Study on relationship between perifollicular blood flow and in vitro fertilization-embryo transfer

Objective：To study the relationship between perifollicular blood flow and follicule development, oocyte maturing rate, fertilizing rate, cleaving rate, embryo quality and the outcomes of embryo transfer. Methods： The samples were selected from 66 suffers who underwent in vitro fertilization（IVF）or intracytoplasmic sperm injection（ICSl）. Eeach patients＇ perifollicular blood flow（diameter ≥ 12mm ）was estimated on the day of human chorionic gonadotropin（HCG）administration. Results：Among 66 cycles, 26（39.4%） cycles resulted in pregnancy, perifollicular blood flow resistance index（Rl）, peak systolic velocity/end diastasis velocity（S/D） of non-pregnant group was significantly higher than that of the pregnant group （P 〈 0.004）. When RI 〈 0.49, the pregnancy rates, fecundation rates, fertilization rates, metaphase numbers for the of second meiosis oocytes increased evidently （P 〈 0.05）, but there were no statistical difference in gonadotropin dosage, cycle frequency, infertility years, ages, estradiol（E2）on the day of HCG administration, numbers of oocyet retrieved and high-quality embryo rates （P 〉 0.05 ）. There were no statistical difference between non-pregnant group and pregnant group in S and D （P 〉 0.05 ）. There was no correlation between periFollicular blood flow RI and follicular diameter by linear regression analysis. Conclusion：Our study shows that perifollicular blood flow RI and S/D are effective indices of predicting the pregnancy outcome of IVF-ET.

Close Correlations Between Carotid Arterial Mean Blood Flow Velocity,Body Mass Index,and Temperature in Normal Individuals

Objective:Assessing carotid and radial pulses is an essential sphygmology method in traditional Chinese medicine(TCM).It is believed in TCM and by doctors that pulse force is markedly linked with the physiological state of a human,including body mass index(BMI)and temperature.However,comprehensive analysis elucidating these potential correlations remains undetermined.Therefore,this investigation aimed to assess the association of pulse strength with human metabolism.Materials and Methods:The mean blood flow velocity(MBFV)of the carotid artery and pulse force of 122 healthy adults included in this investigation were assessed using ultrasound and manual palpation.Their thermal texture map was also acquired.Results:No substantial variation was observed in the carotid arterial MBFV among normal individuals(P>0.05)regardless of body side and gender.However,young individuals had higher blood velocity than middle-aged individuals(P<0.05).Furthermore,it was identified that MBFV was negatively associated with BMI and torso temperature;however,it was positively linked with hand temperature.Conclusions:This investigation revealed that carotid arterial MBFV could indicate the physical state of humans,including BMI and temperature,and therefore,is valuable for elucidating the effect of TCM on yin–yang.The data validated some TCM beliefs and supported the implementation of sphygmology in TCM.

OCULAR BLOOD FLOW EVALUATION (POBF AND GDI) IN INJURED AND HEALTHY FELLOW EYES

Purpose: To assess if injured eyes develop ocular blood flow disturbances that may contribute to development of traumatic glaucoma. Materials and Methods: 25 patients hospitalized for eye injury and elevated IOP were evaluated 24 months after the trauma. All injured and fellow eyes underwent IOP measure, visual field (HFAII, Central 30/2SITA), pulsatile ocular blood flow analysis (POBF, OBF Labs UK), CDI examination (PSV, EDV, and RI) of Ophthalmic Artery, Central Retinal Artery, Short Posterior Ciliary Arteries. Results: IOP was significantly higher in injured eyes (15.1 vs 13.0±2.7mmHg) (P= 0,01), but only 2 eyes (8.8%) were under medical treatment POBF values were significantly lower in injured eyes: 11,25 μl/s in traumatised eyes and 15,40 μl/s in fellow eyes (P = 0.002). Resistivity Index (RI) of all investigated retrobulbar vessels was very significantly higher in injured eyes than in fellow eyes (P= 0.0001). There is no significant correlation between IOP and ocular blood flow disturbances.

