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Objective:To investigate the significance of clinical factors combined with transvaginal ultrasound and contrast-enhanced ultrasound(CEUS) in guiding the choice of treatment plan for cesarean scar pregnancy(CSP).Methods:The clinical and transvaginal ultrasound and CEUS data of 120 patients with CSP from January 2016 to June 2021 in the First People′s Hospital of Foshan were retrospectively analyzed, and they were divided into ultrasound-guided curettage/ hysteroscopic group (Group A, 91 cases) and laparoscopic group (Group B, 29 cases) according to treatment option, and the differences in clinical and ultrasound factors between the two groups were compared, and to determine the relevant clinical and ultrasound indicators for the choice of treatment option.Results:There were statistical differences between the 2 groups in comparison of whether the gestational sac/mass protruded toward the plasma membrane, gestational sac/mass diameter, the main blood supply site of the gestational sac/mass, the site of the chorion/early placenta and scar thickness (all P<0.05). Logistic regression analysis indicated that CEUS showing major blood supply site of the gestational sac/mass ( OR=6.029, P=0.003) and uterine scar thickness ( OR=12.998, P=0.002) were independent risk factors for minimally invasive surgery for CSP. Conclusions:Ultrasound combined with clinical factors have a certain value in the selection of treatment options for CPS, and the thickness of the uterine scar and the main blood supply site of the gestational sac/mass showed in CEUS may be key factors affecting the minimally invasive surgical treatment of CSP.
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Objective:To construct and evaluate a parotid mass malignancy risk model based on ultrasound image characteristics and clinical features of parotid masses.Methods:Ultrasound images and clinical features of 214 patients with parotid masses in the First People′s Hospital of Foshan were retrospectively collected from June 2018 to August 2020. The pathology results were taken as the golden standard. All the clinical features and ultrasound image features were first screened using regression analysis, and then the screened features were used to build a prediction model.Results:Malignant tumors of the parotid gland appeared on ultrasound as hypoechoic solid masses with or without abnormal cervicofacial lymph nodes with poorly defined borders and irregular morphology. Multifactorial analysis showed that facial nerve function, cervicofacial lymph node abnormalities, maximum diameter, morphology and borders of the mass were independent predictors of the risk of malignant parotid masses. A Nomogram prediction model was established using the above 5 indicators, and the results showed a concordance index(C-index) of 0.896 (95% CI=0.834-0.958) for Nomogram. The standard curve showed good agreement between the predictive effect of Nomogram and the actual situation of benign and malignant parotid swellings, with an internally validated C-index of 0.878. Conclusions:Ultrasound is of great value in identifying benign and malignant parotid tumors. The Nomogram model using ultrasound image features and clinical characteristics can assess the biocharacteristics of parotid masses, and the model shows high accuracy in predicting the risk of malignancy of parotid masses.
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Objective:To investigate the feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse among Chinese women.Methods:The prospective multicenter study enrolled 485 women between January 2017 and January 2019. All patients underwent a standard clinical interview, pelvic organ prolapse quantification (POP-Q) examination and transperineal ultrasound examination. Volume data of transperineal ultrasound examinations were obtained at rest and in maximal Valsalva maneuver.Results:The higher POP-Q stage of posterior compartment, the lower rectal ampulla position in maximal Valsalva maneuver (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥2, P<0.001), and the greater rectal ampulla hypermobility (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥ 2, P=0.007). The rectal ampulla position at rest and in maximal Valsalva maneuver and rectocele depth were correlated with prolapse symptoms ( r=-0.200, P<0.001; r=-0.252, P<0.001; r=0.086, P=0.045). The corresponding cut-off values of rectal ampulla position in maximal Valsalva in diagnosing posterior compartment prolapse (POP-Q stage ≥1) and clinical significant posterior compartment prolapse (POP-Q stage ≥2) were 7.32 mm below the symphysis pubis and 12 mm below the symphysis pubis, respectively, with the area under the ROC curve as 0.75 and 0.85, respectively. Conclusions:The ultrasonic measurements by transperineal ultrasound is significantly associated with POP-Q examination in posterior compartment, and it is demonstrated as a useful tool in quantitative assessment of the severity of posterior compartment prolapse.
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Objective:To investigate the association between levator hiatus area, pelvic organ prolapse quantification (POP-Q) examination and prolapse symptoms.Methods:The prospective multicenter study enrolled 996 female patients between January 2017 and January 2019. All enrolled patients underwent a standard clinical interview, POP-Q examination and transperineal ultrasound examination. Volume data of pelvic floor ultrasound examinations were obtained at rest, during contraction and during maximal Valsalva maneuver. The association between levator hiatus area, POP-Q examination and prolapse symptoms was analyzed. The performance of levator hiatus area on maximal Valsalva for assessing significant POP(POP-Q stage≥2) and prolapse symptoms were also evaluated.Results:There were significant differences of levator hiatus area at rest, during contraction and during maximal Valsalva among patients with different POP-Q stages (all P<0.001). Levator hiatus area during maximal Valsalva showed the highest correlation with abdominal dragging sensation ( r=0.277, P<0.001). The area under the ROC curve (AUC) of levator hiatus area during maximal Valsalva for significant POP (POP-Q stage≥2) was significantly higher than that for prolapse symptoms (AUC: 0.77 vs 0.69, P<0.001). Conclusions:Levator hiatus area on transperineal has moderate correlation with POP-Q examination and their association is stronger than the correlation between ultrasound findings and prolapse symptoms.
