MRI and ultrasound scan in prenatal diagnosis of congenital esophageal atresia / 中华围产医学杂志

Objective To investigate the prenatal imaging features of fetal congenital esophageal atresia and to further evaluate the value of MRI and ultrasound scan in the same condition.Methods This study recruited 12 singleton gravidas whose fetuses were initially suspected with congenital esophageal atresia by prenatal ultrasound scan and then confirmed by surgery and/or upper gastrointestinal angiography after birth at Guangzhou Women and Children's Medical Center from May 2011 to May 2017.Imaging features of prenatal MRI and ultrasonography of the 12 fetuses were retrospectively analyzed.Differences in imaging findings of these two methods were analyzed by Chi-square test.Results All 12 women received prenatal ultrasound examination and eight of them underwent MRI scan when fetal congenital esophageal atresia was suggested by ultrasound.Both ultrasound and MRI were capable of identifing polyhydramnios and absent or small stomach bubble (12/12 and 8/8,respectively).However,MRI was superior to ultrasound in detecting "pouch sign "/"oral filling sign" or poor filling of small intestine (7/8 vs 3/12 and 8/8 vs 0/12,x2 were 7.500 and 20.000,both P＜0.01).While,no statistical difference was shown in detecting curved tracheal between MRI and ultrasound (2/8 vs 0/12,x2=3.333,P=0.067).For Gross Ⅰ or Gross Ⅲ congenital esophageal atresia fetuses,no statistically significant difference was found in their imaging features (all P＞0.05).The total detection rates after 32 weeks of gestation of Gross Ⅰ and Gross Ⅲ cases were both 3/6.Conclusions Prenatal MRI is a vital supplement to ultrasound due to its high display rate of characterized features of congenital esophageal atresia.Thus,the combined use of ultrasound and MRI is of great importance for prenatal diagnosis of this fetal abnormality.

Effect of epidural analgesia on the duration of labor stages and delivery outcome / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the effect of epidural analgesia on the duration of labor stages and the delivery outcome.</p><p><b>METHODS</b>This prospective study was conducted in 328 nulliparous term parturients presenting for delivery in December 1 to 31, 2011. The parturients were assigned into epidural analgesia group (n=162) and control group (n=166) according to their request when no contraindications were present. The stage I, stage II, and total duration of labor, volume blood loss, oxytocin use, delivery mode, and neonatal outcomes were compared between the two groups.</p><p><b>RESULTS</b>In epidural analgesia group, the duration of stage I and stage II labor and the total duration of labor was 497.9∓168.4 min, 54.3∓43.8 min, and 522.1∓178.9 min, respectively, significantly longer than those in the control group (404.2∓156.0 min, 31.5∓19.8 min, and 435.8∓159.2 min, respectively, P≤0.05). No significant difference was found between the two groups in the rates of oxytocin use, emergency cesarean section, instrumental delivery, meconium-stained amniotic fluid, and low Apgar scores (P≥0.05).</p><p><b>CONCLUSION</b>Epidural analgesia prolongs the labor duration, especially the second stage of labor, but it does not increase the incidences of emergency cesarean section or instrumental delivery or cause adverse effect on the neonatal outcome, and is therefore safe for pain relief in labor.</p>

Liver diseases in adult-onset Still's disease / 中华全科医师杂志

Clinical data of 108 patients with adult-onset Still's disease(AOSD)were analyzed.The results showed that 56 patients(51.9%)developed liver damage and abnormal liver functioil(alanine aminortransferase and aspartate aminortransferase were significantly increased).Gender,age,time from disease onset to confirmed diagnosis,fever,rash,arthritis,pharyngeal pain,splenomegaly,lymphadenopathy,anemia,leukocvtosis,thrmbocytosis,and increased erythrocyte sedimentation rate,serum C-reactive protein,and serum iton protein showed no significant difierence between the two groups (P＞0.05).Clinical symptoms of liver damage were atypical.Among the 56 patients with liver damage,8 were presented with gastrointestinal symptoms,and 24 showed enlarged liver iu B.ultrasound examination.Our results suggest the prevalence of liver damage in AOSD patients may be hiSh,which could attribute to the disease itself and the medication.The patients would expect good response to corticosteroid treatment and satisfactory outcomes.

Clinical Significance of Detection of Granulocyte Macrophage Colony Stimulating Factor,C Reaction Protein and Tumor Necrosis Factor-?lpha in Infant Cytomegalovirus Hepatitis / 医学研究杂志

Objective To explore the role of granulocyte macrophage colonystimulating factor(GM-CSF),C reaction protein(CRP)and tumor necrosis factor-?lpha(TNF?)in infant cytomegalovirus hepatitis.Methods Cytomegalovirus DNA of 56 cases of children with cytomegalovirus hepatitis and 51 normal controls in blood were detected using FQ-PCR.The levels of GM-CSF and TNF?in serum were assayed with ELISA,and CRP was measured with immunoturbidmemetry assay.Results The levels of M-CSF,CRP and TNF? in serum of infant cytomegalovirus hepatitis were higher obviously than those in serum of the normal control group.Conclution M-CSF,CRP and TNF? participate in pathological immune response and anti-infective immunity of cytomegalovirus hepatitis.

Changes of Activity of Placental Villus Cytochrome C Oxidase in Pregnant Women with Preeclampsia / 华中科技大学学报(医学版)

To explore the role of cytochrome C oxidase (CCO) in the pathogenesis of preeclampsiais, CCO activity was determined in 32 patients with preeclampsia and 26 normotension pregnancy women by the rate of cyanide-sensitive oxidation of reduced cytochrome c using ultraviolet spectrophotometry. The results showed that CCO activity was significantly lower in the preeclampsia group (0. 30±0. 39/min, n=32) than in the control group (0. 73±0. 54/min, n=26), P＜0. 01. The occurrence of IUGR in the preeclampsia group was significantly higher than in the control group (P＜0. 05). It was suggested that the decrease of activity of CCO might interfere with the function of electronic chains, result in the reduction of ATP production, leading to the mitochondria dysfunction and placental dysfunction in preeclampsia patients. Mitochondria dysfunction may be involved in the pathogenesis of preeclampsia.