CDFI与CT、MRI诊断妇科盆腔良恶性肿瘤的比较研究

本文对１２６例（１５２个病灶）经手术病理证实的妇科盆腔良恶性肿瘤进行ＣＤＦＩ检测，其诊断符合率为９２．１％，对良、恶性肿瘤数的检出率分别为９６．５％和８９．５％。按血流信号丰富程度分为Ｏ～Ⅲ级，良、恶性肿瘤分别以Ｏ、Ⅰ级和Ⅱ、Ⅲ级为主（Ｐ＜０．０１）；测定ＰＳ和ＲＩ值，良恶性肿瘤分别表现为中低速中低阻力频谱和高速低阻力频谱（Ｐ＜０．０１）。并与ＣＴ、ＭＲＩ比较，ＣＤＦＩ的准确性（８７．５％～９０．０％）和敏感性（７７．８％～８３．３％），明显高于ＣＴ，与ＭＲＩ相近。三种影像检测的特异性均在９２．９％～９３．３％之间，如联合检测可进一步提高诊断准确率。

低强度抗阻结合血流限制训练12周青年人体成分、肌肉力量及动脉弹性功能

背景:高强度抗阻训练能有效提高肌肉力量,但动脉硬化风险较高;高强度抗阻训练结合有氧运动可有效降低动脉硬化水平;低强度抗阻结合血流限制训练不需要高负荷力量刺激肌肉,或许是提高肌肉力量、保持动脉弹性的科学训练方法。目的:探讨12周的低强度抗阻训练结合血流限制训练对青年人体成分、肌肉力量及动脉弹性功能的影响,为制定个性化训练方案提供理论支撑。方法:随机招募55名大学生并通过抽签的方式随机分为高强度抗阻训练组、高强度抗阻结合有氧运动组及低强度抗阻结合血流限制训练组,分别进行为期12周的高强度抗阻训练、高强度抗阻训练结合有氧运动、低强度抗阻训练结合血流限制训练,训练结束后进行身体成分、肌肉力量及动脉弹性功能测试。结果与结论:12周的训练干预后,高强度抗阻训练组、低强度抗阻结合血流限制训练组的瘦体质量显著增加(P<0.05),3组的最大重复次数(1RM)和膝关节等速肌力均显著增加(P<0.05),高强度抗阻结合有氧运动组、低强度抗阻结合血流限制训练组的动脉弹性功能显著改善(P<0.05)。结果表明:12周的高强度抗阻训练、低强度抗阻训练结合血流限制训练能显著改善身体成分;3种训练方式均能增加肌肉力量;12周的高强度抗阻训练结合有氧运动、低强度抗阻训练结合血流限制训练均能改善动脉弹性功能,且低强度抗阻训练结合血流限制训练的效果优于高强度抗阻训练结合有氧运动。因此,建议将低强度抗阻训练结合血流限制训练作为首选训练方式,以改善动脉弹性,降低动脉硬化的风险。

Assessment of cerebrovascular reserve impairment using the breath-holding index in patients with leukoaraiosis

Many studies have demonstrated that leukoaraiosis is associated with impaired cerebrovascular reserve function. However, the definitive hemodynamic changes that occur in leukoaraiosis are not clear, and there are many controversies. This study aimed to investigate hemodynamic changes in symptomatic leukoaraiosis using transcranial Doppler ultrasonography and the breath-holding test in a Chinese Han population, from northern China. A total of 203 patients who were diagnosed with ischemic stroke or clinical chronic progressive ischemic symptoms were enrolled in this study, including 97 males and 106 females, with an age range of 43-93 years. The severity of leukoaraiosis was evaluated according to the Fazekas grading scale, and patients were divided into four groups accordingly. Grade 0 was no leukoaraiosis, and grades I, II, and III were mild, moderate, and severe leukoaraiosis, respectively, with 44, 79, 44, and 36 cases in each group. Transcranial Doppler ultrasonography and the breath-holding test were performed. The mean blood flow velocity of the bilateral middle cerebral artery was measured and the breath-holding index was calculated. The breath holding index was correlated with leukoaraiosis severity and cognitive impairment. Patients with a low breath holding index presented poor performance in the Montreal Cognitive Assessment (MoCA) and executive function tests. That is, the lower the breath holding index, the lower the scores for the MoCA and the higher for the trail-making test Parts A and B. These results indicate that the breath-holding index is a useful parameter for the evaluation of cerebrovascular reserve impairment in patients with leukoaraiosis. In addition, the breath-holding index can reflect cognitive dysfunction, providing a new insight into the pathophysiology of leukoaraiosis. This study was approved by the Ethics Committee of the Fifth Peoples Hospital of Shenyang, China (approval No. 20160301) and registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1800014421).

