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OBJECTIVE@#To investigate the association of fetal cardiac structural abnormalities with chromosomal aneuploidies and copy number variations (CNVs) in amniocytes.@*METHODS@#328 pregnant women were subjected to fetal ultrasonography and chromosomal microarray analysis (CMA). Based on the fetal heart structure, the subjects were divided into normal (n=273) and abnormal groups (n=55). The detection rates of chromosomal aneuploidies and CNVs were compared between the two groups. Spearman method was used to assess the association between the results and fetal cardiac structural abnormalities.@*RESULTS@#The detection rates for chromosomal aneuploidies and CNVs in the abnormal group were significantly higher than that in the normal group (P< 0.05), and the incidence of fetal cardiac structural abnormalities was strongly associated with chromosomal aneuploidies and CNVs (P< 0.05).@*CONCLUSION@#Fetal chromosomal aneuploidies and CNVs are strongly associated with cardiac structural abnormalities.
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Female , Humans , Pregnancy , Aneuploidy , Chromosome Aberrations , DNA Copy Number Variations , Fetus , Microarray Analysis , Prenatal Diagnosis , Ultrasonography, PrenatalABSTRACT
Objective To ascertain the dose levels to personnel from the activation products in the radiotherapy place of a proton acceterator and to provide technical basis for protection design of the treatment place and the personnel's radiation protection.Methods A PROTEUS 235 proton therapy system was analyzed for the potentials to produce activated nuclides in the air during its operation.The concentrations of the main radionuclides and the resultant personnel doses were estimated.Results The activity concentrations of activated nuclides were 15O 4.1 × 10-2,13N 3.3 × 10-2,41 Ar 6.2 × 10-3 and 11 C 2.0 × 10-2 Bq · cm-3,respectively,in proton accelerator hall,whereas those in the proton beam radiotherapy room were only about 5％ of the corresponding values in the proton accelerator hall.The annual doses to the radiation workers from immersion external exposure due to air activation were less than 1 and 0.1 mSv,respectively,when entering the proton accelerator hall 5 and 30 min after beam stopping;whereas those were 1.3-2.0,0.7-1.2 and 0.3-0.6 mSv,respectively,when entering the therapy hall 0,5 and 15 min after beam stopping.Conclusions The personnel doses received from activated nuclides in the air in the radiotherapy place of a proton acceterator are unignorable.The contribution to doses from immersed external exposure of 15O,13N,41Ar and 11C should be taken into full considerations,with necessary protection measures needed.
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Background:For patients with liver cirrhosis and acute decompensation(AD),it is of great clinical importance to predict short-term mortality at admission. It has been reported that CLIF-C OF,MELD and MELD-Na score can accurately predict the short-term mortality,but all these scoring systems are complicated and have limits in their application. Aims:To define a simple and objective scoring system -- simplified MELD score for short-term mortality prediction in HBV-related cirrhotic patients with AD. Methods:A total of 890 consecutive HBV-related cirrhotic patients with AD hospitalized during Jan. 2005 to Dec. 2010 at Shanghai Ren Ji Hospital were enrolled retrospectively. Clinical data and patients’outcome were collected,and simplified MELD score was calculated by using total bilirubin,international normalized ratio and creatinine values at admission. Patients were classified into different prognostic groups according to their 28-day mortalities and simplified MELD score. Kaplan-Meier survival curve was used to analyze the 1-year accumulate survival rate,and ROC curve was used to evaluate the performance of different scoring systems in predicting 28-day mortality. Results:Simplified MELD score at admission could classify HBV-related cirrhotic patients with AD into low,moderate and high 28-day mortality groups and different long-term prognostic groups;the score of low,moderate and high 28-day mortality group was 0-2,3 and 4-6,respectively,and the corresponding mortality was 5. 5% ,19. 8% and 48. 6% ,respectively. Simplified MELD score had the same good performance as compared with the CLIF-C OF,MELD and MELD-Na scores in predicting 28-day mortality,the area under ROC curve was 0. 828,0. 831,0. 828 and 0. 830,respectively. Conclusions:Simplified MELD score can accurately classify HBV-related cirrhotic patients with AD into low,moderate and high 28-day mortality groups at admission. It is convenient for using in clinical practice.
