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Objective@#To examine the relationship between 7, 8-dihydrodio1-9.10-epoxide benzo[a] pyrene-DNA adducts (BPDE-DNA adducts) in the blood of pregnant women and gestational diabetes mellitus (GDM) and explore the environmental factors of the formation of GDM.@*Methods@#Forty pregnant women who were diagnosed GDM (case group) and 40 pair-matched normal pregnantwomen who had no complications accordingto age, gravidity, parity and gestational weeks(normal control group) were enrolled in this study. Questionnaire survey was used to obtain personal information, and BPDE-DNA adducts was examined by high performance liquid chromatography. Logistic regression model was used to analyze the relationship between BPDE-DNA adductsand GDM.@*Results@#The concentration of BPDE-DNA adducts in peripheral blood of case group [(6.1 ± 2.9) adducts/108nucleotides] was significantly higher than that of normal control group [(3.0 ± 1.7) adducts/108nucleotides] (P<0.05). After controlled for possible confounding factors, it was found that maternal serum BPDE-DNA adduct was a risk factor for the occurrence of GDM (OR=1.99, 95%CI 1.43-2.79), while household income was a protective factor (OR=0.55, 95%CI 0.31-0.98). Each increased quartile of the BPDE-DNA adducts exposure level was associated with an elevated risk of GDM by 2.62 folds(OR=3.62, 95%CI 2.07-6.35).@*Conclusions@#The high level of BPDE-DNA adducts in the peripheral blood of pregnant women is a risk factor for the occurrence of GDM.
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Purpose The patients with varicose veins of lower limbs need to undergo extensive CT or X-ray examinations with high doses of radiation before and after treatment.The aim of this study is to investigate the value of low-dose CT contrast-enhanced scan for the superficial varicosis of lower limbs.Materials and Methods Forty patients diagnosed as superficial varicosis of lower limbs were selected prospectively.According to the scanning parameters,40 patients were randomly divided into four groups:group Ⅰ (standard group) scanned by 120 kV and 250 mAs,group Ⅱ scanned by 120 kV and 100 mAs,group Ⅲ scanned by 100 kV and 200 mAs,group Ⅳ scanned by 80 kV and 300 mAs.The effective dose (ED),signal noise ratio (SNR),contrast noise ratio (CNR) and image quality were evaluated.Results (① There were no significant differences in age,body mass index and height between the four groups (P＞0.05).② The ED values of the four groups were statistically significant (P＜0.05).③ The differences of SNR and CNR had statistical significance between the four groups (F=3.7 and 3.6,P＜0.05).All images met the diagnostic requirements.Conclusion The lower tube voltage and the higher tube current (80 kV,300 mAs) can reduce the radiation dose and have less influence on the image quality,which can meet the clinical diagnostic requirements and can be used as routine scanning parameters for patients with superficial varicosis of lower limbs.
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Objective To compare the accuracy of nucleic acid detection and antibody detection for diagnosing human immunode‐ficiency virus(HIV) infection .Methods Retrospectively analysed data of nucleic acid detection and antibody detection from 124 ca‐ses of patients diagnosed with HIV infection from 2005 to 2014 .The positive rates of the two methods were compared respectively in patients with early‐stage of HIV infection(76 cases) and patients with intermediate and advanced stage of HIV infection (48 ca‐ses) .Results In patients with early‐stage of HIV infectionn ,the positive rate of nucleic acid detection (94 .74% ) was higher than that of antibody detection (84 .21% );while in patients with intermediate and advanced stage of HIV infection ,the positive rate of antibody detection(97 .92% ) was higher than that of nucleic acid detection (81 .25% );both had statistically significant difference (P<0 .05) .Conclusion On the early stage of HIV infection ,the accuracy of nucleic acid detection is higher than that of antibody detection ;while on the intermediate and advanced stage of HIV infection ,antibody detection shows better accuracy .
