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Objective:To explore the feasibility and application value of three dimensional (3D) printing technology in creating models of abnormal fetal aortic arch and its branches.Methods:Eleven cases of abnormal fetuses confirmed fetal aortic arch and its branches anomalies from March 2019 to July 2020 in Renmin Hospital of Wuhan University were prospectively enrolled. All the fetuses underwent two dimensional(2D) echocardiography and spatio-temporal image correlation (STIC) technology examination. The 3D volume images of fetal heart were post-processed by Mimics software to create images of the great vessels and their branches in standard tessellation language format (STL) file. The STL file was output to the 3D printer and the 3D printing models of fetal great vessels and their branches were obtained. Compared with conventional ultrasound, the characteristics and application value of 3D printed models of abnormal fetal aortic arch and its branches were analyzed.Results:Eleven fetuses were successfully modeled and printed out large blood vessels and their branch models. The 3D printing model had its own advantages in displaying large blood vessels and their branch abnormalities. It could provide high quality imaging anatomical details and visualize great vessels origin, branch and position and can better display vascular ring spatial relations.Conclusions:It is feasible to use 3D printing technology to make the fetal aortic arch and its branch abnormal model. The 3D printing model can directly display its characteristic changes and provide a certain reference basis for accurately determining the type of vascular ring in the prenatal stage.
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Objective:To investigate the feasibility of three dimensional(3D) printing fetal heart from spatio-temporal image correlation (STIC) volume-rendered data.Methods:Eight fetuses with normal heart and 3 fetuses with confirmed cardiac anomalies identified by two-dimensional echocardiography from February to May 2019 in Renmin Hospital of Wuhan University were prospectively enrolled in this study. All the fetuses underwent two-dimensional (2D) echocardiography and STIC technology examination. The 3D volume images of fetal heart were post-processed by Mimics software to create images of the fetal heart in standard tessellation language format(STL). The STL file was output to the 3D printer and the 3D printing models of fetal heart and great vessels were obtained. In the process, the numerical values of each index of fetal hearts were measured from 3D digital model, 3D printing models and routine echocardiography images, respectively. The accuracy of 3D modeling was assessed by comparing the measured values of the model with the measured values of the source data.Results:In all the fetuses, STIC volume data of the fetal heart were successfully reprocessed and printed out, the anatomical structure and vascular course could be visually displayed. It showed no significant difference in all the heart size parameters between 3D digital model, 3D printing models and routine echocardiography images (all P>0.05). Moreover, the size parameters were concordant well between the two methods, all of the data points fell within the limits of agreement. Conclusions:The 3D printing of fetal heart using STIC volume images as the data source is feasible.
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Forty eight singleton normal fetuses underwent two-dimensional echocardiography with fetal heart quantitative technique (fetal HQ) in People′s Hospital of Wuhan University on September 2019. Fetal ventricular intima was successfully tracked by fetal HQ software in 45 cases; the length, transverse width, area, and global spherical index(GSI) of four-chamber view were measured with fetal HQ, meanwhile the dynamic tracking curve of ventricular intima was obtained. The left (right) ventricular global strain (GS), fetal area change (FAC), left ventricular ejection fraction (EF) and 24 segment end diastolic diameter (ED), short-axis shortening (FS), spherical index (SI) were calculated. Fetal heart shape and size and cardiac function parameters, as well as z-score of each parameter after adjustment for gestational age, were obtained successfully. The length, transverse width and area were linearly correlated with gestational age, while other parameters and their Z scores were not significantly correlated with gestational age. Z score of measured values of each parameter fell within the normal range of -2<Z <+2. All measurements of repeatability test were within the consistency limit range. It is suggest that fetal HQ can obtain multiple evaluation indexes easily and reliably, and has good reproducibility, which provides a useful tool for quantitative evaluation of fetal heart shape, size and function.