Diagnostic value of different color ultrasound diagnostic method in endometrial lesions

BACKGROUND Endometrial lesions include endometrial cancer and inferior fibroids.Among them,endometrial cancer as a malignant tumor seriously endangers the life and health of patients.Ultrasonography is an important means of diagnosing female reproductive system diseases,and it is of critical value for the early diagnosis of endometrial cancer.However,different ultrasound inspection programs have achieved different results.It is of great significance to choose a suitable inspection program.AIM To explore the diagnostic efficacy of different ultrasonic examination methods in clinical endometrial lesions.METHODS The 140 patients with endometrial lesions who were treated in our hospital from April 2018 to October 2019 were used as the research subjects.All patients underwent transvaginal color ultrasound and transabdominal color ultrasound.We compared the diagnostic coincidence and image display effects of the two different examination methods,and the endometrial thickness,blood flow,uterine effusion and resistance index of different diseases were observed by transvaginal color ultrasound.RESULTS The diagnostic coincidence rate of all types of diseases of transvaginal color ultrasound was significantly higher than that of transabdominal color ultrasound(P=0.001,0.005,0.001 and 0.001).In addition,the excellent and good rate of image display of transvaginal color ultrasound was higher than that of transabdominal color ultrasound(P=0.001).There were significant differences in endometrial thickness in patients with different types of endometrial lesions through the transvaginal color examination(P=0.001).The incidence rate of uterine effusion in patients with endometrial carcinoma was significantly higher than that in patients with other types of endometrial lesions(P=0.001),and the rate of the blood flow was the highest(P=0.001).The comparison of blood flow resistance index indicated that the blood flow resistance index in endometrial cancer patients was the lowest,which shows that the difference was statistically significant(P=0.001).CONCLUSION The overall diagnostic efficacy of transvaginal color ultrasound in the clinical diagnosis of endometrial lesions is better than that of transabdominal color ultrasound,which held higher diagnostic coincidence rate and image display effect.There were significant differences in the thickness of the endometrium and the blood flow in different types of lesions.

The Study of Ovarian Artery Hemodynamics in Patients with Infertility by Color Doppler Energy

Seventy four cases of infertility were examined to study the hemodynamics of the bilateral ovarian arteries at 21st day during the corpus luteum phase by color Doppler energy(CDE) and color Doppler flow imaging (CDFI). All the patients were verified by laparoscopy, fallopian tube patency examination and ovarian function test. Twenty two healthy women served as controls. The results showed that the difference of resistance index(RI)and pulsatility index (PI) of bilateral ovarian arteries between the infertility and the normal controls had statistical significance ( P <0.01), and the PI showed negative correlation with the thickness of endometrium (left side: r =0.724, P <0.01; right side: r =0.756, P <0.01). The results also showed that CDE was more sensitive than CDFI in displaying the ovarian arteries. It could be concluded that the elevated resistance of ovarian artery during the corpus luteum phase was one of the important factors that resulted in infertility.

经阴彩超宫颈癌RI值与其临床病理特征相关性分析

目的探讨经阴彩超检查宫颈癌的血流阻力指数(RI)与临床病理特征的关系。方法收集59例经病理证实为宫颈癌患者和50例经过经阴彩色多普勒检查的宫颈肌瘤患者,比较二者的血流及RI值,根据RI分组:RI <0. 5组、0. 5≤RI≤0. 8组与RI> 0. 8组,分析RI值与宫颈癌临床病理特征的关系。结果宫颈癌RI值明显低于宫颈肌瘤,差异具有统计学意义(P <0. 05); RI <0. 5组、0. 5≤RI≤0. 8组、RI> 0. 8组在FIGO分期、肿瘤直径、病理分级、淋巴结转移、肌层/宫旁浸润方面比较具有有统计学意义(P <0. 05); RI的AUC为0. 564(95%CI:0. 345～0. 824),当Youden指数最大值为0. 723时,对应的RI值为0. 61,将该值作为截断点,敏感性、特异性分别为80. 3%、82. 6%。结论 RI值变化与宫颈癌临床病理特征密切相关,FIGO分期越高、肿瘤直径越大、分化越低、有淋巴结转移及肌层/宫旁浸润的患者RI值越低;检测RI值对宫颈癌的诊断及判断肿瘤的恶性程度、浸润、转移情况具有重要的参考意义。