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Objective To investigate the application of the cytochrome C oxidase subunit Ⅰ gene(COXⅠ ) barcoding in the i‐dentification of wild‐caught ticks .Methods The COXⅠ gene of 9 caught tick individuals with different species was sequenced ,the DNAstar software was used to conduct the sequence comparison and homology analysis .Meanwhile the philp3 .6 software was a‐dopted to select the maximal likelihood(ML) method for constructing the evolutionary trees .Results In the phylogenetic trees ,the samples of sh2011040702 ,ra2011042193 and ra2011051168 with Haemaphysalis were in a branch ,sh2011051404 ,sh2011051408 and ra2011041177 with dermacentor were clustered together ,and sh2011051837 ,sh2011041917 and ra2011041175 with hyalomma were in a branch ,which were consistent with the morphological identification results .Conclusion Making the COXⅠ gene sequence as tick DNA barcoding has certain feasibility for identifying the tick species .
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Objective To explore the clinical value of 256-slice CT whole hepatic perfusion imaging in transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods Twenty-three patients with hepatocellular carcinoma underwent whole hepatic perfusion with the JOG technique one week before TACE.The scanning data of cancer and liver tissues were analyzed using the perfusion software.The cancer tissue perfusion was repeated 4 to 6 weeks after treatment and was compared with that before treatment.Results (1) Before TACE,the HCC lesions were shown on the hepatic arterial perfusion (HAP) map as homogeneous hyper-perfusion lesions in 8 patients and as inhomogeneous hyper-perfusion lesions in 15 patients.The HAP and hepatic arterial perfusion index (HAPI) values of the tumor were higher than those of the liver tissues,while the hepatic portal perfusion (HPP) values of the tumor was lower than that of the liver tissues.The differences were all significant (P ＜ 0.05).(2) Mter TACE,the tumors were totally filled with lipiodol in 3 patients,partially filled with lipiodol in 13 patients,and sparsely filled with lipiodol in the remaining 3 patients.There was no blood perfusion in the lipiodol-filled areas and in the cancer necrotic tissues,but in the sparsely or partially lipiodol-filled areas blood perfusion could still be seen.21 patients received another session of TACE 6 to 8 weeks later.The results between the hepatic arterial digital subtraction angiography (DSA) and the CT perfusion were 100％ matching.The HAP and HAPI values of the tumor decreased when compared with before treatment,and the difference was significant (both P ＜0.05).The HPP values decreased slightly with no significant difference (P ＞ 0.05),while higher HAP and HPI and lower HPP were observed in the active cancer tissues when compared with the liver tissues after treatment (P ＜ 0.05).Conclusion 256-slice MSCT whole liver perfusion imaging can quantitatively reflect abnormal perfusion of hepatocellular carcinoma tissues and postoperative active tissues,and has important guiding significance in the preoperative evaluation,and the postoperative follow up of patients treated with TACE.
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Objective To investigate and evaluate the pregnancy outcomes and fetal loss after fetal reduction of triplets to twins or singleton pregnancy. Methods 282 cases of triplets who received multi-fetal pregnancy reduction (MFPR) at Shandong Provincial Hospital affiliated to Shandong University were recruited from Sep 2001 to Mar 2014. According to the remaining fetal number after MFPR, 231 cases were opted to reduce to twins (twins group) while 51 cases were opted to singleton pregnancy (singleton group).The indication of the former group was fetal abnormalities under ultrasound or on patients′ demand; while the indication for the later group included dichorionic triamniotic (DCTA) triplets or patients′ aspiration. Potassium chloride was injected into the targeted fetal heart until cardiac standstill was obtained. The pregnancy outcomes, gestational age at delivery, birth weight of newborns of the two groups were recorded. Successful pregnancy was defined as take-home at least one baby. Results (1)The overall rate of successful pregnancy was 91.5%(258/282).There were 413 neonates in the twins group, including 4 neonatal deaths and 409 live babies, with the successful rate of 90.5%(209/231). There were 49 neonates in the singleton group, including 2 cases of fetal loss. Thus the successful rate was 96.1%(49/51). There was no difference of successful pregnancy rate between the two groups(P>0.05).(2)The mean gestational age at operation for the twins group and singleton group were(16.5±3.5)weeks and (14.2±2.0) weeks, respectively. Each group was divided into three periods,11-13+6 weeks, 14-16+6 weeks and≥17 weeks.In the twins group, the cases in each time period were129(55.8%,129/231), 50(21.6%,50/231)and 52(22.5%,52/231), respectively. While in the singleton group, the cases in each time period were 27(53%,27/51), 16(31%, 16/51)and 8(16%,8/51).There was no difference between the two groups at each time period(P>0.05). (3)The fetal loss rate in the twins group were 7%(9/129), 12%(6/50), 10%(5/52) at each time period, respectively. While for the singleton group they were 4%(1/27), 0(0/16)and 1/8, respectively. There was no significant difference between the two groups at each time period(P>0.05).(4)The mean birth weight of the twins group was lower than the singleton group [(2 555±447) g vs (3 084±550) g, respectively, P0.05).(5)The gestational age at delivery of the twins group was earlier than the singleton group [(36.2 ± 2.4) weeks vs(38.3 ± 2.2)weeks, respectively,P0.05].Conclusions Reduction to one fetus led to significantly better outcome than two fetuses, with no significant difference in fetal loss rate. It is better to advise patients with triplets reduce to singleton pregnancy.
