all of normal fetuses. Most commonly seen was that FP line passed across to the frontal bone (92.26%). The FP line passed posteriorly to the frontal bone in up to 7.74%, and the mean F distance was 0.24 cm (range, 0.10-0.51 cm). In 21 fetuses of trisomy 21, 14 cases showed the FP line passed across to frontal bone, and 4 cases showed the FP line passed posteriorly frontal bone with the F distance from 0.23 cm to 0.55 cm. Three cases with sloping forehead with FP line passed anteriroly to frontal bone. As to 5 cases of trisomy 18, 2 cases showed FP line passed across to frontal bone, and 3 cases with micrognathia had FP line passed anteriroly to frontal bone. Conclusions No cases with a FP line passed anteriorly to the frontal bone were found in normal fetuses. The FP line, as a reference line for forehead and mandible abnormality, may be a useful tool to detect second trimester profile abnormalities such as sloping forehead and retrognathia.

Clinical and sonographic features of automimune pancreatitis / 中华医学超声杂志（电子版）

Objective To investigate the clinical and sonographic features of automimune pancreatitis (AIP). Methods We analyzed the clinical and sonographic features of 28 patients who were diagnosed as AIP in Peking Union Medical College Hospital from January 2013 to December 2014. Results Clinical features: the initial manifestation was obstructive jaundice in 19 cases. Fourteen cases were accompanied with type 2 diabetes. Eight cases were accompanied with IgG4-related diseases in other organs. Twenty-five cases had elevated IgG4 serum levels. Six cases had positive antinuclear antibodies. Eighteen cases had steroids therapy, 15 of whom had a good response to steroids, 3 of whom had a poor response. The ultrasonographic features were as follows:(1) Among 18 cases of diffuse type of AIP were as follows:16 cases had a diffused,“sausage-like”enlarged pancreas. Fifteen cases had diffusely decreased echogenicity, with fibrous hyperechoic spots. (2) Ten cases of local type of AIP were as follows:the pancreas had local enlarged segment or a“tumor”was formed, but the echogenicity of tumor was similar to the rest of the pancreas. Six cases had irregular shape. (3) Seven cases had ill-defined margin. Six cases had a little blood flow. Two cases had no blood flow. Seven cases had upstream dilation of the main pancreatic duct. Nineteen cases had dilation of the proximal section of the common bile duct. Twelve cases had dilation of the intrahepatic bile duct. Conclusions AIP have some sonographic features. Patients are often older, having abdominal pain, obstructive jaundice, and diffused or local enlargement of pancreas. Combining with the clinical data and laboratory examination may help the diagnosis of AIP.

Correlation and regression analysis of placenta volume at 11-13+6 weeks of pregnancy with newborn baby weights, placenta weights and volumes at birth / 中华医学超声杂志（电子版）

Objective The aim of the study was to determine the placenta volume (PV) at 11-13+6 weeks of gestation by three-dimensional ultrasound (3DUS) in combination with birth weight, placenta weight, placenta volume at birth and maternal age, body mass index (BMI) additionally. Methods From June 2011 to July 2012, placental volumes were prospectively measured by VOCAL (Virtual Organ Computer-aided Analysis) method in 129 normal pregnancies of Peking Union Medical College Hospital at 11-13+6 weeks of Gestation, multiples of the median was calculated (MOM) after logarithmic10 transformation referring to different crown-rump length (CRL) groups. The normal pregnancies were selected without any combinations or fetal abnormalities, then recorded the birth weights, placenta diameters and thicknesses and placenta weight at delivery. The maternal basic status was also concluded in the study. Results Correlation analysis results: (1) The transformed placenta volume MOM showed a significant correlation (Spearman rho=0.200, P0.05). (2) The birthweight showed significant correlations with placenta weight, placecnta volume and maternal BMI (Spearman rho=0.478, 0.361, 0.259 respectively, P<0.01). (3) The placenta weight at birth showed a significant correlation with placenta volume at birth (Spearman rho=0.467, P<0.01) and maternal BMI (Spearman rho=0.198, P<0.05). Regression analysis results: (1) Birth weight (g)=1136.9+1530.9×MOM+45.3×BMI-15.0×maternal age (r=0.29, P=0.01<0.05). (2) Placenta weight (g)=88.1+315.3×MOM+10.0×BMI+0.1×maternal age (r=0.27, P=0.02 <0.05). Conclusions The placental volume at 11-13+6 weeks of gestation has significant correlation with birthweight. This might assist in the identification of the high risk pregnancies caring large or low for gestational age fetuses.

