Reproducibility study of Ovarian-Adnexal Reporting and Data System in describing adnexal masses / 中华超声影像学杂志

Objective:To investigate the intra- and inter-observer agreements of different experiencers using the Ovaria-adnexal Reporting and Data System (O-RADS) in the evaluation of adnexal masses.Methods:Totally 48 patients with adnexal masses (48 masses, mean size 9.5±4.7 cm, range 2.3-18.6 cm) found by ultrasound examination in the Third Affiliated Hospital of Sun Yat-sen University, from May 2019 to March 2020 were retrospectively analyzed. All the masses were confirmed by pathology or surgery. Four observers were divided into 2 senior doctors (Doctor 1 and Doctor 2) and 2 junior doctors (Doctor 3 and Doctor 4). Each observer independently evaluated adnexal masses twice using ultrasound O-RADS before and after systematic training, with an interval of 60 days. The intra-observer and inter-observer agreements were analyzed before and after training.Results:The inter-observer agreement between senior doctors were both excellent before and after systematic training (weight Kappa: 0.833 vs 0.802, percentage of agreement: 83.3% vs 81.3%). Whereas there was difference in the inter-observer agreement between non-experienced observers before and after training (weight Kappa: 0.399 vs 0.824, percentage of agreement: 50.0% vs 77.1%). After training, inter-observer agreement between junior doctors was significantly improved and comparable to senior (weight Kappa: 0.824 vs 0.802, percentage of agreement: 77.1% vs 81.3%). Before and after systematic training, the intra-observer agreements of the same doctor, the senior physicians were better than the junior (weight Kappa: 0.882 and 0.843 vs 0.440 and 0.605; percentage of agreement: 87.5% and 83.3% vs 58.3% and 54.2%).Conclusions:O-RADS risk classification system is a highly reproducible method in the subjective assessment of an adnexal mass among observers with varying levels of expertise. However, systematic training before clinical application is necessary and effective for non-experienced observers.

The Application of Cartilage Tissue Engineering with Cell-Laden Hydrogel in Plastic Surgery: A Systematic Review

BACKGROUND@#As a contour-supporting material, the cartilage has a significant application value in plastic surgery.Since the development of hydrogel scaffolds with sufficient biomechanical strength and high biocompatibility, cell-laden hydrogels have been widely studied for application in cartilage bioengineering. This systematic review summarizes the latest research on engineered cartilage constructed using cell-laden hydrogel scaffolds in plastic surgery. @*METHODS@#A systematic review was performed by searching the PubMed and Web of Science databases using selected keywords and Medical Subject Headings search terms. @*RESULTS@#Forty-two studies were identified based on the search criteria. After full-text screening for inclusion and exclusion criteria, 18 studies were included. Data collected from each study included culturing form, seed cell types and sources, concentration of cells and gels, scaffold materials and bio-printing structures, and biomechanical properties of cartilage constructs. These cell-laden hydrogel scaffolds were reported to show some feasibility of cartilage engineering, including better cell proliferation, enhanced deposition of glycosaminoglycans and collagen type II in the extracellular matrix, and better biomechanical properties close to the natural state. @*CONCLUSION@#Cell-laden hydrogels have been widely used in cartilage bioengineering research. Through 3-dimensional (3D) printing, the cell-laden hydrogel can form a bionic contour structure. Extracellular matrix expression was observed in vivo and in vitro, and the elastic modulus was reported to be similar to that of natural cartilage. The future direction of cartilage tissue engineering in plastic surgery involves the use of novel hydrogel materials and more advanced 3D printing technology combined with biochemistry and biomechanical stimulation.

Preliminary study of prenatal ultrasound in predicting delivery mode of full-term primipara / 中华超声影像学杂志