超声监测脐动脉和大脑中动脉PI、RI、S/D和主动脉ISI、IFI与胎儿生长受限的关系及对不良围产结局的预测

目的探讨超声监测脐动脉和大脑中动脉搏动指数(PI)、阻力指数(RI)、收缩期与舒张期流速比(S/D)和主动脉峡部收缩指数(ISI)、峡部血流指数(IFI)与胎儿生长受限(FGR)的关系及对不良围产结局的预测价值。方法选择120例孕晚期孕妇,年龄21~41岁,平均年龄27.20岁(标准差5.19岁);孕周32~41周,平均孕周35.33周(标准差1.69周);产次1~3次,平均产次1.41次(标准差0.29次);高血压54例,糖尿病62例。将超声确诊为FGR的孕妇作为研究组(n=58),宫内胎儿正常发育孕妇作为对照组(n=62)。应用彩色多普勒超声监测子宫动脉、脐动脉及主动脉峡部血流参数。统计两组孕妇的妊娠结局。根据不同妊娠结局再次将研究组分为正常结局组和异常结局组,比较两组大脑中动脉、脐动脉及主动脉血流参数,并分析以上血流参数与新生儿体质量及新生儿Apgar评分的相关性。运用受试者工作特性(ROC)曲线分析血流参数对不良围产结局的预测价值。结果研究组脐动脉参数PI、RI及S/D值均较对照组明显偏高(1.23±0.15 vs 0.71±0.11、0.89±0.14 vs 0.52±0.08、3.67±0.33 vs 2.73±0.26。P<0.05)。大脑中动脉参数PI、RI及S/D值和主动脉峡部血流参数IFI、ISI值均明显低于对照组(1.11±0.13 vs 1.72±0.18、0.53±0.12 vs 0.87±0.14、2.43±0.26 vs 4.67±0.15、0.23±1.03 vs 1.26±0.05,-0.39±0.03 vs-0.39±0.03。P<0.05);研究组主动脉峡部舒张血流消失或反向发生率为34.48%,高于对照组(4.84%)(P<0.05)。研究组根据不同妊娠结局分为正常结局组31例和异常结局组27例,异常结局组新生儿体质量及Apgar评分均较正常结局组明显偏低[(3.18±0.35)分vs(3.97±0.34)分、(7.21±0.34)分vs(8.67±0.65)分。P<0.05]。异常结局组新生儿大脑中动脉PI、RI、S/D及IFI和ISI等血流参数均较正常结局组明显偏低(1.02±0.1 vs 1.33±0.17、0.53±0.07 vs 0.64±0.15、2.42±0.23 vs 2.52±0.14、0.08±0.01 vs 1.12±0.04、1.12±0.14 vs-0.32±0.01。P<0.05);异常结局组新生儿脐动脉PI、RI及S/D等血流参数显著高于正常结局组(1.46±0.17 vs 1.18±0.12、0.86±0.11 vs 0.72±0.03、3.91±0.45 vs 3.43±0.26。P<0.05)。新生儿大脑中动脉PI、RI及S/D值及主动脉IFI、ISI均与新生儿体质量和新生儿Apgar评分呈正相关,脐动脉PI、RI、S/D值与新生儿体质量和Apgar评分呈负相关(P<0.05)。ROC曲线分析显示,子宫中动脉、脐动脉及主动脉峡部血流参数联合诊断的曲线下面积最高,为0.968(95%CI 0.917~1.000)。结论子宫动脉、脐动脉及主动脉峡部血流参数异常均与FGR的发生密切相关,可辅助临床诊断FGR,联合检测3项血流参数诊断FGR的效能最高。超声监测脐动脉和大脑中动脉PI、RI、S/D和主动脉ISI、IFI可有效提高临床预测FGR预后的准确度。

