Objective:To investigate the ultrasonic characteristics and pregnancy outcomes of fetal umbilical artery occlusion.Methods:A total of 13 cases of fetal umbilical artery occlusion firstly found in Guangdong Maternal and Child Health Care Hospital or referred from other hospitals from January 2016 to December 2021 were analyzed retrospectively. The pregnant women were 19-38 (28.08±6.25) years old. The prenatal ultrasound characteristics were analyzed. The fetal outcomes were followed up.Results:⑴ Eleven cases were found in late pregnancy, and 2 cases in mid-pregnancy. Two umbilical arteries were found during pregnancy and one umbilical artery was found in the later stage. ⑵ Five cases were found that the fetal meridians were less than gestational weeks, 1 case had abnormal fetal structure, 1 case had racket-shaped Placenta, 1 case had umbilical cord wrapped around neck 2 times, 1 case had saccular distension of umbilical vein in abdomen, 1 case had decreased fetal heart rate, and the other 3 cases had no abnormality. ⑶ Six pregnant women chose timely termination of pregnancy or Cesarean section within 2 days. ⑷ Eleven fetuses survived, and 2 did not.Conclusions:Fetal umbilical artery occlusion has obvious ultrasonic features. Only the time of delivery of umbilical artery occlusion is determined by the complications of premature delivery and the fetus conditions.

目的 探讨原发性输卵管癌(PFTC)的临床表现及其超声特征,并分析漏误诊原因.方法 回顾性分析2014年3月至2020年11月经手术病理证实为PFTC的14例患者术前临床资料,分析患者相关临床表现及其超声特征.结果 14例被诊断为PFTC的患者,年龄43～59岁,平均(53.00±1.42)岁,其中,9例已绝经,均已生育.常见首发症状依次为阴道流液(28.57％,4/14)、阴道异常出血(28.57％,4/14)、阴道流液并腹痛(21.43％,3/14)、阴道异常出血并腹痛(7.14％,1/14)、腹痛(7.14％,1/14)及体重下降(7.14％,1/14).PFTC病变输卵管共计17条,术前超声检查结果包括附件区未发现异常声像3条(17.65％,3/17)及附件区发现占位性病变14条(82.35％,14/17).14个占位性病变的超声声像特征包括:囊性包块7个(50.00％,7/14)、囊实性包块6个(42.86％,6/14)、实性包块1个(7.14％,1/14),呈腊肠状或条状的包块有7个(50.00％,7/14);实性部分探及丰富或较丰富彩色血流信号的包块有6个(42.86％,6/14),实性部分探及少许彩色血流信号的包块有1个(7.14％,1/14),阻力指数为0.35～0.70,平均0.47±0.04.结论 PFTC患者临床表现及病灶声像表现多样,诊断需要遵循一定的临床思路,综合各种因素考虑,以提高术前诊断率.

1 一般资料 病例:患儿,女,6 月龄.因"支气管肺炎"入院.入院后发现该患儿咳嗽剧烈时可呕吐胃内容物,非喷射性,不含胆汁.家属自述其平素家中喂养亦有吐奶表现.查体:患儿发育正常,营养较差,出生体重 4kg,现仍为 4kg.临床上为排除小儿先天性肥厚性幽门狭窄,现行小儿幽门超声检查.

Objective To evaluate prenatal ultra sonograpic characteristics in fetus with intrahepatic portosys temic shunt.Methods The ultrasonographic features of 15 cases of fetal intrahepatic portosystemic shunt diagnosed in our hospital were summarized and the prenatal ultrasound images and complications were analyzed.Results (1)Intrahepatic portosystemic shunt typing in 15 prenatal cases:Type Ⅰ 2 cases (13.3％);type Ⅱ 10 cases (66.7％);type Ⅲ 1 cases (6.7％);type Ⅳ 2 cases (13.3％).(2) Common ultrasonic characteristics:The two-dimensional abdominal transverse section revealed intrahepatic vascular disordered;The anechoic area connected the hepatic vein and portal vein.The hepatic vein diameter widened,remote display.Full of color flow signal in echo area,the blood flow spectrum in echo area was similar to the portal vein blood flow spectrum.(3) 5 cases (33.3％) with cardiac enlargement,4 cases (26.7％) with diameter less than corresponding gestational weeks and 4 cases (26.5％) with no other abnormalities.Conclusions The vascular disorder in the liver is the direct sign of portosystemic shunt,and the enlargement of the heart and the little development of the fetus are indirect signs.

