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This article reported a survived case of amniotic band syndrome (ABS) following fetal reduction by radiofrequency ablation. The woman conceived monochorionic diamniotic twin pregnancy spontaneously. Prenatal ultrasound at 24 weeks of gestation indicated twin-twin transfusion syndrome (stage Ⅲ), and radiofrequency ablation for fetal reduction was successfully performed after formal consent. At 28 +6 weeks, ultrasound reexamination revealed significant edema in the left foot of the fetus, with banding around the ankle, as well as the strangulation mark and narrowing rings. Fetal ABS (ⅡB stage) was diagnosed after multidisciplinary consultation. An immediate emergency cesarean section was performed and a live male baby was born. A thin amniotic band could be seen wrapping around the left ankle of the newborn for several rounds, with obvious strangulation marks about 1 cm deep into the skin, and significant edema on the dorsum and sole of the foot, and the submalleolus area. The amniotic band was released at once, and the edema faded gradually after surgery. After a follow-up of 28 days, the lower limbs of the newborn became normal.
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Objective To explore the development of the cross sign of olivepontocerebellar atrophy(OPCA) and its diagnostic value.Methods The clinical and imaging data of 8 patients with OPCA were analyzed retrospec-tively.MRI imaging used SE sequence,plain T1 WI,T2 WI,axial,coronal,sagittal imaging.Results All patients were hide onset.The major clinical presentation was cerebellar atsxia and autonomic nerve dysfunction.Positive radiographic findings were consistent with clinical presentation,mainly for the brain stem atrophy,8 patients of the group had this performance,followed by cerebellar atrophy,6 patients had symmetrical atrophy and 2 patients had asymmetric atro-phy.6 patients after onset of 1.5 -3 years showed a typical cross.Conclusion The cross sign gradually appears at a certain stage of development,and it has high specificity.So the combination of clinical and MRI is valuable for the diagnosis and differential diagnosis of OPCA.
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ObjectiveTo explore the correlation between IL-6-634C/G gene promoter polymorphism and body mass index (BMI),blood sugar (BS),25-hydroxy vitamin D (25-OH-D),and serum lipid levels by investigating in 8-12-year-old Han children in Shanxi province,China.MethodsIn Datong city of Shanxi province,214 8-12-year-old children were enrolled after obtaining informed consent from their parents.The weight and height were measured and the BMI was calculated.BS,serum lipids,and 25-OH-D were determined.IL-6-634C/G polymorphism were detected by polymerase chain reaction restricted fragment length polymorphism.The effects of genotype on BMI,BS,serum lipids,and 25-OH-D were also studied.ResultsThe genotypes of IL-6-634C/G polymorphism in 214 cases were GG ( 15％ ),GC (40％),and CC (45％).The percentages of C and G allele frequencies were 65％ and35％.The genotypes and allele frequencies showed no gender differences ( P ＞ 0.05 ).However,significantly different GG genotypes frequencies were found between overweight and obese children (38.3％) and other children ( normal weight children: 7.3％ ; thin children: 10.9％ ) (x2 =14.715,P =0.006).Multivariate logistic regression analysis showed that IL-6-634C/G polymorphisms and triglyceride were correlated with overweight and obesity (P ＜ 0.05 ).25-OH-D was not correlated with BMI (r =0.075,P =0.528),BS ( r =0.018,P =0.880 ),triglyceride ( r =- 0.097,P =0.417 ),high density lipoprotein cholesterin ( r =0.038,P =0.751 ),and low density lipoprotein cholesterin ( r =- 0.028,P =0.817 ).25-OH-D was not significantly different between overweight and obesity children.The distribution of three genotypes showed no correlation with 25-OH-D deficiency (x2 =0.622,P =0.733 ).ConclusionsIL-6-634C/G polymorphism exists in Han children in Shanxi province.IL-6 gene 634 GG genetype is a risk factor of childhood overweight and obesity,and may affect lipid metabolism.However,it has no direct impact on glucose metabolism.IL-6 gene 634C/G polymorphism and serum 25-OH-D are not relevant.IL-6 gene 634C/G polymorphism is not related to vitamin D deficiency diseases,and may be not related to bone calcium metabolism.25-OH-D is not relevant with BS and blood lipids level,and also is not associated with childhood overweight and obesity.
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The clinical thought is the core and the foundation of clinical ability.The logical teaching strengthens the students'clinical thought most directly and effectively.Through the thought training,the inference thought training and the basic thought rule training the medical students' clinical thought ability can be effectively strengthened.
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Objective To evaluate the hair-removal effect of intense pulsed light (IPL) on hirsutism of spina bifida occulta. Methods 8 patients with hirsutism of spina bifida occulta were treated 3 to 5 times, at 2 month intervals, with ELITE plus IPL. Its wavelength was 610~1000 nm, and spot size was 50 mm ? 10 mm. The macro pulse was composed of a series of micro pulses with equal intervals. The micro pulse duration was 5 ms, the number of micro pulse was 4-15, the interval of micro pulse (delay) was 2~20 ms, and the fluence was 22.3～38.3J/cm2. Results All of the patients were well tolerant under no anesthesia. The hairs were mostly or fully removed after 3 to 5 courses of treatment. Routine washing could be done and bandaging was not applied after treatment. There was no blister, infection, hyperpigmentation and scarring. Little vellus hair regrowth was observed after a 6~12 month follow-up. Conclusions IPL is an ideal method to depilate hirsutism of spina bifida occulta because of its credible effect, simple operation, rapid treatment and no serious complication.
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New type medical talents are in great need in the fierce international competition in medical field.Logic quality is acquired by accumulation,not born to be.Modern medicine sets higher requirement for medical talents in the aspects of logic quality including receiving and processing information,ability of expression and collaboration,forecasting and innovation.Therefore,only through diligent learning,training and repeated practice can enhance the logic quality of medical talents,and develop into winners in the increasingly fiercer international competition in medical field.