COLOR FLOW IMAGING OF HEPATIC CARCINOMA

Color flow imaging(CFI)ultrasound technique can discover the tumor vascularity and superimposed it to convontional B-mode ultrasonogram in real-time. The flow velocity on spectral Doppler sonogram can be measured by setting the sample volume to any selected site.One hundred and thirty-six patients with solid hepatic space-occupied lesions had been admitted and 113 cases were confirmed by operation and pathology,23 patients were strongly suspected by hepatic angiography (HAA).Ninety nine patients with 109 nodules were finally diagnosed as hepatic cellular carcinoma(HCC).According to color flow distribution pattern,3 kinds of color configuation had been nominated.Tumor vascularity discovered by CFI,especially the arterial blood flow was easy to be recognized,and its emerge rate was quite different between HCC group(94.5%)and hemangioma(HCH)group(17.07%)(P<0.01).Spectral Doppler studies were also carried out in these cases and the detectability of arterial flow in HCC group(95.41%)was much higher than that to HCH group (21. 95%) (P<0. 005).Resistant index(RI)and pulsatile index(PI)could be used to differentiate HCC (>0. 50 and >0.80 respectively)from HCH (P<0.001 and P<0.001 respectively).Arterial-portal(A-P) shunt could also be detected by CFI and spectral Doppler(mostly its Vmax>0.6m/s).The detection rate of A-P shunt was 64% in HCC group,but no case could be detected in HCH group.

Testicular vascularization at two locations in relation to hormonal levels,and pixel echotexture in bulls at different ages

Objective:To assess the hemodynamic changes that occurred in the main testicular artery at two different locations such as supra and marginal ones in bulls at three different ages.Methods:Eighteen Baladi bulls were divided according to their age into three different age groups:1 year[n=6;groupⅠwith bodyweight(380±10)kg],3 years[n=6;groupⅡwith bodyweight(570±10)kg],and 6 years old[n=6;groupⅢwith bodyweight(650±10)kg]Baladi bulls.Circumference of the scrotum,thickness of the mediastinum,testicular dimensions,vascularity,and hormonal levels were measured.Testicular hemodynamics were assessed by Doppler ultrasound scanning.Results:Testicular width,length,and volume were significantly different among the three age groups,with the highest in bulls of groupⅢ(P<0.05).The bulls in groupⅢhad significantly higher mediastinal line thickness and scrotal circumference than groupⅠ(P<0.05),but there was no significant difference between groupⅡand groupⅢ.Bulls in groupⅡshowed a decline in Doppler indices(resistance and pulsatility indexes)at both testicular branches compared to the other two groups(P<0.05).Supra and marginal end diastolic velocities in the three age groups were significantly different,with the highest in groupⅡ(P<0.05).Time average velocity(cm/s)was significantly elevated in groupⅡcompared to the other two groups(P<0.05).Both testicular echotextures were significantly decreased in groupⅡ(P<0.05).Estradiol and nitric oxide metabolites were significantly high in groupⅡcompared to the other two groups(P<0.05).Meanwhile,the level of plasma testosterone was maximum in groupⅢ(P<0.05).Positive correlations were found between supratesticular artery resistance and pulsatility indexes(r=0.81;P<0.001),while both resistance and pulsatility indexes had correlated negative with estradiol(r=-0.71 and r=-0.91;P<0.001),and nitric oxide metabolites(r=-0.92 and r=-0.72;P<0.001).Conclusions:Three-year old Baladi bull has the lesser Doppler indices with lesser echotexture and greater nitric oxide with estradiol concentrations,which directs a significant ability for the thermoregulation process.These parameters will help in breeding selection.

子宫动脉RI、PI、S/D参数预测妊娠合并抗磷脂综合征患者胚胎停育的临床价值

目的:探究子宫动脉阻力指数(RI)、血流搏动指数(PI)、子宫动脉收缩期与舒张期流速比(S/D)参数预测妊娠合并抗磷脂综合征患者胚胎停育的临床价值。方法:回顾性分析南京医科大学附属泰州人民医院2018年12月-2021年12月收治的102例妊娠合并抗磷脂综合征患者,收集并整理患者的基础资料,并采用彩色多普勒超声检查子宫动脉的RI、PI、S/D参数。根据患者发育情况将其分为胚胎停育组和胚胎良好组。采用Logistic多因素回归分析探讨影响妊娠合并抗磷脂综合征患者胚胎停育的相关因素,以受试者工作特征曲线(ROC)评估子宫动脉RI、PI、S/D参数对妊娠合并抗磷脂综合征胚胎停育的预测价值。结果:102例妊娠合并抗磷脂综合征患者中出现胚胎停育10例(9.80%),胚胎良好92例(90.20%)。胚胎停育组与胚胎良好组的年龄、BMI、孕周、吸烟、饮酒、高血压、糖尿病比较,差异无统计学意义(P>0.05),胚胎停育组子宫动脉RI、PI、S/D高于胚胎良好组,差异有统计学意义(P<0.05)。Logistic多因素回归分析结果显示,子宫动脉RI、PI、S/D均为妊娠合并抗磷脂综合征患者胚胎停育的影响因素(P<0.05);ROC分析结果显示,子宫动脉RI、PI、S/D联合联测妊娠合并抗磷脂综合征胚胎停育的敏感度为78.92%,特异度为97.40%,曲线下面积(AUC)为0.900,高于RI、PI、S/D单一预测效能(P=0.000)。结论:子宫动脉RI、PI、S/D参数可用于预测妊娠合并抗磷脂综合征胚胎停育,且联合预测效能较高,值得推广应用。

