(1-3)-β-D葡聚糖联合降钙素原、CD4^(+)T淋巴细胞多指标在艾滋病患者马尔尼菲篮状菌感染早期诊断临床研究

目的探讨(1-3)-β-D葡聚糖联合降钙素原(procalcitonin,PCT)、CD4^(+)T淋巴细胞多指标在艾滋病患者马尔尼菲篮状菌感染早期诊断临床研究。方法回顾性选取我院2020年1月—2022年6月住院的120例艾滋病患者为研究对象。依据实验室结果,将其分为马尔尼菲篮状菌感染确诊组(血或组织液培育养出马尔尼菲篮状菌),简称A组(62例),及马尔尼菲篮状菌感染临床诊断组[根据临床症状、体征、血常规及(1-3)-β-D葡聚糖、PCT、CD4^(+)T淋巴细胞多指标诊断],简称B组(58例)。检测患者(1-3)-β-D葡聚糖、PCT、CD4^(+)T淋巴细胞的表达水平,采用受试者工作特征(receiver-operating characteristic,ROC)曲线下面积(area under the curve,AUC)评估上述指标联合检测对艾滋病患者感染马尔尼菲篮状菌的诊断效能。结果A组的(1-3)-β-D葡聚糖和PCT水平均高于B组,CD4^(+)T淋巴细胞个数低于B组(P<0.05);(1-3)-β-D葡聚糖、PCT、CD4^(+)T淋巴细胞联合检测的AUC为0.933,(1-3)-β-D葡聚糖单独检测的AUC是0.812,PCT单独检测的AUC为0.883,CD4^(+)T淋巴细胞单独检测的AUC是0.810,(1-3)-β-D葡聚糖、PCT和CD4^(+)T淋巴细胞联合检测的AUC皆优于三项单独检测,表明(1-3)-β-D葡聚糖、PCT和CD4^(+)T淋巴细胞联合检测的诊断价值皆优于单一指标诊断,且联合检测的特异度、约登指数分别为92.43%和0.580,均高于三项单独检测。结论(1-3)-β-D葡聚糖联合PCT和CD4^(+)T淋巴细胞多指标对艾滋病马尔尼菲篮状菌感染具有非常高的临床诊断价值,能够帮助医生分析出高危风险患者,及时制定治疗方案,同时也承担预后效果的判断依据,对治疗艾滋病马尔尼菲篮状菌感染具有非常重要的研究价值。

1例RHD-CE(3-7)-D基因重组与RHCE变异型患者的血清学与分子生物学分析

目的 研究分析1例Rh血型弱D、弱cE患者的血清学与分子生物学特征,为该类患者的临床安全输血提供实验依据。方法 采用微柱凝胶卡法对患者红细胞进行ABO、RhDCcEe抗原的鉴定,同时采用试管法进行血型复核,抗人球蛋白卡法筛查不规则抗体;采用PCR-SSP法对RhDCcEe(RhD、RhC、Rhc、RhE、Rhe)基因型进行检测;三代全长测序技术对RHD/RHCE基因序列进行测序分析。结果 微柱凝胶卡法鉴定ABO、RhD、RhCcEe血型抗原的结果为:A抗原(-)、B抗原(-)、RhD(1+)、RhC(4+)、Rhc(1+)、RhE(1+)、Rhe(4+)、对照孔(-);试管法ABO、RhD、RhCcEe抗原鉴定该患者表型为:A抗原(-)、B抗原(-)、RhD(w+)、RhC(4+)、Rhc(w+)、RhE(w+)、Rhe(4+),对照管(-);抗人球蛋白卡法筛查患者不规则抗体阴性;PCR-SSP法血型基因分型RhDCcEe结果:RhD(+)、RhC(+)、Rhc(+)、RhE(+)、Rhe(+);RHD/RHCE基因结果:RHD单倍体1为外显子1-10全缺失,而单倍体2为外显子RHD-CE基因重组融合,且确认其重组类型为RHD-CE(3-7)-D,起点在外显子2(g.20238-20312之间),终点在外显子8(g49184-50480之间),同时RHCE基因第6外显子存在新碱基点突变RHCE*cE(827C>A)。结论RHD-CE(3-7)-D基因重组融合与RHCE*cE(827C>A)新等位基因突变可能引起D、cE血型抗原弱表达,为临床安全输血提供了重要的实验数据支持。