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Background:Acute-on-chronic liver failure( ACLF)is a commonly seen liver failure in China,and lacking an animal model that can effectively simulate the dynamic change of immune status of ACLF. Aims:To establish an animal model that can simulate dynamic change of immune status of ACLF by repeated administration of concanavalin A(ConA). Methods:Mice were randomly divided into normal control group and ConA repeated administration group. Mice in ConA repeated administration group were injected with ConA 15 mg/ kg through retrobulbar angular vein every 48 hours for 5 times,and mice in control group were injected with same volume of 0. 9% NaCl solution. Serum levels of IL-6,IL-10,IL- 12,TNF-α,IFN-γ,MCP-1 in peripheral blood were assessed by CBA assay,and the ratio of IL-10/ TNF-α was calculated. The expression of HLA-DR,number and proportion of CD4+ T cells and the expression of PD-1 of monocytes in peripheral blood were detected by flow cytometry. Results:Peripheral blood cytokines changed from predominated proinflammatory cytokines into predominated anti-inflammatory cytokines with the increasing in time of administration in ConA repeated administration group. Compared with control group,HLA-DR expression of monocytes in peripheral blood was significantly decreased(P <0. 05),number and proportion of CD4+ T cells were significantly decreased(P <0. 05), and PD-1 expression was significantly increased( P < 0. 05)in ConA repeated administration group. Conclusions:An animal model of ACLF immune status from systemic inflammatory response syndrome( SIRS) to compensatory antiinflammatory response syndrome(CARS)induced by repeated ConA stimulation is successfully established.
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Objective To compare the advantages and disadvantages of high intensity focused ultrasound (HIFU ) and total abdominal hysterectomy for the treatment of uterine fibroids .Methods 167 patients with symptomatic uterine fibroids were divid‐ed into the HIFU treatment group(n=86) and the hysterectomy group(n=81) .The adverse events were recorded before operation and at postoperative 1 ,3 ,6 months .The questionnaire survey of the uterine fibroid symptoms‐quality of life (UFS‐QOL) was con‐ducted .The health related living quality was evaluated by using the health survey questionnaire‐36(SF‐36) .Results There were no severe adverse events in either group .The significant clinical complications and adverse events in the HIFU group were lower than those in the hysterectomy group .The UFS‐QOL scores in the HIFU group were superior to those in the hysterectomy group ,but the SF‐36 scores at postopertive 3 ,6 months had statistically significant differences between the two groups (P>0 .05) .Conclusion The patients who are unable to tolerate surgery or hope to preserve the uterus and its physiological function are suitable for HI‐FU treatment .
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Objective To evaluate the effect of contrast-enhanced ultrasound(CEUS) in the real-time monitoring treatment of ultrasound-guided high intensity focused ultrasound (HIFU ) for uterine adenomyosis .Methods From January 2013 to September 2013 ,a total of 67 patients who were clinically diagnosticated as uterine adenomyosis were enrolled in this study .49 patients were diffuse type and 18 patients were localized .CEUS was used before ,in ,after ultrasonic treatment to make sure lesions and evaluate the ablation effect .Results 67 patients were 100% perfused before HIFU treatment by CEUS ,the non-perfused volume ratio of 15 patients(22 .4% ) were not enough during treatment ,and more energy were given .During HIFU treatment ,uniform grey scale change was observed in 42 of 67(62 .7% ) patients and massive grey scale change was observed in 25 of 67(37 .3% ) patients .The margin of targets and the non-perfused volume were clearly detected by CEUS .The size of target andymyosis ,the volume ,the non-perfused volume ,and non-perfused volume ratio were(4 .8 ± 1 .5)cm ,(63 .1 ± 57 .2)cm3 ,(59 .1 ± 53 .4 )cm3 ,(76 .4 ± 27 .0)% .The adverse effects occurred in the treatment were not related to CEUS .Conclusion CEUS is an accurate method in assessing the treat-ment effect of HIFU and could be safely used during HIFU treatment for uterine adenomyosis .