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OBJECTIVES@#To investigate the impact of the environmental layout of the neonatal intensive care unit (NICU) on clinical outcomes and neurological development in very/extremely preterm infants.@*METHODS@#A total of 304 very/extremely preterm infants admitted to Children's Hospital of Chongqing Medical University between January 2021 and June 2022 within 24 hours after birth were included in this retrospective cohort study. Based on different environmental layouts in the NICU, the infants were divided into two groups: centralized layout group (n=157) and decentralized layout group (n=147). The clinical outcomes and Test of Infant Motor Performance (TIMP) scores at corrected gestational age between 34 to 51+6 weeks were compared between the two groups.@*RESULTS@#The decentralized layout group had lower incidence rates of bronchopulmonary dysplasia (44.9% vs 62.4%, P<0.05) and intracranial hemorrhage (17.7% vs 28.0%, P<0.05) than the centralized layout group. The cure rate was higher in the decentralized layout group compared to the centralized layout group (68.7% vs 56.7%, P<0.05). The decentralized layout group had higher TIMP scores than the centralized layout group at corrected gestational age between 34 to 51+6 weeks (P<0.05).@*CONCLUSIONS@#The decentralized layout of the NICU exhibits positive effects on the clinical outcomes and early neurological development compared to the centralized layout in very/extremely preterm infants.
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Humans , Infant, Newborn , Infant, Extremely Premature , Infant, Premature, Diseases , Infant, Very Low Birth Weight , Intensive Care Units, Neonatal , Retrospective StudiesABSTRACT
To give full play to the therapeutic advantages of traditional Chinese medicine （TCM） in sepsis， clarify the entry point of integrated TCM and western medicine， further standardize the clinical treatment of TCM， develop a recognized and integrated treatment protocol of TCM and western medicine， and improve the clinical efficacy on sepsis，the Chinese Association of Chinese Medicine organized TCM and western medicine experts specialized in sepsis treatment to conduct in-depth discussions on the advantages of TCM and integrated TCM and western medicine in the treatment of sepsis based on the TCM etiology and pathogenesis of sepsis， a representative acute and critical disease. They emphasized the pathogenesis characteristics of asthenia of healthy Qi and sthenia of pathogenic factors and summarized the roles of Chinese medicine in correcting the imbalance of inflammatory response， improving blood coagulation dysfunction， and relieving organ damage. Furthermore， they proposed the treatment protocol with integrated TCM and western medicine， which is expected to provide references for actual clinical treatment and scientific research.
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Objective To analyze the epidemiological characteristics and diagnosis of imported malaria before and after malaria elimination in Nanjing City of Jiangsu Province, so as to provide the scientific evidence for formulating the malaria control strategy after malaria elimination. Methods Data pertaining to the epidemic situation and individual investigation of malaria in Nanjing City before (from 2012 to 2016) and after malaria elimination (from 2017 to 2020) were captured from the National Notifiable Communicable Disease Reporting System and the Information System for Parasitic Diseases Control and Prevention and were analyzed statistically. Results A total of 178 malaria cases were reported in Nanjing City from 2012 to 2020, and all were imported cases. There were 99 malaria cases reported before malaria elimination in Nanjing City, including 78 cases with Plasmodium falciparum malaria (78.79%), 5 cases with P. vivax malaria (5.05%), 10 cases with P. ovale malaria (10.10%), 3 cases with P. malariae malaria (3.03%) and 3 cases with mixed infections (3.03%), and 79 malaria cases reported after elimination, including 63 cases with P. falciparum malaria (79.75%), 5 cases with P. vivax malaria (6.33%), 9 cases with P. ovale malaria (11.39%), 2 cases with P. malariae malaria (2.53%). There was no significant difference in the proportion of each type of malaria cases in Nanjing City before and after malaria elimination (χ2 =2.400, P > 0.05). Malaria cases mainly acquired Plasmodium infections in African regions, and no significant difference was seen in the proportion of malaria cases returning to Nanjing City from African countries before and after malaria elimination (χ2 = 0.093, P > 0.05). The number of malaria cases peaked in Nanjing City in January and during the period from May to July before elimination, and there was no apparent seasonal variation in the distribution of malaria cases after elimination. The proportion of malaria cases living in Nanjing City was significantly greater after malaria elimination than before