The evaluation of fetal nasal bone absence at second and third trimester and its relationship with chromosomal abnormalities / 中华医学超声杂志（电子版）

Objective To evaluate the ultrasonic characteristics of nasal bone absence at 16-34 weeks of pregnancy referring to fetal chromosomal anomalies. Methods The ultrasonic findings of the 20 fetuses with nasal bone absence at second or third trimester in Peking Union Medical College Hospital were reviewed referring to chromosomal karyotyping and labor induction or birth outcomes. Results The ultrasound features of the 20 fetuses including:(1) There were 17 fetuses showed bilateral nasal bones absence. The sonographic features were absence of hyper echo of nasal bone underneath the skin on either sagittal or transverse section. There were 5 fetuses showed multiple abnormalities:Four fetuses showed cardiac abnormalities (three showed atrioventricular septal defect, one showed ventricular septal defect, one showed ventricular septal defect with abnormal great vessels). One fetus showed duodenal obstruction′double bulbs′. The other minor abnormalities including short femur and humerus, increasing echogenetic bowels, aberrant right subclavian artery, mild unilateral ventriculomegaly, mild renal pelvic ectasia, outreached tongue, abnormal gestures of hands. (2) There were 3 fetuses showed unilateral nasal bone absence. The sonographic features were absence of hyper echo of either nasal bone on transverse section but with hyper echo on sagittal section. Two fetuses showed cardiac abnormalities (one fetus showed atrioventricular septal defect, one showed ventricular septal defect). The other minor abnormalities including short femur and humerus, hyper echogenetic bowels, increasing thickness of nuchal translucency or nuchal fold. Twelve fetuses were induced labor but only one had biopsy showed accordant result with ultrasound. (3) Karyotyping results:there were 9 of trisomy 21, 1 of 4p-and 7 of normal karyotype fetuses showed bilateral nasal bone absence. There were 2 of trisomy 21 and 1 of normal karyotype fetuses showed unilateral nasal bone absence. (4) Birth outcomes and follow-up:twelve fetuses induced labor but only one fetus had biopsy. Eight fetuses were born until term and 5 fetuses showed normal in follow-up. The results of twelve fetuses showed concordant with ultrasonic ifndings. Conclusions Characteristics of the nasal bone absence are absence of bilateral or unilateral nasal bones. If we ifnd nasal bone absence in prenatally ultrasound screening, the karyotyping should be recommended in order to detect chromosomal abnormalities especially trisomy 21.

Fetal discrepancy during first trimester in dichorionic twins / 中华超声影像学杂志

Objective To investigate the incidence and distribution of fetal discrepancy during the first trimester in dichorionic twins.Methods This was a prospective analysis of dichorionic twin pregnancies that underwent 11+0～ 13+6 week scan at a tertiary hospital from Sep 2008 to Oct 2010.Differences in crown-rump length (CRL),nuchal translucency ( NT),heart rate ( HR).deepest vertical pockets of amniotic fluid (DVP) for every pair of twin fetuses were calculated and expressed as absolute value and percentage of discordance.Results A total of 66 dichorionic twin pregnancies were included.The average CRL was significantly different between the larger fetus and the smaller one,which were (65.28 ±8.54)mm and (62.34 ± 8.49) mm respectively ( P ＜ 0.001).The average NT was significantly different between two fetuses,which were ( 1.56 ± 0.35) mm and (1.28 ± 0.30) mm respectively. HR and DVP were also statistically different between two fetuses ( P ＜0.001).Conclusions The growth of two fetuses in normal dichorionic twins is not uniform during the first trimester.

