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Objective:To assess the clinical value of uterine curettage ultrasound in the evaluation of cesarean section scar pregnancy (CSP) after uterine arterial chemoembolization (UAE).Methods:Retrospective analysis were performed in 42 patients who took uterine curettage within 24-48 hours after UAE treatment in the Second Affiliated Hospital of Harbin Medical University from January 2015 to June 2018. The ultrasonic manifestations were graded and classified before UAE. The intraoperative and postoperative complications, time of β-human chorionic gonadotrophin declined to normal limits were evaluated, and the formation of hematoma and hematoma absorption time were followed up by ultrasound.Results:UAE was performed successfully in all patients. The ultrasound-guided scar pregnancy was successfully completed. The uterus was successfully retained in all patients.Among the 42 patients, 18 cases were 3 scores group, and 24 cases were 4 scores group according to the ultrasonic scoring system. Two cases were type Ⅰgroup, 25 cases were type Ⅱ group, and 15 cases were type Ⅲ group according to the ultrasonic classification. The amount of intraoperative complications, postoperative mass formation and absorption time were significantly different between 3 scores group and 4 scores group ( P<0.05). No significant differences were found in intraoperative complications, postoperative complications, postoperative mass formation and β-human chorionic gonadotropin (β-hCG) value among different ultrasonic classification groups ( P>0.05). Conclusions:Ultrasonography has clinical application value in evaluating the prognosis of CSP treated with UAE. Ultrasonic scoring system can evaluate the efficacy and is helpful for predicting clinical outcome of CSP.
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Objective:To classify the ultrasound features of ovarian tumors by modified gynecology imaging reporting and data system(mGI-RADS), and explore the clinical value of mGI-RADS in differentiating of benign and malignant tumors.Methods:The 242 ultrasound images of the adnexal mass from 221 patients with ovarian tumor who underwent ultrasound scan and proceeded surgeries in the Second Affiliated Hospital of Harbin Medical University from September 2017 and December 2019 were involved in the retrospective analysis and compared with the pathological results. According to the latest ultrasound terminology for adnexal masses proposed by the International Ovarian Tumor Analysis (IOTA), the adnexal masses were classified. The suspeted malignant sings were screened for mGI-RADS. Using GI-RADS and mGI-RADS classification systems, all the adnexal masses were double-blindly classified by two senior doctors and their diagnostic efficiencies were evaluated.Results:Among the suspected malignant signs proposed by IOTA, resistance index (RI)<0.5, central blood flow signal, ascites, irregular cystic wall with uneven thickness separation, mass composition (solid component ≥30% and silent shadow attenuation), and papillary structure≥7 mm, showed retatively higher OR values(14.282, 10.372, 9.653, 8.832, 5.851, 4.506, respectively. Using GI-RADS and mGI-RADS classification systems, the diagnostic consistency by the two senior doctors in differentiating benign and malignant ovarian neoplasms was good(Kappa=0.767, P<0.05). Grade Ⅳ was divided into three subtypes (Ⅳa, Ⅳb, Ⅳc) by the mGI-RADS, and their positive predictive values for malignant ovarian masses were 69.0%, 90.4% and 92.9% respectively. When a cut-off value >mGRⅣ was used to distinguish the benign and malignant adnexal tumors, the AUC was the largest, and its sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 93.4%, 93.1%, 90.4%, 95.2% and 93.2%, respectively. Conclusions:The mGI-RADS has a high clinical value in the differential diagnosis of ovarian tumors.
