Endoscopic ultrasonography-related diagnostic accuracy and clinical significance on small rectal neuroendocrine neoplasms

This research aimed to examine the diagnostic accuracy and clinical significance of endoscopic ultrasonography(EUS)in the context of small rectal neuroendocrine neoplasms(NENs).A total of 108 patients with rectal subepithelial lesions(SELs)with a diameter of<20 mm were included in the analysis.The diagnosis and depth assessment of EUS was compared to the histology findings.The prevalence of NENs in rectal SELs was 78.7%(85/108).The sensitivity of EUS in detecting rectal NENs was 98.9%(84/85),while the specificity was 52.2%(12/23).Overall,the diagnostic accuracy of EUS in identifying rectal NENs was 88.9%(96/108).The overall accuracy rate for EUS in assessing the depth of invasion in rectal NENs was 92.9%(78/84).Therefore,EUS demonstrates reasonable diagnostic accuracy in detecting small rectal NENs,with good sensitivity but inferior specificity.EUS may also assist physicians in assessing the depth of invasion in small rectal NENs before endoscopic excision.

Double contrast-enhanced ultrasonography improves diagnostic accuracy of T staging compared with multi-detector computed tomography in gastric cancer patients

BACKGROUND Gastric cancer(GC)is the most common malignant tumor and ranks third for cancer-related deaths among the worldwide.The disease poses a serious public health problem in China,ranking fifth for incidence and third for mortality.Knowledge of the invasive depth of the tumor is vital to treatment decisions.AIM To evaluate the diagnostic performance of double contrast-enhanced ultrasonography(DCEUS)for preoperative T staging in patients with GC by comparing with multi-detector computed tomography(MDCT).METHODS This single prospective study enrolled patients with GC confirmed by preoperative gastroscopy from July 2021 to March 2023.Patients underwent DCEUS,including ultrasonography(US)and intravenous contrast-enhanced ultrasonography(CEUS),and MDCT examinations for the assessment of preoperative T staging.Features of GC were identified on DCEUS and criteria developed to evaluate T staging according to the 8th edition of AJCC cancer staging manual.The diagnostic performance of DCEUS was evaluated by comparing it with that of MDCT and surgical-pathological findings were considered as the gold standard.RESULTS A total of 229 patients with GC(80 T1,33 T2,59 T3 and 57 T4)were included.Overall accuracies were 86.9%for DCEUS and 61.1%for MDCT(P<0.001).DCEUS was superior to MDCT for T1(92.5%vs 70.0%,P<0.001),T2(72.7%vs 51.5%,P=0.041),T3(86.4%vs 45.8%,P<0.001)and T4(87.7%vs 70.2%,P=0.022)staging of GC.CONCLUSION DCEUS improved the diagnostic accuracy of preoperative T staging in patients with GC compared with MDCT,and constitutes a promising imaging modality for preoperative evaluation of GC to aid individualized treatment decision-making.

Interferon-gamma regulates the progression of neuroblastoma cells through interferon-regulatory factor-1

Objective:This study aimed to elucidate the influence of IFN-gamma(IFN-γ)in neuroblastoma(NB)cells and reveal its potential underlying molecular mechanism.Methods:The Cell Counting Kit-8,Transwell apparatus,and flow cytometry were employed to assess cellular viability,migratory capacity,invasive potential,and apoptotic rates,respectively.RNA-seq combined with bioinformatics analysis revealed differentially expressed genes(DEGs)and their possible biological functions.Protein levels were determined by western blot analysis.Results:IFN-γtreatment resulted in diminished cell viability,mitigated migratory and invasive capabilities,and augmented apoptotic activity in the SK-N-BE(2)cell line,whereas it exhibited the opposite effect in SH-SY5Y cells.Furthermore,interferon regulatory factor 1(IRF-1)was the common DEG in both IFN-γ-treated SK-N-BE(2)and SH-SY5Y cells.Additionally,we found that it was underexpressed in NB tissues.The depletion of IRF-1 promoted the progression of both SK-N-BE(2)and SH-SY5Y cells.Moreover,IRF-1 knockdown effectively counteracted the effects of IFN-γon SK-N-BE(2)cells,while exacerbating them in SH-SY5Y cells.Conclusion:This study verified that IFN-γexerted a distinct role in both N-Myc-and non-N-Myc-amplified NB cells,partially by mediating the expression of IRF-1,suggesting that it may serve as a potent agent for treating patients with NB.

