Long noncoding RNAs HAND2-AS1 ultrasound microbubbles suppress hepatocellular carcinoma progression by regulating the miR-873-5p/tissue inhibitor of matrix metalloproteinase-2 axis

BACKGROUND Increasing data indicated that long noncoding RNAs(lncRNAs)were directly or indirectly involved in the occurrence and development of tumors,including hepatocellular carcinoma(HCC).Recent studies had found that the expression of lncRNA HAND2-AS1 was downregulated in HCC tissues,but its role in HCC progression is unclear.Ultrasound targeted microbubble destruction mediated gene transfection is a new method to overexpress genes.AIM To study the role of ultrasound microbubbles(UTMBs)mediated HAND2-AS1 in the progression of HCC,in order to provide a new reference for the treatment of HCC.METHODS In vitro,we transfected HAND2-AS1 siRNA into HepG2 cells by UTMBs,and detected cell proliferation,apoptosis,invasion and epithelial-mesenchymal transition(EMT)by cell counting kit-8 assay,flow cytometry,Transwell invasion assay and Western blotting,respectively.In addition,we transfected miR-837-5p mimic into UTMBs treated cells and observed the changes of cell behavior.Next,the UTMBs treated HepG2 cells were transfected together with miR-837-5p mimic and tissue inhibitor of matrix metalloproteinase-2(TIMP2)overexpression vector,and we detected cell proliferation,apoptosis,invasion and EMT.In vivo,we established a mouse model of subcutaneous transplantation of HepG2 cells and observed the effect of HAND2-AS1 silencing on tumor formation ability.RESULTS We found that UTMBs carrying HAND2-AS1 restricted cell proliferation,invasion,and EMT,encouraged apoptosis,and HAND2-AS1 silencing eliminated the effect of UTMBs.Additionally,miR-873-5p targets the gene HAND2-AS1,which also targets the 3’UTR of TIMP2.And miR-873-5p mimic counteracted the impact of HAND2-AS1.Further,miR-873-5p mimic solely or in combination with pcDNA-TIMP2 had been transformed into HepG2 cells exposed to UTMBs.We discovered that TIMP2 reversed the effect of miR-873-5p mimic caused by the blocked signalling cascade for matrix metalloproteinase(MMP)2/MMP9.In vivo results showed that HAND2-AS1 silencing significantly inhibited tumor formation in mice.CONCLUSION LncRNA HAND2-AS1 promotes TIMP2 expression by targeting miR-873-5p to inhibit HepG2 cell growth and delay HCC progression.

Three-dimensional endoanal ultrasound for diagnosis of perianal fistulas: reliable and objective technique

AIM: To evaluate accuracy of three-dimensional endoanal ultrasound(3D-EAUS) as compared to 2D-EAUS and physical examination(PE) in diagnosis of perianal fistulas and correlate with intraoperative findings. METHODS: A prospective observational consecutive study was performed with patients included over a two years period. All patients were studied and operated on by the Colorectal Unit surgeons. The inclusion criteria were patients over 18, diagnosed with a criptoglandular perianal fistula. The PE, 2D-EAUS and 3D-EAUS was performed preoperatively by the same colorectal surgeon at the outpatient clinic prior to surgery and the fistula anatomy was defined and they were classified in intersphincteric, high or low transsphincteric, suprasphincteric and extrasphincteric. Special attention was paid to the presence of a secondary tract, the location of the internal opening(IO) and the site of external opening. The results of these different examinations were compared to the intraoperative findings. Data regarding location of the IO, primary tract, secondary tract, and the presence of abscesses or cavities wasanalysed.RESULTS: Seventy patients with a mean age of 47years(range 21-77), 51 male were included. Low transsphincteric fistulas were the most frequent type found(33, 47.1%) followed by high transsphincteric(24,34.3%) and intersphincteric fistulas(13, 18.6%). There are no significant differences between the number of IO diagnosed by the different techniques employed and surgery(P > 0.05) and, there is a good concordance between intraoperative findings and the 2D-EAUS(k= 0.67) and 3D-EAUS(k = 0.75) for the diagnosis of the primary tract. The ROC curves for the diagnosis of transsphincteric fistulas show that both ultrasound techniques are adequate for the diagnosis of low transsphincteric fistulas, 3D-EAUS is superior for the diagnosis of high transsphincteric fistulas and PE is weak for the diagnosis of both types.CONCLUSION: 3D-EAUS shows a higher accuracy than 2D-EAUS for assessing height of primary tract in transsphincteric fistulas. Both techniques show a good concordance with intraoperative finding for diagnosis of primary tracts.