Automatic detection of breast lesions in automated 3D breast ultrasound with cross-organ transfer learning

Background Deep convolutional neural networks have garnered considerable attention in numerous machine learning applications,particularly in visual recognition tasks such as image and video analyses.There is a growing interest in applying this technology to diverse applications in medical image analysis.Automated three dimensional Breast Ultrasound is a vital tool for detecting breast cancer,and computer-assisted diagnosis software,developed based on deep learning,can effectively assist radiologists in diagnosis.However,the network model is prone to overfitting during training,owing to challenges such as insufficient training data.This study attempts to solve the problem caused by small datasets and improve model detection performance.Methods We propose a breast cancer detection framework based on deep learning(a transfer learning method based on cross-organ cancer detection)and a contrastive learning method based on breast imaging reporting and data systems(BI-RADS).Results When using cross organ transfer learning and BIRADS based contrastive learning,the average sensitivity of the model increased by a maximum of 16.05%.Conclusion Our experiments have demonstrated that the parameters and experiences of cross-organ cancer detection can be mutually referenced,and contrastive learning method based on BI-RADS can improve the detection performance of the model.

The Application Value of Ultrasound Imaging in the Differential Diagnosis of Benign and Malignant Breast Nodules of BI-RADS 3 and Above

Objective:To explore the diagnostic value of ultrasound imaging for breast nodules of breast imaging-reporting and data system(BI-RADS)category 3 and above.Methods:From June 2021 to July 2022,163 patients with breast nodules of BI-RADS 3 or above were selected as the research subjects.After pathological diagnosis,24 cases were malignant breast nodules of BI-RADS 3 or above,while 139 cases were benign breast nodules of BI-RADS 3 or above.The diagnosis rate of malignant and benign breast nodules of BI-RADS 3 or above,including 95%CI,was observed and analyzed.Results:The malignant and benign detection rates of conventional ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of ultrasound imaging were 93.18%and 87.50%,respectively,with 95%CIs greater than 0.7.Conclusion:Ultrasound imaging can help improve the diagnostic accuracy of benign and malignant breast nodules of BI-RADS 3 and above and reduce the misdiagnosis rate.

