RÉSUMÉ
BACKGROUND: We aimed to investigate the efficacy and safety of echo contrast-enhanced ultrasound (CEUS) during high-intensity focused ultrasound (HIFU) ablation therapy for abdominal wall endometriosis (AWE). METHODS: A total of 67 patients with AWE were treated with HIFU ablation, and their demographic characteristics were retrospectively analysed. Blood perfusion of the focal lesion was assessed before the operation, during ablation and after the operation with the use of an ultrasound contrast agent, and the effect of the ultrasound contrast agent on treatment was assessed over a 1-year follow-up period. The degree of symptom relief and adverse effects were evaluated after HIFU ablation. RESULTS: Eighty-two lesions were ablated in 67 patients. CEUS showed that all lesions were successfully ablated with HIFU. The shrinkage ratio of the lesions significantly increased over the follow-up period. Intermittent pain disappeared at 1 month after the operation, and the patients' pain scores significantly decreased at the 1-year follow-up. The mean [± standard deviation (SD)] lesion volume was 7.64±8.95 cm3 on B-mode ultrasound. The post-HIFU non-perfused volume was 18.34±24.08 cm3, and the rate of massive changes on greyscale imaging was 96.16%±5.44% at 12 months. During the procedure, the main complications were a prickling sensation and tenderness in the treatment area and/or a transient "hot" sensation on the skin. After the procedure, there was no obvious discomfort except for pain. Two patients developed an approximately 1-cm area of skin that exhibited a waxy appearance. Seven patients had haematuria. No severe complications were observed. CONCLUSIONS: Ultrasound contrast agents are effective and safe for evaluating the effect of HIFU ablation on AWE, and this approach provides significant guidance and evaluation benefits for the use of HIFU treatment for AWE without obvious side effects.
RÉSUMÉ
OBJECTIVE: To explore the dynamic changes of adipocytokines and its correlation with insulin resistance during different stages of normal pregnancy. METHODS: Sixty-seven healthy pregnant women (18 first, 19 second and 30 third trimester) as experimental groups and 46 healthy age-matched non-pregnant women as a control group were investigated in a case-control cross-sectional study. Serum soluble tumor necrosis factor receptor (sTNFR) was determined by enzyme linked immunoadsorbent assay (ELISA). Maternal serum leptin and adiponectin were detected by radial immunodiffusion. TNF-alphaR in placenta and fat tissue was examined by streptavidin/peroxidase. RESULTS: The sTNFR-I level was higher in pregnant women than that in the control group (729 +/- 167) ng/L, being significantly higher in second (1003 +/- 241) ng/L and third trimesters (1278 +/- 306) ng/L (P < 0.001). sTNFR-II level of first, second and third trimester groups (1383 +/- 305) ng/L, (1772 +/- 293) ng/L, (1933 +/- 498) ng/L was higher than that in the control group (1002 +/- 221) ng/L (P < 0.001) and was increased with the progress of gestation. Leptin level in late trimester (89 +/- 57) microg/L was significantly higher than that in control group (61 +/- 37) microg/L (P < 0.05). Adiponectin level in second (9 +/- 5) mg/L and third trimesters (10 +/- 4) mg/L was significantly lower than that in control group (14 +/- 7) mg/L (P < 0.05). The sTNFR-I and sTNFR-II were expressed in placenta and fat tissue. CONCLUSION: The dynamic changes of adipocytokines contribute to occurrence of insulin resistance.