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Objective To explore the relative factors of polycystic ovarian syndrome (PCOS) in infertile women.Methods Ninety-eight infertile women diagnosed PCOS at affiliated hospital of the Chinese People's Armed Force Logistic college from Jan.2008 to Dec.2012 were served as PCOS group.Two hundred and eighty infertile women with normal ovarian structure according to laparoscopic examination result were selected as control group.The general information,factors related infertile and laparoscopic examination of the two groups were recorded.Results Fifty-one cases (52.0％) in PCOS group were with menarche age earlier than 13 years old,higher than that of control group (113 (40.4％),x2 =4.03,P ＜ 0.05).Eleven cases (11.2％) in PCOS group were with abnormal menstruation cycle,higher than that of control group (12 (4.3％),x2 =6.12,P ＜ 0.05).The incidence of pelvic adhesions in PCOS group was lower than the control group(60(21.1％) vs.224(40.4％),x2 =13.70,P ＜0.05).Irregular menstruation cycle was risk factor of PCOS (OR=1.770,95％ CI:1.09-2.88,P =0.002).Conclusion Women with earlier menarche and irregular menstruation cycle should be paid more attention in terms of PCOS,early screening,discovery,prevention and treatment,so as to reduce the incidence of PCOS induced infertility and the long-term complications.
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Objective To explore the effect of the self-designed cotton-padded covering for a modified lithotomy position on preventing complications in the lower limbs in patients undergoing gynecological laparscopic surgery.Methods A total of 320 patients undergoing radical hysterectomy or deep invasive endometriosis were selected and randomly divided into an observation group(n=160) and a control group(n=160).The patients in the control group were placed on the routine lithotomy position,the lower extremity and popliteal space protected with oasis outline cushion in the control group,while the patients in the observation group were placed on the same pads,the lower extremity and popliteal space protected with the self-designed cotton-padded coverings.Results The average temperature of the lower limbs of patients after operation in the observation group was significantly higher than that in the control group (P<0.01).The incidences of complications in the observation group were significantly lower than those in the control group(all P<0.05). Conclusion The self-designed cotton-padded covering for modified lithotomy position can effectively prevent the complications of the lower limbs and improve the comfort of patients.
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Purpose To explore the value of direct CT venography (CTV) for the diagnosis of varicose veins of lower limb. Materials and methods Forty patients diagnosed as varicose veins of lower limbs were enrolled. 40 patients with 56 involved limbs underwent direct CTV examination, and their images were stratified and evaluated according to the severity and the scope of the disease. Main assessment:definition and scope of CT axial scans combined with volume rendering (VR) and maximum intensity projection for the display of the varicose veins; situation for the display of perforating veins, deep veins and iliac veins;diagnostic compliance between CTV and DSA. Results All of the 56 involved limbs underwent laser intra-cavity occlusion surgery, among them 7 cases with 11 limbs underwent venous angiography under DSA at the same time. In the evaluation of the VR, excellent proportion was 92.86%(52/56), moderate proportion was 7.14%(4/56). Among the deep veins, ratio of the imaging that was able to meet the diagnostic standard was 94.34%, 88.46%and 27.27%, respectively for calf vein, femoral vein and external iliac vein. The total demonstration rate of perforating veins was 98.21%(55/56). Diagnostic compliance between CTV and DSA was 100.00%. Conclusion Lower extremity direct CTV imaging is convenient and noninvasive for patients with varicose veins, with high compliance with DSA results, thus is significantly valuable for the guide of clinical treatment.