超声及血清CK-19、Galectin-3、miRNA-363联合诊断PTMC颈部淋巴结转移的临床价值

目的 研究超声及血清细胞角蛋白19(CK-19)、半乳糖凝集素3(Galectin-3)及微小核糖核酸-363(miRNA-363)联合诊断甲状腺微小乳头状癌(PTMC)颈部淋巴结转移(CLNM)的临床价值。方法 回顾性选取2021年7月至2023年6月在天津市环湖医院诊断的PTMC患者92例纳入研究组,选择同期本院收治的结节性微小甲状腺肿患者92例纳入对照组。观察两组病灶情况及超声特点;比较两组血清CK-19、Galectin-3、miRNA-363水平,研究组是否发生CLNM患者病灶超声特点及血清CK-19、Galectin-3、miRNA-363水平。分析PTMC~CLNM超声特点与血清CK-19、Galectin-3、miRNA-363水平的相关性。结果 研究组多枚病灶、病灶>0.5 mm、病灶纵横比≥1、病灶形态不规则、病灶边缘模糊、病灶微钙化、病灶低回声、淋巴结肿大占比分别为70.65%、71.74%、82.61%、61.96%、72.83%、80.43%、84.78%、70.65%,均大于对照组(31.52%、52.17%、27.17%、25.00%、19.57%、15.22%、66.30%、22.83%),差异均有统计学意义(P<0.05)。研究组血清CK-19、Galectin-3水平分别为(30.45±3.31)、(4.68±0.48)μg/L,均高于对照组[(7.05±0.73)、(1.72±0.19)μg/L],血清miRNA-363水平为(2.89±0.30) fmol/L,低于对照组[(4.30±0.46) fmol/L],差异均有统计学意义(P<0.05)。研究组发生CLNM患者多枚病灶、病灶形态不规则、病灶边缘模糊、病灶微钙化、淋巴结肿大占比分别为90.91%、86.36%、95.45%、100.00%、90.91%,均大于未发生CLNM患者(64.29%、54.29%、0、25.00%、64.29%),差异均有统计学意义(P<0.05)。研究组发生CLNM患者血清CK-19、Galectin-3水平(41.20±4.42)、(5.94±0.62)μg/L,均高于未发生CLNM患者[(24.36±2.71)、(3.25±0.34)μg/L],血清miRNA-363水平为(2.14±0.23) fmol/L,低于未发生CLNM患者[(3.46±0.36) fmol/L],差异均有统计学意义(P<0.05)。经Pearson相关分析,CLNM患者多枚病灶、病灶形态不规则、病灶边缘模糊、淋巴结肿大及血清CK-19、Galectin-3、miRNA-363水平均与CLNM呈正相关(P<0.05)。结论 超声及血清CK-19、Galectin-3、miRNA-363联合诊断PTMC~CLNM具有较高的临床价值。

超声联合血清AnxA1、MMP-3对NSTE-ACS患者PCI术后冠状动脉再狭窄的预测价值

目的探讨血清膜联蛋白A1(AnxA1)、基质金属蛋白酶-3(MMP-3)联合冠状动脉血管内超声钙化特征对非ST段抬高型急性冠脉综合征(NSTE-ACS)患者经皮冠状动脉介入治疗(PCI)术后冠状动脉再狭窄的预测价值。方法回顾性选取2019年7月至2022年5月鄂州市中心医院行PCI治疗的236例NSTE-ACS患者为研究对象,依据随访1年内冠状动脉再狭窄情况分为再狭窄组(n=24)和非狭窄组(n=212)。收集患者临床资料,对比患者血清AnxA1、MMP-3水平、血管内超声检查结果;采用Logistic多因素回归分析NSTE-ACS患者PCI术后冠状动脉再狭窄影响因素;受试者操作特征(ROC)曲线分析血清AnxA1、MMP-3水平联合钙化特征评分预测术后冠状动脉再狭窄的价值。结果再狭窄组血清AnxA1、MMP-3水平及钙化病变比例、浅表型钙化比例、钙化弧度、钙化长度、钙化特征评分分别为(2.40±0.61)μg/L、(56.49±12.31)μg/L、66.67%、70.83%、(162.18±28.43)°、(25.91±4.56)mm、(5.02±1.28)分,高于非狭窄组[(1.78±0.40)μg/L、(42.78±10.07)μg/L、22.64%、29.72%、(78.41±20.39)°、(13.72±3.68)mm、(3.47±1.02)分],差异均有统计学意义(P<0.05)。AnxA1、MMP-3、钙化特征评分是NSTE-ACS患者PCI术后冠状动脉再狭窄的独立危险因素(P<0.05)。AnxA1、MMP-3、钙化特征评分及3者联合预测NSTE-ACS患者PCI术后冠状动脉再狭窄的AUC分别为0.825、0.780、0.854、0.960。结论AnxA1、MMP-3、钙化特征评分是NSTE-ACS患者PCI术后冠状动脉再狭窄的独立危险因素,3者联合较单一指标对冠状动脉再狭窄的预测价值更高。

Parallel computing approach for efficient 3-D X-ray-simulated image reconstruction

