BACKGROUND Persistent left superior vena cava(PLSVC)is the most common venous system variant.The clinical characteristics and amniotic fluid cytogenetics of fetuses with PLSVC remain to be further explored.AIM To deve...BACKGROUND Persistent left superior vena cava(PLSVC)is the most common venous system variant.The clinical characteristics and amniotic fluid cytogenetics of fetuses with PLSVC remain to be further explored.AIM To develop reliable prenatal diagnostic recommendations through integrated analysis of the clinical characteristics of fetuses with PLSVC.METHODS Cases of PLSVC diagnosed using prenatal ultrasonography between September 2019 and November 2022 were retrospectively studied.The clinical characteristics of the pregnant women,ultrasonic imaging information,gestational age at diagnosis,pregnancy outcomes,and amniocentesis results were summarized and analyzed using categorical statistics and the chi-square test or Fisher’s exact test.RESULTS Of the 97 cases diagnosed by prenatal ultrasound,49(50.5%)had isolated PLSVC and 48(49.5%)had other structural abnormalities.The differences in pregnancy outcomes and amniocentesis conditions between the two groups were statistically significant(P<0.05).No significant differences were identified between the two groups in terms of advanced maternal age and gestational age(P>0.05).According to the results of the classification statistics,the most common intrac-ardiac abnormality was a ventricular septal defect and the most common extrac-ardiac abnormality was a single umbilical artery.In the subgroup analysis,the concurrent combination of intra-and extracardiac structural abnormalities was a risk factor for adverse pregnancy outcomes(odds ratio>1,P<0.05).Additional-ly,all abnormal cytogenetic findings on amniocentesis were observed in the comorbidity group.One case was diagnosed with 21-trisomy and six cases was diagnosed with chromosome segment duplication.CONCLUSION Examination for other structural abnormalities is strongly recommended when PLSVC is diagnosed.Poorer pregnancy outcomes and increased amniocentesis were observed in PLSVC cases with other structural abnor-malities.Amniotic fluid cytogenetics of fetuses is recommended for PLSVC with other structural abnormalities.展开更多
Based on daily precipitation data supplied by the Chinese meteorological administration,hourly reanalysis datasets provided by the ECMWF and daily outgoing long wave radiation supplied by the NOAA,the evolution regula...Based on daily precipitation data supplied by the Chinese meteorological administration,hourly reanalysis datasets provided by the ECMWF and daily outgoing long wave radiation supplied by the NOAA,the evolution regularity of continuous heavy precipitation over Southern China(SC)from April to June in 1979-2020 was systematically analyzed.The interaction between specific humidity and circulation field at the background-scale,the intra-seasonal-scale and the synoptic-scale,and its influence on persistent heavy precipitation over the SC during the April-June rainy season were quantitatively diagnosed and analyzed.The results are as follows.Persistent heavy rainfall events(PHREs)over the SC during the April-June rainy season occur frequently from mid-May to mid-and late-June,exhibiting significant intra-seasonal oscillation(10-30-day)features.Vertically integrated moisture flux convergence(VIMFC)can well represent the variation of the PHREs.A multiscale quantitative diagnosis of the VIMFC shows that the pre-summer PHREs over the SC are mainly affected by the background water vapor(greater than 30 days),intraseasonal circulation disturbance(10-30-day)and background circulation(greater than 30 days),and water vapor convergences are the main factor.The SC is under the control of a warm and humid background and a strong intraseasonal cyclonic circulation,with strong convergence and ascending movements and abundant water vapor conditions during the period of the PHREs.Meanwhile,the westward inter-seasonal oscillation of tropical atmosphere keeps the precipitation system over the SC for several consecutive days,eventually leading to the occurrence,development and persistence of heavy precipitation.展开更多
目的对孤立性永存左上腔静脉畸形(persistent left superior vena cava,PLSVC)的临床特点、自然病程及诊治经验进行系统性分析,以期减少临床漏诊率。方法采集、整理北京积水潭医院1例78岁孤立性PLSVC患者的症状体征演变史及其近21年历...目的对孤立性永存左上腔静脉畸形(persistent left superior vena cava,PLSVC)的临床特点、自然病程及诊治经验进行系统性分析,以期减少临床漏诊率。方法采集、整理北京积水潭医院1例78岁孤立性PLSVC患者的症状体征演变史及其近21年历次就诊的检查资料,进行比较分析。结果该例患者57岁出现心慌的首发症状,11年前因"病态窦房结综合征"安装双腔起搏器,术前检查外周血白细胞、血小板减低,术中发现PLSVC,7年前开始出现腹腔静脉淤血表现,5年前因重度三尖瓣反流、右心功能不全而就诊,3个月前胸部增强CT加血管重建明确为孤立性永存左上腔静脉畸形。结论孤立性永存左上腔静脉阳性症状出现晚,首发症状常为各种心律失常,临床极易漏诊误诊,心脏查体可于早期闻及三尖瓣收缩期杂音,超声心动图为首选筛查手段,心导管检查或增强CT加血管重建可明确诊断。其心律失常治疗包括起搏器植入术及冠状窦靶点消融。部分患者需早期手术治疗,疾病晚期可考虑心脏移植术。展开更多