目的:分析改良式低位产钳术联合无保护会阴助产对分娩质量的影响.方法:选取2016年1月到2018年6月收治于我院的216例产妇作为研究对象,根据助产方案分成以改良式低位钳术助产的对照组(n=108),以及采用改良式低位产钳术联合无保护会阴助产的观察组(n=108),比较两组产妇包括产程时间、住院时间、产后出血量、以及包括会阴裂伤、尿潴留、切口感染等的并发症情况.结果:观察组包括包括产程时间、住院时间、产后出血量以及并发症等相关情况均显著优于对照组,P均＜0.05.结论:采用改良式低位产钳术联合无保护会阴助产可有效改善分娩质量,对产妇的损伤小、安全性高、恢复快,值得推广.

目的 探讨miR21基因表达改变对宫颈癌Siha细胞顺铂敏感性的影响.方法 采用脂质体介导法分别以mi-crOFFTM miR21 inhibitor、micrONTM miR21 mimic、miR21阴性对照试剂转染Siha细胞,实验分为miR21下调组、miR21上调组、阴性对照组及空白对照组.实时荧光定量PCR检测转染后各组细胞中miR21基因的表达水平;CCK-8比色法检测各组细胞对顺铂的半抑制率浓度(50％ inhibitory concentration,IC50值);Annexin V/PI法检测顺铂处理后各组细胞的凋亡率;实时荧光定量PCR和蛋白质印迹法,分别从mRNA和蛋白水平检测顺铂对各组细胞中PTEN、PDCD4基因表达的影响.结果 实时荧光定量PCR检测miR21基因的表达结果显示,miR21下调组的表达明显低于阴性对照组,miR21上调组的表达明显高于阴性对照组,F=255.525,P＜0.001.CCK-8比色法检测结果显示,顺铂对miR21下调组的IC50值为(2.44±0.69) μg/mL,阴性对照组为(3.96±0.07) μg/mL;miR21上调组为(6.93±0.07) μg/mL,空白对照组为(4.05±0.03) μg/mL,F=870.118,P＜0.001.Annexin V/PI检测结果显示,5μg/mL顺铂诱导miR21下调组的凋亡率为(64.36±2.47)％,阴性对照组为(4.2±0.17)％;miR21上调组为(0.06±0.03)％,空白对照组为(4.14±0.25)％,x2=10.385,P=0.016.实时荧光定量PCR检测PTEN和PDCD4结果显示,miR21下调组PTEN的mRNA表达相较于阴性对照组显著增加,miR21上调组PTEN的mRNA表达相较于阴性对照组降低,F=174.057,P＜0.001;miR21下调组PDCD4的mRNA表达相较于阴性对照组显著增加,miR21上调组PDCD4的mRNA表达相较于阴性对照组降低,F=491.283,P＜0.001.蛋白质印迹法检测结果显示,miR21下调组PTEN蛋白表达量为8.845±0.062,阴性对照组7.695±0.056;miR21上调组为6.908±0.058,空白对照组为1,F=16.036,P＜0.01.miR21下调组PDCD4蛋白表达量为9.936±0.036,阴性对照组为8.728±0.019;miR21上调组为7.838±0.066,空白对照组为1,F=55.323,P＜0.001.结论 下调miR21基因可能增加宫颈癌Siha细胞对顺铂的敏感性,上调miR21基因后可能减弱宫颈癌Siha细胞对顺铂的敏感性.

Objective To study the relationship between the methylation status of CPG islands in MEG3 gene promoter region of epithelial ovarian cancer and its clinical and pathological features. Methods The promoter methylation status was evaluated by MSP (methylation-specific polymerase chain reaction ) in 47 cases of ovarian cancer tissue and 15 cases of normal control. Results The methylation ratio (42.6%) of the MEG3 genes in the ovarian cancer was statistically significantly higher (P = 0.035 ) than that (13.3%) in the normal control. The methyation rate of the group with an age > 60 years old was slightly higher than that of the group with an age≤60 years old, without statistically significant (P > 0.05), so was observed in ovarian cancers of stage Ⅰ andⅡ than that in stage Ⅲ and Ⅳ. There were also no significant differences in MEG3 gene methylation positive rate neither in different pathological grading nor in various ovarian cancer tissues (P > 0.05). Conclusion Abnormal methylation in MEG3 gene may be associated with epithelial ovarian cancer , but no relation to its clinical pathology.