elimination (72.15% vs. 55.56%; χ2 = 5.187, P = 0.023). The proportions of businessmen and international students were both 5.05% before malaria elimination, and increased to 15.19% and 13.92% after elimination, respectively (χ2 = 5.229 and 4.229, both P values < 0.05). The percentage of definitive diagnosis of malaria at initial diagnosis was 18.75% in county-level hospitals before malaria elimination and increased to 61.11% after elimination (χ2 = 6.275, P = 0.012), while the proportion of malaria cases with definitive diagnoses in county-level hospitals was 4.04% before malaria elimination and increased to 13.92% after elimination (χ2 = 5.562, P = 0.018). During the period from 2012 to 2020, the proportion of malaria cases with definitive diagnoses within 1 to 3 days post-admission increased from 27.27% in Nanjing City before malaria elimination to 45.57% after elimination (χ2 = 6.433, P = 0.011). Conclusions The epidemic situation of imported malaria remains serious in Nanjing City during the post-elimination stage, and malaria parasite infections predominantly occur in African regions. In addition, there are changes in regional and occupational distributions of malaria cases and the diagnostic capability of malaria increases in county-level hospitals in Nanjing City after malaria elimination. Further improvements in the malaria surveillance system and the diagnostic and treatment capability of malaria in medical institutions at each level are required to consolidate malaria elimination achievements in Nanjing City.
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ObjectiveTo evaluate the effectiveness of Oncomelania snails control following the implementation of integrated schistosomiasis control measures in river channels connecting the Yangtze River in endemic areas of Nanjing City. MethodsThe river channels connecting the Yangtze River with snails in Nanjing City were selected as the study pilots. The integrated schistosomiasis control measures implemented in the study pilots were investigated by means of retrospective analyses and field surveys from 1998 to 2019, and the effectiveness of snail control was evaluated. Results Integrated control measures with emphases on environmental improvements including water resource projects for schistosomiasis control were implemented in the study pilots during the period from 1998 to 2019, including river bank concretion with 84.51 km in length, marshland cutting and dredging with 50.41 km in length, building 2 sluices and 3 overflow dams, digging one floodway and snail control with chemical treatment that covered an area of 3 370.80 hm2. No Schistosoma japonicum infection had been detected in snails since the completion of the integrated control measures. In addition, snails had been eliminated in 6 river channels connecting the Yangtze River until 2019, with the snail habitats reducing from 214.33 hm2 to 52.22 hm2 in 10 river channels connecting the Yangtze River and the snail density reducing to below 0.1 snails/0.1 m2 in snail-breeding river channels connecting the Yangtze River. Conclusions The integrated schistosomiasis control measures with emphases on environmental improvements may effectively control snail breeding and spread in rivers connecting the Yangtze River in endemic areas of schistosomiasis; however, the maintenance of the project and snail surveillance and control should be intensified following the completion of the integrated schistosomiasis control measures.
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Objective To evaluate the change of shear wave velocity (SWV) of renal parenchyma and serum level of transforming growth factor beta 1 (TGF-β1) in the patients with chronic allograft nephropathy (CAN),and further evaluate the correlation between them.Methods A total of 60 patients with chronic allograft nephropathy confirmed by renal biopsy were selected and divided into three groups according to the degree of interstitial fibrosis and tubular atrophy of the transplanted kidney:group C1 (renal cortex involvement ＜ 25％,n =20),group C2 (renal cortex involvement accounted for 26％-50％,n =20),group C3(renal cortex involvement ＞50％,n =20).30 renal transplant recipients with normal renal function were enrolled for control group.The SWV of the renal were measured by virtual touch tissue quantification (VTQ) and the serum level of TGF-β1 were detected by enzyme linked immunosorbent assay (ELISA) in each group.Results Compared with control group,the SWV and serum TGF-β1 in case groups were significantly higher (P ＜ 0.05).SWV measured values:group C3 was the highest,group C2 was middle one and group C1 was the lowest (P ＜0.05).Statistically significant difference in serum TGF-β1 was observed among these three groups (P ＜0.05).The renal SWV and serum TGF-β1 had a significant positive correlation (r=0.631,P＜0.05).Conclusions Both renal SWV and serum TGF-β1 increase as CAN progressed,which have high value in the diagnosis and treatment of CAN.