Accurate 3-dimensional(3-D)reconstruction technology for nondestructive testing based on digital radiography(DR)is of great importance for alleviating the drawbacks of the existing computed tomography(CT)-based method.The commonly used Monte Carlo simulation method ensures well-performing imaging results for DR.However,for 3-D reconstruction,it is limited by its high time consumption.To solve this problem,this study proposes a parallel computing method to accelerate Monte Carlo simulation for projection images with a parallel interface and a specific DR application.The images are utilized for 3-D reconstruction of the test model.We verify the accuracy of parallel computing for DR and evaluate the performance of two parallel computing modes-multithreaded applications(G4-MT)and message-passing interfaces(G4-MPI)-by assessing parallel speedup and efficiency.This study explores the scalability of the hybrid G4-MPI and G4-MT modes.The results show that the two parallel computing modes can significantly reduce the Monte Carlo simulation time because the parallel speedup increment of Monte Carlo simulations can be considered linear growth,and the parallel efficiency is maintained at a high level.The hybrid mode has strong scalability,as the overall run time of the 180 simulations using 320 threads is 15.35 h with 10 billion particles emitted,and the parallel speedup can be up to 151.36.The 3-D reconstruction of the model is achieved based on the filtered back projection(FBP)algorithm using 180 projection images obtained with the hybrid G4-MPI and G4-MT.The quality of the reconstructed sliced images is satisfactory because the images can reflect the internal structure of the test model.This method is applied to a complex model,and the quality of the reconstructed images is evaluated.

血清25-羟维生素-D3 超敏C反应蛋白及心电图参数与ST段抬高型心肌梗死患者介入治疗后发生恶性心律失常的关系

目的:探讨血清25-羟维生素-D3(25-hydroxyvitamin D3,25-(OH)-D3)、超敏C反应蛋白(High sensitivity C-reactive protein,hs-CRP)、心电图参数变化与ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者经皮冠脉介入术(Percutaneous coronary intervention,PCI)后发生恶性心律失常的关系。方法:选取我院2020年1月至2022年6月实施PCI治疗的193例STEMI患者作为研究对象,根据患者术后72h内是否发生恶性心律失常分为心律失常组38例、对照组155例,对比两组患者入院12h内的25-(OH)-D3、hs-CRP、血清电解质、血常规指标、血脂指标、心肌酶学指标,并对患者PCI术后实施连续动态心电图监测,对比两组患者心电图碎裂QRS波、校正Tp-e间期(Corrected Tp-e interval,Tp-ec)、QT离散度(QT dispersion,Qtd),并采用Logistic回归模型分析上述指标与STEMI患者PCI术后发生恶性心律失常的关系。结果:心律失常组患者的血清25-(OH)-D3水平低于对照组,心律失常组患者的血清hs-CRP、Tp-ec测定值、Qtd测定值、碎裂QRS波检出率均高于对照组,上述指标组间差异均具有统计学意义(P<0.05);心律失常组患者的白细胞(White blood cell,WBC)、肌钙蛋白I(Troponin I,cTnI)、肌酸激酶同工酶(Creatine kinase isoenzyme,CK-MB)、肌红蛋白(Myoglobin,MYO)、K+、Mg 2+水平均高于对照组患者,差异具有统计学意义(P<0.05);Logistic回归模型结果显示:cTnI、CK-MB、K+、hs-CRP、Tp-ec、Qtd增高,碎裂QRS波阳性会显著增大STEMI患者PCI后发生恶性心律失常的风险(P<0.05);血清25-(OH)-D3水平增高会降低STEMI患者PCI后发生恶性心律失常的风险(P<0.05)。结论:STEMI患者血清25-(OH)-D3水平降低、hs-CRP增高、PCI术后Tp-ec、Qtd增高、出现碎裂QRS波会增大患者出现恶性心律失常的风险。