加味调肝汤联合西药治疗肝郁肾虚型月经过少疗效及对患者子宫内膜厚度的影响

目的:研究加味调肝汤联合西药治疗肝郁肾虚型月经过少临床疗效及对患者子宫内膜厚度的影响。方法:选取肝郁肾虚型月经过少患者共124例,采用随机数字表法分为观察组和对照组,其中对照组62例采用戊酸雌二醇(E2)、地屈孕酮治疗,观察组62例采用加味调肝汤联合戊酸雌二醇、地屈孕酮治疗。比较两组治疗效果、不良反应发生率,两组治疗前后中医证候积分、子宫内膜厚度、子宫血流阻力指数(RI)和卵泡期性激素水平。结果:观察组治疗总有效率为90.32%,较对照组总有效率75.81%高(P<0.05)。治疗前两组中医证候积分对比差异无统计学意义(P>0.05),治疗3个月后观察组上述积分较对照组更低(P<0.05)。治疗前两组卵泡期子宫内膜厚度、RI值比较,差异无统计学意义(P>0.05),治疗3个月后观察组卵泡期子宫内膜厚度较对照组更厚;RI较之于对照组更低(P<0.05)。治疗前两组卵泡期E2、FSH、LH水平比较无统计学差异(P>0.05);治疗3个月后观察组卵泡期性激素水平比对照组高(P<0.05)。观察组不良反应发生率为11.29%,与对照组的24.19%比较差异无统计学意义(P>0.05)。结论:加味调肝汤联合西药治疗肝郁肾虚型月经过少临床疗效比单用西药治疗效果更佳,能促进子宫内膜生长,降低RI值,调节卵泡期性激素水平。

体检人群中超重和肥胖对基底动脉、颈内动脉和椎动脉功能的影响

目的探讨健康体检人群中,体质量指数(BMI)与颅内动脉(基底动脉、颈内动脉和椎动脉)功能的相关性。方法回顾性选取2023年6至8月健康体检者共1169例。收集一般资料、实验室指标以及经颅多普勒数据。依据BMI分为3组:正常组(<24 kg/m^(2))546例、超重组(24~<28 kg/m^(2))484例和肥胖组(≥28 kg/m^(2))139例。比较3组临床特征、实验室指标、颅内动脉血流速度情况。分析BMI与颅内动脉血流速度的相关性,利用多元线性回归及限制性立方条分析BMI与颅内动脉血流速度的关系,并确定颅内动脉血流速度减慢风险增加的临界值。结果与正常组相比,肥胖组和超重组颅内动脉收缩期血流速度、舒张期血流速度和平均血流速度均较低(P<0.05)。多元线性回归分析显示,BMI与颅内动脉收缩期血流速度、舒张期血流速度及平均血流速度呈负相关(P<0.01),与血管搏动指数、阻力指数无相关性(P>0.05)。限制性立方条结果显示,基底动脉和双侧椎动脉血流速度与BMI之间呈线性相关(P>0.05),双侧颈内动脉血流速度与BMI之间呈非线性相关(P<0.05)。结论健康体检人群中BMI与颅内动脉血流速度呈负相关,当BMI超过特定值(24.18~24.26 kg/m^(2))时,颅内动脉血流速度减慢的风险增加。