Intraoperative cholangio-ultrasonography(IOCUS)during hepatectomy with resection of the biliary confluence:An effective alternative to intraoperative cholangiography

Intraoperative ultrasonography(IOUS)in hepatobiliary surgery is well known as an essential tool for radical and safe hepatectomies,allowing to perform parenchymal sparing surgery and,as consequence,to expand the surgical indications for patients otherwise considered unresectable.Nevertheless,since many years,despite its effectiveness in the study of vascular anatomy of the liver,the gold standard for the assessment of biliary anatomy during surgery is intraoperative cholangiography(IOC),which is used for the validation of preoperative imaging as well as for guiding reconstruction in case of bile duct injury or resection.

Relationship between neonatal respiratory distress syndrome pulmonary ultrasonography and respiratory distress score,oxygenation index,and chest radiography grading

BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a less harmful method for assessing the health of neonates with RDS is needed.AIM To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS severity.METHODS This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December 2022.The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were collected.Spearman correlation analysis was performed to determine the relationships among these values and neonatal RDS severity.RESULTS The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(P<0.05).Spearman correlation analysis showed that before and after treatment,the pulmonary ultrasonography score of neonates with RDS was positively correlated with the respiratory distress score,oxygenation index,and chest X-ray grade(ρ=0.429–0.859,P<0.05).Receiver operating characteristic curve analysis indicated that pulmonary ultrasonography screening effectively predicted the severity of neonatal RDS(area under the curve=0.805–1.000,P<0.05).CONCLUSION The pulmonary ultrasonography score was significantly associated with the neonatal RDS score,oxygenation index,and chest X-ray grade.The pulmonary ultrasonography score was an effective predictor of neonatal RDS severity.

Beta-HCG Levels and Ovarian Ultrasonography Results among Non-Pregnant Women of Reproductive Age in Port Harcourt, Nigeria: A Cross-Sectional Study

Background: Certain ovarian cancers that were previously common in postmenopausal women are now increasingly observed in women of reproductive age. The research on using β-HCG as a diagnostic biomarker for ovarian cancer in women of reproductive age is ongoing. Aim: This study assessed the level of serum β-HCG in non-pregnant women of reproductive age and determined its potential association with suspicious ovarian ultrasonography results. Methods: The study was conducted in Port Harcourt, Nigeria. This study adopted a cross-sectional design on a quota sample of 224 case notes of women aged 18 - 40 years obtained from eight diagnostic centres. A data extraction form was used for data collection. Data analysis employed descriptive statistics, Chi-square, Fisher’s exact test, and Odds Ratio at 95% confidence and 5% significance levels. Results: About 5.8% of the participants exhibited detectable levels of serum β-HCG above 5 IU/L (World Health Organization reference) at a mean concentration of 5.87 (±1.75) IU/L. About 4.0% of the participants had suspicious ovarian lesions identified through ultrasonography. Participants with elevated serum β-HCG levels above the WHO reference were 59 times more likely to have suspicious ovarian lesions (Odds ratio: 59.4, 95%CI: 12.3 - 287.8, p β-HCG level and age (p = 0.041) as well as parity (p Conclusion: Serum β-HCG levels above the WHO reference in non-pregnant women were associated with suspicious ovarian lesions. More rigorous primary research, systematic reviews, and meta-analyses are needed to confirm the findings of this study.

