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Objective:To explore the application value of ultrasonic measurement of the pubic symphysis distance in predicting pubic symphysis diastasis(PSD) during delivery.Methods:A total of 262 pregnant women from June 2021 to July 2022 who delivered at Suzhou Wuzhong People′s Hospital and Jiangyin People′s Hospital were retrospectively analyzed. The patients were divided into PSD group of 26 cases and normal pregnant women group (control group) of 234 cases according to whether or not PSD was confirmed during postpartum follow-up. Relevant data of the two groups were collected, including the biparietal diameter and femoral length of the fetus within 7 days before delivery, the pubic symphysis distance of pregnant women when the cervix was not dilated, pubic symphysis distance when the cervix dilated to 5 cm during the first stage of delivery, and the pubic symphysis distance after delivery, the age of the pregnant woman, the gestational week, the number of pregnancies, and the birth weight of the fetus. The differences of the above relevant data between the two groups were compared.Spearman correlation analysis was used to analyze the correlation between various parameters. The occurrence of postpartum PSD, and Logistic regression was used to analyze the predictive value of various parameters on the occurrence of postpartum PSD. ROC curve was used to analyze the diagnostic efficacy of each parameters to predict PSD.Results:The fetal birth weight, number of pregnancies, pubic symphysis distance in three time points in the PSD group were significantly higher than those in the control group (all P<0.05). The age of the pregnant women was negatively correlated with the occurrence of postpartum PSD ( rs=-0.152, P=0.014). The fetal birth weight, the number of pregnancies, the pubic symphysis distance in the cervix no-dilated and the first stage of labor were positively correlated with the occurrence of postpartum PSD( rs=0.160, 0.166, 0.678, 0.581, all P<0.05). Logistic regression analysis showed that the increase of pubic symphysis distance before labor would increase the risk of postpartum PSD, and the difference was statistically significant ( OR=2 506.028, 95% CI=14.293-439 402.630, P=0.003). The increase of pubic symphysis distance at the first stage of labor increased the risk of postpartum PSD, with a statistically significant difference ( OR=10 704.027, 95% CI=33.830-3 386 803.429, P=0.002). The ROC curve analysis showed that the area under the curve of the pubic symphysis distance in the cervix no-dilated and the first stage of labor for the diagnosis of PSD were 0.896 and 0.917 respectively, the sensitivity were 0.731 and 0.885, the specificity were 0.940 and 0.829, and the corresponding critical values were 0.87 cm and 1.06 cm respectively. The area under the curve of the combination of the two parameters for the diagnosis of PSD was 0.930, the sensitivity was 0.885, and the specificity was 0.876. Conclusions:Ultrasonic measurement of pubic symphysis distance during delivery can predict the occurrence of postpartum PSD in pregnant women and can provide a basis for the occurrence and treatment of postpartum pubic symphysis separation in pregnant women.
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Objective:To study the role of myocardial work parameters in early identification of myocardial injury in neonatal asphyxia.Methods:From July 2020 to December 2021, neonates diagnosed with mild neonatal asphyxia admitted to the Department of Neonatology of our hospital within 24 h after birth were prospectively enrolled into the asphyxia group. Neonates without asphyxia during the same period were selected as the control group and matched with the asphyxia group for gender, gestational age and birth weight at a ratio of 1:1~1:2. The asphyxia group was subgrouped into preterm asphyxia group and term asphyxia group. All neonates received echocardiography within 24 h after birth. Multiple parameters were measured including M-mode, two-dimensional image, Doppler image, global longitudinal strain (GLS) and myocardial work parameters [global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE)]. The level of serum N-terminal pro brain natriuretic peptide (NT-proBNP) was recorded in the asphyxia group. The data were compared between the asphyxia group and the control group. Correlations between myocardial work parameters and other parameters were analyzed.Results:A total of 33 cases were in the asphyxia group and 43 cases were in the control group. The preterm asphyxia group (18 cases) showed significantly lower GWI and GCW than the preterm control group (18 cases) [GWI: (702±153) mmHg vs. (879±205) mmHg, GCW: (1 016±221) mmHg vs. (1 200±271) mmHg] ( P<0.05). No differences existed in GLS, GWW and GWE. The term asphyxia group (15 cases) showed significantly lower GWW than the term control group (25 cases) [45.0 (30.0, 65.0) mmHg vs. 71.0 (35.5,85.5) mmHg] ( P<0.05). No differences existed in GLS, GWI, GCW and GWE. GWI was negatively correlated with serum NT-proBNP level ( r=-0.327, P<0.05). Conclusions:GWI and GCW may indicate myocardial injury in preterm neonates with mild asphyxia.