Fe_(3)O_(4)/BiOBr/BiOI的制备及降解2,4-D的性能研究

采用水热法制备了微米球花状结构的Fe_(3)O_(4)/BiOBr/BiOI复合材料,通过SEM、XRD、XPS和UV-Vis等手段对催化剂进行表征分析。结果表明,该催化剂对2,4-D具有高效的光降解性能和光催化效率(80 min,88%)。降解速率常数为2.498×10^(-2)min^(-1),分别是Br∶I=5∶5(K=2.004×10^(-2)min^(-1))、BiOBr(K=1.289×10^(-2)min^(-1))和BiOI(K=6.98×10-3min-1)的1.25倍、1.94倍与3.58倍。这是由于Fe_(3)O_(4)/BiOBr/BiOI复合材料内部形成了异质结,利于光生载流子的分离。此外,5次循环实验后,降解效率保持在82.9%,证明该催化剂稳定、可回收、可磁分离。

那如-3对胶原诱导性关节炎大鼠的保护作用

目的基于影像学方法探讨蒙药那如-3对类风湿关节炎大鼠的保护作用。方法将大鼠分为正常组、模型组、阳性组及那如-3低、中、高剂量组(0.1、0.2、0.4 g/kg),采用免疫诱导法构建胶原诱导性关节炎(CIA)大鼠模型,给药4周后,观察各组大鼠关节炎评分(AI)及体质量变化。采用ELISA法检测各组大鼠血清VEGF、TNF-α及IL-1水平,高频超声及超声造影(CEUS)评估滑膜增生及新生血管情况,X射线及高分辨率显微计算机断层扫描(micro-CT)评估踝关节骨质破坏情况,HE及免疫组化法观察关节滑膜结构及CD31、VEGF、TNF-α、IL-1β表达。结果与模型组比较,那如-3各剂量组大鼠体质量增加(P<0.05),AI评分未见明显变化(P>0.05),血清VEGF、TNF-α水平、滑膜厚度、能量多普勒成像(PDI)血流分级及造影强度、X射线评分、CD31表达均降低(P<0.05),高剂量组IL-1水平及HE评分均降低(P<0.05)。结论那如-3对类风湿关节炎大鼠关节组织具有保护作用,其可能通过抑制滑膜新生血管及炎性细胞因子减轻滑膜炎症,减轻骨侵蚀,延缓病情进展。

Building 3-D Human Data Based on Handed Measurement and CNN

3-dimension(3-D)printing technology is growing strongly with many applications,one of which is the garment industry.The application of human body models to the garment industry is necessary to respond to the increasing personalization demand and still guarantee aesthetics.This paper proposes amethod to construct 3-D human models by applying deep learning.We calculate the location of the main slices of the human body,including the neck,chest,belly,buttocks,and the rings of the extremities,using pre-existing information.Then,on the positioning frame,we find the key points(fixed and unaltered)of these key slices and update these points tomatch the current parameters.To add points to a star slice,we use a deep learning model tomimic the form of the human body at that slice position.We use interpolation to produce sub-slices of different body sections based on the main slices to create complete body parts morphologically.We combine all slices to construct a full 3-D representation of the human body.

Conical Sonic-Supersonic Solutions for the 3-D Steady Full Euler Equations

This paper concerns the sonic-supersonic structures of the transonic crossflow generated by the steady supersonic flow past an infinite cone of arbitrary cross section.Under the conical assumption,the three-dimensional(3-D)steady Euler equations can be projected onto the unit sphere and the state of fluid can be characterized by the polar and azimuthal angles.Given a segment smooth curve as a conical-sonic line in the polar-azimuthal angle plane,we construct a classical conical-supersonic solution near the curve under some reasonable assumptions.To overcome the difficulty caused by the parabolic degeneracy,we apply the characteristic decomposition technique to transform the Euler equations into a new degenerate hyperbolic system in a partial hodograph plane.The singular terms are isolated from the highly nonlinear complicated system and then can be handled successfully.We establish a smooth local solution to the new system in a suitable weighted metric space and then express the solution in terms of the original variables.