Perioperative and long-term results of ultrasonography-guided single-and multiple-tract percutaneous nephrolithotomy for staghorn calculi

BACKGROUND It is possible that this condition will lead to urosepsis and progressive deterioration of renal function in the absence of surgical intervention.Several recent clinical studies have shown that multi-tract percutaneous nephrolithotomy(MPCNL)has a similar stone free rate(SFR)as standard percutaneous nephrolithotomy(S-PCNL).As a result,M-PCNL was also recommended as a treatment option for staghorn calculi.AIM To examine the perioperative and long-term results of ultrasonography-guided single-and M-PCNL.METHODS This was a retrospective cohort study.Between March 2021 and January 2022,the urology department of our hospital selected patients for the treatment of staghorn calculi using percutaneous nephrolithotomy.The primary outcomes were com plication rate and SFR,and the characteristics of patients,operative parameters,laboratory measurements were also collected.RESULTS In total,345 patients were enrolled in the study(186 in the S-PCNL group and 159 in the M-PCNL group).The SFR in the M-PCNL group was significantly higher than that in the S-PCNL group(P=0.033).Moreover,the incidence rates of hydrothorax(P=0.03)and postoperative infection(P=0.012)were higher in the M-PCNL group than in the S-PCNL group.Logistic regression analysis demonstrated that post-operative white blood cell count(OR=2.57,95%CI:1.90-3.47,P<0.001)and stone size(OR=1.59,95%CI:1.27-2.00,P<0.001)were associated with a higher overall complication rate in the S-PCNL group.Body mass index(OR=1.22,95%CI:1.06-1.40,P=0.004)and stone size(OR=1.70,95%CI:1.35-2.15,P<0.001)were associated with increased overall complications in the M-PCNL group.CONCLUSION Multiple access tracts can facilitate higher SFR while slightly increasing the incidence of acceptable complications.

Correlation of dynamic contrast-enhanced ultrasonography and the Ki-67 labelling index in pancreatic ductal adenocarcinoma

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant and aggressive tumor,and high Ki-67 expression indicates poor histological differentiation and prognosis.Therefore,one of the challenges in diagnosing preoperatively patients with PDAC is predicting the degree of malignancy.Dynamic contrast-enhanced ultrasonography(DCE-US)plays a crucial role in abdominal tumor diagnosis,and can adequately show the microvascular composition within the tumors.However,the relationship between DCE-US and the Ki-67 labelling index remains unclear at the present time.AIM To predict the correlation between Ki-67 expression and the parameters of DCEUS.METHODS Patients with PDAC who underwent DCE-US were retrospectively analyzed.Patients who had received any treatment(radiotherapy or chemotherapy)prior to DCE-US;had incomplete clinical,imaging,or pathologic information;and had poor-quality image analysis were excluded.Correlations between Ki-67 expression and the parameters of DCE-US in patients with PDAC were assessed using Spearman’s rank correlation analysis.The diagnostic performances of these parameters in high Ki-67 expression group were evaluated according to receiver operating characteristic curve.RESULTS Based on the Ki-67 labelling index,30 patients were divided into two groups,i.e.,the high expression group and the low expression group.Among the relative quantitative parameters between the two groups,relative half-decrease time(rHDT),relative peak enhancement,relative wash-in perfusion index and relative wash-in rate were significantly different between two groups(P=0.018,P=0.025,P=0.028,P=0.035,respectively).The DCE-US parameter rHDT was moderately correlated with Ki-67 expression,and rHDT≥1.07 was more helpful in accurately diagnosing high Ki-67 expression,exhibiting a sensitivity and specificity of 53.8%and 94.1%,respectively.CONCLUSION One parameter of DCE-US,rHDT,correlates with high Ki-67 expression.It demonstrates that parameters obtained noninvasively by DCE-US could better predict Ki-67 expression in PDAC preoperatively.