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From November.2015 to December 2016,targeted hand ultrasonographic examinations were carried out on 532 fetuses with family history,suspected limb deformities or other abnormalities.The number,size and shape of metacarpal and phalangeal bones were observed from coronal,axial and sagittal view.Three-dimensional ultrasound examination was performed on the suspected short fingers of fetal hands.Follow-up data were obtained in 382 cases.In 6 cases of prenatally detected brachydactyly,5 were bilateral and 1 case was unilateral.In these cases,more than one ossification centers of phalanxes were not present or significantly smaller.In 6 cases of brachydactyly,the termination of pregnancy was performed in 4 (including 2 cases with multiple malformations,and 2 cases with brachydactyly family history but without other abnormalities),while in other 2 cases without other abnormalities the pregnancy was retained until birth.X-rays and autopsies confirmed the prenatal diagnosis of brachydactyly in 4 cases of pregnancy termination,but duplicated distal phalanges of bilateral thumbs of 1 case was missed in prenatal scan.It is suggested that the targeted ultrasonographic scan of the fetal hands in high-risk population during pregnancy helps to detect severe brachydactyly.
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Prenatal 2D and 3D ultrasonographic examinations were performed for 67 008 pregnant women in Renmin Hospital of Wuhan University from January 2013 to December 2016.Among 69 013 fetuses,71 cases of congenital vertebral deformities were diagnosed with a detection rate of 0.103%.There were 40 cases of semi-vertebrae,23 cases of butterfly vertebrae,2 cases of coronal vertebral body fissure and 6 cases of vertebral fusion.Half vertebral deformity was the most common vertebral abnormality accounting for 56.3%(40/71),and the coronal vertebral body fissure was the least abnormality.Among 71 abnormal vertebral fetuses,there were 40 cases with other abnormalities,of which 28 fetuses were induced abortion, 12 fetuses were born;there were 31 cases of simple vertebral body anomalies,of which 8 fetuses were born and 23 fetuses were induced abortion.In infants with a single vertebral anomalies had no significant scoliosis,X-ray examination was performed 3-6 months after birth,the results were consistent with prenatal ultrasound diagnosis.Fifty one cases of induced abortion were examined by X-ray,the prenatal diagnosis was consistent with X-ray findings in 48 cases,and the remaining 3 cases were all multiple hemi-vertebrae with missed diagnosis of congenital butterfly vertebral deformity.
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The clinical data of 39 cases of intrauterine pregnancy complicated with cornual pregnancy after in-vitro fertilization embryo transfer ( IVF-ET) were analyzed retrospectively .All the patients were diagnosed by transvaginal ultrasound in early pregnancy , and the position of the gestational sac and its external process were determined by transvaginal ultrasound .According to the location and size of the gestational sac, the patients were divided into two groups: in group A (n=29) the gestational sac was located close to the interstitial tube and the gestational sac was larger , prominent out of the corners of the uterus;in group B (n=10) the gestational sac was located towards the uterine cavity , gestational sac was smaller and the embryo was not active .The laparoscopic angle wedge resection for group A and ultrasound-guided embryo reduction for group B were performed respectively .After treatment , 38 cases were stable to term delivery with intrauterine pregnancy; abortion occurred in 1 case of group A 2 weeks after operation . The early diagnosis and treatment is very important for intrauterine pregnancy complicated with cornual pregnancy . Ultrasonography provides an accurate preoperative assessment and intraoperative real -time monitoring during embryo reduction , which provides an alternative approach for the treatment of intrauterine pregnancy combined with cornual pregnancy .
