The Prenatal Ultrasound Diagnosis and Perinatal Outcome of Polydactyly: A Retrospective Cohort Study, 2016-2023.

OBJECTIVE: To determine the significance of polydactyly identified on prenatal ultrasonography and provide a detailed analysis of characteristics and perinatal outcomes of fetal polydactyly. METHODS: This is a retrospective cohort study of pregnancies with a postnatal diagnosis of fetal polydactyly between January 2016 and December 2023. The population was divided into 2 groups at postnatal diagnosis: the isolated polydactyly group and the nonisolated polydactyly group. Clinical data, prenatal ultrasonography, related genetic results, and postnatal outcomes were obtained. RESULTS: Our study cohort comprised 328 fetuses with polydactyly. The overall detection rate of polydactyly by prenatal ultrasound was 19.2%, and the first detection rate in the first-, second-, and third-trimester were 0.9%, 14.6%, and 3.7%, respectively. Preaxial polydactyly (PPD) of hand was the most common type and the most common type of foot polydactyly was postaxial polydactyly (PAP) both in the isolated group and in the nonisolated group; the central polydactyly is rare. Syndactyly was the most common abnormality complicated with polydactyly. Between the nonpolydactyly group, the isolatedpolydactyly group and the nonisolated polydactyly group, there was a significant difference in perinatal outcome (P < .001). CONCLUSION: The second trimester is the best gestational age for prenatal ultrasound detection of polydactyly. Polydactyly of hand was more likely PPD, while polydactyly of foot was more likely PAP. When polydactyly is detected by routine prenatal ultrasound, detailed ultrasound examination and prenatal counseling should be performed to determine the possibility of an underlying genetic syndrome.

[Pollution Characteristics and Source Apportionment of Heavy Metals in Topsoil of Counties Along the Shandong Section of the Yellow River].

The 25 counties along the Shandong section of the Yellow River are the core areas for promoting the ecological protection and high-quality development of the Yellow River in Shandong Province. Moreover, it is of great significance to study the current situation, sources, and potential risks of heavy metal pollution in the topsoil in this region. In this study, 103 soil samples were collected from the 25 counties along the Shandong section of the Yellow River, and the contents of eight heavy metals （As, Cu, Pb, Cr, Zn, Ni, Cd, and Hg） were determined. The pollution characteristics of heavy metals were analyzed and evaluated using the geological accumulation index and potential ecological risk index. Correlation analysis and the positive matrix factorization （PMF） model were used to analyze the sources of heavy metals. The results showed that the average contents of Cu and Cr were lower than that of the background values of soils, whereas the average contents of As, Pb, Zn, Ni, Cd, and Hg were 1.16, 1.42, 1.05, 1.14, 2.29, and 1.85 times higher than that of the background values, respectively, and the average contents of all eight elements were lower than the screening value of soil pollution risk in agricultural land. In terms of different heavy metal variations, the coefficient of variation （CV） of Cu and Cd was higher than 0.500, indicating high variations, whereas As, Pb, Cr, Zn, Ni, and Hg showed moderate variation. Cd and Hg were slightly polluted, whereas the other six elements were not polluted. Cd and Hg had a moderate potential ecological risk level, whereas the other six elements were at a low level. Correlation analysis and PMF model showed that the sources of heavy metals in the study area were influenced by four factors, i.e., agricultural activities, natural sources, industrial emissions, and atmospheric dust from coal combustion and vehicle exhaust emissions, and the relative contribution rates were 32.4%, 34.9%, 16.5%, and 16.2%, respectively.

The upper airway parameters: the potential diagnostic clues for congenital intrathoracic lesions.