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@#AIM: To observe the morphology of corneal incision between femtosecond laser-assisted cataract surgery(FLACS)with 2.4mm micro-incision and conventional phacoemulsification cataract surgery(CPCS)with 2.4mm micro-incision, evaluating the safety and stability of the incision.<p>METHODS: This was a prospective controlled study. A total of 89 cataract patients(99 eyes)who underwent cataract surgery were collected. All patients were divided into two groups: 44 cases(49 eyes)in FLACS group and 45 cases(50 eyes)in CPCS group. Morphology of clear corneal incision was observed by OCTA postoperative.<p>RESULTS: There was no external wound dehiscence in FLACS group on 1d postoperative, while 10% patients had external wound dehiscence in CPCS group(<i>P</i><0.05). There were no external wound dehiscence in both groups on 1wk, 1mo and 3mo postoperative. On 1wk and 1mo postoperative, the incidences of internal wound dehiscence in FLACS group(47% of 1wk and 10% of 1mo)were lower than that in CPCS group. There were statistically significant difference(68% of 1wk and 26% of 1mo)(<i>P</i><0.05). On 1d and 3mo postoperative, there were no significant difference in internal wound dehiscence in both groups. There were no significant differences in descemet membrane detachment(DMD)in both groups.<p>CONCLUSION: Femtosecond laser-assisted cataract surgery(FLACS)is benefit for wound closure and reducing abnormal incision construction.
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Objective To understand the prevalence of Toxoplasma gondii infection among special populations in Nanjing City, so as to provide the reference for formulating the interventions for the prevention and control of T. gondii infections in this population. Methods The HIV/AIDS patients, tumor patients, pregnant women, and people with livestock and poultry breeding or processing works were selected as the study subjects from September to November 2015. The venous blood samples were collected from each participant for detecting IgG and IgM antibodies against T. gondii by ELISA. Results The overall prevalence of T. gondii infection was 10.2% in the study subjects in Nanjing City. The T. gondii infection rates were 12.2%, 11.3%, 4.0%, and 13.0% among the HIV/AIDS patients, tumor patients, pregnant women, and people with livestock and poultry breeding or processing works, respectively, and there was no statistically significant difference among the four groups (χ2 = 5.668, P = 0.130). The prevalence of T. gondii infection was higher in men than in women (15.3% vs. 5.8%; χ2 = 10.213, P = 0.001), and there were significant differences in the prevalence of T. gondii infection in terms of gender (χ2 = 9.501, P = 0.023), education levels (χ2 = 9.850, P = 0.043) or occupations (χ2 = 8.983, P = 0.062). Conclusions The infection rate of T. gondii among the special population in Nanjing City is high. Therefore, the health education intervention should be strengthened in the follow-up work for the special population.