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Objective@#To investigate the role and mechanism of action of Yiqi Huoxue Recipe (YQHXR) in regulating autophagy and reversing liver fibrosis in rats with carbon tetrachloride (CCl4)-induced liver fibrosis.@*Methods@#Healthy male Wistar rats were intraperitoneally injected with a mixture of CCl4 (30%) and olive oil (70%) twice a week for 8 weeks to establish a rat model of liver fibrosis. The rats administered normal diet were used as control group. Furthermore, YQHXR or Fuzheng Huayu Recipe (FZHYR) was intragastrically administered to the rats. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured using an automatic biochemical analyzer. Hematoxylin-eosin (HE) staining and Masson staining were performed to observe the degree of fibrosis in rat liver. The protein expression of α-smooth muscle actin (α-SMA) and type I collagen α1 chain (Col1A1) in liver tissue was measured by immunohistochemistry. Furthermore, the mRNA and protein expression of α-SMA, Col1A1, autophagy-related protein 7 (Atg7), microtubule-associated protein 1 light chain 3 (LC3), and ubiquitin-binding protein (SQSTM1/p62) were determined using qRT-PCR and Western blotting, respectively. Comparison between multiple groups was made by one-way analysis of variance, and comparison between any two groups was made using the LSD test. P < 0.05 was considered as statistically significant.@*Results@#The YQHXR group and FZHYR group had significantly lower serum levels of ALT and AST than the model group (ALT: 66.8±10.42 U/L and 73.2±10.33 U/L vs 106.80±18.24 U/L, F = 31.672, P < 0.001; AST: 122.6±16.65 U/L and 125.4±16.92 U/L vs 278.4±66.14 U/L, F = 25.539, P < 0.001). The pathological grades of hepatic fibrosis were S5.64±0.22, S3.70±0.35, and S3.90±0.34 in the model group, YQHXR group, and FZHYR group, respectively (F = 362.188, P < 0.001). Compared with the control group, the YQHXR group and FZHYR group had significantly reduced mRNA and protein expression of α-SMA, Col1A1, Atg7, and LC3B and significantly increased expression of p62 (all P < 0.05), and the differences were greatest in the YQHXR group.@*Conclusion@#YQHXR and FZHYR can prevent or reverse liver fibrosis by regulating hepatocyte autophagy and inhibiting hepatic stellate cell activation and collagen deposition.
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ObjectiveTo investigate the association of single nucleotide polymorphisms (SNPs) of programmed cell death-1 (PD-1) gene with chronic hepatitis C virus (HCV) infection and the effect of antiviral therapy with interferon combined with ribavirin. MethodsA total of 228 patients with chronic hepatitis C (CHC) who were hospitalized in seven hospitals in Hebei Province, China from October 2010 to October 2012 were enrolled and treated with interferon combined with ribavirin as the individualized antiviral therapy. Eighty-one persons who underwent physical examination were enrolled as control group. The TaqMan probe method was used to detect PD-1 gene polymorphisms. The distribution of alleles and genotypes at PD-1.1 and PD-1.3 were compared between the two groups, and the association between the SNPs of PD-1.1 and PD-1.3 and anti-HCV effect was analyzed. The chi-square test was used for the comparison of categorical data between groups. ResultsThe CHC group showed significantly higher frequencies of T allele and TT genotype at PD-1.1 than the control group (52.41% vs 43.21%, χ2=4.059, P=0.044; 28.51% vs 14.81%, χ2=6.469, P=0.039). The SNPs of PD-1.1 gene were not significantly associated with complete early virologic response or sustained virologic response (both P＞0.05). Both groups had CC genotype at PD-1.3. ConclusionPD-1.1 T allele might be associated with chronic HCV infection, and patients carrying TT genotype have a high risk of chronic HCV infection. PD-1.1 polymorphism is not associated with virologic response to anti-HCV therapy.
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The treatment responses to pegylated interferon alpha (PEG-IFNα)in patients with chronic hepatitis B (CHB)are associated with the genetic polymorphisms,immune status,hepatitis B virus genotype,and viral load of the host.This article reviews the recent studies on influential factors for the responses to PEG-IFNαin CHB patients.The important predictors of the clearance and seroconversion of HB-sAg and HBeAg and sustained virological response include interleukin-28B (IL-28B)gene polymorphism,baseline level of interferon-inducible protein-10,IL-17A,IL-10,tumor necrosis factor-α,viral load and genotype,and changes in serum HBsAg and HBeAg levels at weeks 12 and 24 of treatment.
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To explore the diagnostic values of real-time elastosonography quantitative parameters in uterine fibroids and adenomyoma.The clinical data of 175 cases were analyzed retrospectively.Strain ratios (B/A) of lesion and normal adjacent myometrium were measured and mean B/A was calculated.The average B/A of uterine fibroids and adenomyoma was 3.81 ±0.52 and 1.39 ±0.46 respectively.And there was significant statistic difference (t =2.563,P ＜ 0.05).the accuracy rates of real-time elastosonography in the diagnosis of uterine fibroids and adenomyoma were high at 97.4％ (148/152) and 95.3％ (122/128) respectively.Real-time elastosonography has high diagnostic values for uterine fibroids and adenomyoma.