Clinical value of oral contrast-enhanced ultrasonography in diagnosis of gastric tumors

BACKGROUND The incidence of gastric cancer remains high,and it is the sixth most common cancer and the fourth leading cause of cancer deaths worldwide.Oral contrastenhanced ultrasonography is a simple,non-invasive,and painless method for the diagnosis of gastric tumors.AIM To explore the diagnostic value of oral contrast-enhanced ultrasonography for the detection of gastric tumors.METHODS The screening results based on oral contrast-enhanced ultrasonography and electronic gastroscopy were compared with those of the postoperative pathological examination.RESULTS Among 42 patients with gastric tumors enrolled in the study,the diagnostic accordance rate was 95.2%for oral contrast-enhanced ultrasonography(n=40)and 90.5%for electronic gastroscopy(n=38)compared with postoperative pathological examination.The Kappa value of consistency test with pathological findings was 0.812 for oral contrast-enhanced ultrasonography and 0.718 for electronic gastroscopy,and there was no significant difference between them(P=0.397).For the TNM staging of gastric tumors,the accuracy rate of oral contrast enhanced ultrasonography was 81.9%for the overall T staging and 50%,77.8%,100%,and 100%for T1,T2,T3,and T4 staging,respectively.The sensitivity and specificity were both 100%for stages T3 and T4.The diagnostic accuracy rate of oral contrast-enhanced ultrasonography was 93.8%,80%,100%,and 100%for stages N0,N1-N3,M0,and M1,respectively.CONCLUSION The accordance rate of qualitative diagnosis by oral contrast-enhanced ultrasonography is comparable to that of gastroscopy,and it could be used as the preferred method for the early screening of gastric tumors.

Dynamic ultrasonography for optimizing treatment position in superior mesenteric artery syndrome:Two case reports and review of literature

BACKGROUND Superior mesenteric artery(SMA)syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta(SMA-Ao).Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome,individual variations in the optimal patient position have been noted.In this report,we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each patient.CASE SUMMARY Case 1:A 90-year-old man with nausea and vomiting.Following diagnosis of SMA syndrome by computed tomography(CT),ultrasonography(US)revealed the SMA-Ao distance in the supine position(4 mm),which slightly improved in the lateral position(5.7–7.0 mm)without the passage of duodenal contents.However,in the sitting position,the SMA-Ao distance was increased to 15 mm accompanied by improved content passage.Additionally,US indicated enhanced passage upon abdominal massage on the right side.By day 2,the patient could eat comfortably with the optimal position and massage.Case 2:An 87-year-old woman with vomiting.After the diagnosis of SMA syndrome and aspiration pneumonia by CT,dynamic US confirmed the optimal position(SMA-Ao distance was improved to 7 mm in forward-bent position,whereas it remained at 5 mm in the supine position).By day 7 when her pneumonia recovered,she could eat with the optimal position.CONCLUSION The optimal position for SMA syndrome varies among individuals.Dynamic US appears to be a valuable tool in improving patient outcomes.

Point of care ultrasonography as the new“Laennec Sthetoscope”

Point of care ultrasonography(POCUS)has evolved to become the fifth pillar of the conventional physical examination,and use of POCUS protocols have significantly decreased procedure complications and time to diagnose.However,lack of experience in POCUS by preceptors in medical schools and nephrology residency programs are significant barriers to implement a broader use.In rural and low-income areas POCUS may have a transformative effect on health care management.

Point-of-care ultrasonography spotlight:Could venous excess ultrasound serve as a shared language for internists and intensivists?

Point-of-care ultrasonography(POCUS),particularly venous excess ultrasound(VExUS)is emerging as a valuable bedside tool to gain real-time hemodynamic insights.This modality,derived from hepatic vein,portal vein,and intrarenal vessel Doppler patterns,offers a scoring system for dynamic venous congestion assessment.Such an assessment can be crucial in effective management of patients with heart failure exacerbation.It facilitates diagnosis,quantification of congestion,prognostication,and monitoring the efficacy of decongestive therapy.As such,it can effectively help to manage cardiorenal syndromes in various clinical settings.Extended or eVExUS explores additional veins,potentially broadening its applications.While VExUS demonstrates promising outcomes,challenges persist,particularly in cases involving renal and liver parenchymal disease,arrhythmias,and situations of pressure and volume overload overlap.Proficiency in utilizing spectral Doppler is pivotal for clinicians to effectively employ this tool.Hence,the integration of POCUS,especially advanced applications like VExUS,into routine clinical practice necessitates enhanced training across medical specialties.