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Objective To compare the outcomes of multifetal pregnancy reduction (MFPR)performed at different gestational ages,and to analyze the influence on pregnancy outcomes.Methods Data of 302 women with multifetal pregnancies conceived after assisted reproductive technology (ART) from January 2002 to February 2012 in Department of Obstetrics and Gynecology of Provincial Hospital Affiliated to Shandong University were collected and divided into two groups.The study group involved 152 multifetal pregnancy cases (triplets or quadruplets),which were further divided into three subgroups according to the timing of MFPR to twins,12-13 +6 (n=91),14-15+6(n=32) and 16-24+6 gestational weeks (n=29).The control group involved 150 twin pregnancy cases.MFPR was performed by trans abdominal intra cardiac injection of 10％ potassium chloride (KCl) solution under ultrasound guidance.Gestational age of delivery,birth weight,incidence of gestational diabetes mellitus (GDM) and hypertensive disorder complicating pregnancy (HDCP) were analyzed by t test,one-way ANOVA or Chi-square test.Results Pregnancy loss rate of the study group (14.5％,22/152) was higher than that (6.7％,10/150) of control group,x2=4.857,P＜0.05.Pregnancy loss rate of the subgroup undergoing MFPR during 16-24+6 gestational weeks (31.0％,9/29) was higher than that during 12-13 +6 gestational weeks (8.8％,8/91,x2=7.212,P＜0.05) and that of control group (x2=12.749,P＜0.05).There were no differences in pregnancy loss rate between control group and MFPR during 12-13+6 gestational weeks (x2=0.370,P＞0.05),and during 14-15+6 gestational weeks (15.6％,5/32,x2 =1.739,P＞0.05).No statistically significant difference was found between the study group and control group in mean gcstational age at delivery[(36.9±l.8) weeksvs (37.0±1.8) weeks,t =-0.346,P＞0.05],mean birth weight of large babies [(2720.4±455.0) g vs (2729.1±413.8) g,t =-0.163,P＞0.05] and small babies [(2409.2±412.6) g vs (2416.2±436.8) g,t=-0.136,P＞0.05].There were no differences between the study group and control group in delivery rate at 28-34 gestational weeks [6.2％ (8/130)vs6.4％ (9/140),x2 =0.009,P＞0.05],birth weight discordance rate [12.3％ (16/130) vs11.4％ (16/140),x2=0.050,P＞0.05],GDMrate[3.1％ (4/130) vs2.1％ (3/140),x2 =0.659,P＞0.05] and HDCP rate [11.5％ (15/130) vs 8.6％ (12/140),x2 =0.010,P＞0.05].Conclusions There is risk of pregnancy loss after MFPR,but MFPR before 16 weeks of gestation might decrease the risk.
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Objective To investigate factors with pelvic adhesions and the effect of different degrees pelvic adhesions on fallopian tube recanalization in infertile patients.Methods Total of 527 infertile patients undergoing hysteroscopy and laparoscopic surgery in Affiliated Hospital of Chinese People's Armed Police Forccs Logistics College were studied retrospectively.According to the extent of pelvic adhesions,tubal umbrella adhesions and atresia,377 cases were classified into adhesion groups,including 73 cases in grade Ⅰ,221 cases in grade Ⅱ,75 cases in grade Ⅲ and 8 cases in grade Ⅳ based on adhesion score.The 150 cases with no obvious pelvic adhesion were matched as control group.Among 8 cases with grade Ⅳ ahesion were exluded from ahesion group the relationship between pelvic adhesions and related history,abdominal lesions,tubal patency and the prognosis were studied.Results(1)Related factors:the frequency of pelvic adhesion and more than 7 years of infertility of 23.9％(88/369)in adhesion group were significantly higher than 12.0％(18/150)in control groups.(2)History:compared with the control group(12.7 ％,19/150;28.7％,43/150;11.3％,17/150;12.0％,18/150;17.3％,26/150),patients with pelvic adhesions present more incidence abortion(23.6％,87/369),uterine cavity operation(38.2％,141/369),ectopic pregnancy(20.9％,77/369),pelvic inflammatory disease(25.5％,94/369)and abdominopelvic surgery (31.4％,116/369).