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A total of 104 patients with polycystic ovarian changes on ultrasound were divided into polycystic ovary syndrome (PCOS) and polycystic ovaries (PCO) groups according to their clinical symptoms and endocrine examinations.And 40 women with normal ovulation served as the controls.Ovarian volume (OV),ovarian stroma area (SA),ovarian total area (TA) and SA/TA ratio were measured by transvaginal uhrasonography.Their endocrine hormone levels were determined.Patients with PCOS showed significantly higher OV,SA,TA and SA/TA than those of PCO and control groups.SA/TA was positively correlated with testosterone.The median serum levels of anti-Mullerian hormone (AMH) and inhibit B in the PCO group were intermediate between those in control and PCOS groups.AMH and inhibin B of PCOS were higher than the PCO and control groups.It indicated that the levels of AMH and inhibit B were associated with the degree of polycystic ovaries and they could be used to differentiate PCOS and PCO.SA/TA is associated with the elevated serum testosterone of PCO.And SA/TA is an important ultrasonic parameter for diagnosing PCOS.
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Seventy eight infertile women were examined by three dimensional hysterosalpingocontrast-sonography(3D-HyCoSy) and X-ray hysterosalingography (HSG) to observe flowing condition of fallopian tube.With the laparoscopy as gold standard,the sensitivity,specificity,positive predictive value and negative predictive value of 3D-HyCoSy in diagnosis of fallopian tube infertility were 94.7％,83.7％,93.9％ and 82.4％ ; those for HSG were 96.4％,82.6％,92.3％,93.0％ and 90.5％,respectively.U test showed that two methods had good consistency. The results suggested that 3D-HyCoSy provides an effective method in evaluation of fallopian tube pathology for infertile women.
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Objective To investigate the diagnostic value of parametric imaging of contrast-enhanced ultrasound (CEUS) in retroperitoneal tumors using SonoLiver software. Methods Sixty cases of retroperitoneal tumors were analyzed by CEUS with SonoLiver software. The color-mapped images of timedependent indexes, such as rise time(RT), time to peak(TTP), mean transit time(mTT), were abserved in the regions of interests(ROIS). The degree of the coincidence between pathologic diagnosis and parametric imaging diagnosis was carefully study by comparing parametric images with histopathological findings.Results 1 ) There was statistical significance of RT, TTP and mTT between the benign and malignant retroperitoneal tumors. 2) The time-dependent parametric images were obvious different between benign lesions and malignant lesions. The malignant lesions enjoyed a confused boundary and distribute disorderly,while the benign tumors had a clear distribution. There was a good coincidence degree between pathologic diagnosis and parametric imaging diagnosis(κ =0. 625, P =0. 000). Sensibility, specificity, the rate of misdiagnosis and missed diagnosis, the degree of accuracy respectively was 85.3 ％, 76.9 ％, 23.1 ％, 14.7 ％,81.7％ by the new diagnosis method. Conclusions Parametric imaging is a very useful way of evaluating the level of blood flow with the tumors and provides a new vision in the diagnosis of retroperitoneal tumors. It demonstrates retroperitoneal tumors clearly and objectively.
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Seventy eight patients suspected of intrauterine adhesion (IUA) were scanned with two-dimensional (2D) and three-dimensional (3D) transvaginal uhrasonography, the results were analyzed with hysteroscopic findings as the gold standard. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of three-dimensional transvaginal ultrasonography in diagnosis of IUA were 97% (58/60), 18/18, 97% (76/78), 100% (58/58) and 90% (18/20). Three-dimensional transvaginal ultrasonography was more accurate in diagnosis of IUA than two-dimensional ultrasonography ( P < 0. 01 ),and the IUA classification and grading with three-dimensional transvaginal ultrasonography was better correlated with hysteroscopic findings.