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Objective To investigate the effect of microecological therapy on rotavirus ( RV)-induced diarrhea and infants’ immunologic function in infants. Methods 150 infants with RV diarrhea were randomly divided into the ex-perimental group and the control group. The control group was given the treatment of montmorillonite powder. The experimental group was given live combined bifidobacterium and lactobacillus tablets in addition to montmorillonite powder. The clinical efficacy and the improvement of clinical symptoms were compared between the two groups. RV antigen and immunologic function were detected with colloidal gold method. Immune function was detected by flow cytometry and ELISA. Results The total effective rate of the experimental group was 90.7%,and it was significant-ly higher than that of the control group which was 74.7%(P＜0.05). Compared with the control group, the antidi-arrheal time, fever clearance time and disappearance time of vomiting symptoms in the experimental group were shorter ( P＜0.05) . The negative conversion rate of RV virus antigen in the experimental group after 1 and 2 weeks treatment was significantly higher than that in the control group ( P＜0.05) . After 3 weeks treatment, RV virus antigen in the experimental group all turned negative, but the control group still had a positive rate of 12.0% ( P＜0.05) . The peripheral blood CD3+, CD4+and the ratio of CD4+/CD8+in the experimental group after treatment were significantly higher than those before treatment and those in the control group after treatment ( P＜0.05) , the same phenomenon was found in serum immunoglobulin A ( IgA) and IgM ( P＜0.05) . No adverse events occurred during the treatment period in the two groups. Conclusions Microecological therapy has an exact curative effect and high safety in the treatment of infantile RV diarrhea, it could effectively improve the immunologic function of the infants.
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Objective To summarize the effect of individualized rehabilitation nursing combined with music therapy on one patient with severe pneumonia complicated with multiple organ failure. Methods Based on the comprehensive evaluation of patients,the rehabilitation programs including critical care,person-alized rehabilitation care and personalized music therapy were established,and the corresponding nursing mea-sures and muscle training were implemented. Results After careful nursing, music therapy and muscle training for seven days, the score of Acute Physiology and Chronic Health Evaluation Scoring System (APACHE II) decreased from 28 to 14; the upper limb muscle strength increased;the score of Self-rating Anxiety Scale(SAS)decreased from 71 to 52;the score of Fugl-Mey-er Assessment(FMA)increased from 38 to 80;and modified Barthel index increased from 0 to 55. Conclusion Personalized rehabilitation care could effectively promote the recovery,and increase the activities of daily living of patients with severe pneumonia complicated with multiple organ failure.
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Objective To understand the prevalence of Toxoplasma gondii infection among special populations in Nanjing City, so as to provide the reference for formulating the interventions for the prevention and control of T. gondii infections in this population. Methods The HIV/AIDS patients, tumor patients, pregnant women, and people with livestock and poultry breeding or processing works were selected as the study subjects from September to November 2015. The venous blood samples were collected from each participant for detecting IgG and IgM antibodies against T. gondii by ELISA. Results The overall prevalence of T. gondii infection was 10.2% in the study subjects in Nanjing City. The T. gondii infection rates were 12.2%, 11.3%, 4.0%, and 13.0% among the HIV/AIDS patients, tumor patients, pregnant women, and people with livestock and poultry breeding or processing works, respectively, and there was no statistically significant difference among the four groups (χ2 = 5.668, P = 0.130). The prevalence of T. gondii infection was higher in men than in women (15.3% vs. 5.8%; χ2 = 10.213, P = 0.001), and there were significant differences in the prevalence of T. gondii infection in terms of gender (χ2 = 9.501, P = 0.023), education levels (χ2 = 9.850, P = 0.043) or occupations (χ2 = 8.983, P = 0.062). Conclusions The infection rate of T. gondii among the special population in Nanjing City is high. Therefore, the health education intervention should be strengthened in the follow-up work for the special population.
