正常孕妇胎儿脐动脉血流的临床研究

目的:探讨胎儿脐动脉的S/D值与孕龄的关系,把东北与西南地区的S/D值对照,探讨两地的S/D值是否有差异。方法:将东北地区714例和西南地区642例末次月经明确、平时月经规律的正常妊娠的孕妇,孕龄为20周~42周,每4周为一组,将其脐动脉的S/D值加以记录,计算出每组孕龄的S/D值范围,得出孕龄与S/D值的对应关系,并将两地的S/D值范围对照,验证两地脐动脉S/D值是否具有差异。结果:随着孕龄的增加脐动脉的S/D值呈下降趋势,两地之间正常胎儿的S/D值无差异性,P>0·05。结论:脐动脉的S/D值不具有区域性的差异,是一个较客观的指标,对临床具有指导意义。     

MRI评价胎儿胼胝体缺如及其合并畸形

目的 利用MRI评价胎儿胼胝体缺如及其合并畸形。方法 对81胎MRI诊断胼胝体缺如胎儿，分析胼胝体缺如类型，观察其合并颅脑畸形类型及数目。结果 81胎中，单纯胼胝体缺如47胎、合并畸形34胎；合并蛛网膜囊肿12胎，Dandy-Walker畸形7胎，小脑发育不良5胎，神经元移行异常5胎，大枕大池4胎，室管膜下囊肿4胎，脑实质出血2胎，脑裂畸形、脑穿通畸形及脑膜膨出各1胎。结论 MRI可显示胼胝体缺如胎儿及其合并其他颅脑畸形，为评估胎儿预后提供更多信息。     

Inversion mode: a new volume analysis tool for 3-dimensional ultrasonography.

OBJECTIVES: The main goal was to introduce the inversion mode as a new image analysis tool for the examination of fluid-filled structures using 3-dimensional ultrasonography during pregnancy. METHODS: Three-dimensional ultrasonography was performed on fetuses having fluid collections of noncardiac origin. Threshold adjustment was used to visually assign full transparency to voxels that were associated with fluid. A new postprocessing tool, called the inversion mode, was activated to transform this region of interest into opaque voxels. The morphologic appearance of fluid collections and their anatomic relationship to other organs were shown in this manner. RESULTS: Diagnostic features were shown by this technique in several fetuses with problems that included pleural effusion, duodenal atresia, urinary tract abnormalities, and hydrocephaly. Furthermore, the inversion mode also permitted surface reconstruction of an irregular pleural effusion that had close resemblance to results with the Virtual Organ Computer-Aided Analysis rotational slice technique. Acoustic shadowing was also documented as a potential technical limitation of this method. CONCLUSIONS: The inversion mode can display scattered or contiguous fluid-filled structures in ways that can be very difficult or impossible to accurately characterize with conventional ultrasonography. It may be particularly helpful for the evaluation of multiple fluid-filled cysts or irregular fluid collections in the fetus.     

A Simple Rule for Prenatal Diagnosis of Total Anomalous Pulmonary Venous Return

The objective of this series was to describe a simple rule for prenatal diagnosis of total anomalous pulmonary venous return (TAPVR). Fourteen fetuses had a prenatal diagnosis of TAPVR by the simple rule, including the following components: (1) the major criterion, which was the absence of a connection between the pulmonary vein and the left atrium; and (2) at least 1 of the following minor criteria: (a) the presence of a vascular confluence behind the atria, (b) abnormal spectral Doppler waveforms in the pulmonary veins, (c) a smooth posterior wall of the left atrium, (d) increased retroatrial space, (e) a dilated coronary sinus (cardiac type), (f) a dilated superior vena cava or brachiocephalic vein, and (g) an additional vessel on the 3‐vessel/3‐vessel and trachea view or a vertical descending vein. All were accurately diagnosed, and none were missed by the diagnosis. In summary, the simple rule described is helpful in increasing the number of accurate prenatal diagnoses of TAPVR.     

实时三维超声在产前胎儿超声检查中的初步应用

目的探讨实时三维超声在产前胎儿超声成像中应用的临床价值。方法对26例孕龄16～41周的正常适龄胎儿进行实时三维超声检查。观察胎儿的心脏、颜面部、头颅、胸腹部各重要解剖结构。实时显示三维图像,或者在检查结束后脱机分析图像。结果26例胎儿均获得满意的实时三维图像,包括心脏、颜面部、头颅、胸腹部结构。其中26例观察了心脏,14例观察了颜面部,12例观察了头颅,6例观察了胸腹部。结论实时三维超声能够实时直观地显示胎儿各部位解剖结构的三维立体图像,比传统的二维超声提供更直观的图像信息,其在胎儿先天性畸形显像及筛查中具有重要的应用价值。     

