Analysis of the clinical diagnosis and treatment of fetal meconium peritonitis.

BACKGROUND: The purpose of this study was to improve diagnostic and therapeutic standards by examining the clinical features, treatment, and prognosis of fetal meconium peritonitis (FMP), as well as the diagnostic efficacy of ultrasound for FMP. METHODS: The clinical data of 41 infants and pregnant women diagnosed with meconium peritonitis (MP) and treated at the Fujian Maternal and Child Health Hospital from January 2013 to January 2020 were analyzed retrospectively. Clinical data, imaging data, complications, treatment strategies, pregnancy outcomes, neonatal prognoses, and follow-up outcomes were all analyzed. RESULTS: The MP prenatal diagnosis rate was 56.1% (23/41), the neonatal surgery rate was 53.7% (22/41), and the survival rate was 85.4% (35/41). Intraperitoneal calcification (23 pregnant women, 56.1%), intestinal dilatation (13 pregnant women, 31.7%), peritoneal effusion (22 pregnant women, 53.7%), intraperitoneal pseudocyst (7 pregnant women, 17.1%), and polyhydramnios were diagnosed via prenatal ultrasound (18 pregnant women, 43.9%). Twenty-two pregnant women were assigned to the surgical treatment (operation) group, while 18 were assigned to the conservative treatment group. In the operation group, there were 9 cases of ileal atresia (40.9%), 7 cases of jejunal atresia (31.8%), 2 cases of atresia at the jejunum-ileum junction (9.1%), 2 cases of ileal perforation (9.1%), 1 case of ileal necrosis (4.5%), and 1 case of adhesive obstruction (4.5%). There was no statistically significant difference (p > .05) in the occurrence of various prenatal ultrasound findings by etiology. CONCLUSION: Multiple prenatal ultrasound markers have been identified for MP. To improve the efficacy of newborn treatment for FMP and reduce neonatal mortality, dynamic monitoring of ultrasound image alterations and strengthened integrated perinatal management are necessary.

Three-dimensional convolutional neural network model to identify clinically significant prostate cancer in transrectal ultrasound videos: a prospective, multi-institutional, diagnostic study.

Background: Identifying patients with clinically significant prostate cancer (csPCa) before biopsy helps reduce unnecessary biopsies and improve patient prognosis. The diagnostic performance of traditional transrectal ultrasound (TRUS) for csPCa is relatively limited. This study was aimed to develop a high-performance convolutional neural network (CNN) model (P-Net) based on a TRUS video of the entire prostate and investigate its efficacy in identifying csPCa. Methods: Between January 2021 and December 2022, this study prospectively evaluated 832 patients from four centres who underwent prostate biopsy and/or radical prostatectomy. All patients had a standardised TRUS video of the whole prostate. A two-dimensional CNN (2D P-Net) and three-dimensional CNN (3D P-Net) were constructed using the training cohort (559 patients) and tested on the internal validation cohort (140 patients) as well as on the external validation cohort (133 patients). The performance of 2D P-Net and 3D P-Net in predicting csPCa was assessed in terms of the area under the receiver operating characteristic curve (AUC), biopsy rate, and unnecessary biopsy rate, and compared with the TRUS 5-point Likert score system as well as multiparametric magnetic resonance imaging (mp-MRI) prostate imaging reporting and data system (PI-RADS) v2.1. Decision curve analyses (DCAs) were used to determine the net benefits associated with their use. The study is registered at https://www.chictr.org.cn with the unique identifier ChiCTR2200064545. Findings: The diagnostic performance of 3D P-Net (AUC: 0.85-0.89) was superior to TRUS 5-point Likert score system (AUC: 0.71-0.78, P = 0.003-0.040), and similar to mp-MRI PI-RADS v2.1 score system interpreted by experienced radiologists (AUC: 0.83-0.86, P = 0.460-0.732) and 2D P-Net (AUC: 0.79-0.86, P = 0.066-0.678) in the internal and external validation cohorts. The biopsy rate decreased from 40.3% (TRUS 5-point Likert score system) and 47.6% (mp-MRI PI-RADS v2.1 score system) to 35.5% (2D P-Net) and 34.0% (3D P-Net). The unnecessary biopsy rate decreased from 38.1% (TRUS 5-point Likert score system) and 35.2% (mp-MRI PI-RADS v2.1 score system) to 32.0% (2D P-Net) and 25.8% (3D P-Net). 3D P-Net yielded the highest net benefit according to the DCAs. Interpretation: 3D P-Net based on a prostate grayscale TRUS video achieved satisfactory performance in identifying csPCa and potentially reducing unnecessary biopsies. More studies to determine how AI models better integrate into routine practice and randomized controlled trials to show the values of these models in real clinical applications are warranted. Funding: The National Natural Science Foundation of China (Grants 82202174 and 82202153), the Science and Technology Commission of Shanghai Municipality (Grants 18441905500 and 19DZ2251100), Shanghai Municipal Health Commission (Grants 2019LJ21 and SHSLCZDZK03502), Shanghai Science and Technology Innovation Action Plan (21Y11911200), and Fundamental Research Funds for the Central Universities (ZD-11-202151), Scientific Research and Development Fund of Zhongshan Hospital of Fudan University (Grant 2022ZSQD07).