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Objective:To investigate the changes of T-lymphocyte subsets, T-cell immunoglobulin and mucin domain molecule-1 (TIM-1) and TIM-3 levels, and cytokines in the peripheral blood of patients with active tuberculosis.Methods:From December 2017 to December 2018, 50 tuberculosis patients and 50 cured tuberculosis patients in Zhejiang Hospital of Integrated Chinese and Western Medicine were selected as the tuberculosis group and cured tuberculosis group, respectively. Fifty healthy individuals in the same period were selected as the control group. Flow cytometry was used to detect the T-lymphocyte subsets in the peripheral blood. The mRNA levels of TIM-1, TIM-3, interferon(IFN)-γ and interleukin(IL)-4 in peripheral blood mononuclear cells (PBMC) were detected by quantitative real-time polymerase chain reacticn (PCR). T test was used for statistical analysis. Results:The ratio of CD4 + /CD8 + T lymphocytes in the tuberculosis group (1.21±0.50) decreased significantly, comparing with those in the cured tuberculosis group (1.88±0.62) and the control group (1.92±0.82). The differences were statistically significant ( t=2.148 and 2.207, respectively, both P<0.05). The mRNA levels of TIM-1, TIM-3 and IL-4 in PBMC in the tuberculosis group were 2.16±0.37, 1.59±0.36 and 1.52±0.69, respectively, which were all higher than those in the cured tuberculosis group (1.60±1.23, 1.01±0.52 and 0.91±0.36, respectively) and the healthy control group (1.40±0.27, 0.92±0.34 and 0.79±0.42, respectively). All of these differences were statistically significant ( t=14.120, 11.440, 17.130, 12.090, 12.050 and 17.030, respectively, all P<0.05). However, the IFN-γ mRNA level (0.43±0.11) was lower than that in the cured tuberculosis group (1.74±0.72) and the control group (1.82±1.17), and the differences were both statistically significant ( t=13.880 and 11.430, respectively, both P<0.05). Conclusion:The immune dysfunction in patients with active tuberculosis may be related to the low ratio of CD4 + /CD8 + T lymphocytes, the increased expressions of TIM-1 and TIM-3, and the imbalance of helper T lymphocyte (Th)1/Th2 cytokines.
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@#Objective To investigate the effects of local injection of Botulinum toxin A (BTX-A) on hemifacial spasm guided by periph-eral nerve stimulation. Methods 57 patients with hemifacial spasm from January, 2012 to June, 2015 received local multi-point injection of BTX-A guided by peripheral nerve stimulation. The grades of facial spasm were evaluated before, 72 hours and 6 months after treatment. They were followed up for 3-9 months. Results The spasm reduced in the patients both 72 hours and 6 months after treatment (χ2=4.946, P<0.05). The incidence was 98.25% of satisfaction and 92.99% of very well 72 hours after treatment, while it was 91.23% and 78.95% 6 months after treatment. The relief of spasm was maintained for (23.1 ± 2.3) weeks. Conclusion Injection of BTX-A guided by peripheral nerve stimulation is effective on hemifacial spasm for a long time.
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Objective To compare the curative effects of multi-level puncture versus single-level puncture percutaneous vertebroplasty(PVP) for treatment of multiple-level osteoporotic vertebral body compression fractures(OVCF) in senile patients.Methods From June 2008 through November 2014,89 senile patients with fresh multiple-level OVCF underwent PVP guided by C-arm fluoroscopy in prone position.Of them,51 received PVP in which the vertebrae of multiple levels were simultaneously punctured for bone cement injection while the other 38 received PVP in which the vertebrae of multiple levels were punctured one by one for bone cement injection.The 2 groups were compatible with no significant differences in preoperative demographic data (P ＞ 0.05).The 2 groups were compared in terms of visual analgesic scale (VAS),operation time for a single vertebra,fluoroscopy times for a single vertebra,bone cement injection amount for a single vertebra,and extraosseous cement leakage.Results PVP procedures were successful in both groups without serious complications.The VAS scores in both groups at 2 days post-operation were significantly lower than those at pre-operation(P ＜ 0.05).The operation time and fluoroscopy times for a single vertebra in the multi-level puncture PVP group were significantly less than those in the single-level puncture PVP group (P ＜ 0.05).There were no significant differences between the 2 groups in bone cement injection amount for a single vertebra or extraosseous cement leakage (P ＞ 0.05).Conclusions The curative effects of multi-level puncture and single-level PVP are satisfactory for senile OVCF,but multi-level puncture PVP may lead to less operation time and less X-ray exposure.