(3)Endoscopy exploration:the incidence of hydrosalpinx(24.7％,91/369),tube distorted(15.7％,58/369)and salpingostomy(72.9％,269/369)in adhesion group were higher than those in control group(2.0％,3/150;4.0％,6/150;12.0％,18/150),but relatively lower incidence of pelvic endometriosis lesions(5.7％,21/369)and mesosalpinx cysts(16.3％,60/369)than those in control group(16.0％,24/150;30.0％,45/150).The rate of proximal tubal recanalization(59.5％,91/153)in adhesion group was lower than 75.4％(52/69)in control group.However,the rate of distant tubal recanalization of 84.4％,(281/333)in adhesion group and;13/15 in control group didn't show statistical difference.(4)Prognosis:the rate of ectopic pregnancy of 9.7％(29/299)in adhesion group was significantly higher than 3.1％(4/128)in control group.Among cases with grade Ⅲ adhesion exhibited the highest rate of ectopic pregnancy(13.0％,7/54;OR =4.62,95％ CI:1.29-16.50).(5)Multivariate analysis:it was found that more than two drug abortions(OR =3.29,95％ CI:1.34-8.07),pelvic and (or)abdominal surgery history(OR =2.20,95％ CI:1.35-3.57)and pelvic inflammatory disease history (OR =1.54,95％ CI:1.21-1.97)were risk factors with pelvic adhesions.Conclusion More than or equal to two drug abortion history,pelvic inflammatory disease and pelvic and abdominal surgery damage were important factors for pelvic adhesions of infertility patients,which may decrease the possibility of proximal tubal recanalization and increase ectopic pregnancy risk.
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Objective To compare the outcomes of multifetal pregnancy reduced to twins with initial twin pregnancy.Methods This study included all patients who had high-order multiple pregnancies from August 2007 to September 2010 ( n =567 ) in outpatient or inpatient of Department of Obstetrics and Gynecology,Provincial Hospital Affiliated to Shandong University.There were 478 initial twin pregnancys (non-reduced group ) and 89 multifetal pregnancy reduced to twins (reduced group).All fetal reduction procedures were performed after 12 weeks gestation.The maternal ages,gestational ages at delivery,pregnancy complications,birth weight of twins and neonatal outcomes were observed in all groups.Results ( 1 ) Average maternal ages and mean gestational ages at delivery:the average maternal ages were ( 29.7 ± 4.5) and (29.9 ± 5.0 ) years for the non-reduced and reduced groups,respectively,no statistical significance (P =0.755).The mean gestational ages at delivery in the nonreduced and reduced twins were (35.3 ± 3.9) and ( 34.4 ± 6.3 ) weeks,respectively ( P ＜ 0.01 ).( 2 ) Pregnancy complications:the rate of pre-eclampsia was 8.2％ ( 39/478 ) in the nonreduced group and 12.4％ (11/89) in the reduced group,no statistical significance ( P =0.199 ).The rates of gestational diabetes mellitus were 1.7％ ( 8/478 ) and 3.4％ ( 3/89 ),respectively,no statistical significance ( P =0.287 ).( 3 ) Neonatal outcomes:① the frequencies of birth weight discordances ＞ 400 g were 28.9％ for the nonreduced group and 27.0％ for the reduced group,no statistical significance ( P =0.715 ).The frequencies of birth weight discordances ＞ 100 g were 75.1％ for the nonreduced group and 75.3％ for the reduced group,no statistical significance (P =0.972).②The mean birth weight of the nonreduced twin group was significantly higher than that of the reduced group [ ( 2700 ± 468 ) g vs.( 2352 ± 602 ) g,respectively,P ＜ 0.0l ],there was statistical significance.The mean birth weight of gestational ages ＞ 36 +1 weeks at delivery of the nonreduced twin group was significantly higher than that of the reduced group [ (2809 ± 424) g vs.(2707 ± 506) g,respectively,P ＜0.01 ],there is statistical significance.③The rate of infant mortality( gestational ages ＞28 weeks at delivery) was 1.3％ ( 1/78 ) for the reduced group and 2.2％ ( 10/448 ) for the nonreduced group.The major morbidity rate was 3.8％ (3/78) for the reduced group and 4.0％ (18/448) for the nonreduced group,no statistical significance ( P =0.588,0.943 ).Conclusions Multiple pregnancies after fetal reduction were still associated with a mild increased risk when compared to initial twin pregnancies and their abortion rate is high.The gestational ages of the reduced group were affected by the initial number of fetuses,and the birth weights of reduced twins were lower than that of the nonreduced twins.