The Application Value of Contrast-Enhanced Ultrasonography in Assessing the Efficacy of Ultrasound-Guided Lauromacrogol Injections in Cesarean Scar Pregnancies.

OBJECTIVE: To investigate the application value of contrast-enhanced ultrasonography (CEUS) in ultrasound-guided lauromacrogol injections in patients with cesarean scar pregnancies (CSP). METHODS: A total of 31 patients diagnosed with CSP, who underwent an ultrasound-guided lauromacrogol injection + curettage in our hospital between February 2019 and December 2020 and had a complete recovery confirmed by a postoperative ultrasound review and serum ß-human chorionic gonadotropin (ß-hCG) assay, were enrolled as the study subjects. According to the volume of intraoperative blood loss and the duration of postoperative vaginal bleeding, the patients were divided into two groups, with 19 in the significantly effective group (Group A) and 12 in the effective group (Group B). The recorded clinical data, including age, duration of amenorrhea, number of pregnancies, number of deliveries, time since last cesarean delivery, number of cesarean deliveries, and preoperative serum ß-hCG levels, were retrospectively analyzed. The morphological indicators in CEUS before the lauromacrogol injection, as well as immediately and 12-24 hours after the injection, were compared between the groups. RESULTS: In Group A, the post-injection CEUS showed no enhancement, single strip enhancement, and sparse punctate enhancement, while in Group B, it showed a more irregular ring and local patch enhancement. In addition, the number of cases where the CEUS showed no enhancement 12-24 hours after the injection was more than that of the immediate CEUS after the injection. In Group A, four (21.1%) cases showed a single strip-like blood flow on the immediate postoperative CEUS, four (21.1%) cases showed a sparsely dotted blood flow on the immediate postoperative CEUS, and three cases turned into no enhancement 12-24 hours after the injection. A total of four cases in Group B showed that the contrast enhancement range 12-24 hours after the injection was reduced compared with that of the immediate contrast after the injection. CONCLUSION: Contrast-enhanced ultrasonography can guide the location selection of the lauromacrogol injection in patients with CSP, and its postoperative morphological indicators can adequately predict the therapeutic effect after curettage and guide clinical management.

[Adaptability of Broussonetia papyrifera to sewage sludge and its characteristics of nutrient and heavy metal uptake and accumulation]. / æž„æ ‘çš„æ±¡æ³¥é€‚åº”æ€§åŠå »åˆ†å’Œé‡é‡‘å±žå¸æ”¶ç´¯ç§¯ç‰¹å¾.