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Objective:To evaluate the myocardial reserve effect in rabbits′ model of myocardial inshemia-reperfusion by layer-specific strain of speckle tracking imaging and low dose dobutamine stress echocardiography(LDDSE).Methods:Forty rabbits were randomly divided into two groups: ischemia-reperfusion group (IR group) and pharmacological postconditioning group (ATP-PostC group). Echocardiography examinations were performed at baseline, 60 min after ligation (before and after dobutamine stress), and 120 min after reperfusion (before and after dobutamine stress). The size of each chamber was measured and the left ventricular ejection fraction(LVEF) was calculated and the heart rate was recorded. The longitudinal strain of endocardium(SLsys-endo), longitudinal strain of myocardium(SLsys-mid), longitudinal strain of epicardium(SLsys-epi) were acquired. Triphenyl tetrazolium chloride(TTC) and Evans blue staining were applied in two rabbits randomly selected from each group at 60 min after ligation, dobutamine stress and 120 min after reperfusion, respectively.Results:①After coronary artery ligation, LVEF decreased in both groups( P<0.05), SLsys-endo, SLsys-mid, and SLsys-epi decreased in two groups( P<0.01). After low dose dobutamine stress, the SLsys-endo, SLsys-mid and SLsys-epi in the two groups increased, which was different from that after lagation( P<0.05). ②After 120 min reperfusion, the longitudinal strain of the myocardium of both groups increased compared with that after lagation( P<0.01, P<0.05), and the increase in ATP-PostC group was significantly higher than that in IR group( P<0.01). There was no significant difference between the IR group and the first LDDSE( P<0.05). After LDDSE again, the SLsys-endo and SLsys-mid in the two groups further increased, which was different from that after reperfusion ( P<0.05). And the SLsys-endo and SLsys-mid were higher in ATP-PostC group than those in IR group ( P<0.05). ③Pathological results showed that there was no significant difference in myocardial infarct size between IR group and ATP-PostC group at 60 min after ligation ( P>0.05). After 120 min reperfusion, the percentage of myocardial infarct size in the IR group was significantly higher than that in the ATP-PostC group ( P<0.05). Conclusions:Layer-specific strain of STI combined with LDDSE can early detect regional myocardial dysfunction and accurately assess myocardial reserve function, and with endocardial longitudinal strain being more sensitive.
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Objective@#To assess the clinical value of uterine curettage ultrasound in the evaluation of cesarean section scar pregnancy (CSP) after uterine arterial chemoembolization (UAE).@*Methods@#Retrospective analysis were performed in 42 patients who took uterine curettage within 24-48 hours after UAE treatment in the Second Affiliated Hospital of Harbin Medical University from January 2015 to June 2018. The ultrasonic manifestations were graded and classified before UAE. The intraoperative and postoperative complications, time of β-human chorionic gonadotrophin declined to normal limits were evaluated, and the formation of hematoma and hematoma absorption time were followed up by ultrasound.@*Results@#UAE was performed successfully in all patients. The ultrasound-guided scar pregnancy was successfully completed. The uterus was successfully retained in all patients.Among the 42 patients, 18 cases were 3 scores group, and 24 cases were 4 scores group according to the ultrasonic scoring system. Two cases were type Ⅰgroup, 25 cases were type Ⅱ group, and 15 cases were type Ⅲ group according to the ultrasonic classification. The amount of intraoperative complications, postoperative mass formation and absorption time were significantly different between 3 scores group and 4 scores group (P<0.05). No significant differences were found in intraoperative complications, postoperative complications, postoperative mass formation and β-human chorionic gonadotropin (β-hCG) value among different ultrasonic classification groups (P>0.05).@*Conclusions@#Ultrasonography has clinical application value in evaluating the prognosis of CSP treated with UAE. Ultrasonic scoring system can evaluate the efficacy and is helpful for predicting clinical outcome of CSP.
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Objective To investigate the incidence of abnormalities and adverse reactions of intrauterine device ( IUD) by three‐dimensional transvaginal ultrasound ,and guide the correct selection of IUD . Methods Female volunteers who came to our hospital for health check‐up from July 2016 to February 2018 were selected as subjects to obtain information of the belt loop time and number of loops . T hree‐dimensional transvaginal ultrasound was used to observe and record the IUD types and positions . T he incidence of location abnormalities ,adverse reactions and cervical lesions of differnet types of IUD were retrospectively analyzed . Results T wo thousand one hundred and thirteen eligible subjects were included in the study ,including 423 cases of McuIUD ,506 cases of circular ring ,405 cases of uterine ring ,372 cases of T‐ring and 407 cases of γ ring . T he statistical analysis showed that the incidence of adverse reactions after wearing rings was as high as 34 .07% ,and the adverse reaction rate of different IUD was different . McuIUD had the highest incidence of adverse reactions ,compared with the circular ring ,the uterine ring ,the T‐ring , and the γ ring ( 47 .99% vs 25 .88% ,27 .41% ,37 .10% ,33 .66% ; all P ＜ 0 .05 ) . Different IUD had different incidence of adverse reactions . T he low back pain rate in McuIUD and γ ring were higher than the other 3 IUDs . T he low back pain rate of McuIUD was higher than the circular ring ,the uterine ring and the T‐ring ( 23 .4% vs 15 .71% ,14 .07% ,13 .7 1% ; all P ＜ 0 .01 ) . Different types of IUD had different incidence of location anomalies . T he descending rate of the circular ring was higher than that of the McuIUD and γ ring ( 6 .32% vs 3 .30% ,3 .19% ; all P＜ 0 .05 ) ,and no statistically significant difference compared with the uterine ring and T‐ring ( 6 .32% vs 3 .45% ,4 .30% ; all P ＞0 .05 ) . T he incarceration rate of the mother ring was higher than that of the circular ring ,uterine ring and T‐ring ( 3 .07% vs 0 ,0 .25% ,0 .54% ;all P ＜0 .01) . T he intrauterine rotation rate of uterine ring and γ ring were higher than that of McuIUD , circular ring and T‐ring ( all P ＜0 .01) . Pregnancy ＞1 and ring times ≥2 were related with the occurrence of adverse reactions of IUD ( P ＜ 0 .05 ) . T he incidence of cervical erosion in the T‐ring was the highest compared with the McuIUD ,circular ring ,uterine ring ,and γ ring ( 30 .65% vs 16 .78% ,16 .80% ,18 .02% , 17 .69% ; all P ＜0 .01) . Conclusions The incidence of adverse reactions is higher in women with different types of IUD . T he incidence of different types of abnormal IUD position is different . T he frequency of pregnancy and band ring are related to the occurence of adverse veactions to IUD .