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Objective To investigate the changes and significance of early immune response in specific T cell with invasive pulmonary aspergillosis(IPA) patients. Methods Peripheral blood mononuclear cells (PBMCs) were separated from whole blood of 8 cases of healthy individuals (healthy group) and 24 cases of IPA patients (IPA group, including 6 cases of pathological diagnosis, 9 cases of clinical diagnosis and 9 cases of tentative diagnosis), and the heat-inactivated Aspergillus fumigatus spores (Conidia) was used as an antigen to stimulate PBMCs produce Aspergillus-specific T lymphocytes. Interferon-gamma (IFN-γ) secreation, type and ratio of cytokine synthesis was examined. Results In IPA group, dot enzyme linked immunosorbent assay(ELISPOT) showed that the positive rate of IFN-γin pathological diagnosis patients and clinical diagnosis patients (5/6,7/9) was higher than that in tentative diagnosis patients (3/9). The positive rate of IFN-γin IPA group was 62.5%(15/24), in healthy group was 0 (0/8), and there was significant difference (P<0.05). The levels of CD4+T and CD4+T/CD8+T in IPA group were 0.202 0±0.085 6 and 1.01±0.34, in healthy group were 0.3853±0.1265 and 1.55±0.41. The levels of CD4+T and CD4+T/CD8+T in IPA group were significantly lower than those in healthy group ( P<0.05 or<0.01). The level of CD 8+T in IPA group was 0.298 5±0.069 1, and in healthy group was 0.257 6±0.102 6. The level of CD8+T in IPA group was 05). Conclusion Conidia as antigen can induce the specific Th1-type immune response of IPA, and display the immune status of the IPA patients, and can provide new ideas and methods for the diagnosis and assessment of the disease.
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To investigate the CT findings of thoracic sarcoidosis and improve the understanding and diagnostic level of the disease. Retrospective analysis of the pathology or clinical treatment were observed in 20 patients with thoracic sarcoidosis accorded with the diagnostic standard of CT performance. There were 15 cases confirmed by pathology and 5 cases verified after clinical treatment. There were hilar or mediastinal lymph nodes in 90% cas-es, pulmonary mainly nodules in 60% case, pulmonary fibrosis in 20% cases, bronchovascular bundle thickening in 15%cases, pleural effusion in 10% cases, interlobular septal thickening in 15% cases, ground-glass opacity in 10% cases and pulmonary consolidation in 5% cases. CT findings of thoracic sarcoidosis may help improve the rate of its diagnosis.
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ObjectiveTo evaluate the clinical value of prenatal ultrasonography combined with maternal serology screening for chromosomal abnormality in 15 to 20+6 gestational weeks.MethodsSix hundred and twenty-eight pregnant women (628 fetuses) in 15 to 20+6 gestational weeks were selected to undergo prenatal ultrasonography, who were in critical risk of trisomy 21 or trisomy 18 by maternal serology screening. Transabdominal ultrasonography were performed and fetal nasal bone and nuchal fold were detected. Those who had nasal bone hypoplasia, thickened nuchal fold (NF>6 mm) and other abnormal fetal soft markers underwent amniocentesis for karyotyping analysis. ResultsThere were 6 cases of nasal bone hypoplasia (0.96%, 6/628), including one case of thickened nuchal fold, two cases of echogenic bowel, two cases of choroid plexus cysts and 1 case of echogenic cardiac focus. All these 6 cases underwent amniocentesis and 2 were trisomy 21 (33.3%, 2/6). The other 4 cases had no significant chromosomal abnormality.ConclusionsPrenatal ultrasonography may improve the detection rate of chromosomal abnormality for those pregnant women who are in critical risk of chromosomal abnormality prompted by serology screening. But invasive procedures are still needed to verify the chromosomal abnormality.