Prenatal sonographic diagnosis of fetal intracranial hemorrhage / 中华超声影像学杂志

Objective To investigate the diagnostic value of prenatal ultrasonography in the fetal intracranial hemorrhage.MethodsIn a retrospective analysis,the ultrasonographic findings of five fetuses with intracranial hemorrhage diagnosed in our hospital were reviewed and compared with other imagemodalities.ResultsIn the five fetuses with intracranial hemorrhage,the ultrasonographic features mainly includeddilateduni-orbilateralventriclesandintraventricularechogenicfociorperiventricular echodensities.The diagnosis of all cases were confirmed by prenatal magnetic resonance.Four of these cases chose termination of pregnancy,and the other fetus had a normal neurological follow-up after birth.Conclusions Fetal intracranial hemorrhage can be diagnosed accurately by prenatal ultrasonography,especially in the second and third trimester.It is rarely associated with other anomalies.Prenatal sonographic examination may detect the lesion and help to evaluate the prognosis.

Measurement and assessment of fetal tricuspid waveform in first-trimester / 中华超声影像学杂志

Objective To investigate the clinical value and method of fetal tricuspid regurgitation in the first trimester.Methods Fetuses were performed ultrasonography at 11 to 14 gestational weeks,measuring crown rump length,nuchal translucency and acquiring tricuspid waveform.All the fetuses were followed up until 6 months after birth,including prenatal ultrasound examination,maternal serum biochemistry and karyotype test.Results A total of 262 fetuses were performed ultrasonography in the first trimester,the tricuspid waveform were acquired successfully in 249 (95%).Nine cases with tricuspid regurgitation were detected,including 3 cases of trisomy 21,3 cases with complex heart defects,one case with omphalocele,two resulted in intrauterine death and one case of normal chromosome and phenotype.Conclusions Tricuspid waveform is relatively easier to examine and assessment.Tricuspid regurgitation is a useful first-trimester ultrasound marker for the detection of chromosomal abnormalities,cardiac defects,and adverse pregnancy outcome.

Prenatal sonographic diagnosis of hemivertebra / 中华超声影像学杂志

Objective To investigate the diagnostic value of prenatal ultrasonography in the fetal hemivertebra. Methods The ultrasonographic findings of three fetuses with hemivertebra diagnosed in our hospital were reviewed and compared with those of postnatal ultrasonography,other image modalities,and autopsy. Results In all fetuses,a distortion of the spine was observed where only one half of the vertebra could be identified. The parents opted for termination of the pregnancy in one case and the deformity was confirmed by autopsy. The other two fetuses were delivered and in one fetus the diagnosis was confirmed by radiological assessment. Conclusions Hemivertebra can be diagnosed accurately by second-trimester ultrasonography. The prognosis is mostly favorable when no other anomalies are associated. Meticulous examination may disclose the lesion and help decide the fate of pregnancy.

Fetal akinesia deformation sequence: an etiology of fetal multiple joint contractures with poor prognosis / 中华超声影像学杂志

ObjectiveTo evaluate the diagnostic capability of prenatal ultrasound in diagnosis of fetal akinesia deformation sequence (FADS).MethodsThe prenatal sonographic characteristics of 5 fetuses with FADS were analyzed retrospectively.ResultsBoth multiple joint contractures and central nervous system (CNS) anomalies,which include 5 small head circumferences,2 short cerebellar diameters,and 1 flat forehead,were found by prenatal ultrasound in all 5 FADS fetuses.Additional fetal abnormalities such as micrognathia,polyhydramnios,short umbilical cord and intrauterine growth retardation were also observed.The results of fetal chromosome analysis were available in 2 cases indicating normal karyotype.Conclusions Prenatal identification and diagnosis of FADS is possible based on the findings of sonographic examination.