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To evaluate the effect of an automatic identification system of Schistosoma japonicum miracidia, and compare it with the traditional eye detection method in the simulation field.A total of 260 fecal samples were collected from schistosomiasis non-endemic areas, and the test sample bottles containing schistosome miracidia were prepared according to different experimental needs. Thirty fecal samples for the sensitivity test were separately added with five fresh miracidia per sample, and then the mixed samples were detected by two experienced technicians (with more than 15 years’ traditional test experience) or the automatic system. The positive detection rates were compared between the two methods. Thirty fecal samples for repetition test were separately added with ten fresh miracidia per sample, and then the mixed samples were detected separately with the automatic identification system by two experienced technicians. The results were compared between two persons. The two methods including the automatic identification system and the traditional eye detection method were carried out blindly with totally 200 samples in the simulation field. There were three groups (each with 30 samples) : Group 1 with more than 21 fresh miracidia, Group 2 with 6 to 20 fresh miracidia, and Group 3 with 1 to 5 fresh miracidia. The other 110 samples were as a negative group. The detection time, accuracy, missed detection rate, and false detection rate of the two methods were statistically compared.The positive detection rates of the 30 positive samples were 43.33% and 33.33% by the two technicians with the traditional eye detection method, respectively, while the detection rate was 80.00% by the automatic identification system, and the difference was statistically significant (χ2 = 7.05, χ2 = 12.97, both P < 0.01). Thirty positive samples were detected by the two technicians using the same automatic identification system, and the positive detection rates of the two were 96.67% and 86.67%, respectively, with no significant difference (χ2 = 0.27, P > 0.05). The experiments showed that the correct detection rate of the positive samples was 98.00% by the automatic identification system, which was higher than 79.75% by the traditional eye detection method. The detection time of the automatic identification system was shortened by half compared with that of the traditional eye detection method. The missed detection rate, and false detection rate of the automatic identification system were 2.22% and 1.82%, respectively, which were much lower than 35.56% and 7.73% of the traditional eye detection method.Compared with the traditional eye detection method, the automatic identification system of S. japonicum miracidia has the advantages of high sensitivity, good repeatability, short detection time, high accuracy, low missed detection rate, and low false detection rate. It can be used in the field and clinical detection in replacement of the traditional eye detection method.
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Clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for sepsis is strictly in accordance with the latest diagnostic criteria for sepsis (sepsis-3) for the treatment of septic patients at different stages through syndrome differentiation. At present, the abuse of antibiotics and the prevalence of drug-resistant bacteria are very serious, without effective solutions. Thus, this is the first time to focus on traditional Chinese medicine combined with antibiotics to treat sepsis, in order to minimize the incidence of drug-resistant bacteria. This Guideline tends to systematically analyze the sepsis period, septic shock period as well as different clinical symptoms and traditional Chinese medicine measures for organ dysfunction in the sepsis process. By analyzing and interpreting the Guideline systematically, the clinicians could understand its purpose, significance and core ideas more thoroughly, and grasp the recommended specific interventions as well as their advantages and disadvantages, hoping to better implement the Guideline, provide guidance to clinicians and standardize the treatment of sepsis by traditional Chinese medicine.
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Humans , Anti-Bacterial Agents , Therapeutic Uses , Medicine, Chinese Traditional , Sepsis , Drug TherapyABSTRACT
Objective To investigate relationships between serum levels of anti?tyrosinase IgG antibody(TYR IgG)as well as anti?tyrosinase?related protein?1 IgG antibody(TRP?1 IgG)and vitiligo. Methods Enzyme linked immunosorbent assay(ELISA)was performed to detect serum levels of TYR IgG and TRP?1 IgG in 260 patients with vitiligo and 50 health controls. The threshold for defining a positive test result was set at 3 standard deviations above the mean serum level of TYR IgG or TRP?1 IgG in the healthy controls. Results The positive rate of TYR IgG and/or TRP?1 IgG in the vitiligo group was 57.31%(149/260). The positive rates of TYR IgG and TRP?1 IgG were both significantly higher in the vitiligo group than in the control group(TYR IgG:37.3%[97/260]vs. 0,χ2=25.441, P0.05). Among patients with vitiligo, the positive rate of TRP?1 IgG was significantly higher in females than in males(χ2=5.811, P20 years(χ2=6.498, P 20 years (both P >0.05). Conclusion Detection of TYR IgG and TRP?1 IgG may provide some evidence for the diagnosis and treatment of vitiligo.