宫腔镜冷刀微剪分离术应用于重度IUA患者中的疗效及对其血清指标的影响

目的:分析宫腔镜冷刀微剪分离术应用于重度宫腔粘连(IUA)患者中的疗效及对其血清指标的影响。方法:采取便利抽样的方法选取2022年1月—2023年1月黄冈市黄州区人民医院妇产科收治的80例重度IUA患者作为研究对象,根据随机数表法将患者分为对照组与观察组,各40例。对照组予以宫腔镜电切手术,观察组予以宫腔镜冷刀微剪分离术,比较两组临床疗效、月经改善情况、子宫内膜动脉血流、子宫内膜厚度及血清指标。结果:观察组总有效率为95.0%,高于对照组的77.5%,差异有统计学意义(P<0.05);观察组月经恢复总有效率为90.0%,高于对照组的72.5%,差异有统计学意义(P<0.05);术后30 d、90 d,两组子宫内膜动脉血流与子宫内膜厚度较术前显著改善,两组术后90 d优于术后30 d,且观察组阻力指数(RI)、搏动指数(PI)低于对照组,而子宫内膜厚度高于对照组,差异有统计学意义(P<0.05);术后30 d、90 d,两组血清指标较术前显著改善,两组术后90 d优于术后30 d,且观察组血清转化生长因子-β_(1)(TGF-β_(1))、白细胞介素-6(IL-6)及纤溶酶原激活物抑制因子-1(PAI-1)水平均低于对照组,而基质金属蛋白酶-9(MMP-9)水平高于对照组,差异有统计学意义(P<0.05)。结论:宫腔镜冷刀微剪分离术应用于重度IUA患者可取得显著效果,不仅能提升临床疗效及月经改善效果,还能促进子宫内膜动脉血流与子宫内膜厚度恢复,有效改善血清指标。

低分子肝素与阿司匹林联合应用于子宫动脉血流阻力升高复发性流产保胎治疗中的效果

目的分析低分子肝素联合阿司匹林治疗子宫动脉血流阻力升高复发性流产的效果。方法选取150例复发性流产患者,采用随机表法分为对照组及研究组,每组75例。对照组采用地屈孕酮治疗,研究组采用低分子肝素联合阿司匹林治疗。对比两组患者的子宫动脉阻力指数、激素水平及凝血功能。结果治疗后,研究组左、右侧子宫动脉阻力指数分别为(0.52±0.11)、(0.46±0.12),均低于对照组的(0.72±0.13)、(0.72±0.16)(P<0.05)。治疗后,研究组各项激素指标水平及凝血功能指标水平均优于对照组(P<0.05)。结论低分子肝素联合阿司匹林可改善复发性流产患者的子宫动脉血流阻力,调节其激素水平,改善其凝血功能,具有保胎作用,值得推广应用。

胎儿大脑中动脉、脐动脉血流指标水平与脐血血气分析结果的相关性分析

目的 分析胎儿大脑中动脉、脐动脉血流指标水平与脐血血气分析结果的相关性。方法 选取90例孕产妇,根据是否出现胎儿窘迫分为对照组(未发生胎儿窘迫,74例)和观察组(发生胎儿窘迫,16例)。于孕产妇孕晚期实施常规超声检查,并在新生儿出生后进行脐血血气分析检测。比较两组胎儿大脑中动脉及脐动脉血流指标[舒张期血流速度(VD)、收缩期血流速度(VS)、搏动指数(PI)、阻力指数(RI)及收缩期峰值血流速度与舒张末期血流速度之比(S/D)]水平,胎儿脐血血气指标[二氧化碳分压(PCO_(2))、氧分压(PO_(2))、碱剩余(BE)、p H值]水平;分析胎儿大脑中动脉及脐动脉血流指标水平与脐血血气指标水平相关性。结果 对照组大脑中动脉VD、VS、PI、RI及S/D分别为(20.17±2.01)cm/s、(68.31±2.39)cm/s、(1.48±0.28)、(0.74±0.18)、(4.45±0.74),脐动脉VD、VS、PI、RI及S/D分别为(16.64±4.25)cm/s、(61.02±4.21)cm/s、(0.74±0.21)、(0.59±0.10)、(3.24±0.72);观察组大脑中动脉VD、VS、PI、RI及S/D分别为(15.04±2.03)cm/s、(66.25±2.37)cm/s、(1.25±0.31)、(0.55±0.14)、(3.22±0.85),脐动脉VD、VS、PI、RI及S/D分别为(12.25±3.89)cm/s、(57.26±4.30)cm/s、(1.02±0.20)、(0.75±0.14)、(2.25±0.64)。与对照组相比,观察组胎儿大脑中动脉VD、VS、PI、RI及S/D更低,脐动脉VD、VS、S/D更低,脐动脉PI、RI更高(P<0.05)。观察组胎儿p H(7.15±0.03)、PO_(2)(23.24±4.29)mm Hg(1 mm Hg=0.133 k Pa)及BE(-7.24±1.41)mmol/L低于对照组的(7.26±0.02)、(28.11±4.36)mm Hg、(-6.01±1.45)mmol/L,PCO_(2)(61.33±2.37)mm Hg高于对照组的(45.35±2.31)mm Hg(P<0.05)。胎儿大脑中动脉VD、VS、PI、RI、SD与脐血p H、PO_(2)、BE呈正相关,与脐血PCO_(2)呈负相关(P<0.05)。胎儿脐动脉VD、VS、SD与p H、PO_(2)、BE呈正相关,与PCO_(2)呈负相关(P<0.05),脐动脉血PI、RI与p H、PO_(2)、BE呈负相关,与PCO_(2)呈正相关(P<0.05)。结论 胎儿大脑中动脉、脐动脉血流指标水平与脐血血气分析结果存在相关性,明确动脉血流指标水平以及脐血血气分析结果可为临床评估胎儿窘迫提供指导。

