Ultrasound analysis of the effect of second delivery on pelvic floor function in Chinese women.

In our study, patients who had a second delivery were categorised into the following 4 groups. Pelvic floor ultrasound data were compared during the 6th week after the second delivery. The incidence of cystoceles was highest in group A and lowest in group D. In addition, groups A and B had a higher rate of rectoceles or perineum descent. Similarly, the areas of the levator hiatus were higher in Groups A and B during Valsalva manoeuvres. The area of the levator hiatus from the resting state to the Valsalva manoeuvre effect had the greatest change in Group A. A comparison of the PR thickening rates among the four groups did not reveal significant differences. All second delivery methods can cause varying degrees of pelvic organ prolapse and decreased pelvic floor function; however, vaginal delivery as the second delivery mode may have a more significant effect in Chinese women.Impact StatementWhat is already known on this subject? Different modes of delivery have significantly different effects on female pelvic floor function. Pregnancy beyond 35 weeks of gestation has an effect on female pelvic floor function, irrespective of the mode of delivery.What do the results of this study add? This study analysed the impact of different delivery modes on Chinese female pelvic floor function. Parous women who underwent different modes of second delivery all demonstrated different degrees of pelvic organ prolapse, as well as pelvic floor function decline.What are the implications of these findings for clinical practice and/or further research? Our study will provide basic research of Chinese female pelvic floor function after a second delivery, which will be of clinical significance around the world, as well as in China. China will keep promoting further delivery as the aging population is increasing. If the developing countries want to promote the second delivery around the women, they have basic research and data to instruct the females.

Iodine Nutrition and the Prevalence Status of Thyroid Nodules in the Population: a Cross-sectional Survey in Heilongjiang Province, China.

The aim of this study was to determine the iodine nutritional status and the epidemiological characteristics of thyroid nodules (TNs) in the adult population of Heilongjiang Province. From December 2017 to December 2018, a total of 3661 adults aged 20-70 years were selected through probability proportional to size (PPS) sampling for a cross-sectional survey. During the field epidemiological investigation, each participant received a questionnaire survey and thyroid ultrasonography examination. The iodine concentrations in casual urine specimens and household edible salt were measured. The household coverage of iodized salt was 86.56%. The median urinary iodine concentration (MUIC) in the adult population in Heilongjiang Province was 161.57 µg/L (25th-75th percentile: 100.35-245.15 µg/L). The prevalence of TNs was 36.88%, and the prevalence in females was significantly higher than that in males (41.25% vs 32.50%, χ2 = 11.841, P < 0.01). The prevalence of TNs increased with age (χ2trend = 49.80, P < 0.001). The prevalence of multiple TNs increased with age (χ2trend = 48.709, P < 0.001). There was no significant difference in the MUIC between healthy control group and those with TNs (Z = - 1.386, P = 0.166). The female, age (40-49 age group, 50-59 age group, 60-70 age group), BMI (obesity, overweight), history of hypertension, history of diabetes, and smoking history were all independent risk factors that affected the occurrence of TNs. The iodine nutritional status of the adult population in Heilongjiang Province was adequate. The prevalence of TNs was higher in middle-aged and elderly women, so these individuals should be the focus of the prevention and treatment of thyroid nodule disease.

Contrast-Enhanced Ultrasonography in Sclerotherapy for Ovarian Endometrial Cyst.