BACKGROUND: The diagnosis of congenital intrathoracic lesions still has limitations. The airway development was influenced by intrathoracic factors. Whether the diagnostic value of the upper airway parameters in congenital intrathoracic lesions has not been confirmed. OBJECTIVES: We aimed to compare fetal upper airway parameters between normal fetuses and fetuses with intrathoracic lesions, and we tried to verify its diagnostic value in intrathoracic lesions. METHODS: This was an observational case-control study. In the control group, 77 women were screened at 20-24 weeks' gestational age, 23 were screened at 24-28 weeks' gestational age, and 27 were screened at 28-34 weeks' gestational age. In the case group, 41 cases were enrolled (6 cases of intrathoracic bronchopulmonary sequestration, 22 of congenital pulmonary airway malformations, and 13 of congenital diaphragmatic hernia). Fetal upper airway parameters (tracheal width, the narrowest lumen width, and width of the subglottic cavity and laryngeal vestibule) were measured using ultrasound equipment. The correlations between fetal upper airway parameters and gestational age, and the differences in fetal upper airway parameters between cases and controls, were analyzed. The standardized airway paraments were acquired, and their potential diagnostic value for congenital intrathoracic lesions were analyzed. RESULTS: The fetal upper airway parameters of both groups were positively correlated with the gestational age: The control group, tracheal width (R2 = 0.569, p < 0.001), narrowest lumen width (R2 = 0.429, p < 0.001), subglottic cavity width (R2 = 0.551, p < 0.001), laryngeal vestibule width (R2 = 0.349, p < 0.001). The case group (tracheal width R2 = 0.474, p < 0.001) narrowest lumen width (R2 = 0.425, p < 0.001), subglottic cavity width (R2 = 0.623, p < 0.001), laryngeal vestibule width (R2 = 0.347, p < 0.001). Fetal upper airway parameters of the cases group were smaller than those of the controls group. The tracheal width in fetuses with congenital diaphragmatic hernia was the smallest among the other case groups studied. The standardized tracheal width has the best diagnostic value for congenital intrathoracic lesions in the standardized airway paraments (the area under the ROC curve was 0.894), and has a high diagnostic value for congenital pulmonary airway malformations and congenital diaphragmatic hernia (the area under the ROC curve was 0.911 and 0.992, respectively). CONCLUSION: Fetal upper airway parameters differ between normal fetuses and fetuses with intrathoracic lesions, and might offer potential diagnostic clues for congenital intrathoracic lesions.

The grading of stomach position for postnatal outcomes in isolated left-sided congenital diaphragmatic hernia: A systematic review and meta-analysis.

OBJECTIVES: To evaluate the correlation between stomach position (SP) grading and postnatal outcomes in fetuses with isolated left-sided congenital diaphragmatic hernias (CDHs). METHODS: A literature search was conducted using the PubMed, Embase, and Cochrane Library databases. The corresponding 95% confidence intervals (CIs) were used to assess the differences in the odds of mortality according to the SP graded as level 0 to level 3. To evaluate the reliability of our results, a sensitivity analysis was also conducted. RESULTS: Nine papers with a total of 542 fetuses with isolated left-sided CDH were included. Congenital diaphragmatic hernia pregnancies complicated by an intrathoracic stomach had higher odds of neonatal mortality when compared with intraabdominal stomach (odds ratio [OR] 2.86; 95% CI 1.38-5.94). Four papers with SP grading from level 0 to level 3 were included in a subgroup analysis. Stomach position at level 1 and level 2 had lower odds of neonatal mortality when separately compared to level 3 (OR 0.12; 95% CI 0.04-0.33) and (OR 0.30; 95% CI 0.16-0.54). Stomach position at level 1 had lower odds of neonatal mortality when compared with level 2 + 3 (OR 0.25; 95% CI 0.09-0.66). CONCLUSION: Survival of fetuses with isolated left-sided CDH is correlated with the SP.

Ovary-derived Decellularized Extracellular Matrix-based Bioink for Fabricating 3D Primary Ovarian Cells-laden Structures for Mouse Ovarian Failure Correction.