Detection of Congenital Uterine Malformation by Using Transvaginal Three-dimensional Ultrasound

This study assessed the clinical application of transvaginal three-dimensional ultrasound （3D TVUS） in the diagnosis of congenital uterine malformation. A retrospective study was performed on 62 patients with congenital uterine malformation confirmed hysteroscopically and/or laparoscopically. The patients were subjected to transvaginal two-dimensional ultrasound （2D TVUS） and 3D TVUS. The accuracy rate was compared between the two methods. The accuracy rate of 3D TVUS was （98.38%, 61/62）, higher than that of 2D TVUS （80.65%, 50/62）. 3D TVUS coronal plane imaging could demon- strate the internal shape of the endometrial cavity and the external contour of the uterine fundus. It al- lowed accurate measurement on the coronary plane, and could three-dimensionally show the image of cervical tube, thereby providing information for the diagnosis of some complex uterine malformation. 3D TVUS imaging can obtain comprehensive information of the uterus malformation, and it is superior to 2D TVUS for the diagnosis of congenital uterine malformations, especially complex uterine anomaly.

Prenatal Diagnosis of Sirenomelia by Two-Dimensional and Three-Dimensional Skeletal Imaging Ultrasound

Summary： This study sought to evaluate the contribution of two-dimensional ultrasound （2D-US） and three-dimensional skeletal imaging ultrasound （3D-SUIS） in the prenatal diagnosis of sirenomelia. Be- tween September 2010 and April 2014, a prospective study was conducted in a single referral center using 3D-SU1S performed after 2D-US in 10 cases of sirenomelia. Diagnostic accuracy and detailed findings were compared with postnatal three-dimensional helical computed tomography （3D-HCT）, radiological findings and autopsy. Pregnancy was terminated in all 10 sirenomelia cases, including 9 singletons and I conjoined twin pregnancy, for a total of 5 males and 5 females. These cases of sirenomelia were deter- mined by autopsy and/or chromosomal examination. Initial 2D-US showed that there were 10 cases of oligohydranmios, bilateral renal agenesis, bladder agenesis, single umbilical artery, fusion of the lower limbs and spinal abnormalities; 8 cases of dipus or monopus; 2 cases of apus; and 8 cases of cardiac abnormalities. Subsequent 3D-SUIS showed that there were 9 cases of scoliosis, l0 cases of sacrococ- cygeal vertebra dysplasia, 3 cases of hemivertebra, 1 case of vertebral fusion, 3 cases of spina bifida, and 5 cases of rib abnormalities. 3D-SUIS identified significantly more skeletal abnormalities than did 2D-US, and its accuracy was 79.5% （70/88） compared with 3D-HCT and radiography. 3D-SUIS seems to be a useful complementary method to 2D-US and may improve the accuracy of identifying prenatal skeletal abnormalities related to sirenomelia.

