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Objective:To analyze the prenatal ultrasound manifestation of trisomy 21 syndrome and investigate the clinical significance of prenatal ultrasound in screening 21-trisomy syndrome.Methods:A retrospective analysis of prenatal ultrasound results of 200 fetuses diagnosed with 21-trisomy syndrome by karyotype from May 2017 to August 2018 in Hunan Provincial Maternal and Child Health Care Hospital. Ultrasound abnormalities were divided into isolated soft markers, simple structural abnormalities, complex ultrasound markers. The relationship between these markers and trisomy 21 was analysed.Results:200 fetuses with trisomy 21 syndrome diagnosed by karyotype, in which 39 cases (19.5%, 39/200) abnormalities were detected by ultrasound, including soft indexes and structural abnormalities/other abnormalities. The rates of isolated soft indexes, simple structural abnormalities/ other abnormalities and complex ultrasound markers were 15.5%(31/200), 2.0%(4/200), 2.0%(4/200), respectively. The most common of soft markers in the first trimester was thickened nuchal translucency (4/18), thickened nuchal fold (13.19%, 24/182) in the second trimester, followed by nasal bone dysplasia, tricuspid regurgitation and polyhydramnios (1.65%, 3/182). The most common structural malformations in the second trimester was cardiovascular malformation (3.30%, 6/182).Conclusions:Prenatal ultrasound has a role to play in the screening of 21-trisomy syndrome, but exerts certain limitations. It is necessary to strengthen the understanding of the ultrasonographic features of trisomy 21 and improve the detection rate of abnormal indicators. Meanwhile, it should be combined with serological screening, non-invasive prenatal testing technology to increase the detection rate of trisomy 21.
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Objective:To explore the causes of misdiagnosis and missed diagnosis of fetal liver, hemangioma by prenatal ultrasound, aimed at improving the diagnostic rate of fetal liver hemangioma by prenatal ultrasound.Methods:Six cases of misdiagnosed fetal liver hemangioma in Hunan Province Maternal and Child Health Hospital between January 2016 and October 2018 were selected. In these cases, live births were tracked until they were 6-24 months old, while autopsy was carried out on induced fetuses. These failed cases were analyzed retrospectively, in terms of their scanning methods, ultrasonographic features and pregnancy outcomes.Results:Three cases were misdiagnosed by perinatal ultrasound: the time for the first discovery of masses in these cases was 37 + 3 weeks, 39 + 5 weeks and 37 + 4 weeks respectively. All of these tissues appeared as mixed echogenic masses and were misdiagnosed as hepatoblastoma. The other three cases were categorized as prenatal ultrasound missed diagnosis: in one case, prenatal ultrasound examination failed to detect the disease in question during the whole pregnancy, while ultrasound examination revealed lesions 2 days after birth; the other case didn′t see the detection of hepatic hemangioma was not detected until the 40th week of pregnancy by ultrasound in another case, as prenatal ultrasound at 31 + 6 weeks and 37 + 4 weeks showed nothing abnormal; yet prenatal ultrasound examination of the third case showed no findings in which at 26 + 6 weeks pregnant, but ultrasound performed at 33 weeks into gestation suspected slightly hypoechoic area in the liver, which was indicated hepatic hemangioma by MRI. Among the 6 cases, 2 of the induced fetuses were confirmed as hepatic capillary tumor by autopsy and pathological examination by with the consents of their family; four live births were confirmed to be hepatic hemangioma by contrast-enhanced CT scan and clinical follow-up observation. Conclusions:Multi-angle and multi-section scanning technique should be adopted in prenatal ultrasound examination of fetal liver. Mean while observations must also be made of any changes in the hepatic vein and any displacement of the peripheral organs of the liver, while ultrasonic images and color Doppler flow imaging features of the lesions are further analyzed. These actions lead to an improvement in the diagnostic accuracy of fetal liver hemangioma, which serves as a useful clinical guide to active and effective intervention measures.
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Objective To explore the effect of psychological intervention on patients with advanced ovarian cancer. Methods A total of 80 patients with advanced ovarian cancer patients combined with carboplatin or Western him paclitaxel combined with cisplatin in the treatment of patients, the implementation of grouping according to nursing, patients in the control group for routine care, patients in the observation group in the control group on the basis of psychological nursing. The two groups were observed and compared the clinical effect of intervention. Results The observation group the effective rate of the treatment and nursing satisfaction rate were significantly higher than the control group; the implementation of group nursing, observation group patients psychological status and improve the psychological status of patients in the observation group after treatment were better, and the control group have obvious difference. Conclusion For patients with advanced ovarian cancer chemotherapy, combined with psychological intervention on the basis of routine nursing, can significantly improve the treatment efficiency, improve the psychological status of patients, is worthy of clinical application
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Objective Through comparing the traditional teaching rounds model with innovation model, explore appropriate teaching rounds model for Radiotherapy. Methods From September 2009 to June 2010, 82 students of Kunming Medical University were randomly divided into two groups, 41 students in test group with innovation teaching rounds model, and 41 students in control group with traditional model. The results of the two groups were compared. Results The differences of survey and test scores were statistically significant ( <0.01) between the test and control groups. Conclusion Test group could effectively improve the clinical thinking,practice operating capacity and teaching quality, mobilize the initiative and enthusiasm for learning.The teaching rounds model needs further exploration,improvement and evaluation.