Adaptive Window Based 3-D Feature Selection for Multispectral Image Classification Using Firefly Algorithm

Feature extraction is the most critical step in classification of multispectral image.The classification accuracy is mainly influenced by the feature sets that are selected to classify the image.In the past,handcrafted feature sets are used which are not adaptive for different image domains.To overcome this,an evolu-tionary learning method is developed to automatically learn the spatial-spectral features for classification.A modified Firefly Algorithm(FA)which achieves maximum classification accuracy with reduced size of feature set is proposed to gain the interest of feature selection for this purpose.For extracting the most effi-cient features from the data set,we have used 3-D discrete wavelet transform which decompose the multispectral image in all three dimensions.For selecting spatial and spectral features we have studied three different approaches namely overlapping window(OW-3DFS),non-overlapping window(NW-3DFS)adaptive window cube(AW-3DFS)and Pixel based technique.Fivefold Multiclass Support Vector Machine(MSVM)is used for classification purpose.Experiments con-ducted on Madurai LISS IV multispectral image exploited that the adaptive win-dow approach is used to increase the classification accuracy.

A"messenger zone hypothesis"based on the visual three-dimensional spatial distribution of motoneurons innervating deep limb muscles

Coordinated contraction of skeletal muscles relies on selective connections between the muscles and multiple classes of the spinal motoneuro ns.Howeve r,current research on the spatial location of the spinal motoneurons innervating differe nt muscles is limited.In this study,we investigated the spatial distribution and relative position of different motoneurons that control the deep muscles of the mouse hindlimbs,which were innervated by the obturator nerve,femoral nerve,inferior gluteal nerve,deep pe roneal nerve,and tibial nerve.Locations were visualized by combining a multiplex retrograde tracking technique compatible with three-dimensional imaging of solvent-cleared o rgans(3DISCO)and 3-D imaging technology based on lightsheet fluorescence microscopy(LSFM).Additionally,we propose the hypothesis that"messenger zones"exist as interlaced areas between the motoneuron pools that dominate the synergistic or antagonist muscle groups.We hypothesize that these interlaced neurons may participate in muscle coordination as messenger neurons.Analysis revealed the precise mutual positional relationships among the many motoneurons that innervate different deep muscles of the mouse.Not only do these findings update and supplement our knowledge regarding the overall spatial layout of spinal motoneurons that control mouse limb muscles,but they also provide insights into the mechanisms through which muscle activity is coordinated and the architecture of motor circuits.

The Clinical Value of Ultrasound Image Texture Analysis in the Diagnosis of Uterine Adhesions

Purpose: This review examines the diagnostic value of transvaginal 3D ultrasound image texture analysis for the diagnosis of uterine adhesions. Materials and Methods: The total clinical data of 53 patients with uterine adhesions diagnosed by hysteroscopy and the imaging data of transvaginal three-dimensional ultrasound from the Second Affiliated Hospital of Chongqing Medical University from June 2022 to August 2023 were retrospectively analysed. Based on hysteroscopic surgical records, patients were divided into two independent groups: normal endometrium and uterine adhesion sites. The samples were divided into a training set and a test set, and the transvaginal 3D ultrasound was used to outline the region of interest (ROI) and extract texture features for normal endometrium and uterine adhesions based on hysteroscopic surgical recordings, the training set data were feature screened and modelled using lasso regression and cross-validation, and the diagnostic efficacy of the model was assessed by applying the subjects’ operating characteristic (ROC) curves. Results: For each group, 290 texture feature parameters were extracted and three higher values were screened out, and the area under the curve of the constructed ultrasonographic scoring model was 0.658 and 0.720 in the training and test sets, respectively. Conclusion Relative clinical value of transvaginal three-dimensional ultrasound image texture analysis for the diagnosis of uterine adhesions.