Sequential transcatheter arterial chemoembolization,three-dimensional conformal radiotherapy,and high-intensity focused ultrasound treatment for unresectable hepatocellular carcinoma patients

The purpose of this study was to evaluate the outcome of patients with unresectable hepatocellular carcinoma（HCC） treated by sequential therapy of transcatheter arterial chemoembolization（TACE）,three-dimensional conformal radiotherapy（3-DCRT） and high-intensity focused ultrasound（HIFU）.From October,2005 to September,2010,120 patients with unresectable HCC received the sequential treatments of several courses of TACE followed in 2-4 weeks by 3-DCRT and then a single session of HIFU with a curative intent.The median tumor irradiation dose was 40 Gy.Tumor response,toxicity and overall survival rate were analyzed.Clinicopathologic factors affecting the primary technique effectiveness and overall survival rates were investigated by univariate analysis or multivariate analysis.All 120 HCC patients were followed up by the last follow-up time.Among these patients,hepatic toxicities due to treatment were notable in 9 cases.Gastrointestinal bleeding after the overall treatment occurred in 2 cases,leukopenia of grade III was detected in 1 case,radiation-induced liver disease（RILD） was observed in 2 patients,and first-and second-degree skin burn around the HIFU treatment zone were observed in 2 patients and 1 patient,respectively.Among 120 patients,23,83 and 14 cases achieved partial response,stable disease and progressive disease,respectively.The overall survival rates at 1 year,3 years and 5 years were 70%,35% and 15%,respectively,with a median survival time of 26 months.Both Child-Pugh liver function grading and radiation dose were determined to be independent predictors for overall survival revealed by the multivariate analysis.It is concluded that the sequential therapy of TACE,3-DCRT and HIFU is a promising therapeutic regimen for unresectable HCC.

Assessment of Sub-Endometrial Junction Zone by 3-Dimensional Transvaginal Ultrasound in Unexplained Recurrent Implantation Failure and Its Effect on ICSI Outcomes

BACKGROUND: Sub-endometrial junction zone (JZ) plays an important role in most of reproductive functions. OBJECTIVE: To find out the effect of the sub-endometrial JZ thickness assessment by 3-D trans-vaginal ultrasound (TVUS) on intracytoplasmic sperm injection (ICSI) outcomes in patients with unexplained recurrent implantation failure (RIF). SETTING: ART Unit of Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Qena, Egypt. DURATION: From April 2016 to October 2018. STUDY DESIGN: A prospective observational study. METHDS: Fifty couples with history of unexplained RIF in previous ICSI cycles and prepared for another ICSI cycle (group I) and fifty couples with unexplained infertility prepared for ICSI for the first time (group II) had been included in this study. At time of ovum pick up, 3-DTVUS was done for all cases in both groups for assessment of sub endometrial junction zone thickness and correlated with ICSI outcome. RESULTS: There were statistically significant differences between group I and group II in JZ thickness in the 3 uterine regions (fundus, anterior and posterior walls) with p 0.001, but there were mildly statistically significant differences between both groups in chemical and clinical pregnancy rates with p < 0.01. CONCLUSIONS: The thickness of JZ in patients with history of unexplained RIF was higher than those with unexplained infertility scheduled for ICSI. The JZ thickness was inversely correlated with increased embryo implantation rates in ICSI procedures, the thinner the JZ thickness was associated with higher pregnancy rates (both chemical and clinical pregnancy rates).

Application of three dimensional conformal radiation therapy combined with high-intensity focused ultrasound for prostate cancer

