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Objective:To explore the application value of renal artery resistance index in the diagnosist of intra-abdominal hypertension (IAH) in critically ill patients.Methods:89 patients with risk factors of IAH in the intensive care unit of Zhangzhou Hospital Affiliated to Fujian Medical University from February 2022 to June 2022 were retrospective analyzed. The intra-abdominal pressure (IAP) were measured by bladder, and patients divided into IAH group (IAP≥12 mmHg) and non-IAH group (IAP <12 mmHg). The resistance index (RI) of the right renal aorta, segment artery and interlobar artery were measured by color Doppler ultrasound. The difference between the measurement indicators of patients in the IAH and non-IAH groups and the correlation with IAP were analyzed. As for different indicators to predict the diagnostic efficacy of IAH, ROC curve analysis was used to evaluate the effect. And further multivariate logistic regression analysis was to find independent risk predictor.Results:A total of 89 patients were included in the study, including 44 patients with normal IAP and 45 patients diagnosed IAH. There were significant differences in the right renal aorta, segmental artery and interlobar artery RI (all P<0.01). The interlobar artery RI≥0.698 was the highest diagnostic cut-off,area under the curve was 0.914, sensitivity was 82.2%, specificity was 97.7%, and Jordon index was 0.799. The Spearman correlation analysis of IAP and the ultrasonographic measurements revealed a strong correlation between right renal interlobar artery RI and IAP ( r=0.741, P<0.01). The multivariate logistic regression analysis showed that the right renal interlobar artery RI ( OR= 24.472, 95% CI:5.122~116.919, P<0.01) was an independent risk predictor of IAH ( P<0.01). Conclusion:Right renal interlobar artery RI had better diagnostic efficacy of IAH,renal ultrasound could be used as an alternative, non-invasive technique for the diagnosis and follow-up of IAH.
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Venous thromboembolism ( VTE) is one of the common complications of gynecological pelvic surgery. The incidence of VTE is increased year by year and the mortality was increased. Therefore the prevention and treatment of postoperative VTE in patients with gynecological pelvic surgery should be given high attention. Reviewing and summarizing the related literatures on the etiology, diagnosis, treatment and prevention of VTE after gynecological pelvic surgery, it is concluded that the early clinical symptoms of VTE after gynecological pelvic surgery are atypical, and clinical diagnosis needs to be made by means of platelet count, D-Dimer, coagulation function and color Doppler ultrasonography of both lower extremities. Anticoagulation, anti-platelet, elastic socks, intermittent pneumatic pressure pump and inferior vena cava filter are the main prevention and treatment methods. Preventive treatment before and after surgery is partic-ularly important.
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The clinical data of 113 early pregnant (11-14 weeks) women with high risk of placenta accreta undergoing ultrasound examination in Jinhua Maternal and Child Health Hospital from June 2013 to June 2018 were retrospectively analyzed.Among them,there were 21 cases of placenta accreta (implanted group) and 92 cases without placenta accreta (non-implanted group).The diagnostic value of different μltrasound signs for placenta accreta was assessed.The sensitivity of loss of clear zone was 71％(15/21),and the specificity was 87％ (80/92);the sensitivity of placental lacunae and bladder wall interruption was 67％(14/21) and 62％(13/21),and the specificity was 78％(72/92) and 95％(87/92),respectively.The uterovesical hypervascularity has the lowest sensitivity (38％,8/21),but the highest specificity (98％,90/92).When combination of 2 sings was used for diagnosis,the sensitivity of the ultrasound examination was 76％ (16/21) and the specificity was 65％(60/92);when the combination of 3 signs was used,the sensitivity and specificity were 76％ (16/21) and 93％ (86/92),respectively.It is suggested that ultrasound examination in early pregnancy may find all types of placenta implants with good diagnostic accuracy.
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Objective: To explore the relationship between glycemic control and visceral adiposity index (VAI) among type 2 diabetes mellitus (T2DM) patients.Methods: A community-based epidemiological field study for patients with T2DM aged ≥ 40 years was conducted in China.Every participant underwent physical examinations, biochemical tests of fasting glucose, glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and so on, and a questionnaire, including anthropometric characteristics, lifestyle, disease history, family history, and medication use.Those participants with HbA1c ≥7.0% were classified as the poorly controlled in our analysis of relationship between glycemic control and VAI.Anthropometric characteristics, lifestyle, and biochemical indexes of the participants were compared among the groups of different VAI levels.Logistic models were applied in multiple analysis adjusting for possible confounders.Results: A total of 1 607 patients with T2DM were recruited in our analysis with a mean age of (59.4±8.1) years and an average T2DM duration of (7.0±6.4) years.Among them, 78.3% were on hypoglycemic therapy.The cutoff points of quartiles of VAI were calculated for the males and females, respectively.According to the ascending order of the quartiles of VAI, the participants were divided into four groups, i.e.Q1, Q2, Q3, and Q4.The poor glycemic control rate for these groups were 60.6%, 65.7%, 70.1%, and 71.0%, respectively (Trend χ2=12.20, P<0.001).After adjustment for age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), LDL-C, smoking, cardio-cerebral vascular disease (CVD) history, hypoglycemic therapy, T2DM duration, and family history of diabetes, the Logistic regression models showed that the glycemic control rate was significantly associated with VAI levels among the patients with T2DM.Compared with the participants in group Q1, the ORs of poor glycemic control for those in groups Q2, Q3, and Q4 were 1.239 (95%CI 0.918 to 1.672), 1.513 (95%CI 1.117 to 2.050), and 1.535 (95%CI 1.128to 2.088), respectively (trend P=0.003).With each quartile increase in VAI, the OR of poor glycemic control was 1.162 (95%CI 1.054 to 1.282).Conclusion: The glycemic control among the patients with T2DM is significantly associated with VAI.High level of VAI is an indicator of poor glycemic control.
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Objective To discuss the therapeutic effect of uterine arterial embolization in treating adenomyosis.Methods Uterine arterial embolization was performed in 80 patients with adenomyosis.The patients were followed up for 3,6,12 and 24 months after the operation.After the treatment the degree of dysmenorrhea,the menstrual flow and the uterine volume were observed and were compared with those before the treatment.Results After uterine arterial embolization the clinical symptoms were relieved in all 80 patients.The menstrual flow was markedly decreased,the anemia was obviously improved and the uterine volume was significantly reduced,while the ovary functioning was not apparently affected.The symptom of dysmenorrhea completely disappeared one month after the therapy in 76 cases and four months after the therapy in the remaining 4 cases.Conclusion Uterine arterial embolization is a mini-invasive and safe therapy with remarkable therapeutic results and few side-effects.Therefore,this treatment can significantly improve the patient's living quality.
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Objective To discuss the therapeutic effect of uterine arterial embolization in treating adenomyosis.Methods Uterine arterial embolization was performed in 80 patients with adenomyosis.The patients were followed up for 3,6,12 and 24 months after the operation.After the treatment the degree of dysmenorrhea,the menstrual flow and the uterine volume were observed and were compared with those before the treatment.Results After uterine arterial embolization the clinical symptoms were relieved in all 80 patients.The menstrual flow was markedly decreased,the anemia was obviously improved and the uterine volume was significantly reduced,while the ovary functioning was not apparently affected.The symptom of dysmenorrhea completely disappeared one month after the therapy in 76 cases and four months after the therapy in the remaining 4 cases.Conclusion Uterine arterial embolization is a mini-invasive and safe therapy with remarkable therapeutic results and few side-effects.Therefore,this treatment can significantly improve the patient’s living quality.