Fertility preservation is becoming a clinical duty in practice. Three-dimensional (3D) bioprinting technology is potentially realize ovarian morphological repair and reproductive endocrine function rebuild. There is no published work on 3D bioprinting ovary using a decellularized extracellular matrix (dECM)-based bioink, though dECM is the preferred matrix choice for an artificial ovary. The study aimed to explore swine ovarian dECM-based bioink to fabricate 3D primary ovarian cells (POCs)-laden structures for mouse ovarian failure correction. In this study, the ovarian dECM was converted to dECM-based bioink by dECM solution mixed with a seaweed gelatin blend solution of bioink that was characterized using scanning electron microscopy, circular dichroism, rheology, hematoxylin and eosin staining, and immunohistochemistry. The 3D scaffolds were, then, printed with or without POCs by the extrusion 3D bioprinter. The laden POCs viability was detected with the live/dead assay kit. A female castrated mouse model was established, and the mice were treated with five different methods. The results revealed that the 3D scaffold encapsulating POCs group had more positive signals in neoangiogenesis, cell proliferation and survival than the 3D scaffold group, and ensured sex hormone secretion. Meanwhile, the expression of germ cells in the 3D scaffold encapsulating POCs group was more intensely than the non-printed hydrogel encapsulating POCs group. The work shows that the 3D bioprinting ovary employing ovarian dECM-based bioink is a promising approach for ovarian failure correction.

Ultrasound combined with hysteroscopy for optimum treatment of Robert's uterus: a case report and a review.

BACKGROUND: Rbert's uterus, also known as asymmetric septate uterus, is a rare genital malformation first reported by Dr. Robert in 1970. Robert's uterus is characterized by a septate uterus with a blind hemicavity and an intact external fundus. According to some reports, Robert's uterus was typically managed by laparoscopic uterine resection of a hemicavity, laparoscopic endometrectomy, and even hysterectomy. Considering that fertility preservation is important in young patients, we recommend ultrasound-guided hysteroscopic septum resection as an optimum treatment for Robert's uterus. CASE PRESENTATION: Herein is described a clinical case of Robert's uterus in a 15-year-old girl who was misdiagnosed for primary dysmenorrhea in the beginning. Magnetic resonance imaging (MRI) and 3-dimensional (3D) ultrasound identified an asymmetrical uterine septum. The patient was treated using ultrasound-guided hysteroscopic treatment without laparoscopy. The surgical procedure lasted less than an hour, and the symptoms of dysmenorrhea were relieved during a six months follow-up. CONCLUSIONS: Ultrasound-guided hysteroscopic septum resection is the preferred treatment for Robert's uterus.

Printing 3D vagina tissue analogues with vagina decellularized extracellular matrix bioink.

A variety of factors can cause vaginal loss. The patients are suffering from great psychological and physical pain, and there is an urgent need for vagina reconstruction. 3D-bioprinting is expected to achieve vaginal morphological restoration and true functional reconstruction. The current study aimed to explore the biomimetic 3D vagina tissue printing with acellular vagina matrix (AVM) bioink. The AVM from pig was converted to bioink by 15% gelatin and 3% sodium alginate mixed with the AVM solution. Rheology, scanning electron microscopy and HE staining were performed to characterize the bioink's viscosity, morphologies and biocompatibility. After printing, the viability of bone marrow mesenchymal stem cells (BMSCs) in the printed 3D scaffolds in vitro was investigated by a live/dead assay kit. Then, subcutaneous transplantation in rats were divided randomly into 3D scaffold group and 3D scaffold encapsulating CM-Dil-labeled BMSCs group. The results of HE, immunohistochemistry and immunofluorescence staining revealed that 3D scaffold encapsulating BMSCs expressed significant effects on the vascularization and epithelization of the printed vagina tissue, and the BMSCs could acquire the phenotype of vaginal epithelial cells and endothelial-like cells. The work showed that the biomimetic 3D vagina tissue with AVM bioink encapsulating BMSCs is a promising approach for vagina reconstruction.

A stereological study of 3D printed tissues engineered from rat vaginas.