脐血血清促代谢因子水平与胎儿生长发育的关系

目的 探讨脐血血清促代谢因子(betatrophin)水平与胎儿生长发育的关系,为胎儿保健提供依据。方法 2018年1-7月选择瑞安市人民医院妇幼分院出生的大于胎龄儿(LGA)、适于胎龄儿(AGA)和小于胎龄儿(SGA)各30例。检测脐血、母血和羊水betatrophin水平,分析脐血血清betatrophin水平与胎儿生长发育各指标、糖脂代谢指标、瘦素和脂联素等的相关性。结果 LGA、AGA、SGA的脐血血清betatrophin水平分别为(1 009.210±98.761)、(929.487±80.949)、(910.590±105.518)ng/L,差异有统计学意义(F=8.986,P＜0.001);三组新生儿血脂各指标水平比较差异均无统计学意义(P>0.05);相关分析显示脐血betatrophin水平与新生儿出生体重、重量指数(PI)、胎龄,脐血瘦素、甘油三酯水平呈正相关(r=0.537、0.502、0.250、0.422、0.832,P＜0.05),与脐血脂联素水平呈负相关(r=-0.257、P＜0.05),与母血和羊水betatrophin水平,孕前和分娩时体重量、孕前体重指数(BMI)、孕期体重指数增加量(ΔBMI),胎盘重量,脐血和产妇血糖(PG)、胰岛素(INS)、胰岛素抵抗指数(HOMA-IR)无相关性(P>0.05);多元线性回归分析显示血betatrophin是新生儿出生体重独立影响因素(P＜0.05)。结论 Betatrophin参与胎儿生长发育调节,脐血betatrophin水平可反映胎儿的生长发育状况。     

氟在胎儿组织中的分布研究

本文对31具胎儿组织氟测定观察,氟能透过母体胎盘进入胎儿,胎儿组织氟含量以骨骼中最高,脑组织中最低,并随母体摄氟量和胎龄的增加而增高。     

产前超声检查对胎儿眼部异常的检测价值

胎儿眼部先天性异常是一类罕见的疾病,产前较难诊断.产前超声检查被认为具有检查方便、无创伤、重复性好等优点.通过产前超声检查可发现胎儿眼部的先天异常,如先天性白内障、先天性无眼球或小眼球、永存原始玻璃体增生症等.超声检查可直观地显示不同孕周胎儿的眼部结构,具有提示和诊断先天性眼部异常的临床价值.     

Effects of exogenous hormones and glucose on plasma levels and hepatic metabolism of amino acids in the fetus and in the newborn rat

Summary The present study examines the role of insulin, glucagon and cortisol in the regulation of gluconeogenesis from lactate and amino acids in fetal and newborn rats. Injection of glucagon in the fullterm fetal rat caused a rise in glucose (and insulin) and a fall in blood levels of most individual amino acids, stimulated hepatic accumulation of ¹⁴C-amino isobutyric acid and ¹⁴C-cycloleucine and increased the conversion of ¹⁴C lactate, alanine and serine to glucose in vivo and in vitro (liver slices). Such changes were equivalent to the changes seen in 4 h old newborn rats. When glucagon was administered at birth, little difference was observed between control and treated animals in plasma amino acids and a smaller increment in conversion of ¹⁴C substrate to glucose occurred. By contrast, insulin injection at birth caused hypoglycemia, suppression of levels of certain amino acids and inhibition of conversion of ¹⁴C substrates into glucose. Glucose injection at birth caused elevated glycemia and plasma insulin and suppression of most amino acid levels and of conversion of ¹⁴C substrate into glucose. Cortisol injection at birth caused a marked, generalized hyperaminoacidemia, a stimulation of glucagon secretion and of conversion of ¹⁴C substrates into glucose. These observations support the thesis that glucagon plays a major role in the induction of hepatic gluconeogenesis and that insulin acts as an antagonist hormone.     

Assessment of the radiological safety of a Genoray portable dental X-ray unit

Objectives:

The portable dental radiographic systems are generally used in emergency situations (e.g. during natural disasters) for disabled/aged patients and in patient rooms. This study assesses the output exposure of a portable dental radiographic system measured using thermoluminescent dosemeters (TLDs).

Methods:

Occupational exposure of the operator was determined when the portable dental unit was used for mandibular and maxillary teeth exposure.

Results:

The doses of some critical organs of an operator were measured using TLDs implanted within the Rando phantom.

Conclusions:

Considering the annual organ dose limits, the eye lens dose limit is the main factor determining the frequency of system application.