Sound waves and solutions:Point-of-care ultrasonography for acute kidney injury in cirrhosis

This article delves into the intricate challenges of acute kidney injury(AKI)in cirrhosis,a condition fraught with high morbidity and mortality.The complexities arise from distinguishing between various causes of AKI,particularly hemodynamic AKI,in cirrhotic patients,who experience hemodynamic changes due to portal hypertension.The term"hepatocardiorenal syndrome"is introduced to encapsulate the intricate interplay among the liver,heart,and kidneys.The narrative emphasizes the often-overlooked aspect of cardiac function in AKI assessments in cirrhosis,unveiling the prevalence of cirrhotic cardiomyopathy marked by impaired diastolic function.The conventional empiric approach involving volume expansion and vasopressors for hepatorenal syndrome is critically analyzed,highlighting potential risks and variable patient responses.We advocate for a nuanced algorithm for AKI evaluation in cirrhosis,prominently featuring point-of-care ultrasonography(POCUS).POCUS applications encompass assessing fluid tolerance,detecting venous congestion,and evaluating cardiac function.

Comprehensive review on the diagnostic strategies for esophageal tuberculosis:the role of endoscopic ultrasonography

Esophageal tuberculosis(ET)is a relatively rare clinical condition,characterized by often atypical clinical features.The lack of specificity in diagnostic methods,such as esophagogastroduodenoscopy and various imaging techniques,frequently leads to misdiagnosis and inappropriate treatments.Compared to esophagogastroduodenoscopy,endoscopic ultrasonography(EUS)offers a more comprehensive examination of esophageal tuberculosis lesions,including the extent of wall layer involvement and the internal structure characteristics of the lesions.Furthermore,when necessary,endoscopic ultrasonography-guided fine-needle aspiration can be employed to acquire deeper pathological tissue,significantly aiding diagnosis.When combined with the patient’s clinical presentation,endoscopic findings,and pathological features,EUS plays a crucial role in the definitive diagnosis of ET and in the differential diagnosis process.This article meticulously reviews both national and international literature to summarize the relevant features of ET,with a focus on its appearance under EUS,and to highlight the clinical value of EUS in enhancing the diagnosis of ET and in distinguishing it from other conditions.The aim is to offer guidance for the accurate diagnosis of ET.

腹腔妊娠超声表现

目的观察腹腔妊娠超声表现。方法回顾性分析18例经手术及病理证实的腹腔妊娠的孕妇超声及临床资料。结果孕早期15例,术前超声均未能诊断腹腔妊娠,但宫腔内未见明显孕囊回声而于盆腔内见包块,位于附件区8例、子宫前方2例、子宫后方2例,附件区及子宫前方1例、宫颈后方1例、紧邻宫壁1例,周围均未见明显输卵管回声。孕中期2例,分别于孕13+6周、21周经超声诊断腹腔妊娠,孕囊分别位于子宫左侧及子宫后方;孕晚期1例,于孕35+4周经超声诊断腹腔妊娠,孕囊位于子宫右侧;上述3例超声均表现为孕囊位于子宫外侧,孕囊周边未见子宫肌层包裹,宫腔内无胎盘种植,胎儿周边均见积液回声。腹腔妊娠术前超声诊断率16.67%(3/18)。结论孕早期发现异位妊娠包块较大,或孕囊位于宫颈旁、子宫前后方及宫壁,且包块周边未见输卵管样回声时,应考虑腹腔妊娠可能。孕中晚期腹腔妊娠超声表现为孕囊位于子宫外侧,孕囊周边无子宫肌层包裹,宫腔内无胎盘种植,以及胎儿周边见积液回声;经腹联合经阴道超声有助于提高腹腔妊娠诊断率。