Broussonetia papyrifera, an important fast-growing economic tree species in China, has the advantages of strong adaptability, high-biomass, and high bioconcentration of heavy metals. Sewage sludge contains a great deal of nutrients and heavy metals. Planting B. papyrifera with sewage sludge can achieve the goals of sewage sludge remediation as well as resources production of B. papyrifera. A pot experiment was conducted to investigate growth, uptake and accumulation of nutrient and heavy metal in different organs (root, stem, leaf) of B. papyrifera, with treatments of control (lateritic red soil), 50% sewage sludge (mixed substrates of 50% sewage sludge and 50% lateritic red soil based on weight) and 100% sewage sludge. The comprehensive evaluation of capacity of uptake and accumulation was also carried out by principal component analysis and membership function. The results showed that B. papyrifera could grow normally in both 50% and 100% sewage sludge substrates, with higher plant height and biomass than that in the control, especially in 100% sewage sludge substrate. The quality index in 100% sewage sludge substrate (1.02) was 4.3 times and 2.4 times as that of the control and 50% sewage sludge substrate, respectively. The content of N in different organs and P in stem increased significantly in both 50% and 100% sewage sludge substrates. The content of K in stem and leaf was significantly decreased in 100% sewage sludge substrate, which were significant lower than that of control. The uptake of heavy metals such as Cu, Zn, Pb, Cd, Ni for B. papyrifera were mainly through roots. There was positive correlation between the content of heavy metals in root and sewage sludge ratio. The content of Pb and Cd in leaves were lower than the limit value of Hygienic Standard For Feeds (GB 13078-2017). The capacity for absorption and accumulation of Cd was better than that of other heavy metals. Compared with the control, rootretention rates of Zn, Pb and Cd significantly increased in both 50% and 100% sewage sludge substrates (57.8%-85.8%), while Cu and Ni significantly increased in 100% sewage sludge substrate (67.5% and 74.8%). Nutrient and heavy metal accumulations in total plant in both 50% and 100% sewage sludge substrates were significantly higher than that in the control, with 100% sewage sludge substrate being significantly higher than that in 50% sewage sludge substrate. Compared with 50% sewage sludge substrate, the increment rates of nutrient and heavy metal accumulations in different organs as well as total plants in 100% sewage sludge substrates were greatly increased. The rank of comprehensive evaluation scores of adaptability, element uptake and accumulation was in an order: 100% sewage sludge substrate (0.848) > 50% sewage sludge substrate (0.344) > control (0.080). With good adaptability to sewage sludge, B. papyrifera could grow normally in sewage sludge andeffectively absorb and fix nutrients and heavy metals. It is feasible to plant B. papyrifera into the sewage sludge for remediation of sewage sludge and resource production.

[Effects of surface and mixed application of sewage sludge on Neolamarckia cadamba root growth]. / è¡¨æ–½å’Œæ··æ–½æ±¡æ³¥å¯¹å›¢èŠ±æ ¹ç³»ç”Ÿé•¿çš„å½±å“.

The utilization of sewage sludge in forests is an important way of recycling. However, the effect of sewage sludge application on woody plant root growth has been rarely reported. The effects of surface application and mixed application of sewage sludge (mass ratio in 10%) on the dynamics in root morphology of a fast-growing tree species (Neolamarckia cadamba), soil pH, electric conductivity, and heavy metal content of roots in different soil layers were analyzed by a rhizobox experiment. The relationship between root length and soil pH value, electric conducti-vity, and root heavy metal content were further analyzed. Results showed that mixed application of sewage sludge inhibited root length, root surface area, and root volume. After 120 and 240 days of mixed application, total root length in the 0-20 cm soil layer was 76.9% and 67.4% of that of no sewage sludge application, respectively. Surface application of sewage sludge did not affect root length and root surface area but increased root volume. The mixed application of sewage sludge significantly increased soil pH, electric conductivity, and root heavy metal content. Root Cd contents in 0-20 cm and 20-40 cm soil layers with the mixed application of sewage sludge were 11.5 and 10.0 times as that of no sewage sludge application, respectively. Soil electric conductivity had a significant nega-tive correlation with root length in 0-20 cm soil layer among different treatments. Root Cd content had a significant negative correlation with root length in both the surface and the mixed applications of sewage sludge. These results indicated that mixed application of sewage sludge could inhibit N. cadamba root growth mainly by increasing soil electric conductivity and root Cd content, while the surface application of sewage sludge did not affect root growth.

