Prenatal echocardiography in the diagnosis of fetal double aortic arch / 中华超声影像学杂志

To explore the way of prenatal echocardiography in the diagnosis of fetal double aortic arch . Methods T he data of fetuses diagnosed as double aortic arch in 6 prenatal centers in Hunan in echocardiograms performed at 20－36 weeks of gestation from 2013 to 2018 were reviewed . T he characteristics of echocardiographic with double aortic arch , and the associated malformations were observed ,the clinical outcome were analyzed . Results T he main echocardiographic features of the double aortic arch were three‐vessel‐tracheal view s ,which showed a bifurcation of the ascending aorta and a ring consisted of aortic right and left arch . From this retrospective analysis , 29 double aortic arches were identified ,which 8 cases ( 28% ) combined with cardiac defect and extracardiac abnormalities , 1 case with 22q11 deletion . Among them ,5 cases were confirmed by autopsy ,24 cases were diagnosed by computed tomography angiography ( 8 cases were confirmed by operation ) . Conclusions Systematic prenatal echocardiography in the diagnosis of fetal double aortic arch has significant clinical value in the cliagnose of double aortic arch ,w hether it is associated with other malformations and is important for assessing fetal prognosis .

Prenatal echocardiographic diagnosis and differential diagnosis of fetal double outlet ventricle / 中华超声影像学杂志

Objective To investigate the clinical value of prenatal diagnosis of fetal double outlet ventricle . Methods T he data of double outlet ventricle from fetal echocardiography in Second Xiangya Hospital of Central South University and Changde Women and Children Health Hospital of Hunan Province from January 2000 to August 2018 were collected . T he statistical method was used to analyze characteristics of echocardiography ,related‐intracardiac and extracardiac abnormalities ,postnatal echocardiography ,surgery and autopsy findings . Results Ninety‐four fetuses were diagnosed with double outlet ventricle ,including 84 cases of double outlet right ventricle ( DORV ) and 10 cases of double outlet left ventricle ( DOLV ) . T he pregnancy was terminated in 45 cases . Autopsy was offered to all patients after termination of pregnancy ,42 cases were consistent with prenatal diagnosis ,1 case was tetralogy of fallot ,2 cases were transposition of great artery . Forty‐nine cases were decided to continue the pregnancy ,32 cases of them were confirmed by postpartum surgery ,17 cases were confirmed by postnatal echocardiography . Echocardiographic findings of fetal double outlet ventricle was characterized by the origin of the both great arteries arising predominantly or completely( ＞50% ) from the same ventricle . Conclusions Prenatal ultrasound diagnosis of double outlet ventricular has important clinical value ,facilitate appropriate prenatal counseling and postnatal management and it should be differentiated with transposition of the great arteries ,tetralogy of fallot and ventricular septal defect .

Study on application of Munro adult operating room pressure ulcer risk assessment table in general anesthesia / 重庆医学

Objective To test the clinical validity of use of the Chinese version of Munro adult pressure ulcer risk-assessment scales (Munro scales),Braden scales,Qian Weiming operation pressure ulcer risk-assessment scales (self-designed scales) in the patients with general anesthesia surgery.Methods Three investigators respectively used the Munro scales,Braden scales and self-designed scales to conduct the pressure ulcer risk-assessment on 261 patients with general anesthesia surgery before operation,at the end of operation and at exiting from anesthesia recovery room.The sensitivity,specificity,positive predictive value and negative predictive value of each assessment tool were calculated.Results The best critical values of the Munro scales before operation,at the end of operation and at exiting from anesthesia recovery room were 8.0,24.5,28.5 points respectively;which of the Braden scale were 18.5,11.5,13.5 points respectively;which of self-made scale were 12.5,13.5,13.5 points respectively.The area under the ROC curve of the three different scales at the beginning of the operation above was 0.653,0.596,0.652.The area under the ROC curve of the three different scales at the end of the operation above was 0.872,0.548,0.792.The areas under the ROC curve of the three different scales before operation were 0.868,0.773 and 0.813 respectively.Conclusion The Chinese version of Munro scales is more suitable for the assessment of operative patient's pressure ulcer risk than the Braden scale and self-designed scales,but the preoperative risk assessment needs to be improved.

Recent advances in diagnosis and treatment of PEHO syndrome / 中国医师杂志

The progressive encephalopathy with edema,hypsarrhythmia,and optic atrophy (PEHO) syndrome is a unique pediatric neurodevelopmental disorder,characterized by a combination of severe mental retardation,early onset epileptic seizures,pedal edema,optic/cerebellar atrophy,and early death.The affected individuals have neither optic atrophy nor the typical neuroradiological findings has been described as PEHO-like syndrome.At present,there are few reports about PEHO syndrome in China.In this study,we summarizes the incidence,etiology,clinical manifestations,and related genes of PEHO syndrome,and aims to provide assistance for future clinical work.

Prenatal ultrasonic diagnosis and outcome of fetal inferior vena cava malformation / 中华超声影像学杂志

Objective To evaluate the clinical value of prenatal ultrasound in the diagnosis of inferior vena cava malformation.Methods The ultrasonographic features of 95 cases of fetal inferior vena cava malformation were retrospectively analyzed,and compared with autopsy or postpartum follow-up.Results Among the 95 cases of fetal inferior vena cava malformation,39 cases were confirmed by autopsy,56 cases were diagnosed by neonatal ultrasonography,5 cases were confirmed by angiography or operation.Among them,37 cases were interrupted inferior vena cava,37 cases were double inferior vena cava,21 cases were left inferior vena cava.Forty of the 95 cases were terminate pregnancy(due to intracardiac or extracardiac malformations)or neonatal deaths(42.1%),and 55 cases had good prognoses(57.9%).Conclusions Prenatal ultrasound has important clinical value in diagnosing of inferior vena cava malformation,clearing whether it is associated with other malformations and assessing fetal prognosis.

Progress on Fluorescent Probes for Thiols / 分析化学

Thiols, which are components of many proteins and simple molecules, play an important role in the cellular antioxidant defense system. The quantitative determination of thiols is important in biochemistry and clinical chemistry. Fluorescent probes, which have its apparent advantages in sensitivity and, most importantly, in imaging thiols in vivo, even in single living cells, appear to be particularly attractive. In this review, we classify the fluorescent probes based on their different reaction mechanisms with thiols and summarize the recent progresses of thiols fluorescent probes with fifty-one

Factors influencing health insurance patients hospitalization expenses for three disease entities / 中华医院管理杂志

Objective To identify the chief factors influencing health insurance patients' hospitali-zation expenses so as to provide basis for the control of irrational increase in medical expenses and reform in the mode of medical insurance payment. Methods All the medical insurance cases involving the three disease entities in two hospitals of a certain city for the past three years, which totaled 647, were collected and a statistical analysis was made of the possible influencing factors using multi-stepwise regression analysis. Results The factors influencing the health insurance patients' hospitalization expenses included choice of hospitals, length of stay, performance of operations, proportion of drug fees, and province- wide readjustment of medical service prices. Reducing length of stay and lowering proportion of drug fees were the key to controlling expenses. Conclusion It is imperative to formulate scientific diagnostic and treatment routines and expense standards for single disease entities, speed up and deepen reform in the medical insurance system, and, on the basis of trying out payment based on certain single disease entities, implement payment based on disease entities.