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<p><b>OBJECTIVE</b>To evaluate the changes in retinal functions using multifocal electroretinography (mfERG) following intravitreal injection of Lucentis for treatment of wet age-related macular degeneration.</p><p><b>METHODS</b>This prospective study was conducted in 14 patients (9 men and 5 women, 14 eyes) with wet age-related macular degeneration receiving treatment with intravitreal injections of ranibizumab (Lucentis) in our hospital between October, 2014 and January, 2016. All the patients received the treatment following a 1+PRN protocol and after the initial injection, the patients were followed up monthly for 6 months to decide if additional injections were needed. The corrected visual acuity and mfERG findings of the patients were assessed before and at l, 3 and 6 months after the initial injection.</p><p><b>RESULTS</b>At the last follow-up, the patients received injections for a mean of 2.86∓1.58 times. The best corrected visual acuity (BCVA) at 1 month after the initial treatment was not significantly different from that before treatment (P=0.07), but showed significant improvements at 3 and 6 months (P<0.05). In mfERG, the implicit time of the 6 rings showed no significant decrease after the treatment, but the amplitude density of P1 and N1 in rings 1 and 2 improved significantly at 1, 3, and 6 months after the initial injection (P<0.05).</p><p><b>CONCLUSION</b>Multifocal electroretinography can serve as a useful modality for evaluating visual function changes in patients receiving intravitreal injection of Lucentis for wet age-related macular degeneration.</p>
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<p><b>OBJECTIVE</b>To predict orthologous sequences of the GENCODE-identified 13 562 human long non-coding RNAs (lncRNA) in 16 mammalian genomes and construct a lncRNA database LongMan for lncRNA studies.</p><p><b>METHODS</b>The exon structures of a total of 13 562 human lncRNAs were analyzed using RNAfold, and their orthologous sequences were searched against 16 mammalian genomes using Infernal. The potential orthologous genes, transposons and splicing signals of human lncRNAs were predicted to construct a lncRNA database with a updating mechanism.</p><p><b>RESULTS</b>and</p><p><b>CONCLUSION</b>The lncRNA database LongMan we constructed, which currently contains 133 646 orthologous lncRNAs, provides information of the sequences, alignments, transposons, and species-specific insertions and deletions and allows database search on combinatorial conditions, graphic display and data download. As the first large-scale mammalian orthologous lncRNA database, LongMan has important values in future comparative and functional studies of lncRNAs.</p>
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Animals , Humans , Databases, Nucleic Acid , Exons , RNA, Long NoncodingABSTRACT
Wnt3a, one of Wnt family members, plays key roles in regulating pleiotropic cellular functions, including self-renewal, proliferation, differentiation, and motility. Accumulating evidence has suggested that Wnt3a promotes or suppresses tumor progression via the canonical Wnt signaling pathway depending on cancer type. In addition, the roles of Wnt3a signaling can be inhibited by multiple proteins or chemicals. Herein, we summarize the latest findings on Wnt3a as an important therapeutic target in cancer.
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Humans , Cell Division , Physiology , Gene Expression Regulation, Neoplastic , Physiology , Neoplasm Proteins , Metabolism , Physiology , Neoplasms , Genetics , Metabolism , Pathology , Tumor Cells, Cultured , Wnt Signaling Pathway , Physiology , Wnt3A Protein , Metabolism , PhysiologyABSTRACT
Objective To develop a detection method based on the technology of gene chips which can quickly distinguish genes of Enterococcus faecalis, E.faecium and vancomycin resistance.Methods Based on the specific gene ( ddl) sequences of two types of Enterococcus from GenBank, oligonucleotide probes which could detect and distinguish special genes and drug resistance genes ( vanA,vanB) of Enterococcus were designed and compounded.Then,the probes were dotted to modified slide.The target DNA fragments of vancomycin-resistant Enterococcus ( VRE) were labeled with biotin by multiple PCR amplification, and then hybridized with oligonucleotide probes on slide.The results were analyzed by portable imager.The multiple PCR system, hybridization reaction and condition of the chemiluminescence method were optimized before the specificity, sensitivity and reproducibility of the chip were evaluated.Results One universal primer, four specific primers, one universal probe and four specific probes were selected.This gene chip was demonstrated of high specificity and repeatability.The detection sensitivity was 103 CFU/ml.The gene chip detection results of 10 clinical samples were basically consistent with the drug sensitivity test ( 8/10 ) .Conclusion A gene chip technique for the detection of VRE is established successfully.It is possible to distinguish the type of VRE and detect the genetic phenotypes of drug resistance by gene chip technique.