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This study was aimed to optimize the best extraction technology of traditional Chinese medicine (TCM) Biminkang and establish the HPLC-ELSD method for determination of Astragaloside Ⅳ content. This test used heat-ing reflux which preferred ethanol as solvent extraction, extraction rate as an index to extract. By the single factor ex-periment, three factors which affect extraction rate greater were selected from the solvent concentration, extraction time, liquid ratio and extraction times. And then L9(34) orthogonal test was used to design the extraction technology of compound preparation Biminkang. HPLC-ELSD was performed on Diamonsil C18 column (250 mm í 4.6 mm, 5 μm) with H2O(A)-acetonitrile(B) (0~45 min: 22%B, 45~60 min: 22%~32%B) as mobile phase, flow rate was at 1.0 mL·min-1. The temperature of drift tube was 100℃ and the flow rate of N2 was 2.5 L·min-1. The column temperature was 30℃. The results showed that the best extraction technology of compound preparation Biminkang was liquid-solid ra-tio of 8 mL·g-1, ethanol concentration of 70%, 1.5 h for each extraction time, and extracted for three times. The re-sults showed that the presence of ethanol concentration and extraction times affected significantly. The ultimately de-termined optimal extraction conditions were as follows. The liquid-solid ratio of 8 mL/g, ethanol concentration of 70%, 1.5 h for each extraction time, and extracted for two times. The linear range of Astragaloside Ⅳ content was from 0.87 μg to 8.72 μg. And the regression equation was Y = 1.545 4X + 5.875 9, r = 0.999 7. The average re-covery rate was 95.05%. The RSD was 2.64%. It was concluded that the optimized extraction technology was stable, reasonably practicable, and suitable for industrial production.
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Objective To investigate the effects of local injection of Botulinum toxin type A (BTX-A) on spastic cerebral palsy guided by peripheral nerve stimulation. Methods 30 children with spastic cerebral palsy received local multi-point injection of BTX-A guided by peripheral nerve stimulation. They were assessed with modified Ashworth scale (MAS) and Gross Motor Function Assessment Scale (GM-FM-88) before and 1 week, 3 months and 6 months after treatment. Results The scores of MAS decreased significantly 1 week, 3 months and 6 months after treatment (P<0.001). The scores of GMFM-88 increased 3 months and 6 months after treatment (P<0.001). Conclusion Injection of BTX-A guided by peripheral nerve stimulation is effective on spastic cerebral palsy.
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Objective To determine the CT and MR findings of Madelung syndrome. MethodsFive cases of Madelung syndrome were collected in our hospital from February 2006 to June 2009, including 3 cases of typeⅠMadelung syndrome and 2 cases of typeⅡ Madelung syndrome. The 5 cases were all examined by CT, meanwhile 1 case by CT enhancement scanning and 2 cases by MR. The clinical characteristics and imaging manifestations were analyzed. Results CT and MR images in 3 patients of typeⅠMadelung syndrome displayed fat accumulation within the subcutaneous tissue of the upper trunk and deep layer tissue of neck. The diffuse masses were located around the neck, upper chest and shoulders, which were called horse collarandbuffalo humps. The other 2 cases of type Ⅱ Madelung syndrome displayed fat thickening within the subcutaneous tissue of the proximal extremities, anterior chest wall, showing special appearance of vigorous sailor. All the 5 patients showed fat deposit within the subcutaneous tissue of the anterior rectus abdominis, inguina and fat accumulation within the scrotum. CT showed proliferated fat at the subcutaneous tissue of the involved regions. The CT value of proliferated fat were between -30 and -70 HU. The proliferated fat tissue all could be displayed on MR T1WI,T2WI and T2WI fat suppression sequence, with typical hypointensity on T1WI and hyperintensity on T2WI, hypointensity on fat-suppression sequence and fibrous septation presenting among fat tissue. Conclusion Combination with the history of long-term alcohol abuse, the Madelung syndrome could be diagnosed by CT and MR, which had great value in the surgical planning for identifying the extent of disease.