Objective:Prostate cancer is a form of cancer that develops in the prostate,a gland in the male reproductive system.Prostate cancer tends to develop in men over the age of fifty;it is one of the most prevalent types of cancer in men.This article introduced a new method of prostate cancer treatment with the combination of three dimensional conformal radiation therapy (3D-CRT) and high-intensity focused ultrasound (HIFU),its efficacy was evaluated.Methods:From January 2004 to December 2009,95 patients were diagnosed with prostate cancer,among them,48 patients were received combined therapy with total irradiation of TD 60 Gy/30 Fx and 5 fractions of HIFU treatment,while 47 patients were received with pure 3D-CRT with total irradiation of TD (66-72) Gy/(33-36) Fx.Various indicators were evaluated,such as the local control rate and distant metastasis rate,the changes in blood PSA and fPSA,changes in T-lymphocyte subsets and NK cells,as well as acute adverse reaction of normal tissue.Results:The local response rate difference between the two groups had statistical significance (P < 0.05);the changes in blood PSA and fPSA were significant (P < 0.05);CD3+,CD4+,CD8+,CD4+/CD8+ and NK cells of the combined group increased obviously (P < 0.01),while the latter group had no increase (P > 0.05);the combined group had lower blood cells reduction and II-level acute adverse reaction of rectum,bladder and caput humeri than the pure group,but the II-level acute adverse reaction of urogenital canal in the combined group was higher (P < 0.05).Conclusion:The combined therapy with 3D-CRT and HIFU is a good way for the treatment of aged-related prostate cancer.It can ease the symptoms,control the disease and lengthen the survival time.

3D-PDU对宫腔粘连术后妊娠结局的预测

目的探讨经阴道三维能量多普勒超声(three-dimensional power Doppler ultrasound,3D-PDU)对轻、中度宫腔粘连松解术(transcervical resection of adhesion,TCRA)后妊娠结局的预测价值。方法选取2020年1月至2021年12月于浙江省立同德医院行TCRA治疗并有生育要求的66例轻、中度宫腔粘连(intrauterine adhesions,IUA)患者,其中31例成功妊娠患者纳入妊娠组,35例未成功妊娠患者纳入非妊娠组。患者于术前及术后3个月行3D-PDU检测,获得子宫内膜厚度(endometrial thickness,ED)、宫腔容积(uterine volume,EV)、子宫内膜血管生成指数(vasculogenesis index,VI)、血流指数(blood flow index,FI)、血管生成-血流指数(vasculogenesis-blood flow index,VFI)。随访术后1年患者的受孕情况,观察上述相关指标对术后妊娠结局的预测价值。结果术后患者的ED、EV、VI、FI、VFI较术前明显改善(P<0.05),且妊娠组患者的改善情况优于非妊娠组(P<0.05);受试者操作特征曲线下面积分别为0.80、0.84、0.68、0.65、0.88。结论3D-PDU通过测量轻、中度IUA患者手术前后的ED、EV、VI、FI、VFI可有效预测TCRA术后患者的妊娠结局,为疗效评估及指导后续治疗提供参考依据。

Numerical study on three-dimensional flow field of continuously rotating detonation in a toroidal chamber

Gaseous detonation propagating in a toroidal chamber was numerically studied for hydrogen/oxygen/nitrogen mixtures. The numerical method used is based on the three-dimensional Euler equations with detailed finiterate chemistry. The results show that the calculated streak picture is in qualitative agreement with the picture recorded by a high speed streak camera from published literature. The three-dimensional flow field induced by a continuously rotating detonation was visualized and distinctive features of the rotating detonations were clearly depicted. Owing to the unconfined character of detonation wavelet, a deficit of detonation parameters was observed. Due to the effects of wall geometries, the strength of the outside detonation front is stronger than that of the inside portion. The detonation thus propagates with a constant circular velocity. Numerical simulation also shows three-dimensional rotating detonation structures, which display specific feature of the detonation- shock combined wave. Discrete burning gas pockets are formed due to instability of the discontinuity. It is believed that the present study could give an insight into the interest- ing properties of the continuously rotating detonation, and is thus beneficial to the design of continuous detonation propulsion systems.