文摘BACKGROUND Persistent left superior vena cava(PLSVC)is the most common venous system variant.The clinical characteristics and amniotic fluid cytogenetics of fetuses with PLSVC remain to be further explored.AIM To develop reliable prenatal diagnostic recommendations through integrated analysis of the clinical characteristics of fetuses with PLSVC.METHODS Cases of PLSVC diagnosed using prenatal ultrasonography between September 2019 and November 2022 were retrospectively studied.The clinical characteristics of the pregnant women,ultrasonic imaging information,gestational age at diagnosis,pregnancy outcomes,and amniocentesis results were summarized and analyzed using categorical statistics and the chi-square test or Fisher’s exact test.RESULTS Of the 97 cases diagnosed by prenatal ultrasound,49(50.5%)had isolated PLSVC and 48(49.5%)had other structural abnormalities.The differences in pregnancy outcomes and amniocentesis conditions between the two groups were statistically significant(P<0.05).No significant differences were identified between the two groups in terms of advanced maternal age and gestational age(P>0.05).According to the results of the classification statistics,the most common intrac-ardiac abnormality was a ventricular septal defect and the most common extrac-ardiac abnormality was a single umbilical artery.In the subgroup analysis,the concurrent combination of intra-and extracardiac structural abnormalities was a risk factor for adverse pregnancy outcomes(odds ratio>1,P<0.05).Additional-ly,all abnormal cytogenetic findings on amniocentesis were observed in the comorbidity group.One case was diagnosed with 21-trisomy and six cases was diagnosed with chromosome segment duplication.CONCLUSION Examination for other structural abnormalities is strongly recommended when PLSVC is diagnosed.Poorer pregnancy outcomes and increased amniocentesis were observed in PLSVC cases with other structural abnor-malities.Amniotic fluid cytogenetics of fetuses is recommended for PLSVC with other structural abnormalities.
基金National Natural Science Foundation of China(42088101)。
文摘Based on daily precipitation data supplied by the Chinese meteorological administration,hourly reanalysis datasets provided by the ECMWF and daily outgoing long wave radiation supplied by the NOAA,the evolution regularity of continuous heavy precipitation over Southern China(SC)from April to June in 1979-2020 was systematically analyzed.The interaction between specific humidity and circulation field at the background-scale,the intra-seasonal-scale and the synoptic-scale,and its influence on persistent heavy precipitation over the SC during the April-June rainy season were quantitatively diagnosed and analyzed.The results are as follows.Persistent heavy rainfall events(PHREs)over the SC during the April-June rainy season occur frequently from mid-May to mid-and late-June,exhibiting significant intra-seasonal oscillation(10-30-day)features.Vertically integrated moisture flux convergence(VIMFC)can well represent the variation of the PHREs.A multiscale quantitative diagnosis of the VIMFC shows that the pre-summer PHREs over the SC are mainly affected by the background water vapor(greater than 30 days),intraseasonal circulation disturbance(10-30-day)and background circulation(greater than 30 days),and water vapor convergences are the main factor.The SC is under the control of a warm and humid background and a strong intraseasonal cyclonic circulation,with strong convergence and ascending movements and abundant water vapor conditions during the period of the PHREs.Meanwhile,the westward inter-seasonal oscillation of tropical atmosphere keeps the precipitation system over the SC for several consecutive days,eventually leading to the occurrence,development and persistence of heavy precipitation.
文摘目的对孤立性永存左上腔静脉畸形(persistent left superior vena cava,PLSVC)的临床特点、自然病程及诊治经验进行系统性分析,以期减少临床漏诊率。方法采集、整理北京积水潭医院1例78岁孤立性PLSVC患者的症状体征演变史及其近21年历次就诊的检查资料,进行比较分析。结果该例患者57岁出现心慌的首发症状,11年前因"病态窦房结综合征"安装双腔起搏器,术前检查外周血白细胞、血小板减低,术中发现PLSVC,7年前开始出现腹腔静脉淤血表现,5年前因重度三尖瓣反流、右心功能不全而就诊,3个月前胸部增强CT加血管重建明确为孤立性永存左上腔静脉畸形。结论孤立性永存左上腔静脉阳性症状出现晚,首发症状常为各种心律失常,临床极易漏诊误诊,心脏查体可于早期闻及三尖瓣收缩期杂音,超声心动图为首选筛查手段,心导管检查或增强CT加血管重建可明确诊断。其心律失常治疗包括起搏器植入术及冠状窦靶点消融。部分患者需早期手术治疗,疾病晚期可考虑心脏移植术。
