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Objective:To measure the morphological parameters of the fetal vertebral centrum ossification centers (COC) in the second-third trimester using MRI susceptibility weighted imaging (SWI), and to explore the growth and development trajectory of the vertebrae.Methods:Fetus in the second-third trimester with normal vertebrae development were prospectively and continuously included in Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2015 to December 2021, and the SWI scanning of fetal spine was performed. The following morphometric parameters of the C4, T6, L3, S1 vertebrae COC were measured, including sagittal diameter, transverse diameter, height, cross-sectional area and volume. The linear and nonlinear regression analysis was used to derive the best-fit curve for each parameters and gestational age.Results:A total of 112 fetuses were recruited with gestatonal age 21-39 (29.4±3.9) weeks, including 30 cases of C4, 58 cases of T6, 92 cases of L3, 62 cases of S1. Fetal spine in utero with global curvature was kyphosis, presenting two primary curves (thoracic and sacral kyphosis). The morphological parameters sagittal diameter, transverse diameter, height, cross-sectional area and volume of C4 followed the quadratic polynomial rule during 25 to 38 weeks (R 2=0.938, 0.943, 0.952, 0.957, 0.982). During 21 to 38 weeks, the sagittal diameter, transverse diameter and height of the T6 followed the exponential growth pattern (R 2=0.915, 0.923, 0.849) and the growth of the area and volume followed the quadratic polynomial growth pattern (R 2=0.943, 0.961). The L3 followed the quadratic polynomial rule during 21 to 39 weeks (R 2=0.910, 0.916, 0.914, 0.942, 0.948) The sagittal diameter, transverse diameter and height of the S1 followed the linear growth pattern (R 2=0.905, 0.911, 0.922) and the area and volume followed the quadratic polynomial growth pattern (R 2=0.930, 0.964) during 23 to 39 weeks. Conclusions:The growth and development of C4, T6, L3 and S1 COC of fetus in the second-third trimester has a good correlation with gestational age. The growth of fetal vertebral COC in the early stage is slow, but with the growth of gestational age, the growth rate of vertebral bodies accelerates.
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Objective:To investigate the effect of white noise reduction earplugs combined with eye mask on the sleep quality of ICU patients.Methods:A total of 136 patients who were hospitalized in the ICU ward of the Second People′s Hospital of Liaocheng from April to November 2019 were selected and divided into 3 groups according to the random number table method. Group 1 (3M earplug + eye mask, 45 cases), group 2 (white noise reduction earplug + eye mask, 46 cases), and group 3 (control group, 45 cases). On the first night after enrollment, all patients were given routine care only. On the second and third nights, group 1 was given 3M ear plugs and eye masks, group 2 was given white noise reduction earplugs and eye masks, and group 3 was given routine care only. On the morning of the second and fourth day, patients′ baseline Richards Campbell Sleep Questionnaire (RCSQ), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores were assessed.Results:After the intervention, the sleep depth, sleep latency, wake at night, return to sleep, sleep quality, nocturnal subjective noise perception and total score in RCSQ in group 1 were (55.98 ± 19.65), (57.66 ± 19.56), (55.68 ± 16.25), (58.17 ± 11.32), (60.54 ± 16.33), (60.65 ± 12.58), (57.60 ± 17.21) respectively, in group 2 were (56.65 ± 18.36),(61.33 ± 20.33), (65.35 ± 23.22), (60.36 ± 19.35), (63.78 ± 20.36), (66.56 ± 10.21) and (61.49 ± 17.52), in group 3 were (45.96 ± 17.79), (48.36 ± 13.65), (48.21 ± 13.49), (51.36 ± 13.65), (51.33 ± 16.45), (43.06 ± 17.15) and (49.04 ± 15.32). There were statistically significant differences in each dimension and its total scores among the three groups (F values were 4.33-8.35, all P<0.05). Compared with group 3, each dimension and total scores of groups 1 and group 2 were higher than those of group 3, and the differences were statistically significant (t values were 2.37-7.96, all P<0.05). After the intervention, the SAS score of group 2 was (43.32 ± 21.68), which was lower than that of group 1 (57.75 ± 22.68) and group 3 (60.65 ± 19.88), and the difference were statistically significant (t=3.09, 3.99, both P<0.05).Conclusions:3M earplugs or white noise reduction earplugs combined with eye masks can effectively improve the sleep quality of ICU patients, and white noise reduction earplugs combined with eye masks can also relieve the anxiety of patients.
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Objective:To discuss the feasibility of prenatal MRI in evaluating fetal auricle developmental malformation and atresia of external auditory canal.Methods:Fifteen pregnant women (aged from 22 to 40 years old, mean age 31.3±5.2 years old) with fetal external ear developmental malformation suspected by ultrasound underwent MR scanning between November 2017 and May 2019. All of them were singleton. The gestational age ranged from 23 weeks to 35 weeks, with an average of (27.5±3.5) weeks. The sensitivity, specificity and accuracy of MRI and ultrasound in the diagnosis of fetal auricle malformation and atresia of external auditory canal were calculated and compared, using postnatal follow-up as the gold standard. Fisher exact test was used to compare the efficacy of MRI and ultrasound in diagnosing atresia of external auditory canal.Results:A total of 30 fetal external ears were detected in 15 fetuses, without auricle absence. Totally 19 external ears with developmental malformation were confirmed by postnatal follow-up, including 19 ears with auricle malformation and 15 ears with external auditory canal atresia. The accuracy of MRI and ultrasound in the diagnosis of auricle malformation was both 100% (19/19). For the diagnosis of external auditory canal atresia, the sensitivity, specificity and accuracy of MRI and ultrasound were 93.3% (14/15), 75.0% (3/4), 89.5% (17/19) and 33.3% (5/15), 25.0% (1/4), 31.6% (6/19), respectively. The sensitivity and accuracy of MRI in the diagnosis of atresia of external auditory canal were significantly higher than those of ultrasound, with statistically significant difference ( P=0.004, 0.001). Conclusion:MRI plays an important role in the diagnosis of fetal external ear developmental malformation, which can be used as an effective supplement to ultrasound, especially for the diagnosis of external auditory atresia.
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Objective To explore the value of ultrasound in diagnosis and classification of pilomatricoma.Methods Ultrasonic features of 63 cases with pilomatricoma confirmed by operation and pathology were analyzed and summarized retrospectively.Results According to if there was calcification in the tumor,pilomatricoma cases were classified into two groups(calcific group and non-calcific group).In addition,there were three subgroups in the calcific group based on the size and disposition of calcification:subgroup Ⅰ,completely echogenic mass with strong posterior acoustic shadowing in the subcutaneous layer (n=17,26.98%);subgroupⅡ,hypoechoic nodules with tiny calcification diffused distributed(n=15,23.80%);subgroup Ⅲ,hypoechoic nodules with large calcification(n=8,12.70%).Twenty-three cases (36.51%)were distributed into non-calcific group.Conclusions Ultrasonography is valuable for diagnosis and differential diagnosis of pilomatricoma,and it is an essential examination method for the tumor before operation.