Schroth疗法联合核心力量训练改善轻度青少年特发性脊柱侧凸患者的侧凸角度

背景:青少年特发性脊柱侧凸明确的发病原因尚未可知,寻找解决青少年特发性脊柱侧凸的临床方法迫在眉睫。目的:探讨Schroth疗法联合核心力量训练对轻度青少年特发性脊柱侧凸的效果,为轻度青少年特发性脊柱侧凸的临床治疗提供更多依据。方法:选择2022年7月至2024年1月在南通大学附属医院康复医学科与脊柱外科就诊的轻度青少年特发性脊柱侧凸患者110例作为研究对象,根据患者及家长意愿,分为试验组和对照组,每组55例。对照组观察随访,试验组进行Schroth疗法联合核心力量训练,每天45 min,坚持24周。比较两组患者治疗前后影像学参数、体表指标、三维超声成像角度和生活质量的差异。结果与结论:①治疗24周后,试验组主弯Cobb角、顶椎偏距、颈椎前凸角均较治疗前有显著改善(P<0.05),而对照组无显著差异(P>0.05);试验组主弯Cobb角、顶椎偏距明显优于对照组(P<0.05);②治疗24周后,试验组躯干旋转角度明显低于治疗前(P<0.05),而对照组无显著差异(P>0.05);试验组躯干旋转角度明显低于对照组(P<0.05);③治疗24周后,试验组三维超声成像椎板中心法角度明显减小(P<0.05),而对照组无显著差异(P>0.05);试验组三维超声成像椎板中心法角度明显低于对照组(P<0.05);④治疗24周后,在生活质量上,试验组的疼痛维度评分显著增高(P<0.05),试验组和对照组的自我形象维度评分均较治疗前显著增高(P<0.05),两组的心理健康维度评分较治疗前显著降低(P<0.05);疼痛、自我形象、心理健康和满意度维度评分,试验组均明显高于对照组(P<0.05);⑤提示Schroth疗法联合核心力量训练能改善轻度青少年特发性脊柱侧凸患者的主弯Cobb角、顶椎偏距、颈椎前凸角,降低躯干旋转角度,减少三维超声成像角度,提高生活质量,对轻度青少年特发性脊柱侧凸治疗有效。

高频超声联合剪切波弹性成像评估寻常痤疮的临床价值

目的探讨高频超声联合剪切波弹性成像(SWE)评估寻常痤疮的临床价值。方法收集于我院就诊的寻常痤疮患者86例,按临床严重程度分级分为Ⅰ级组(20例)、Ⅱ级组(26例)、Ⅲ级组(20例)、Ⅳ级组(20例)。均行高频超声和SWE检查,比较各组痤疮的形态学特征(边界、形态、内部回声、后方回声、侵犯皮肤长度及深度等)、血流分级及弹性模量平均值;分析痤疮的超声图像特征与临床严重程度分级的相关性。结果Ⅰ级组痤疮均表现为边界不清晰、形态不规则、后方回声未见增强,60%(12/20)表现为毛囊增宽,40%(8/20)表现为真皮层内低回声区;Ⅱ级组痤疮均表现边界不清晰、形态不规则、后方回声未见增强、真皮层内低回声区,11%(3/26)可见点状钙化;Ⅲ级组痤疮均表现为边界不清晰、形态不规则、后方回声未见增强、真皮层内低回声区,30%(6/20)可见点状钙化;Ⅳ级组痤疮均表现边界清晰、形态规则、后方回声增强、真皮层及皮下组织低回声区,80%(16/20)可见点状钙化,20%(4/20)出现窦道。各组痤疮侵犯皮肤长度及深度比较差异均有统计学意义(均P<0.001);Ⅰ级组与Ⅱ级组、Ⅲ级组、Ⅳ级组血流分级比较差异均有统计学意义(均P<0.05),其余各组血流分级两两比较差异均无统计学意义;各组痤疮弹性模量平均值比较差异有统计学意义(P<0.05),且Ⅳ级组痤疮弹性模量平均值低于其余各组,差异均有统计学意义(均P<0.05)。相关性分析显示,痤疮内钙化、侵犯皮肤长度及深度、血流分级与临床严重程度分级均呈正相关(r=0.562、0.953、0.956、0.688,均P<0.001)。结论高频超声联合SWE可以评估不同临床严重程度分级的痤疮形态学特征、血流及硬度情况,有一定的临床价值。