Objective:To explore the feasibility of prenatal ultrasound in predicting delivery mode of full-term primipara.Methods:The study prospectively enrolled primiparas with gestational age ≥37 weeks, singleton, cephalic and no contraindications to vaginal delivery who underwent routine prenatal examination in the Third Affiliated Hospital of Sun Yat-sen University from September 2020 to February 2021.In addition to routine fetal ultrasound examination, the transperineal ultrasound examination was performed to assess the angle of progression (AOP), head perineum distance (HPD), the angle of pubic arch and the anteroposterior diameter, left and right diameter, area and perimeter of levator ani hiatus of pregnant women in different states were measured; Cervical length (CL) was examined by transvaginal ultrasound. The delivery mode was tracked, and the indicators related to natural delivery were screened out. Receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of relevant indicators in predicting natural delivery.Results:A total of 142 cases were included in this study, including 112 cases of natural delivery and 30 cases of manual intervention delivery. There were no significant differences in age, gestational weeks, biparietal diameter, head circumference, body mass index (BMI) and neonatal weight between the natural delivery group and the manual intervention delivery group (all P>0.05). Multivariate regression analysis showed that AOP was associated with natural delivery( OR=1.048, P=0.008). ROC curve analysis showed that the area under the curve was 0.648 with AOP 96.92° as the node, and the specificity and positive predictive values were 83.33% and 0.909 1 respectively. Conclusions:It is feasible to predict the mode of delivery by prenatal ultrasound in full-term primiparas. AOP is related to the mode of delivery, which can provide more reference information for clinical practice.

Application of translabial ultrasound in female periurethral benign solid lesions / 中华超声影像学杂志

Objective:To investigate the value of translabial ultrasound (TLUS) in female periurethral benign solid lesions (PBSL).Methods:Twenty-one female patients (21 lesions) with PBSL identified pathologically within the process of cystoscope or surgery from June 2017 to December 2020 were enrolled. All of them underwent urethral examination (UE) and TLUS. The detection rates of the lesions of UE and TLUS were compared, and the ultrasonic diagnostic accuracy and ultrasonic manifestations were analyzed.Results:Sixteen of the 21 patients showed lower urinary tract symptoms (76.19%). Among the 21 lesions, the detection rates of UE and TLUS were 52.38% (11/21) and 85.71% (18/21), respectively, the difference was statistically significant ( P=0.019). The length of 18 lesions detected by TLUS was (1.79±1.04)cm, and 13 lesions (72.22%) were shorter than 3 cm. Among 18 cases, urethral caruncle (13 cases) was the most common benign periurethral mass, the main ultrasonic manifestations of urethral caruncle showed hyperecho lesions in the middle and distal urethra, and the blood flow was mostly in a branch-like distribution. At the same time, there were 5 cases of urethral myoma and other solid lesions, the main ultrasonic manifestations of urethral myoma showed clear boundary, low echo and peripheral short strip blood flow. Using pathological results as the gold standard, the accuracy of ultrasonic diagnosis was 88.89% (16/18). Conclusions:TLUS is able to improve the detection rate of periurethral benign solid lesions, and the diagnostic concordant rate is acceptable.TLUS can provide more diagnostic and therapeutic information.

A prospective multi-center cross-sectional study of urethral mobility in normal parous women in China / 中华超声影像学杂志

Objective:To assess the urethral mobility of normal parous women in China and explore the impacts of related risk factors on it using translabial ultrasound.Methods:Females who met the inclusion criteria in 37 tertiary hospitals from February 2017 to August 2018 were included. All women underwent standardized translabial ultrasound examination and the urethral rotation angle (URA), bladder neck position at maximum Valsalva maneuver (BNP-V) and bladder neck descent (BND) were measured. Questionnaires were used to collect basic information including age, height, weight, body mass index (BMI), past medical history, maternity history, and urinary incontinence related history. Mann-Whitney U test and multiple linear regression analysis were adopted to explore the influences of age, BMI, delivery mode and parity on normal parous women′s urethral mobility. Then, the study subjects were divided into different groups and the corresponding values of URA, BNP-V and BND were compared. Results:Compared with parous women with normal BMI and no history of vaginal delivery, those who were overweight and/or had a history of vaginal delivery were more likely to gain greater URA and BND ( P<0.05). The URA and BND were not significantly different between women with different times of cesarean sections ( P>0.05); while for women with a history of vaginal delivery, these two parameters increased with the increase of the number of transvaginal deliveries ( P<0.05). Conclusions:BMI and vaginal delivery are important risk factors for the urethral mobility of normal parous women. The urethral mobility increases with the increase of BMI and the number of vaginal deliveries.