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Objective To investigate relations between villus Benzo (a)pyrene (BaP)-DNA adducts and blighted ovum in early pregnancy, and to explore possible environmental factors influencing embryo development. Methods One hundred and two pregnant women with blighted ovum were selected into this study as research group; and 102 normal pregnant women were taken as control group; the age, gravidity, parity and gestational weeks of the two groups were matched. After artificial abortion, villi of the patients were collected and washed by normal saline. Then, the tissue was homogenated and genome DNA was extracted to detect quantity of the tissue. BaP-DNA adducts levels were examined by high-performance liquid chromatography-fluorescence method (HPLC). The personal information of pregnant women was collected by questionnaire. Logistic regression model was used to investigate the association between BaP-DNA adducts and blighted ovum. Results BaP-DNA adducts level in villi of research group [(8. 9±8. 2) adducts/108 nucleotides] was significantly higher than that of control group [(2. 0±1. 4) adducts/108 nucleotides], P＜0.05. The higher the BaP-DNA adducts in villi, the higher risk the blighted ovum; when the BaP-DNA adducts level increased to 6.06 adducts/108 nucleotides, the risk of blighted ovum might increase 59.39 times (95% CI:15.50-227.55). Maternal education level was a protective factor (OR=-0.21, 95%CI:-0. 19--0.03) after controlling potential confounders. Conclusions High level of villi BaP-DNA adducts might increase the risk of blighted ovum in early pregnancy, and could have an adverse effect on embryo development.
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Objective To study on the research focus of angiotensin converting enzyme inhibitor(ACEI) and calcium channel blocker.Methods From 1999 to 2008,the literature which the "angiotensin converting enzyme inhibitor"and"angiotensin converting enzyme inhibitor" in SCI database were collected.CiteSpace visualization techniques were uesd to analyze hot fields,hot spot of the author and the hot article on two types of the drugs.Results There were 5 hot fields on two type of drugs,respectively were theray,ACEI,hypentesion,CCB and randomized-trial.The most frequent intermediate words were hypentesion and mortality,etc.The hotest fields were HARVARD UNIV and UNIV MILAN respectively,and the hotest magazine were Hypentesion,Hypentesions Rev respectively.Conclusion CiteSpace visualization techniques can make a scitific conclusion on ACEI and CCB.
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Objective To assess the clinial application of 3D reconstruction with MSCT for acetabular fractures.Methods Volume scanning was performed in 20 patients with acetabular fractures,all data sets were transferred to workstation.Reconstruction were done with more thinner slices.Results Acetabular frature 3D images went all the way with the results of surgery in 17 cases.Conclusion MSCT 3D images can compare beauty with gross specimen,which could be propitious to the subtype of acetabulum fracture and have an advantage in the application.
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Objective To evaluate the diagnostic value of multi-slice CTA(MSCTA) in cerebral aneurysms.Methods 15 patients with cerebral aneurysms were undergone MSCTA,of which,DSA were performed in 5 cases,and Gnglielmi detachable coil were performed in 2 cases . The images of 15 patients were processed with maximum intensity projection ( MIP ) , volume rendering ( VR ) and multiple planar reconstruction ( MPR ) .Results 16 cerebral aneurysms in 15 patients were found by MSCTA , the location of aneurysms was in the vertebral artery in 2,in the cerebral arterial circle in 5,in the anterior cerebral artery in 5 ,and in the middle cerebral artery in 3.DSA displayed 4 cerebral aneurysms in 5. 3D-CTA imaging and MPR combined with original transect images and multi-angle observation wereof great advantageous for diagnosis. The position, size and width of the fundus of cerebral aneurysms in 5 patients displayed by CTA wereaccordant with the results of DSA.Conclusion MSCTA can display cerebral aneurysms clearly. 3D-CTA combined with MPR and original images can make diagnosis more accurate and objective, and provide valuable information for surgery or interventional therapy.