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Objective:To investigate the effect of alendronate sodium tablets combined with salmon calcitonin in the treatment of elderly patients with hip osteoporotic fracture, and the changes of serum bone metabolism.Methods:From January 2016 to December 2019, 86 elderly patients with osteoporotic hip fracture who were operated in Xin'an International Hospital were divided into observation group (43 cases) and control group (43 cases) according to the random digital table method.The control group was treated with salmon calcitonin, and the observation group was treated with alendronate sodium on the basis of the control group.The course of treatment was 6 months in both two groups.The changes of serum calcium and phosphorus, Harris score of hip joint and bone metabolism were compared before and after treatment.Results:There were no statistically significant differences in serum calcium and phosphorus levels between the observation group and the control group (all P>0.05). After treatment, the Harris score of hip joint in the observation group[(87.10±3.46)points] was higher than that in the control group [(78.65±4.32)points]( t=10.011, P<0.05). The serum β-CTX [(0.27±0.05)μg/L] in the observation group was lower than that in the control group [(0.39±0.07)μg/L], while the ALP [(117.93±10.15)U/L] in the observation group was higher than that in the control group[(98.32±8.97)U/L], the differences were statistically significant( t=9.147, 9.493, all P<0.05). Conclusion:Alendronate combined with salmon calcitonin can improve the bone metabolism of elderly patients with hip osteoporotic fracture, and improve the function of hip joint.
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Objective To investigate the feasibility and accuracy of transperineal real‐time three‐dimensional ultrasound combined with clinical factors in predicting the risk of female stress urinary incontinence( SUI ) . Methods T hree hundred and forty‐eight female patients with SUI diagnosed were selected as the case group ,and 102 healthy people in the same period were selected as the control group . All subjects underwent transperineal real‐time three‐dimensional ultrasound . T he ultrasonic parameters of resting state ,contraction and Valsalva were measured ,and the clinical parameters such as age ,height , weight ,history of pregnancy and childbirth were collected . According to the time sequence ,all the subjcets were divided into derivation cohort and verification cohort inproportion to 2∶1 ,single factor screening and logistic multiple regression analysis were carried out on 24 factors ,and the risk model was established . T he cut‐off value of the disease probability P was determined by the ROC curve of the subjects ,and then the accuracy of the cut‐off value in predicting SUI was verified in the verification group . Results Single factor analysis showed that 13 parameters were associated with SUI( all P ＜0 .05) . Logit P＝2 .014+1 .870× Z1 was established by multivariate logistic regression analysis . T he cut‐off value of the disease probability P determined by ROC curve was 0 .823 . T he predictive sensitivity of the model was 68 .1% ( 95% CI : 59 .6% －76 .6% ) ,specificity was 91 .2% ( 95% CI :86 .0% －96 .4% ) ,positive predictive value was 64 .3%( 95% CI : 55 .6% － 73 .0% ) and negative predictive value was 92 .5% ( 95% CI : 86 .2% － 98 .8% ) . Conclusions It is feasible to predict the risk of female stress urinary incontinence by transperineal real‐time three‐dimensional ultrasound combined with clinical factors . Although ,some limitations with the prediction model ,it has accuracy in predicting SUI with obvious symptoms .
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Objective@#To investigate the feasibility and accuracy of transperineal real-time three-dimensional ultrasound combined with clinical factors in predicting the risk of female stress urinary incontinence(SUI).@*Methods@#Three hundred and forty-eight female patients with SUI diagnosed were selected as the case group, and 102 healthy people in the same period were selected as the control group. All subjects underwent transperineal real-time three-dimensional ultrasound. The ultrasonic parameters of resting state, contraction and Valsalva were measured, and the clinical parameters such as age, height, weight, history of pregnancy and childbirth were collected. According to the time sequence, all the subjcets were divided into derivation cohort and verification cohort inproportion to 2∶1, single factor screening and logistic multiple regression analysis were carried out on 24 factors, and the risk model was established. The cut-off value of the disease probability P was determined by the ROC curve of the subjects, and then the accuracy of the cut-off value in predicting SUI was verified in the verification group.@*Results@#Single factor analysis showed that 13 parameters were associated with SUI(all P<0.05). Logit P=2.014+ 1.870×Z1 was established by multivariate logistic regression analysis. The cut-off value of the disease probability P determined by ROC curve was 0.823. The predictive sensitivity of the model was 68.1% (95%CI: 59.6%-76.6%), specificity was 91.2% (95%CI: 86.0%-96.4%), positive predictive value was 64.3% (95%CI: 55.6%-73.0%) and negative predictive value was 92.5% (95%CI: 86.2%-98.8%).@*Conclusions@#It is feasible to predict the risk of female stress urinary incontinence by transperineal real-time three-dimensional ultrasound combined with clinical factors. Although, some limitations with the prediction model, it has accuracy in predicting SUI with obvious symptoms.
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AIM: To investigate the relationships between I?1 hs1,2 VNTR polymorphism and IgA nephropathy. METHODS: Four hundred and ninteen patients with IgA nephropathy and their first-degree relatives were recruited. Two hundred and one sex and age-matched normal Chinese Han volunteers were also recruited as controls. After extracting genomic DNA, the VNTR genotypes of I?1 hs1,2 region were determined by PCR and electrophoresis, and the results were analyzed by transmission disequilibrium test (TDT) and haplotype relative risk (HRR) in the families, and Chi-Square test in the case-control analysis. RESULTS: ① TDT analyses showed that B allele of the I?1 hs1,2 VNTR region was significantly more transmitted from heterozygous parents to patients than expected (101 Trios, ?2=6.818, P