超声测量的视力残疾职校生腹部脂肪含量与血脂异常的关系研究

目的:调查视力残疾职校生血脂健康状态,探讨人体测量指标(BMI和腰围)和超声评估指标(肝肾回声比值、皮下脂肪厚度及内脏脂肪厚度)与血脂异常的关系。方法:纳入66例视力残疾职校生,分析人体测量指标、超声脂肪评估指标与血脂之间的相关性;比较人体测量指标和超声评估指标在血脂异常和正常学生间的差异。结果:66例中,血脂异常检出率27.3%(18/66)。人体测量指标及超声评估指标均与血脂有较好的相关性(r=0.35~0.64,均P<0.05)。血脂异常学生的年龄、BMI、脂肪肝比例、腰围、肝肾回声比值、皮下及内脏脂肪厚度均高于血脂正常学生,且视力残疾程度更严重(均P<0.05)。肝肾回声比值(OR=46.6,P=0.01)和年龄(OR=1.3,P=0.02)是血脂异常的危险因素,两者联合诊断血脂异常的AUC为0.88(95%CI0.74~0.96),敏感度和特异度分别为100.0%和68.9%。肝肾回声比值联合年龄预测血脂异常的AUC显著高于单独使用腰围、BMI、内脏脂肪厚度及皮下脂肪厚度(Z=2.45~4.13,均P<0.05)。结论:该校视力残疾学生血脂异常检出率较高,超声评估指标及人体测量指标与血脂密切相关,且年龄联合肝肾回声比值能更好地预测血脂异常。

1例胎儿腹膜后神经母细胞瘤影像学表现

孕妇27岁,孕1产0,孕39周产前超声提示胎儿腹膜后占位;无特殊病史及家族史。产前超声:胎儿右肾与右肾上腺间近脊柱处见45 mm×29 mm×25 mm偏强回声团(图1A),边界尚清,形态规则,内部回声欠均匀;CDFI示其内边缘为主的血流信号(图1B)。产前MRI:胎儿右肾近脊柱前缘处哑铃状异常信号,边界清,局部呈尖端指向椎间孔的锐角,T1WI及T2WI均呈等信号(图1C),弥散加权成像(diffusion weighted imaging,DWI)呈高信号,表观弥散系数(apparent diffusion coefficient,ADC)图信号降低;考虑腹膜后来源,神经源性肿瘤可能。

达妥昔单抗β治疗儿童神经母细胞瘤安全性分析

目的探讨本中心达妥昔单抗β治疗神经母细胞瘤患儿的临床反应及安全性。方法回顾性分析13例2022年以来接受达妥昔单抗β免疫治疗的儿童神经母细胞瘤患儿,总结并分析治疗中出现的不良反应,评估治疗过程的安全性及患儿的耐受性。结果达妥昔单抗β治疗过程中主要有发热、疼痛、胃肠道反应(腹泻/恶心/呕吐)、毛细血管渗漏综合征、眼毒性、支气管痉挛、皮疹、血液学毒性及感染等不良反应,基本都是3级及以下的不良反应,通过一些常见药物的对症治疗或调整达妥昔单抗β的输注速度后均能得到有效的缓解,安全性较高;患者随着治疗周期推进,各种不良反应发生率下降,对治疗的耐受性较好。结论应用达妥昔单抗β治疗儿童神经母细胞瘤具有良好的安全性和耐受性,随着治疗周期的增加,不良反应逐步减少甚至消失。