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To evaluate the changes of myocardial viability and systolic function in rabbits with different ischemic periods by layer‐specific strain of ultrasound speckled tracking imaging ( ST I) and low dose dobutamine stress echocardiography ( LDDSE ) . Methods T hirty‐six rabbits were randomly divided into 3 groups( n ＝12) : ①myocardial infarction group Ⅰ :coronary artery occlusion for 45 min ; ②myocardial infarction group Ⅱ :coronary artery occlusion for 60 min ; ③ myocardial infarction group Ⅲ :coronary artery occlusion for 90 min . Echocardiography examinations were performed at baseline ,after ligation and low dose dobutamine stress . After the experiment ,rabbits were killed and the hearts were taken to assess viable or nonviable mycardium , triphenyl tetrazolium chloride and Evans blue staining were applied . Results ①After coronary artery ligation ,left ventricular ejection fraction( LVEF) decreased in 3 groups ( all P ＜ 0 .05 ) , the ventricular global endocardial longitudinal strain ( GSLsys‐endo ) , global myocardial longitudinal strain( GSLsys‐mid) ,and global epicardial longitudinal strain( GSLsys‐epi) decreased in 3 groups ( all P ＜ 0 .05 ) ,the longitudinal strain of endocardium ( SLsys‐endo ) ,longitudinal strain of myocardium ( SLsys‐mid) ,longitudinal strain of epicardium ( SLsys‐epi) decreased in viable myocardial ( all P＜0 .05) ; ②While low dose dobutamine stressing ,the GSLsys and SLsys increased in each groups ,and the GSLsys‐endo ,GSLsys‐mid ,GSLsys‐epi and SLsys‐endo of viable segments in each group were increased ( P＜0 .05) ; ③After ligation and low dose dobutamine stress ,the GSLsys in endocardium in three groups were different( P ＜0 .05) ,and the SLsys in endocardium of viable segments in three groups were different ( P＜0 .05) . Conclusions Layer‐specific strain of STI combined with LDDSE can accurately evaluate the changes of myocardial viability and systolic function in different ischemic periods ,and the longitudinal strain of endocardium is more sensitive ;moreover ,with the increase of coronary artery occlusion time ,the infarcted myocardium increases ,myocardial viability and systolic function decrease .
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Objective To evaluate the effect of chlamydiaphage virus protein 2(Vp2) on the recombinant virus and virus screening research, and it clinical value thereof. Methods To compare the Vp2 protein sequences to get the conserva-tive region with COBALT. A phylogenetic tree was built with ProteinBlast of Distance tree. The amino acid sequence in the high conservative region was predicted by the methods of Gamier-Robson and Chou-Fasman, and its flexibe regions were predicted by Karplus method. The hydrophilicity plot was predicted by Kyte-Doolittle and Hopp-Woods method. The sur-face probability was analysed by Emini, and the antigenic index was analysed by Jameson-Wolf method. Results The six Chlamydiaphage Vp2 proteins were the highly conserved sequences. There were obvious differences between Chp1Vp2 and other 5 Vp2 proteins. There were the main structure-alpha helix and some cell epitopes in the high conserved region. Con-clusion Vp2 protein is the important component of chlamydia phage capsid with the conservative nature. Vp2 protein has complicated structures and high conservative region with strong immunogenicity, playing a practical value of research in vi-rus recombinantment and screening the wild strains of chlaymdia trachomatis phage.