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Objective To investigate the relationship between serum leptin and carotid intima-media thickness in patients with type 2 diabetes mellitus. Methods 35 patients with type 2 diabetes mellitus (DM) and 16 normal controls were studied. Fasting serum leptin, fasting glucose(FBG), HbAlc, C-peptide, lipide, systolic(SBP), diastolic blood pressure(DBP), body mass index (BMI) and waist circ-umference (WC) were measured in all subjects. The intima-media thickness (IMT) of common carotid artery was measured by high-resolu-tion ultrasound imaging. Results IMT of T2DM was positively correlated with leptin concentration. Conclusion Serum leptin concentra-tion is independently associated with the IMT of carotid artery, which suggest that leptin may be an independent risk factor of atherosclerosis.
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nosis and treatment of EDO.
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Objective To analyze the blood perfusion characteristics of retroperitoneal benign and malignant tumors by real-time contrast enhanced ultrasonography and discuss its value in the differential diagnosis.Methods The study involved 42 patients with pathological evidence through surgery or needle biopsy,including 12 patients with benign retroperitoneal tumors and 30 patients with malignant retroperitoneal tumors.The blood perfusion characteristics of two groups were observed under low mechanical index after the injection of contrast ultrasound agent(SonoVue),and the changes of twodimensional ultrasonography and the time-intensity curve(TIC)were analyzed. Results During real time contrast enhancement,the different characteristics of retroperitoneal benign and malignant tumors were observed.Malignant tumors in retro peritoneum presented the pattern of ultrasound contrast agent(UCA) enhancement from center to periphery and enhanced overall uneven mainly,begin tumors presented peripheral enhancement pattern or uniformity and overall strengthening of the main.TIC curve between benign and malignant tumors displayed that contrast enhanced intensity of region of interest(P＜0.00 1),ascending slop and halftime of descending were statistically significant(P＜0.05).Conclusions Real-time contrast-enhanced ultrasonography is a valued method to provide information for the differential diagnosis in retroperitoneal benign and malignant tumors.
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Objective To observe the change of serum thyroid peroxidase antibody(TPOAb) in the patients with Hyperthyroidism and Thyroid gland tumor of different phases.Methods The level of TPOAb was observed,the relation between the changed TPOAb level and reduced thyroid function was studied.Results Among 89 cases,50 cases had normal or slightly elevated TPOAb level.However,after treatment,31 cases showed a raised TPOAb level.Of 19 cases with hypothyroidism or its sub-clinical type.There were 39 cases with positive TPOAb.After the treatment,2 cases changed to negative TPOAb,26 cases lowered,and 3 cases had hypothyroidism.There were 29 cases taking thyroid tablets without hypothyroidism.Conclusion The change of TPOAb level can be observed during the treatment for hyperthyroidism and t hyroid gland tumor.The elevated TPOAb level often predicts the decreased thyroid function.The patients with positive TPOAb should be carefully followed,and for hyperthyroidism patients the treatment should be taken with care.
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@#ObjectiveTo investigate the association between homocysteine and cerebral infarction, as well as between different subtypes of cerebral infarction.Methods105 cases with cerebral infarction were divided into two subgroups, according to TOAST criteria, large-artery disease and small-artery disease.In addition,50 normal persons were selected as control group.Fasting blood samples were drawn from antecubital vein for measurement of plasma total homocysteine,glucose and lipids.Enzyme conversion immunoassay was applied to detect plasma total homocysteine (tHcy) levels.ResultsThe mean tHcy of cerebral infarction, which was (24.85±24.56) μmol/L, was significantly higher than that of control group, which was (16.18±6.97) μmol/L(P<0.05).There was a significant difference of homocysteine between large-artery disease,which was (30.46±31.16) μmol/L, and small-artery disease,which was (18.43±10.73) μmol/L,or the control group(P<0.05),but there was no significant difference between small-artery disease and the control group. ConclusionThe mean tHcy significantly elevated in large-artery disease,which indicated that elevated plasma homocysteine levels is an independent risk factor for atherosclerotic vascular disease.