经阴道三维彩超联合血β-人绒毛膜促性腺激素对早期宫外孕的诊断价值

目的探讨经阴道三维彩超联合血β-人绒毛膜促性腺激素(β-hCG)对早期宫外孕的诊断价值。方法选取2020年8月至2023年9月安庆市第一人民医院收治的80例早期宫外孕患者作为研究对象,设为观察组。另选取同期80例宫内孕孕妇设为对照组。分析两组超声指标与血β-hCG水平;绘制超声指标、血β-hCG单独及联合诊断早期宫外孕的受试者工作特征(ROC)曲线;通过病理结果分析经阴道三维彩超联合血β-hCG诊断的准确性。结果两组阻力指数、搏动指数、收缩期峰值流速比较,差异无统计学意义(P>0.05);观察组子宫内膜厚度、血β-hCG水平均小于对照组,差异具有统计学意义(P<0.05)。ROC曲线结果显示,子宫内膜厚度、血β-HCG及两者联合诊断宫外孕的曲线下面积分别为0.833、0.877及0.975(P<0.05)。与病理结果比较,经阴道三维彩超联合血β-hCG诊断漏诊、误诊5例,诊断准确率为93.75%。结论经阴道三维彩超联合血β-hCG对早期宫外孕具有较高的诊断价值,可为临床快速准确诊断早期宫外孕提供可靠信息。

Non-invasive assessment of liver fibrosis using twodimensional shear wave elastography in patients with autoimmune liver diseases

AIM To determine the diagnostic accuracy of two-dimensional shear wave elastography(2D-SWE) for the noninvasive assessment of liver fibrosis in patients with autoimmune liver diseases(AILD) using liver biopsy as the reference standard.METHODS Patients with AILD who underwent liver biopsy and 2D-SWE were consecutively enrolled. Receiver operating characteristic(ROC) curves were constructed to assess the overall accuracy and to identify optimal cut-off values.RESULTS The characteristics of the diagnostic performance were determined for 114 patients with AILD. The areas under the ROC curves for significant fibrosis, severe fibrosis, and cirrhosis were 0.85, 0.85, and 0.86, respectively, and the optimal cut-off values associated with significant fibrosis(≥ F2), severe fibrosis(≥ F3), and cirrhosis(F4) were 9.7 k Pa, 13.2 k Pa and 16.3 k Pa, respectively. 2D-SWE showed sensitivity values of 81.7% for significant fibrosis, 83.0% for severe fibrosis,and 87.0% for cirrhosis, and the respective specificity values were 81.3%, 74.6%, and 80.2%. The overall concordance rate of the liver stiffness measurements obtained using 2D-SWE vs fibrosis stages was 53.5%.CONCLUSION2D-SWE showed promising diagnostic performance for assessing liver fibrosis stages and exhibited high cut-off values in patients with AILD. Low overall concordance rate was observed in the liver stiffness measurements obtained using 2D-SWE vs fibrosis stages.

Infinite Three-Dimensional Coordination Polymers: Synthesis and Structures of [Cd (4,4'-bpy)_2 (H_2O)_2]_n (pic)_(2n),[Zn (4,4'-bpy)_2 (H_2O)_2]_n(pic)_(2n) (H_2O)_(2n), and [Zn (4,4'-bpy)_2 (H_2O)_2]_n (4,4'-bpy)_n(H_2O)_n (pic)_(2n)

Three Complexes of the formula [Cd (4,4'-bpy)_2 (H_2O)_2]_n. (pic)_(2n) (1) [Zn (4,4'-bpy)_2 (H_2O)]_n (4,4'-bpy)_n(H_2O)_n (pic)-(2n) (2) and [Zn (4,4'-bpy)_2 (H_2O)]_n (4,4'-bpy)_n (pic)-(2n)(H_2O)_n (3) (4.4'-bpy = 4.4'-bipyridine. pic = picric anion ) have been synthesized and characterized by elemental analysis and single-crystal x-ray diffraction. They all have infinite three-dimensional network structure. crystallizing in the monoclinic space group C2/c (1) and Cc (2.3).