Value of prenatal ultrasonography in diagnosis of fetal biliary cystic malformation / 中华超声影像学杂志

Objective To investigate the diagnositic value of ultrasonography in fetuses with cystic biliary malformation. Methods Three cases of cystic biliary malformation diagnosed in our hospital by prenatal ultrasound were followed up until surgery after birth. Results In all three cases.an anechoic cystic lesion was detected in the right upper abdomen at 16,26,34 weeks' gestation respectively, which were diagnosed as biliary cystic malformation by prenatal ultrasound. Two cases were confirmed as choledochal cyst by surgery, one case as biliary atresia. The maximum diameter during pregnancy of choledochal cyst were 3. 9 cm and 4.2 cm respectively, which increased steadily as gestational age advanced, with normal gallbladder in continuity with the choledochal cyst. But the largest diameter of the cyst in congenital biliary atresia was 1.7 cm and remained unchanged throughout the remaining pregnancy, the gallbladder could not be detected or an irregular small gallbladder was shown. Excision of the cyst and Roux-en-Y hepaticojejunostomy were successfully performed in all three cases. Postoperative course were uneventful. Conclusions Cyst diameter, change in size, gallbladder ultrasound pattern may allow to make a prenatal differential diagnosis of biliary tree cystic malformation. Small and stable cyst with an undetected gallbladder or small gallbladder is more suggestive of biliary atresia than choledochal cyst. Precise imaging may facilitate prenatal counseling and perinatal management. The outcomes had improved with earlier operations.

Ultrasonographic study on intraductal papillary mucinous tumors of the pancreas / 中华超声影像学杂志

Objective To analyze the clinical and ultrasonographic features of intraductal papillary mucinous neoplasm (IPMN) of the pancreas and to assess the usefulness of transabdominal ultrasonography. Methods Twelve patients with IPMN underwent surgery, including 4 (33.3%)with adenoma and 8(66.7%) with adenocarcinoma. IPMN was classified into 3 categaries by the site of main duct,branch duct and combined type based on the ultrasonographic findings preoperatively. All the clinical presentations and the ultrasonographic imaging findings were analyzed and compared with the histologic diagnosis. Results Of malignant IPMNs,diabetes was presented in 5 cases,elevated CA19-9 was presented in 4 cases and steatorrhea was presented in 2 cases. But these was not presented in benigns. Transabdominal ultrasonography revealed all the cystic or cystic-solid lesions in this study. The mean diameter of the lesions with adenoma was (1.4 ± 0.8)cm (range,0.5 - 2.0 cm) and that with adenocarcinoma was (6.3 ± 6.0)cm (range, 2.0 - 20 cm). The mean diameters of the main duct for the cases with adenomas and adenocarcinomas were (1.0 ± 0.8) cm and ( 1.6 ± 1.0) cm, respectively. Among the adenomas, 3 cases were calssified as branch type and 2 were demonstrated with mural nodules and no colour signals was detected within them. Five of the malignancies were considered as main duct type and 3 were combined type. Seven cases were detected mural nodules and showed abundant colour flow signals within them. Conclusions Transabdominal ultrasonography revealed the pancreatic cystic lesions and dilated ducts of IPMN. Some characteristics should be considered for malignancy: clinical symptoms, tumor size and mural nodules with colour flow signals,which may be helpful for the diagnosis and management of IPMN.