Effects of sewage sludge and other wastes application on the growth and element uptake of Jatropha curcas in abandoned rare-earth mine soil.

The wastes such as sewage sludge (SS) can be used to amend soil of abandoned rare-earth mine land (ARL). The energy plant Jatropha curcas could be used as a pioneer tree species in the ARL. In a pot experiment to address the responses of growth and element uptake of J. curcas, three treatments were established: adding SS to the soil of ARL (T1), adding SS and bagasse to the soil of ARL (T2), adding SS, bagasse and passivator to the soil of ARL (T3), with the untreated soil of the ARL as the control (CK). The results showed that compared with CK, T1 only significantly increased the plant height of J. curcas, T2 and T3 significantly increased the plant height, ground diameter and dry biomass of J. curcas, of which the total dry biomass increased by more than 184.7%. All the three treatments significantly increased the contents of N, P, K and Cu in J. curcas. T1 and T2 significantly increased the proportion of exchangeable Zn, Cd and Ni in the substrates, while T3 showed the opposite effects. T3 significantly decreased the migration factor (M) and mobility factor (MF) of Zn, Cd, Ni in the substrates, and significantly reduced the contents of Zn, Pb, Cd, Ni in J. curcas, with an inhibition rate of over 36.1%. The comprehensive evaluation of the membership function showed that the order of growth promotion effects on J. curcas was T2>T3>T1>CK, while the order of capacity of inhibiting J. curcas to accumulate Cu, Zn, Pb, Cd, Ni was T3>CK>T2>T1. The combined application of SS and bagasse significantly promoted the growth and element accumulation of J. curcas, and the addition of passivator significantly reduced heavy metals uptake without affecting the growth of J. curcas.

[Heavy metal tolerance of Miscanthus plants and their phytoremediation potential in abandoned mine land]. / èŠ’å±žæ¤ç‰©é‡é‡‘å±žè€æ€§åŠå ¶åœ¨çŸ¿å±±åºŸå¼ƒåœ°æ¤è¢«æ¢å¤ä¸­çš„åº”ç”¨æ½œåŠ›.

Miscanthus has been recognized as promising candidate for phytoremediation in abandoned mine land, because of its high tolerance to heavy metals and bioenergy potential. Miscanthus has been reported tolerant to several heavy metal elements. However, it has not been recognized as hyperaccumulator for these elements. The detailed mechanisms by which Miscanthus tolerates these heavy metal elements are still unclear. According to recent studies, several mechanisms, such as high metabolic capacity in root, an abundance of microbes in the root-rhizosphere, and high capacity of antioxidation and photosynthesis might contribute to enhance the heavy metal tolerance of Miscanthus. Miscanthus has a certain potential in the phytoremediation of abandoned mine land, because of its high suitability for the phytostabilization of heavy metals. Moreover, Miscanthus cropping is a promising practice to enhance the diversity of botanical species and soil organism, and to improve soil physical and chemical properties. Here we reviewed recent literatures on the biological characteristics and the heavy metal tolerance of Miscanthus, and its phytoremediation potential in abandoned mine land. A basic guideline for using Miscanthus in abandoned mine land phytoremediation and an outlook for further study on the mechanisms of heavy metals tolerance in Miscanthus were further proposed. We hoped to provide theoretical references for phytoremediation in abandoned mine land by using Miscanthus.