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Objective To study the clinical manifestation and MRI feature of toxic encephalopathy after inhaling caffeine and sodium benzoate. Methods Three patients with toxic encephalopathy induced by inhaling caffeine and sodium benzoate were observed clinically and with MRI. Results The 3 patients were male. They all had definite addiction histories (the time of addiction for 3 years to 7 years ). There were special language and retropulsive dystonia besides the common characteristics of toxic encephalopathy:reaction retardation and disturbance of intelligence. MRI showed the change of generalized demyelination in bilateral symmetrical cerebral hemisphere, posterior limbs of internal capsule, corpus callosum, medial lemniscus, and cerebellum hemisphere dentate nucleus. The clinical symptoms of 3 patients were significantly improved 40 days after the adrenocortical steroid and neurotrophic treatment. The mild mood disorder remained in case 1. Conclusion Clinical manifestation and MRI of toxic encephalopathy after inhaling caffeine and sodium benzoate are known, so we could diagnose the patients of the disease in time.
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[Objective]To establish an animal model of heterotopie ossification(HO)induced by Achilles' tenotomy in Sprague-Dawley(SD)rat and to investigate its possible mechanism.[Method]Thirty six male SD rats were divided into 3 groups(n=12).In sham group,incision and suturation were performed only in the left leg.Partial tenotomy was performed in the left Achilles tendons in PAT group.In AT group,tenotomy was performed in the left Achilles tendons to establish animal model of HO.X-ray and histological examinations were made at 6 and 10 weeks after operation.[Result](1)No HO occurred in the sham and PAT groups.(2)In AT group,3 rats showed cartilage and bone formation on X-rays while the remaining 3 rats showed chondrification in histological examination at 6 weeks after operation.At 10 weeks all rats showed bone formation with trabecular bone.This kind of HO developed through a process of endochondral ossification.[Conclusion]Tenotomy is a simple,effective and feasible method to induce HO.
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Objective To study the continuous drainage treatment by percutaneous puncture of Splenic Abscess (SA), which is due to double-embolization for treatment of liver cancer with hypersplenism. Methods 158 patients with liver cancer with hypersplenism were adopted as the subjects, of which, 7 ones were complicated with SA. Results The symptoms of the 7 ones were all alleviated, such as fever, abdominal pain, left interior pain. Conclusion Continuous drainage treatment by percutaneous puncture, combined with flushing abscess cavity by antibiotics solution, is very effective for SA due to double-embolization.
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Objective To discuss the emergency interventional therapy for ureter invasion by CACX, obstructive bilateral hydronephrosis and uremia complicated with hemorrhoea. Methods 5 cases with ureter invasion by CACX, obstructive bilateral hydronephrosis and uremia suffered from hemorrhoea during hemodialysis, who were performed with emergency interventional therapy. Results After therapy, hemostasis were realized in all cases, and all symptoms were alleviated, such as vaginal fluid and fall-swell in pelvis. The short-term total effective rate was 100% . Conclusion Interventional chemoembolization can be used in the treatment of CACX with acute hemorrhoea.
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Objective To analyze the reasons of CT misdiagnosis of solid-pseudopapillary tumor of pancreas (SPTP), including wrong orientation, mislocation. Methods The literatures on SPTP were discussed. Results Lesions of SPTP could appear at any position of the pancreas. Conclusion The result is very significant for guiding treatment and judging prognosis.
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Objective To evaluate stepping DSA technology in lower extremity artey disease. Methods 12 cases performed with stepping DSA in lower extremity artery were examined with TOSHIBA Infinixi digital subtraction angiography system, of which, 8 ones were also examined with conventional DSA. Results Stepping DSA technology could decrease the dosage of contrast agent and the examination.
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Objective To evaluate angiography and interventional embolization in diagnosis and treatment of massive hemobilia.Methods During 10 years,9 patients with massive hemobilia underwent emergency selective hepatic artery angiography to find the bleeding points,and then embolized the feeding branches.Results All cases demonstrated clearly on angiography about the arterial hemorrhage,and extravasation of contrast-medium.Hemorrhage was stanched immediately after embolization of the feeding branches of the hepatic artery.Conclusion Selective hepatic angiography and interventional embolization for massive hemobilia is a safe and efficient diagnostic and therapeutic method.(J Intervent Radiol,2006,15:213-214)
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Three hundred patients with Graves′ disease (GD) were analysed according to clinical data, which showed a negative correlation between thyroid 131 I turnover and effective half life, suggesting that 131 I turnover is an important parameter for GD therapy of 131 I dose calculation, and a higher cure rate is found in GD patients whose 131 I turnover is less than 1.