Differences in the findings of color Doppler sonography between atherosclerotic and non-atherosclerotic renal artery stenosis / 中华超声影像学杂志

Objective To evaluate the differences among five representative and useful Doppler parameters in the diagnosis of the three common types of renal artery stenosis (RAS). Methods Five Doppler parameters including renal peak systolic velocity (RPSV), renal-aortic ratio (RAR), renal-interlobar ratio (RIR),acceleration time (AT),and resistant index (RI) were measured in 221 patients before renal arteriography. Differences between the groups of patients with various clinical causes of RAS were analyzed by Chi-Squared test. One-way ANOVA or t test were used to compare the means between different groups.The optimal cutoff value was determined with the maximum sum of sensitivity and specificity. Results Of the 442 renal arteries (main and accessory renal arteries) demonstrated at arteriography,214 were normal or stenosed less than 50 %, 204 stenoses 50% - 99 %, and 24 occlusions. RIR, RAR and RI were significantly different between the atherosclerotic and non-atherosclerotic RAS groups (P ＜0.05), while RPSV and AT were not. The optimal cutoff values of RAR,RIR and RI for detecting RAS between the atherosclerotic and non-atherosclerotic groups were much different (2.5 versus 1.9, 5. 1 versus 6.5, 0.57 versus 0.50,respectively) ,but those of RPSV and AT were similar or the same (170 cm/s versus 200 cm/s,51 ms versus 51 ms,respectively). Conclusions In the case of RAS (diameter reduction≥50%),it is advised to establish separate cutoff values of RAR, RIR and RI according to atherosclerotic and non-atherosclerotic RAS, but the same cutoff value of RPSV and AT can be applied. RIR is a good Doppler parameter in the diagnosis of RAS,especially atherosclerotic and fibromuscular dysplasia RAS.

Investigation of frontomaxillary facial angle in fetuses at 11+0 to 13+6 weeks with two- and three-dimensional ultrasound / 中国医学影像技术

Objective To investigate the role of two-dimensional ultrasound (2DUS) and three-dimensional ultrasonography (3DUS) in the measurement of fetal frontomaxillay facial (FMF) angle. Methods FMF angle in fetuses at 11~(+0) to 13~(+6) weeks were measured with 2DUS and 3DUS respectively. The difference between measurements and reproducibility were compared, and the relationship between FMF angle measured with 3DUS and crown-rump length (CRL) was assessed.Results FMF angle was obtained in 37 fetuses. Assessable fetuses increased with increased CRL, while the values of FMF angle decreased. Qualified 3D volumes were obtained from 30/37 (81.08%) fetuses, while qualified 2D measurements were available in 18/37 (48.65%) fetuses. For the same fetus, the difference between two measurements with 3DUS was significantly less than that with 2DUS (1.68°±1.01° vs 2.78°±1.95°, P<0.01). For the 11 fetuses assessed with both methods, the values of FMF angle obtained with two methods were not significant different. There was significant negative correlation between FMF angle and fetal CRL (r＝-0.540,P<0.01).Conclusion FMF angle in fetuses at 11~(+0) to 13~(+6) weeks can be achieved rapidly and accurately with 3DUS.

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

Objective To determine the diagnostic value of two and three dimensional ultrasound in detecting fetal hand malformations. Methods In the retrospectively analysis,the severe fetal hand malformations detected by prenatal ultrasound during the recent three years in our hospital were classified according to the prenatal sonographic characteristics,family history,karyotype analysis and autopsy results,etc.Results Fourteen fetuses with hand-anomaly were detected during the 16-28th week of gestation,both hands were affected in 10 cases,with the same morphology bilaterally in 8 cases.Thirteen cases had other abnormal sonographic findings.They were detected and classified into three categories,Wrist deformity (9 cases),three fetuses were associated with total absence of radius and radial clubhand,and six fetuses had palmar deviated hands,with various etiologies including familial hereditary arthrogryposis multiplex congenita,distal type 1 (AMCD1),amniotic band syndrome,body stalk anomaly,trisomy18 and micromelia.Hand (figer) hypoplasia or aphasia (3 cases),one hand was absent in one fetus without associated anomaly,absence of five fingers with ipsilateral multicystic dysplastic kidney in the second fetus,and the third fetus had split hand/foot malformation (SHFM).Overlapping fingers (4 cases),three of them were trisomy18,and two fetuses had both wrist deformity and overlapping fingers.Conclusions Prenatal two and three dimensional ultrasound play an important role in detecting and diagnosing severe type of fetal hand malformations.