Development of a CRISPR/Cpf1 gene editing system in silkworm Bombyx mori / 生物工程学报

The CRISPR/Cas9 gene editing system has been widely used in basic research, gene therapy and genetic engineering due to its high efficiency, fast speed and convenience. Meanwhile, the discovery of novel CRISPR/Cas systems in the microbial community also accelerated the emergence of novel gene editing tools. CRISPR/Cpf1 is the second type (V type) CRISPR system that can edit mammalian genome. Compared with the CRISPR/Cas9, CRISPR/Cpf1 can use 5'T-PAM rich region to increase the genome coverage, and has many advantages, such as sticky end of cleavage site and less homologous recombination repair. Here we constructed three CRISPR/Cpf1 (AsCpf1, FnCpf1 and LbCpf1) expression vectors in silkworm cells. We selected a highly conserved BmHSP60 gene and an ATPase family BmATAD3A gene to design the target gRNA, and constructed gHSP60-266 and gATAD3A-346 knockout vectors. The efficiency for editing the target genes BmATAD3A and BmHSP60 by AsCpf1, FnCpf1 and LbCpf1 were analyzed by T7E1 analysis and T-clone sequencing. Moreover, the effects of target gene knockout by different gene editing systems on the protein translation of BmHSP60 and BmATAD3A were analyzed by Western blotting. We demonstrate the CRISPR/Cpf1 gene editing system developed in this study could effectively edit the silkworm genome, thus providing a novel method for silkworm gene function research, genetic engineering and genetic breeding.

Feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse / 中华超声影像学杂志

Objective:To investigate the feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse among Chinese women.Methods:The prospective multicenter study enrolled 485 women between January 2017 and January 2019. All patients underwent a standard clinical interview, pelvic organ prolapse quantification (POP-Q) examination and transperineal ultrasound examination. Volume data of transperineal ultrasound examinations were obtained at rest and in maximal Valsalva maneuver.Results:The higher POP-Q stage of posterior compartment, the lower rectal ampulla position in maximal Valsalva maneuver (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥2, P<0.001), and the greater rectal ampulla hypermobility (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥ 2, P=0.007). The rectal ampulla position at rest and in maximal Valsalva maneuver and rectocele depth were correlated with prolapse symptoms ( r=-0.200, P<0.001; r=-0.252, P<0.001; r=0.086, P=0.045). The corresponding cut-off values of rectal ampulla position in maximal Valsalva in diagnosing posterior compartment prolapse (POP-Q stage ≥1) and clinical significant posterior compartment prolapse (POP-Q stage ≥2) were 7.32 mm below the symphysis pubis and 12 mm below the symphysis pubis, respectively, with the area under the ROC curve as 0.75 and 0.85, respectively. Conclusions:The ultrasonic measurements by transperineal ultrasound is significantly associated with POP-Q examination in posterior compartment, and it is demonstrated as a useful tool in quantitative assessment of the severity of posterior compartment prolapse.

Application of 3D/4D translabial ultrasound in the diagnosis of female urethral diverticulum / 中华超声影像学杂志

Objective:To explore the value of 3D/4D translabial ultrasound in the diagnosis and differential diagnosis of female urethral diverticulum.Methods:The paired chi-square test was used to compare the diagnostic accuracy of 2D translabial ultrasound and 3D/4D translabial ultrasound in 21 suspected urethral diverticulum patients who visited the Third Affiliated Hospital of Sun Yat-Sen University from November 2013 to January 2020. And Kappa consistency test was used to evaluate the consistency between these two methods and the pathological results.Results:All 21 patients with suspected urethral diverticulum were diagnosed by postoperative pathology, of which 16 cases were urethral diverticula and 5 cases were paraurethral cysts. The typical appearance of urethral diverticulum on 3D/4D translabial ultrasound was a cystic structure traversing the urethral rhabdosphincter. Additionally, septa, calcification or solid neoplasm can also be seen in some cases. The sensitivity/specificity of 2D translabial ultrasound and 3D/4D translabial ultrasound were 75.00%/100% and 93.75%/100%, respectively, no statistical differences were found both in sensitivity and specificity between these two methods(all P>0.05). The Kappa consistency test showed that the consistency between 2D translabial ultrasound and pathological diagnosis was general (Kappa=0.588, P=0.003), while the consistency between 3D/4D translabial ultrasound and pathological diagnosis was good (Kappa=0.877, P<0.001). Conclusions:3D/4D translabial ultrasound has a high value in the diagnosis of female urethral diverticulum, and it is worthy of clinical application.

