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Objective:To assess the validity of ultrasonic surveillance of percentage change in the levator ani hiatal antro posterior diameter (LHap) in the diagnosis of pelvic floor muscle dysfunction.Methods:Two hundred and forty seven women suspected to have pelvic floor disorder related symptoms from January to December 2017 were enrolled. Digital palpation of the puborectalis muscle using modified Oxford score grading system (MOS) was performed.Women with MOS point of 0, 1, 2, or 3 were defined as having low pubic floor muscle contraction (LPFMC), and those with MOS point of 4 or 5 were defined as having normal pubic floor muscle contraction (NPFMC). Then ultrasound measurement of LHap diameter at rest, at maximum contraction, and at the maximum Valsalva were performed in all women to calculate the percentage decrease on contraction (PDC%) and percentage increase on Valsalva (PIV%). Statistical analysis was performed to test the significance of differences in PDC% and PIV% between the LPFMC group and NPFMC group, and the ROC curve analysis was performed to evaluate the validity of using PDC% and PIV% for predicting LPFMC.Results:Compared with the NPFMC group, the PIV% of LPFMC group was significantly larger [(6.07±4.20)% vs (11.29±10.49)%, P<0.001], and the PDC% was significantly smaller [(31.36±3.34)% vs (17.66±10.82)%, P<0.001]. A cut-off of PIV%>5.19% predicted LPFMC with sensitivity 71.43%, specificity 57.89%, and the area under the ROC curve was 0.69. A cut-off of PDC%<25.37% predicted LPFMC with sensitivity 66.39%, specificity 97.37%, and the area under the ROC curve was 0.84. To diagnose LPFMC by the combination of PIV >5.19% and PDC%<25.37%, the sensitivity was 84.55%, the specificity was 55.00%, and area under ROC was 0.70. Conclusions:Ultrasonic measurement of percentage change in the LHap diameter is valuable for the diagnosis of pelvic floor muscle dysfunction.
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Objective To investigate the value of the ultrasonic elastic quantitative analysis technique of organization diffusion in adenomyosis.Methods Ninty-three patients with adenomyosis were divided into adenomyosis group (n =52) and adenomyoma group (n =41),and fourty healthy subjects were enrolled as control group.All subjects underwent conventional ultrasound and real-time tissue elastography.Eleven elastic characteristics of all the subjects were performed.Results Different characteristics of ultrasound elastography images appeared in different groups.The measured values of elastic characteristics were significantly different between case group and normal group (P 0.05).The cutoff values of every index were analyzed by ROC curve.The strongest specificity index was SD(99%),the highest sensitivity index was ASM(100%),and the highest accuracy index was IDM(94%).Conclusions The value of ultrasonic elastic quantitative analysis of organization diffusion technique in adenomyosis can improve the ultrasound diagnosis of this diease.
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Objective To assess the role of pelvic ultrasound examination in discriminating between normal girls,isolated premature thelarche/pubarche /menarche and central precocious puberty (CPP).Methods Eighty-four isolated premature thelarche/pubarche /menarche cases,47 CPP cases,and 177 normal girls aged 0-10 years were recruited.All diagnoses were confirmed by the gonadotropin-releasing hormone-stimulation test.All subjects underwent pelvic ultrasound examination for the measurement of length,width,thickness,and volume of the uterine body,uterine cervix,and ovary,and the number of follicles with diameter≥ 4 mm.The groups were subdivided by age intervals when the difference in ultrasound measurements between CPP,isolated premature thelarche/pubarche/menarche,and normal girls were analyzed.Results 1) Differentiation between CPP and normal girls:for the 6-8 years,there were 11 variables elevated in CPP as compared to the normal girls.Uterine cervix thickness was the most efficient parameter as judged by the largest value of area under the ROC curve (0.958).The best cut-off,sensitivity,and specificity was 0.73 cm,93.30％,and 85.70％ respectively;for the 8-10 years,uterine body volume was the best parameter among the 10 elevated variables as judged by the largest area under the ROC curve (0.869),3.23 cm3 was the best cut-off limit with a sensitivity of 84.21％ and a specificity of 52.11％.2) Differentiation between isolated premature thelarche/pubarche/menarche and normal girls:for the 0-6 years,ovary thickness was the best variable as judged by the largest area under the ROC curve (0.806),0.98cm was the best cut-off limit with a sensitivity of 76.46％ and a specificity of 84.85 ％ ;for the 6-8 years,ovary width was the best variable among the 8 valuable variables for its largest area under the ROC curve (0.843),1.39 cm was the best cut-off limit with a sensitivity of 85.71％ and a specificity of 73.81％ respectively;for the 8-10 years,uterine cervix thickness was the best variable among the 5 valuable variables for its largest area under ROC curve (0.841),0.75 cm was the best cut-off limit with a sensitivity of 90.48％ and a specificity of 64.21％.3) Differentiation between CPP and isolated premature thelarche/ pubarche/menarche cases:for the 6-8 years,uterine cervix length and width were potential parameters.Uterine cervix length was the best variable for its largest area under the ROC curve(0.764),and 1.49 cm was the best cut-off limit,the corresponding sensitivity and specificity was 93.33％ and 55.17％ respectively;for the 8-10 years,3 variables could be used,among which uterine cervix length was the best variable for its largest area under the ROC curve (0.893),1.88 cm was the best cut-off limit with a sensitivity of 100％ and a specificity of 71.43％.Condusions Pelvic ultrasound examination is a valuable tool for the diagnosis and differentiation between CPP,isolated premature thelarche/pubarche /menarche and normal girls.
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<p><b>BACKGROUND</b>Previous epidemiological studies have consistently found a positive family history of esophageal cancer is associated with a significantly increased risk of the cancer. However, whether the elevated risk could be attributed to common household exposure or inherited susceptibility is uncertain. This study aimed to highlight the effect of genetic predisposition by noting the significant differences in onset age and multiple primary cancers between esophageal squamous cell carcinoma (ESCC) cases with or without a positive family history of the cancer.</p><p><b>METHODS</b>Age at onset and the percentage of multiple primary cancers were compared between ESCCs with (n = 766) or without (n = 1 776) a positive family history of the cancer in a consecutive surgery cohort at the Department of Thoracic Surgery of Hebei Tumor Hospital and the Fourth Hospital of Hebei Medical University.</p><p><b>RESULTS</b>Overall, ESCCs with a positive family history of the cancer featured both a significantly younger age of onset and significantly more multiple primary cancers than those with a negative family history (onset age 51.83 vs. 53.49 years old, P < 0.01; percent of multiple primary cancers 5.50% vs. 1.70%, χ(2) = 25.42, P < 0.01). Both the differences were evident in subgroup analyses, but did not correlate. While age at onset differed significantly by family history among the male, smoking, and drinking groups, the difference of multiple primary cancers was significant among the otherwise nonsmoking, nondrinking, and younger onset age groups.</p><p><b>CONCLUSIONS</b>Younger age of onset and multiple primary cancers associated with ESCCs with a positive, as opposed to a negative family history of the cancer, suggest a genetic predisposition. The results of subgroup analyses indicate a younger age of ESCC development results from the interaction of environmental and genetic risk factors, but multiple primary cancers may be related only to genetic predisposition.</p>