超声B-Flow联合外周血NLR、CRP对颈动脉粥样硬化斑块易损性的诊断效能研究

目的探讨超声二维灰阶血流显像技术(B-Flow)联合外周血中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)诊断颈动脉粥样硬化(CAS)斑块易损性的价值。方法纳入2019年2月至2022年8月在天津市永久医院诊查的152例CAS患者为研究对象,均利用颈动脉斑块超声B-Flow和数字减影血管造影(DSA)检查斑块性质,并检测外周血NLR、CRP水平,以DSA结果为“金标准”,将患者分为易损斑块组和稳定斑块组,统计超声B-Flow检查结果,比较两组外周血NLR、CRP水平,分析超声B-Flow、外周血NLR、CRP水平三者单独及联合诊断CAS斑块易损性的价值。结果DSA检查结果显示,152例CAS患者检出66例易损斑块,86例为稳定斑块;超声B-Flow检查出72例易损斑块,80例稳定斑块,以DSA检查结果作为“金标准”,超声B-Flow诊断易损斑块的灵敏度、特异度、准确度分别为84.85%、81.39%、82.89%;易损斑块组外周血NLR、CRP水平均高于稳定斑块组(P<0.05);超声B-Flow联合外周血NLR、CRP水平诊断CAS易损性斑块的灵敏度、特异度、曲线下面积(AUC)分别为98.48、81.39%、0.907,联合诊断的灵敏度高于单独诊断,AUC高于单独诊断(P<0.05),特异度与单独诊断相近。结论超声B-Flow、外周血NLR、CRP均对CAS斑块易损性具有一定的诊断效能,但三者联合诊断效能更好。

三维超声结合TUI技术与血清β-hCG联合P检测诊断异位妊娠效果比较

目的:探讨经阴道三维超声联合断层超声显像技术(TUI)与血清β-人绒毛膜促性腺激素(β-hCG)联合孕酮(P)诊断异位妊娠效果。方法:选取2020年6月-2022年12月本院妇产科接诊的高度怀疑异位妊娠妇女200例,均接受经阴道三维超声、TUI、血清β-hCG和P检查或检测,以临床及手术病理学结果作为金标准,对比两种方式诊断异位妊娠的临床价值。结果:经阴道三维超声联合TUI诊断异位妊娠符合率为92.5%、诊断输卵管妊娠符合率为95.0%、诊断子宫角妊娠符合率为81.8%;异位妊娠患者的血清β-hCG、P水平均高于宫内妊娠妇女(P<0.05)。经阴道三维超声联合TUI诊断异位妊娠灵敏度93.2%、特异度89.7%,血清β-hCG联合P诊断异位妊娠灵敏度为82.0%、特异度71.8%;经阴道三维超声联合TUI诊断不同类型输卵管妊娠,在包块直径、包块边界、包块内部结构、卵黄囊检出率、原始心管检出率方面均有不同(均P<0.05)。结论:经阴道三维超声联合TUI诊断异位妊娠较血清β-hCG联合P有更高的灵敏度和特异度,对输卵管妊娠类型可以早期作出相关判断。

3-Dimensional Body Measurement Technology

3 - dimensional body measurement technology, the basis of developing high technology in industry, accelerates digital development of aplparel industry. This paper briefly introduces the history of 3 - dimensional body measurement technology, and recounts the principle and primary structure of some types of 3 - dimensional automatic body measurement system. With this understanding, it discusses prospect of 3- dimensional CAD and virtual technology used in apparel industry.