Biomechanical performance of weight-bearing bone after remodeling in a rabbit model of disuse osteoporosis / 中国组织工程研究

BACKGROUND: Disuse osteoporosis is bone mass loss caused by muscular inactivity and reduced weight bearing. OBJECTIVE: To observe bone structure and mineral matter content as well as bone biomechanicai performance change at different time points during the development of disuse osteoporosis. DESIGN, TIME AND SETTING: The present randomized, controlled, and self-controlled animal experimental was performed in the General Hospital of Tianjin Medical University between September and November 2003. MATERIALS: A total of 55 male Japanese rabbits, aged 8 months, weighing 2.5-3.0 kg were enrolled for this study. METHODS: The right hind limbs of 50 randomly selected rabbits were immobilized by cast (experimental sides). The corresponding left hind limbs were untouched (control sides). The remaining 5 rabbits were raised for 3 months, and their bilateral hind limbs were used for controls. Ten rabbits were sacrificed by intravenous injection of air at each time point (2, 4, 6, 8, and 12 weeks after immobilization). MAIN OUTCOME MEASURES: Mechanical test was performed on bilateral tibiofibula for determination of calcium content. Hematoxylin-eosin staining and Masson staining of bilateral metatarsal bones were performed for histological observation. RESULTS: There was significant difference in indices of tibiofibula on the experimental sides, including maximum loading, elastic modulus, and calcium content among different time points, while significant difference also existed between the experimental side and the blank controls (P＜0.05). There was no significant difference in above-mentioned indices between the control side and blank controls as well as between control sides (P＞0.05). The experimental side limbs exhibited thinned cortical bone, increased pores, sparse and fine trabecular bone with several fragmentations, expanded medullary cavity, and increased osteoblasts. Masson staining results demonstrated that with disuse time going, collagen was decreasingly formed. The control side and blank control limbs showed thickened metatarsal bone and cortical bone, a few pores, and compactly arranged trabecular bone with normal structure. CONCLUSION: During the development of disuse osteoporosis, calcium content and the entire biomechanical performance are gradually and slowly decreased to accommodate the stress environment and functional status.

Prenatal diagnosis of fetal dysplastic kidney with normal amniotic fluid volume by ultrasonography / 中华超声影像学杂志

Objective To determine the diagnostic value and clinical significance of sonographically detected fetal dysplastic kidney with normal amniotic fluid volume. Methods At the 2nd or 3rd trimester of gestation,the fetuses with unilateral or bilateral renal anomalies (ahnormal size,echo,shape or cyst of the kidney) and normal amniotic fluid volume received systemic ultrasound examination,autopsy or follow-up until after birth. The fetus with only dilated renal pelvis was not included. Results Eleven fetuses of dysplastic renal anomalies with normal amniotic fluid volume were identified by prenatal ultrasound. Among the five fetuses affected by unilateral multicystic kidney dysplasia (MCKD),the renal anomaly was isolated in four fetuses,and the other one was complicated with absence of the ipsilateral hand. One of the two fetuses of unilateral renal agenesis had no other associated anomaly and the other one was complicated with hydrocephalus,spina bifida,ipsilateral absent radius and single umbilical artery,correspongding to the VACTERL syndrome. Two fetuses of pelvic kidney and horseshoe kidney respectively was proved by postnatal ultrasound. One fetus was diagnosed as autosomal dominant polycystic kidney disease(ADPKD)on the basis of multiple renal cysts and a positive family history,the fetus also had cardiac rhabdomyoma. One fetus of bilateral normal sized hyperechoic kidneys was proved to be renal dysplasia by autopsy. Conclusions Unilateral MCKD is the most common type of fetal renal dysplasia which can be detected by prenatal ultrasound with normal amniotic fluid volume. Based on the sonographic characteristics and the family history,most of the dysplastic renal anomalies can be diagnosed prenatally and the prognosis can be predicted.