Correlation between levator hiatus area, pelvic organ prolapse quantification and prolapse symptoms / 中华超声影像学杂志

Objective:To investigate the association between levator hiatus area, pelvic organ prolapse quantification (POP-Q) examination and prolapse symptoms.Methods:The prospective multicenter study enrolled 996 female patients between January 2017 and January 2019. All enrolled patients underwent a standard clinical interview, POP-Q examination and transperineal ultrasound examination. Volume data of pelvic floor ultrasound examinations were obtained at rest, during contraction and during maximal Valsalva maneuver. The association between levator hiatus area, POP-Q examination and prolapse symptoms was analyzed. The performance of levator hiatus area on maximal Valsalva for assessing significant POP(POP-Q stage≥2) and prolapse symptoms were also evaluated.Results:There were significant differences of levator hiatus area at rest, during contraction and during maximal Valsalva among patients with different POP-Q stages (all P<0.001). Levator hiatus area during maximal Valsalva showed the highest correlation with abdominal dragging sensation ( r=0.277, P<0.001). The area under the ROC curve (AUC) of levator hiatus area during maximal Valsalva for significant POP (POP-Q stage≥2) was significantly higher than that for prolapse symptoms (AUC: 0.77 vs 0.69, P<0.001). Conclusions:Levator hiatus area on transperineal has moderate correlation with POP-Q examination and their association is stronger than the correlation between ultrasound findings and prolapse symptoms.

The comparison of bladder neck descent and the hiatus area of levator ani between lithotomy position and separating-legs-holding-knees position / 中华超声影像学杂志

Objective:To investigate whether the bladder neck descent and the area of levator ani hiatus obtained on the maximum Valsalva were consistent at the lithotomy position and separating-legs-holding-knees position.Methods:Forty four subjects who underwent perineal pelvic floor four-dimensional ultrasound at 6-8 weeks postpartum in Third Hospital of Longgang Shenzhen from November 2019 to January 2020 were enrolled in this study. All subjects were able to effectively complete the maximum Valsalva maneuver both at the lithotomy position and the separating-legs-holding-knees position. The bladder neck descent and hiatus area of the levator Ani on the maximum Valsalva at these two positions were measured and compared.Results:The bladder neck descent at the separating-legs-holding-knees position was higher than that at the lithotomy position [(41.06±8.25)mm vs (39.96±8.10)mm; t=-2.965, P=0.005], and the hiatus area of levator Ani at the separating-legs-holding-knees position was larger than that at the lithotomy position[(27.55±4.90)cm 2 vs (26.32±4.76)cm 2; t=-3.820, P<0.001]. Conclusions:The bladder neck descent and the area of levator Ani hiatus on the maximum Valsalva at separating-legs- holding-knees position are larger than those on the maximum Valsalva at the lithotomy position.

Mechanism analysis of Anti-BmNPV resistant strain NC99R / 生物工程学报

Bombyx mori is a lepidopteran insect with important economic value. Bombyx mori nucleopolyhedrovirus (BmNPV) causes huge economic loss to silkworm industry in China every year. The objective of this study is to determine the anti-BmNPV mechanism of Bombyx mori strain NC99R, and to provide a basis for understanding the molecular mechanism of the silkworm resistance strain. The normal control Dazao (DZ) strain and the NC99R resistant strain were fed with occlusion bodies (OB). The median lethal dose (LD50) analysis of the DZ and NC99R showed that the LD50 of DZ was 1.2×10⁵ OBs/larva, while NC99R was 1.8×10⁶ OBs/larva. The LD50 of the NC99R was about 15 times higher than the DZ. The mortality of DZ and NC99R were analyzed, which were fed with 1×10⁶ OBs/larva and injection with 1×10⁶ BVs/larva. The results showed that the death peak of DZ was concentrated in the 4th to 6th day. And the death peak of NC99R was concentrated in the 6th to 8th day, with a delay of 1-2 days compared with the control. The BmNPV DNA copy number showed that the BmNPV genome in DZ proliferated rapidly. The copy number of BmNPV DNA in NC99R were increased slowly after oral infection and body injection. HE staining showed that midgut tissue has no significant difference between DZ and NC99R in the early stage of oral infection. At 96 h p.i., the nucleus of DZ midgut became larger and shedding. The NC99R had enlarged nuclei, but the cells were still arranged neatly. Finally, the expression of virus genes in different periods were analyzed by RT-PCR. The results indicated that the immediate early gene ie-1 expression levels began to down-regulate after 24 h p.i.. The early, late, and extremely late genes were also down-regulated, and finally maintained at a lower expression level.