3D-TAS联合3D-TVS检查在剖宫产术后瘢痕妊娠早期诊断及分型中的应用价值

目的评估经腹部三维超声(3D-TAS)联合经阴道三维超声(3D-TVS)检查在剖宫产术后瘢痕妊娠(CSP)患者早期诊断和分型中的应用价值。方法选取2020年3月至2023年3月洛阳市第一人民医院收治的疑似CSP者135例,均接受3D-TAS、3D-TVS检查,以术后病理作为“金标准”,分析3D-TAS、3D-TVS单独及联合检查在CSP者早期诊断和分型中的价值。结果135例疑似CSP患者中,术后病理证实CSP 100例(74.07%),非CSP 35例(25.93%)。且3D-TAS与3D-TVS联合检查诊断早期CSP的敏感度、准确率均明显高于3D-TAS、3D-TVS单独检查,而漏诊率、阴性预测值均明显低于3D-TAS、3D-TVS单独检查,差异均有统计学意义(P<0.05)。术后病理证实,100例CSP患者中Ⅰ型25例、Ⅱ型57例、Ⅲ型18例;3D-TAS、3D-TVS联合检查分型结果:Ⅰ型18例、Ⅱ型45例、Ⅲ型17例,分型检出率为80.00%(80/100),与病理结果CSP分型一致性检验较好(Kappa值为0.769,95%可信区间0.598~0.881,P<0.001)。结论3D-TAS、3D-TVS联合检查对CSP患者具有较高的早期诊断价值,并能为CSP分型诊断提供可靠依据,故可作为剖宫产术后再次妊娠患者筛查CSP的首选方式。

经阴道超声联合3D-TVS Render成像诊断子宫内膜病变的临床价值分析

目的分析经阴道超声联合三维超声(3D-TVS)Render成像诊断子宫内膜病变的临床价值。方法回顾性分析2019年11月至2022年11月我院收治的123例子宫内膜病变患者的临床资料,术前或诊刮前均行经阴道超声、3D-TVS Render成像检查,以病理检查结果作为“金标准”,分析经阴道超声联合3D-TVS Render成像对子宫内膜病变的诊断价值。结果经病理检查结果显示,123例患者中子宫内膜癌24例,子宫内膜良性病变99例;子宫内膜癌患者经阴道超声检查的子宫内膜厚度(ET)高于良性病变患者,经3D-TVS Render成像检查的子宫内膜血管指数(VI)、血流指数(FI)、血管血流指数(VFI)高于良性病变患者(P<0.05);绘制ROC曲线结果显示,ET、VI、FI、VFI联合诊断子宫内膜病变的AUC为0.968,高于各指标单独诊断。结论经阴道超声联合3D-TVS Render成像对子宫内膜病变的诊断价值较高,值得临床推广应用。

孕妇血清β-HCG、PAPP-A联合三维超声对胎儿脊柱裂的诊断价值

目的 分析孕妇血清β-人绒毛膜促性腺激素(β-HCG)、妊娠相关蛋白A(PAPP-A)联合三维超声对胎儿脊柱裂的诊断价值。方法 选择2020年1月至2022年1月在郑州大学附属郑州中心医院产前检查疑似胎儿脊柱裂的131例孕妇作为研究对象,收集孕妇资料。所有产妇均进行三维超声检查,以酶联免疫吸附法、化学发光法检测孕妇血清β-hCG、PAPP-A水平。绘制受试者工作特征(ROC)曲线评估血清β-HCG、PAPP-A联合三维超声对胎儿脊柱裂的诊断价值,以多因素logistic回归分析影响胎儿脊柱裂发生的因素。结果 本研究中131例疑似胎儿脊柱裂孕妇中109例确诊为脊柱裂,其中开放型脊柱裂90例,19例闭合型脊柱裂。三维超声检查显示为脊柱裂者95例,非脊柱裂者36例。脊柱裂组血清β-HCG水平高于非脊柱裂组(P<0.05),血清PAPP-A水平低于非脊柱裂组(P<0.05)。绘制ROC曲线评估血清β-HCG、PAPP-A水平联合三维超声诊断胎儿脊柱裂的价值,结果显示,三者单独检测敏感性及特异性至少为77.27%,联合检测敏感性、特异性均为95%以上,具有更高的诊断价值。多因素logistic回归分析显示,血清β-HCG、PAPP-A水平为影响胎儿脊柱裂发生的因素(P<0.05)。结论 孕期血清β-HCG、PAPP-A水平为影响胎儿脊柱裂发生的因素,与三维超声联合检测可为临床诊断胎儿脊柱裂提供重要参考价值,临床应尽早筛查以降低分娩脊柱裂新生儿的风险。