多普勒超声子宫动脉血流参数联合凝血相关指标对易栓症所致复发性流产妊娠结局的预测价值

目的:探讨多普勒超声子宫动脉血流参数联合凝血相关指标对易栓症所致复发性流产妊娠结局的预测价值。方法:选取2020年1月至2023年1月北京市海淀医院妇科门诊就诊的82例复发性流产患者,所有患者均进行相关治疗,并统计随访结果。所有患者于入院次日治疗前均进行子宫动脉搏动指数(PI)、阻力指数(RI)、收缩压最大血流速度(S)与舒张末期最大血流速度(D)比值(S/D),以及活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT)及D二聚体(D-D)检测。采用Pearson相关性分析PI、RI与S/D与APTT、PT、FIB、TT、D-D的相关性;采用受试者工作特征(ROC)曲线下面积(AUC)分析PI、RI、S/D、APTT、PT、FIB、TT及D-D单独检测及联合检测预测易栓症所致复发性流产妊娠结局的价值。结果:随访结果显示,82例复发性流产患者妊娠成功49例,妊娠丢失33例,妊娠成功孕妇的PI、RI与S/D均明显低于妊娠丢失孕妇,差异有统计学意义(t=10.598、6.693、3.059,P<0.05);APTT、PT、FIB、TT、D-D水平均明显低于妊娠丢失孕妇,差异有统计学意义(t=9.552、96.462、22.767、5.100、95.805,P<0.05);PI与APTT、PT、FIB、TT及D-D均存在正相关性(r=3.178,P<0.05),RI与APTT、PT、FIB、D-D均存在正相关性(r=3.246,P<0.05),S/D与PT、FIB、TT、D-D均存在正相关性(r=3.246,P<0.05);PI、RI、S/D、APTT、PT、FIB、TT及D-D单独检测及联合检测预测易栓症所致复发性流产妊娠结局灵敏度分别为42.40%、48.50%、39.40%、48.50%、63.60%、72.70%、42.40%、39.40%、84.80%,特异性分别为98.00%、71.40%、55.10%、75.50%、59.20%、71.40%、77.60%、85.70%、98.80%,AUC分别为0.674、0.685、0.409、0.646、0.784、0.788、0.566、0.563和0.941。结论:PI、RI及S/D子宫动脉血流参数与APTT、PT、FIB、TT和D-D凝血相关指标单独及联合检测预测易栓症所致复发性流产妊娠结局均具有一定的价值,且联合检测的预测价值更高。

右美托咪定和布托啡诺联合镇静对猫肾动脉阻力指数的影响

通过彩色多普勒超声判断镇静对健康成年猫肾叶间动脉阻力指数(RI)是否会产生影响,采用彩色多普勒超声测定肾叶间动脉RI值和宠物血压计检测血压的相关数值,记录镇静前和肌肉注射右美托咪定与布托啡诺联合镇静后10 min和30 min,6只猫的RI值、血压和心率等指标。结果表明,镇静后10 min与镇静前相比肾动脉RI值显著降低(P<0.05),平均动脉压显著升高(P<0.05);心率在镇静后2个时间均降低,镇静后30 min时有显著差异(P<0.05)。3个时间段的肾RI值与SYS、DIA、MAP和HR之间均无显著相关性(P>0.05)。选择右美托咪定和布托啡诺联合给药可用于镇静平稳期肾脏RI的测定。该镇静方案对心血管系统有一定影响,使用时需要时刻对心率和血压进行监护。