膈肌超声联合25(OH)D_(3)和NT-proBNP检测在老年COPD机械通气撤机结局中的预测价值

目的:探讨膈肌超声联合25-羟维生素D_(3)[25(OH)D_(3)]、N末端脑钠肽前体(NT-proBNP)检测在老年慢性阻塞性肺疾病(COPD)机械通气撤机结局中的预测价值。方法:选取2022年7月—2023年6月在温州医科大学附属衢州医院ICU行机械通气的128例COPD患者,首次开始自主呼吸测试(SBT)当天进行实验室检查,SBT时通过超声检查测量膈肌位移(De)、呼气末膈肌厚度(DTee)、膈肌增厚率(DTF),根据首次撤机结局分为撤机成功组97例和撤机失败组31例,比较两组临床资料、膈肌超声指标、25(OH)D_(3)、NT-proBNP水平,采用Logistic回归分析撤机结局的影响因素,采用受试者工作特征(ROC)曲线分析膈肌超声指标和实验室指标预测撤机结局的价值。结果:撤机失败组患者机械通气时间、急性生理与慢性健康(APACHeⅡ)评分、浅快呼吸指数(RSBI)、C反应蛋白(CRP)、NT-proBNP水平高于撤机成功组,De、DTee、DTF、25(OH)D_(3)低于撤机成功组,差异有统计学意义(P<0.05);机械通气时间、RSBI、APACHeⅡ评分、De、DTF、25(OH)D_(3)、NT-proBNP是影响机械通气撤机结局的主要因素,差异有统计学意义(P<0.05)。De、DTF、25(OH)D_(3)、NT-proBNP以及联合应用预测机械通气患者撤机结局的AUC为0.737、0.713、0.727、0.661、0.845,联合应用的AUC大于其他单一指标,差异有统计学意义(P<0.05)。结论:De、DTF、25(OH)D_(3)、NT-proBNP对COPD机械通气撤机结局有良好的预测价值,联合应用预测撤机结局更准确,可用于指导临床撤机。

The role of 3-dimensional ultrasound for the diagnosis of congenital uterine anomalies

Objectives: To demonstrate the value of 3-dimensional (3-D) ultrasound (US) in the diagnosis of congenital uterine anomalies. Methods: Fifty one infertile patients referred to our US unit during 12 years period, with suspected diagnosis of congenital uterine anomalies by previous HSG or 2D US examinations, were evaluated by transvaginal 3-D US. The 3-D US diagnoses were compared to the initial HSG diagnosis, and to hysteroscopic evaluation when performed. Results: 3-D scan confirmed the initial HSG diagnosis in 27 out of 51 (52.9%) women. The concordancy rates between the initial diagnosis by HSG and 3-D US results were 30.4% for bicornuate uterus;75% for arcuate uterus;83% for septate uterus;and 80% for unicornuate uterus. Of the 13 cases with normal HSG and suspicious 2-D US, 30.8% were found to be normal by 3D sonography. In cases where hysteroscopy was done, the results were 100% in concordance with the 3-D US evaluations. Conclusions: 3-D US is an accurate test for the assessment of uterine congenital anomalies. Its ability to concomitantly visualized, the external uterine contour with the uterine cavity on the same coronal plan, makes this noninvasive, easy to perform test the procedure of choice for the diagnosis of uterine anomalies.

新生儿感染性肺炎血清Gal-3、IL-17水平与肺超声评分关系及对继发呼吸窘迫综合征的预测价值

为探讨新生儿感染性肺炎(NIP)血清半乳糖凝集素-3(Gal-3)、白细胞介素-17(IL-17)水平与肺超声评分关系及对继发呼吸窘迫综合征(RDS)的预测价值,本研究选取NIP患儿98例作为研究组,根据是否继发RDS分为RDS患儿和无RDS患儿,选取同期健康新生儿98例作为对照组,均进行血清Gal-3、IL-17水平检测,研究组进行肺超声检查。结果显示研究组血清Gal-3、IL-17水平高于对照组,血清Gal-3、IL-17水平与肺超声评分呈负相关;Gal-3、IL-17是NIP继发RDS的独立危险因素,胎龄是NIP继发RDS的独立保护因素;血清Gal-3、IL-17水平联合预测NIP继发RDS的AUC值大于单一指标预测值,患者受益良好。由此可见,NIP患儿血清Gal-3、IL-17水平与肺超声评分关系密切,临床通过检测血清Gal-3、IL-17水平可评估NIP患儿继发RDS的风险。