BACKGROUND: This study aims to retrieve the stereological data from rat vaginas for 3D printing tissue-engineered vaginas. METHODS: In this study, five female Sprague-Dawley rats, aged 8-12 weeks, were used to obtaining the vagina tissues. Each vagina was divided into eight segments fixed in 4% paraformaldehyde and embedded in paraffin, whose two consecutive sections of each block were stained using hematoxylin and eosin (H&E) and anti-α-actin antibody with immunohistochemistry staining, respectively. The thickness of the epithelium, lamina propria, the smooth muscle layer, and the adventitia layer are measured. Then, the volume density of the epithelial cells and smooth muscle cells are counted using design-based stereology. RESULTS: The length and width of the rat vaginas were 2 and 1.5 cm, respectively. The thickness of the epithelium, lamina, propria, and adventitia layer was measured, and no significant difference was observed. However, the thickness of the smooth muscle layer was significantly different among these eight segments. The smooth muscle layer of the lower vagina is thicker than the upper vagina. The average volume density of epithelial cells and smooth muscle cells is 1.61×109/cm3 and 5.38×108/cm3. There was a significant difference observed. CONCLUSIONS: We had successfully retrieved the stereological data of the vaginas. The gained data will supply us with the information for 3D printing vaginas and new insights into the structure of the vagina.

Efficacy of high intensity focused ultrasound treatment for cystic adenomyosis: a report of four cases.

BACKGROUND: Cystic adenomyosis is a particular type of adenomyosis, High intensity focused ultrasound (HIFU), as a non-invasive method, has also been used to treat adenomyosis. The purpose of this study was to investigate the efficacy, safety, and feasibility of HIFU for the treatment of cystic adenomyosis. METHODS: Diagnosis of cystic adenomyosis was obtained through trans-vaginal ultrasound and magnetic resonance imaging (MRI). Ultrasound-guided HIFU ablation was performed under conscious sedation. The patients were evaluated by the comparison of pre-HIFU and post-HIFU imaging, as well as the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire subscales, consisting of Symptom Severity Score (SSS) and Heath Related Quality of Life (HRQL). RESULTS: HIFU was effective in treating cystic adenomyosis. No complications were observed in the four patients who were successfully treated with HIFU. Compared to preoperative symptoms and patient satisfaction, symptoms at the first follow-up observed significant improvements, with no dysmenorrhea and high health-related quality of life. During the outpatient follow-up of one month, three months, and six months postoperation, the four patients were still without dysmenorrhea and were highly satisfied with the HIFU ablation. CONCLUSIONS: HIFU, as a non-invasive treatment, supplies a safe and effective possibility for the treatment of cystic adenomyosis.

Atmospheric mercury in an eastern Chinese metropolis (Jinan).

Urban emissions are a major contributor to atmospheric Hg budgets. Continuous measurements of total gaseous mercury (TGM) and particulate-bound mercury (PHg) in PM2.5 were conducted from October 2015 to July 2016 in a metropolis, Jinan, in eastern China. Average TGM and PHg concentrations were 4.91 ± 3.66 ng m-3 and 451.9 ± 433.4 pg m-3, respectively, in the entire study period. During the winter heating period (HP), mean concentrations of TGM and PHg were 5.79 ng m-3 and 598.7 pg m-3, respectively, twice higher than those during the non-heating periods (NHPs). During the HP, TGM exhibited a distinct diurnal pattern with a peak in the morning and a minimum in the afternoon on less polluted days but a singular peak at midday on heavily polluted days. The diurnal variation of TGM during the NHPs was predominantly influenced by the variation in boundary layer height while during the HP by anthropogenic emissions. The ratio of PHg/PM2.5 in Jinan was one to two orders of magnitude larger than those elsewhere worldwide and those in soil and coal, which suggested the high enrichment of PHg in PM2.5 in Jinan. Correlation and principle component analysis results suggested that PHg and TGM had common combustion sources during the HP, whereas PHg resulted mainly from biomass burning and meteorological variations during the NHPs. High Hg concentrations in Jinan were mostly caused by emissions from coal-fired power plants, especially for those situated east of the sampling site. In addition, TGM and PHg concentrations significantly increased during haze and fog episodes, but decreased during a dust episode due possibly to strong ventilation conditions combined with partitioning of Hg between adsorption to PM2.5 and coarse dust particles.

PM2.5-Bound Toxic Elements in an Urban City in East China: Concentrations, Sources, and Health Risks.