We investigated contrast-enhanced ultrasonography (CEUS) characteristics related to the perfusion pattern and parameters of the time-intensity curve of ovarian endometrial cysts (OECs) pre- and post-sclerotherapy. Forty-three patients with one-sided, single, untreated OECs underwent CEUS pre- and post-sclerotherapy. OEC wall thickness was measured by 2-D ultrasonography and CEUS, and CEUS enhancement patterns and time-intensity curve parameters before and after sclerotherapy were compared. OEC wall thickness remained essentially unchanged post-sclerotherapy. Wall thickness was significantly larger on 2-D ultrasonography than on CEUS. The OEC wall exhibited rapid enhancement and slow clearance both pre- and post-sclerotherapy. Wash-in and wash-out times remained unchanged. The wall exhibited iso-enhancement pre-sclerotherapy, but low and partially uneven enhancement post-sclerotherapy. Post-treatment, time to peak was delayed, peak intensity was reduced and perfusion slope was decreased. The contrast agent arrival time and area under the curve remained similar. CEUS enhancement patterns and quantitative parameters were altered post-sclerotherapy; thus, treatments involving sclerosing agent retention can help to improve the efficacy of sclerotherapy for OEC.

Four-dimensional hysterosalpingo-contrast sonography with auxiliary hydrogen peroxide examination for the diagnosis of fallopian tube patency following interventional treatment of ovarian ectopic cysts.

OBJECTIVE: The present study aimed to explore the practical value of using four-dimensional hysterosalpingo-contrast sonography with auxiliary hydrogen peroxide examination which is necessary for the diagnosis of fallopian tube patency following treatment of ovarian ectopic cysts. METHODS: A retrospective analysis of hysterosalpingography (HSG) examination data from 71 patients who had received sonography-guided interventional treatment for ovarian ectopic cysts at the Fourth Affiliated Hospital of Harbin Medical University was carried out. The 71 cases were divided into three groups. Four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) with the contrast agent SonoVue was carried out in the first group (4D-HyCoSy group), hydrogen peroxide (H2O2) examinations were carried out in the second group (H2O2 group), and the final group consisted of patients who underwent 4D-HyCoSy followed by an auxiliary H2O2 examination where necessary (4D-HyCoSy/H2O2 group). Results of these examinations were then compared to those of a standard HSG examination using lipiodol radiography that had been carried out a month beforehand. RESULTS: (1) The rates of diagnostic accordance with standard HSG examination results for the 4D-HyCoSy, H2O2, and 4D-HyCoSy/H2O2 groups were 86.9, 70.5 and 91.8% respectively. The H2O2 group accordance rate was significantly lower than that of the other two groups (p < 0.05). (2) Compared to the tubal patency results of the standard HSG examination, the sensitivity, specificity, positive predictive value, negative predictive value, and Youden index of the 4D-HyCoSy group were 83.3, 89.3, 83.3, 89.3, and 0.73% respectively. For the H2O2 group, these values were 66.7, 73.9, 70, 70.8, and 0.41%, respectively, and for the 4D-HyCoSy/H2O2 group were 90, 93.5, 90, 93.5, and 0.84%, respectively. All of these values were significantly higher in the 4D-HyCoSy/H2O2 group than in the other two groups. CONCLUSIONS: The use 4D-HyCoSy with auxiliary H2O2 examination for the diagnosis of tubal patency is safe, non-invasive, and easy to carry out. It can also improve the diagnostic accuracy rate of 4D-HyCoSy and H2O2 examinations used on their own.

Ultrasonography-guided multidrug stratification interventional therapy for cesarean scar pregnancy.

PURPOSE: To explore the clinical value of ultrasonography-guided multidrug stratification interventional therapy for cesarean scar pregnancy (CSP). METHODS: Aspiration of gestational sac fluid, injection of methotrexate in the sac, injection of homeostatic agent and pituitrin in the uterine muscle layer, and injection of triple anti-inflammatory drugs around the uterus in 12 patients with CSP. The lesion volume, serum ß-hCG level, and blood flow were observed. RESULTS: The mean ß-hCG level continued to decrease posttreatment, and the greatest reduction occurred in week 1. The mean number of days needed for serum ß-hCG values to decrease to normal level was 39.1 ± 10.1 days. Mass volumes reduced and the mean number of days for the masses to disappear was 24.6 ± 14.1 days. The blood flow around the lesions continued to decrease. CONCLUSIONS: Ultrasonography-guided multidrug interventional therapy for CSP is a new, safe, effective, minimally invasive method.