3D-PDUS 血流参数对宫腔镜下重度宫腔黏连分解术后复发的预测价值

目的探讨三维能量多普勒超声(three-dimensional power Doppler ultrasound,3D-PDUS)血流参数对重度宫腔黏连(intrauterine adhesion,IUA)患者宫腔镜下宫腔黏连分解术后复发的预测价值。方法选取2021年1月至2022年12月于云南省第三人民医院行宫腔镜下宫腔黏连分解术的100例重度IUA患者为研究对象。分别于术前、术后1个月进行3D-PDUS检查,获得血管指数(vascularization index,VI)、血流指数(flow index,FI)、血管化血流指数(vascularization-flow index,VFI)。依据术后3个月复发情况将患者分为复发组和未复发组,评价术后复发的影响因素。评价VFI、VI、FI对术后复发的预测价值。统计学方法采用t检验、χ^(2)检验、Logistic回归分析及受试者操作特征(receiver operating characteristic,ROC)曲线分析。结果重度IUA患者术后与术前VI(0.56±0.22与0.14±0.06,t=18.418)、FI(22.67±2.34与17.62±2.39,t=15.098)、VFI(0.98±0.47与0.07±0.03,t=19.322)比,术后均高于术前(P<0.001)。术后复发组与未复发组VI(0.31±0.15与0.65±0.24,t=6.869)、(15.1±2.1与25.5±2.5,t=18.930)、VFI(0.67±0.17与1.09±0.25,t=8.055)比较,复发组术后均低于未复发组(P<0.001)。随机森林算法显示,重要性评分前5的变量依次为术后VFI、VI、FI、人工流产次数、病程;术后VFI(OR=0.279,95%CI:0.137~0.569)、VI(OR=0.257,95%CI:0.122~0.541)、FI(OR=0.275,95%CI:0.125~0.603)、人工流产次数(OR=5.702,95%CI:1.258~25.841)、病程(OR=5.976,95%CI:1.301~27.449)为术后复发影响因素(P值均<0.001)。术后1个月VFI、VI、FI单项及联合预测术后复发的曲线下面(areaunder the curve,AUC)分别为0.744、0.837、0.799、0.938,且联合预测高于单独指标预测(P<0.001)。结论重度IUA患者宫腔镜下宫腔黏连分解术后血流参数VI、FI、VFI升高,联合检测各血流参数对术后复发具有一定预测价值。

孕中期母体血清F-β-HCG、VB12、Hcy水平、四维彩超联合检测对胎儿中枢神经系统畸形(CNS)的诊断价值

目的 探究孕中期四维彩超联合母体血清维生素B12(VB12)、游离-β-人绒毛膜促性腺激素(F-β-HCG)、同型半胱氨酸(Hcy)水平检测对胎儿中枢神经系统畸形(CNS)的诊断价值。方法 选取2021年07月~2023年08月于我院就诊的78例疑似胎儿CNS孕妇,以生产结局为金标准,统计生产结局、四维彩超结果,并分析四维彩超诊断效能,比较发生CNS与正常者母体血清Hcy、VB12、F-β-HCG水平,效能分析采用受试者(ROC)曲线。结果 四维彩超诊断灵敏度、准确度分别为86.67%、94.87%,漏诊率为13.33%;发生胎儿CNS的母体血清F-β-HCG、Hcy水平均高于正常者(P<0.05);母体血清VB12水平低于正常者(P<0.05);母体血清维生素B12、F-β-HCG、Hcy水平、四维彩超联合诊断胎儿CNS的AUC为0.962,最佳预测敏感度、特异度分别为93.33%、85.71%,均高于单独诊断。结论 四维彩超联合母体血清维生素B12、F-β-HCG、Hcy水平诊断可作为筛查CNS的辅助指标,具有较高的诊断灵敏度,可为临床及时诊断,终止妊娠,避免畸形新生儿提供可靠依据。