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Objective To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods Totally, 2219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1％, 1755/2219) and the placenta percreta (PP) group (20.9％, 464/2219), according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ2=157.961) and placenta previa (χ2=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.
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Objective To assess the correlation between fractional anisotropy(FA) value and α-SMA of renal tissue in patients with chronic kidney disease (CKD).Methods 33 CKD patients underwent MRI standard scanning and diffusion tensor imaging(DTI).FA values were measured on both medulla and cortex of bilateral kidneys on the FA map.24 patients were performed renal biopsy to detect the expression of α-SMA.The integrated optical density of positive-staining region was calculated for each view.The relationship between the FA values and the integrated optical densities of α-SMA was analyzed by using Bivariate correlation analysis.Results There was a significant negative correlation between the cortical FA values and the integrated optical densities of α-SMA (P=0.001).There was a significant negative correlation between the medullary FA values and the integrated optical densities of α-SMA (P=0.035).Conclusion FA value of DTI was correlated with α-SMA of renal tissue in patients with CKD.
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Objective To explore the optimal dose ratio set in the hip digital tomosynthesis (DTS),and to reduce patient's examination dose as low as possible.Methods Ninety patients who received hip DTS examination were randomly divided into 3 groups,with the dose ratio as 6,7 and 8,respectively.One-way ANOVA test was used to compare.the image quality and radiation dose among 3 groups.Results The values of entrance surface dose (ESD),dose-area product (DAP) and image quality score of 3 groups were [(3.76 ± 1.89) mGy,(18.41 ± 11.71) dGy·cm2,3.03 ± 0.24],[(5.24±2.76)mGy,(26.99±13.34)dGy·cm2),3.60±0.11],and [(6.39±1.75)mGy,(36.96± 22.49) dGy· cm2,3.64 ± 0.09],respectively.The difference among three groups was statistically significant (F =10.94,9.45,139.26,P ＜ 0.05).The S-N-K test showed that both ESD values and DAP values in 6,7,and 8 time-dose ratio group was from small to large.The image quality score of 6 time-dose ratio group was lower than that of the other groups with no significant difference.Conclusions Dose ratio is one of the important parameters to result in the radiation dose of DTS.Dose ration 7 is optimal in hip DTS,which could match the image quality and radiation dose best and finally protect patients from unnecessary radiation damage.
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Objective To analyze the diagnostic value of MSCT and MRI in detecting the distal third of tibia shaft fracture complicated with occult posterior malleolar fracture.Methods One hundred and fifty-one patients with the distal third of tibia shaft spiral fracture underwent X-ray examination.For patients without posterior malleolar fracture on X-ray,MSCT and MR imaging were further performed.A binomial test was used to evaluate the significance of the differences between MSCT and MRI in the detection of posterior malleolar fractures and cortical involvement.Results A total of 126 (83.4％) in 151tibia shaft fracture were found to be associated with posterior malleolar fracture.Twenty-seven ( 21.4％ ) cases with posterior malleolar fracture were detected on X-ray.MSCT and MR examination were performed in 124 cases.Ninety-nine posterior malleolar occult fractures were detected on MRI,which included 81cases showed on MSCT.The sensitivity,specificity and accuracy of posterior malleolar occult fracture on MRI were 100％ (99/99),100％ (25/25) and 100％ ( 124/124),while they were 81.8％ (81/99),100％ (25/25)and 85.5％ (106/124) for MSCT respectively.The accuracy of posterior malleolar occult fracture on MRI was significant higher than MSCT ( Z =2.56,P =0.01).Seventy-eight cortical fractures were found on MSCT among 99 posterior malleolar occult fractures,while 51fractures were found on MRI.The sensitivity,specificity and accuracy of cortical fracture involvement were 100％ (78/78),100％ (21/21) and 100％ ( 99/99) for MSCT,while they were 65.4％ (51/78),100％ (21/21) and 72.7％ (72/99) for MRI respectively.The accuracy of cortical fracture involvement on MSCT was significant higher than MRI ( Z =4.02,P =0.00).Conclusions MRI has a higher accuracy than MSCT in detecting the distal third of tibia shaft fracture complicated with occult posterior malleolar fracture,while MSCT has a higher accuracy than MRI in detecting cortical fracture involvement.
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@#Objective To explore the effect of psychological intervention of the patients with acute stroke in pre-hospital first aid. Methods 148 patients with acute stroke who had been treated by psychology in pre-hospital first aid were chosen and interviewed, comparing with 100 patients with acute stroke in hospital in same state. Results There was a significant difference between two groups about realization to disease, attitude to disease, mental reaction, treating confidence, compliance, and so on. Conclusion Psychological intervention can improve the patients with acute stroke in pre-hospital first aid effectly in the realization about disease, correct attitude about disease, capability of fighting diseases, confidence for recovery from the illness and compliance.
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Objective To compare the efficacy and safety of tranexamic acid(TA)and norethisterone(NET)for the treatment of patients with ovulatory menorrhagia in China. Methods Onehundred and thirty one patients with proven ovulatory menorrhagia from gynecologic clinics of 5 teaching hospitals located in 4 different cities in China were enrolled during Jul 2004 to Dec 2006.Ameng them 128 completed the study.Patients were randomly divided into two therapeutic regimen groups:TA 1g thrice daily during menstrual cycle days(D)1-5,69 cases;or NET 5 mg twice daily on D19-26.59 cases.The drugs were administered for 2 consecutive cycles,then withdrawn and patients were followed-up for 1 more cycle.Data on menstrual blood loss [ estimated by pictorial blood assessment chart(PBAC)],length of menstrual periods,quality of life(QOL)evaluated by a 6 item health-related questionnaire were collectedbefore,during each cycle and were compared.Results Both treatments led to significant decreases of mean PBAC scores and shorter duration of menstrual periods,and improved the QOL ranking during the twotreatment cycles.The mean percentages of PBAC decrements in the TA first and second cycles were significantly greater than those in the NET corresponding cycles(35%VS 17%,P=0.004;4J4%VS 34%,P=0.04 respectively).The success rate of TA second cycle was higher than that of the NET second cycle (41%VS 24%,P=0.04).Improvement of QOL ranking in the TA first cycle was also significantly better than those in the NET first cycle ( P=0.03).The percentage of patients with at least 1 adverse event in TA group(19%)was significantly lower than that in NET group(35%,P=0.04).Patients'willingness tocontinue the treatment in the TA second and follow-up cycles(94%,79%respectively)were significantly higher than those in the corresponding cycles of NET groups(79%,59%respectively;P=0.01,P=0.02).Conclusion The regimen of TA 3 g daily during menstrual days 1-5 is a more effective and tolerable treatment than luteal phase norethisterone for patients with ovulatory menorrhagia.
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Objective To study the disease chart among pre-hospital first aid in Tangshan people'hospital.Methods Prospectively collecting data of pre-hospital first aid 2580 patients from 2006 to 2007,analyzing the data,sex,age,visitingtime,emergency diagnosisand results,etc.Results Among pre-hospital first aid 2580 patients,traf-rice diseases,neurosystem diseases,cerebral infarction,coronary heart disease are the first three diseases.The highest times of pre-hospital first aid are 8:00～10:00,14:00～16:00 and 20:00～22:00.The admission rate is 44.46%.Conclusion Pre-hospital first aid should be based on the data,age,visiting time of the disease,scientifically arranging pre-hospital,training for pre-hospital first aid staff,so,the patients will be the fast and best pre-hospital flint aid.