孕妇血清信号转导和转录激活因子3、脂质运载蛋白2检测联合彩色多普勒超声预测胎儿窘迫的价值分析

目的 检测孕妇血清信号转导和转录激活因子3(signal transducer and activator of transcription 3,STAT3)、脂质运载蛋白2 (lipocalin-2,LCN2)水平,探讨孕妇血清STAT3、LCN2检测联合彩色多普勒超声对胎儿窘迫的预测价值。方法 选取2020年5月至2022年5月西北妇女儿童医院收治的疑似胎儿窘迫的181例孕妇作为研究对象,收集其基线资料,根据胎儿窘迫诊断标准分为窘迫组89例和非窘迫组92例。采用超声诊断仪检查胎儿大脑中动脉血流参数收缩末期峰值与舒张末期峰值的比值(umbilical artery end systolic peak/end diastolic peak,S/D)、搏动指数(pulsatility index,PI)、阻力指数(resistant index,RI),采用酶联免疫吸附法测定血清STAT3、LCN2水平;采用多因素Logistic回归分析检验彩色多普勒超声参数及血清STAT3、LCN2水平与胎儿窘迫的关系;绘制受试者操作特征(receiver operator characteristic,ROC)曲线检验彩色多普勒超声参数及血清STAT3、LCN2水平对胎儿窘迫的预测价值。结果窘迫组血清STAT3、LCN2水平及阿普加评分、S/D、PI、RI低于非窘迫组,差异有统计学意义(P<0.05)。彩色多普勒超声参数S/D、PI、RI及血清STAT3、LCN2均与胎儿窘迫相关(P<0.05)。S/D、PI、RI及血清STAT3、LCN2水平及五者联合预测胎儿窘迫的曲线下面积分别为0.798、0.770、0.771、0.861、0.774、0.956,95%CI分别为0.732~0.864、0.703~0.838、0.699~0.844、0.805~0.917、0.705~0.843、0.927~0.985。两组一般资料差异无统计学意义(P>0.05)。结论 孕妇血清STAT3、LCN2水平降低可能与胎儿窘迫发生有关,二者与彩色多普勒超声参数S/D、PI、RI联合可有效预测胎儿窘迫。

四维超声联合血清circHIPK3、circ0003416诊断胎儿先天性心脏病价值

目的:探索四维超声联合血清环状RNA同源域相互作用激酶3(circHIPK3)、环状RNA0003416(circ0003416)诊断胎儿先天性心脏病(CHD)价值。方法:收集2021年11月-2023年11月本院接诊的胎儿均疑似CHD孕妇324例临床资料,以产后随访或引产病理解剖结果为金标准,分为CHD组(43例)、非CHD的对照组(281例)。收集两组一般资料,采用实时荧光定量PCR法检测血清circHIPK3、circ0003416水平;记录四维超声检测结果,Kappa行一致性检验;受试者工作特征(ROC)曲线分析四维超声联合血清circHIPK3、circ0003416对CHD的诊断价值。结果:CHD组血清circHIPK3(1.41±0.18)高于对照组(1.19±0.13),血清circ0003416(0.82±0.11)低于对照组(1.03±0.14)(均P<0.05);四维超声诊断CHD与最终确诊结果的一致性较好(Kappa=0.809,P<0.001);四维超声、血清circHIPK3、circ0003416诊断CHD的曲线下面积(AUC)均较高,但联合诊断AUC(0.976)及敏感度(97.7%)最高(P<0.001)。结论:CHD母体血清circHIPK3升高、血清circ0003416水平降低,四维超声联合血清circHIPK3、circ0003416水平对CHD的诊断价值较高,可为CHD临床筛查提供参考。