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Objective To investigate the present status of the emergency nursing training to form the curricula system for emergency nursing training of nurses (including course projects,class hour,teaching form,training aim).Methods Based on the actual investigation,literature research,using Delphi method,the training course system of emergency nursing was established.Results Cronbach's α coefficient was 0.943 and the expert authority coefficient was 0.868.Emergency training should be included in the nursing training program,and the four modules courses were built.With reference to emergency management requirements of home and abroad and the training model of foreign troops as well as combining the reality of our country to set up the training objectives,to improve class hour,enrich teaching form,and adjust the training content to set up the emergency training evaluation model.Conclusions The results of this study supply basic guarantee for nurses to increase coping ability of emergency affairs as well as training basis and reference with clear structure and content,reasonable design and reliable results.
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Objective To investigate the treatment effect of minimally invasive excision in intrahepatic bile duct stones. Methods Ac-cording to different treatment methods, 280 patients with intrahepatic bile duct stones were divided into the treatment group (180 cases) and the control group(100 cases). The control group were given open hepatic lobectomy while the treatment group were given minimally invasive treatment of hepatic lobectomy by laparoscopy. Results All patients had successfully completed surgery and the stones were removed. Compared the operation time,intraoperative blood loss,and blood transfusion of the two groups,and there were no statistically significance (P>0. 05). The postoperative hospitalization,time of drainage tube remove, time of analgestic drug use in treatment group were obviously lower than those in control group,which had statistically significance (P<0. 05). The common postoperative complications of the two groups were bile leakage,wound infection,pleural effusion and subphrenic abscess,et al. The complication rate of treatment group was 2. 2%, while it was 10. 1% in the control group, which had significant difference (P<0. 05). All the patients were followed-up for 6 months, and there was no death in patients. Conclusion Intrahepatic bile duct stones in progress could be treated by hepatic resection surgery. Laparoscopic techniques could accelerate the recovery of patients and reduce the complication rate,and it would become a new treatment option.
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ObjectiveTo explore the clinical value of three-dimensional (3D) skeletal ultrasound mode imaging, 3D helical computer tomography (3D-HCT) and MRI in diagnosing lower limb skeletal malformations of fetal sirenomelia.MethodsSeven fetuses were suspected of sirenomelia with routine prenatal ultrasonography examination. Three-dimensional skeletal ultrasound mode imaging and MRI were used to conifrm the diagnosis, and the results were compared to those of pathology, 3D spiral CT or X-ray after termination. Five of them underwent chromosome examination including chorionic villus or umbilical cord biopsy.ResultsSix fetuses were singletons and one fetus was a conjoined twin. Three fetuses were male, while four fetuses were female. All fetuses with sirenomelia showed varying degrees of skeletal abnormalities: 1 case of typeⅢ, 2 cases of typeⅣ, 3 cases of typeⅤ and 1 case of typeⅥ. No foot was detected in one case and only single foot was detected in other 6 cases. In 7 cases, 3D skeletal ultrasound mode imaging could demonstrate all the lower limb skeletal malformations, including abnormal femur and tibioifbula, single foot or no feet. Prenatal MRI could demonstrate abnormal femur in 4 cases, abnormal tibioifbula in 1case, and no foot malformation. The results of 3D spiral CT after termination were consistent with X-ray and pathological examination results.ConclusionsAs a new imaging technology for detecting fetal skeletal malformations, prenatal 3D skeletal ultrasound mode imaging and postnatal 3D spiral CT both can display fetal bone clearly. They both have important clinical value in diagnosing lower limb skeletal malformations.