Concentrations of PM2.5-bound trace elements have increased in China, with increasing anthropogenic emissions. In this study, long-term measurements of PM2.5-bound trace elements were conducted from January 2014 to January 2015 in the urban city of Jinan, east China. A positive matrix factorization model (PMF) and health risk assessment were used to evaluate the sources and health risks of these elements, respectively. Compared with most Chinese megacities, there were higher levels of arsenic, manganese, lead, chromium, and zinc in this city. Coal combustion, the smelting industry, vehicle emission, and soil dust were identified as the primary sources of all the measured elements. Heating activities during the heating period led to a factor of 1.3⁻2.8 higher concentrations for PM2.5 and all measured elements than those during the non-heating period. Cumulative non-carcinogenic and carcinogenic risks of the toxic elements exceeded the safety levels by 8⁻15 and 10⁻18 times, respectively. Arsenic was the critical element having the greatest health risk. Coal combustion caused the highest risk among the four sources. This work provides scientific data for making targeted policies to control air pollutants and protect human health.

Distribution and sources of particulate mercury and other trace elements in PM2.5 and PM10 atop Mount Tai, China.

The concentrations of particulate mercury (PHg) and other trace elements in PM2.5 and PM10 in the atmosphere were measured at the summit of Mount Tai during the time period of 15 June - 11 August 2015. The average PHg concentrations were 83.33 ±â€¯119.1 pg/m3 for PM2.5 and 174.92 ±â€¯210.5 pg/m3 for PM10. Average concentrations for other trace elements, including Al, Ca, Fe, K, Mg, Na, Pb, As, Se, Cu, Cd, Cr, V, Mo, Co, Ag, Ba, Mn, Zn and Ni ranged from 0.06 ng/m3 (Ag) to 354.33 ng/m3 (Ca) in PM2.5 and 0.11 ng/m3 (Co) to 592.66 ng/m3 (Ca) in PM10. The average concentrations of PHg were higher than those at other domestic mountain sites and cities in other counties, lower than those at domestic city sites. Other trace elements showed concentrations lower than those at the domestic mountain sites. Due possibly to increased control of emissions and the proportion of new energy, the PHg and trace element concentrations decreased, but the PHg showed concentrations higher than those at the Mountain sites, this showed that the reasons was not only severely affected by anthropogenic emissions, but also associated with other sources. The concentration changed trend of the main trace elements indicated that PHg, trace elements and particle matters present positive correlation and fine particulate matter has a greater surface area which was conductive to adsorption of Hg and trace elements to particles. On June 19, June 27 and July 6, according to the peak of mercury and trace elements, we can predict the potential sources of these three days. The results of principal component analysis (PCA) suggested that, crustal dust, coal combustion, and vehicle emissions were the main emission sources of PHg and other trace elements in Mount Tai. The 24-h backward trajectories and potential source contribution function (PSCF) analysis revealed that air masses arriving at Mount Tai were mainly affected by Shandong province. Mount Tai was subjected to five main airflow trajectories. Clusters 1, 2, 3, and 5 represented four pathways for local and regional sources and cluster 4 originated long-distance transportation. Central Shandong was the main source regions of PHg, Pb, Se, As, Cu and Cd. Southeastern and northwestern Shandong province and northern Jiangsu province were the most polluted source regions of Mn, Zn, and Ni. The crustal elements Fe and Ca had similar distributions of potential source regions, suggested by the highest PSCF values in southeastern Shandong and northern Jiangsu.

Characteristics and potential sources of atmospheric particulate mercury in Jinan, China.

Measurements of atmospheric particulate mercury (PHg) were conducted at a suburban site in Jinan, China from June 2014 to December 2015. The average PHg concentration was 508.5±402.7pgm-3, and the average Hg content in PM2.5 (particles with a diameter of 2.5µm or less) was 6.60±5.82µgg-1. Both PHg and Hg content in PM2.5 aerosols were comparable to levels in some cities in China and were much higher than in cities in North America and Europe. Weak correlations were found between PHg and meteorological parameters. The correlations between PHg and other pollutants in ambient air, including SO2, CO and NOχ, together with their wind dependence were used for source analysis, which suggested coal-fired industries, cement plants and traffic emissions as potential local sources for the site. Cluster analysis of 36-h backward trajectories suggested that the regional transport from southwestern Shandong Province also contributed to PHg in Jinan.