Advance in the study of distal junctional problem after thoracolumbar surgery / 中华骨科杂志

Distal junctional problem (DJP) is one of the severe complications after spinal correction, fixation and fusion. As the number of patients receiving spinal surgery increased recently, the incidence of DJP also increased dramatically. Compared with proximal junctional problem, the incidence of DJP is low. However, the clinical symptoms are severe, and the rate of surgical revision is high in patients with distal junctional problems. DJP include distal junctional kyphosis (DJK) and distal junctional failure(DJF). The definition of DJK is confusing, however, and the most commonly used was that the distal junction Angle at the last follow-up was greater than 10° and increased by 10° compared with that before surgery. There are 6 DJF modes: progressive loss of lumbar lordosis,acute wedging in the disc below the instrumentation, fracture of LIV, osteoporotic fracture below the long rigid fixation, failure of the instrumentation at LIV, spinal stenosis and or segmental instability underneath the instrumentation. Possible risk factors for DJP include weight, age, type of spinal deformity, osteoporosis, choice of LIV, hip disease, deformity location, surgical approach, surgical procedure, fusion segments, fixation devices, LIV at L5, fixed to S1 with no iliac screws, poor restoration of spinal alignment, et al. Currently, there are some controversies in DJP, mainly including the incidence, risk factors whether needs to and how to revise. The review intends to conduct a simple literature review of the current DJP diagnostic criteria, incidence, risk factors, and other research progress, in order to improve the understanding of the distal junction problem.

Advance in evaluation of lumbar function after long fixation of degenerative scoliosis / 中华外科杂志

With the aging of the population, the incidence of degenerative lumbar scoliosis has increased year by year. Long-segment orthopedic fixation surgery is an important method for the treatment of severe degenerative lumbar scoliosis. Currently, the evaluation of postoperative results is mainly based on the degree of relief of postoperative clinical symptoms, as well as the improvement of imaging deformity and balance. The studies show that although surgery has high difficulty and risk, most patients can benefit from surgery. Besides, it is reported that long-segment fixation can alleviate the symptoms of pain and improve the quality of life. However, it also decreases the local activity of the lumbar spine, leading to stiffness of lumbar, which may affect the activities of daily living (ADL) partly. Lumbar Stiffness Disability Index (LSDI) is a scale for evaluating the impact of lumbar spine stiffness on ADL. The scale has certain limitations and needs to be applied to Chinese people on the basis of optimization. In this paper, the researches of lumbar spine function evaluation after degenerative lumbar scoliosis and long segmental orthopedic fixation and the clinical use of LSDI are briefly reviewed.

Assessment of the feasibility of transperineal ultrasound combined with clinical factors in predicting female stress urinary incontinence factors / 中华超声影像学杂志

Objective To investigate the feasibility and accuracy of transperineal real‐time three‐dimensional ultrasound combined with clinical factors in predicting the risk of female stress urinary incontinence( SUI ) . Methods T hree hundred and forty‐eight female patients with SUI diagnosed were selected as the case group ,and 102 healthy people in the same period were selected as the control group . All subjects underwent transperineal real‐time three‐dimensional ultrasound . T he ultrasonic parameters of resting state ,contraction and Valsalva were measured ,and the clinical parameters such as age ,height , weight ,history of pregnancy and childbirth were collected . According to the time sequence ,all the subjcets were divided into derivation cohort and verification cohort inproportion to 2∶1 ,single factor screening and logistic multiple regression analysis were carried out on 24 factors ,and the risk model was established . T he cut‐off value of the disease probability P was determined by the ROC curve of the subjects ,and then the accuracy of the cut‐off value in predicting SUI was verified in the verification group . Results Single factor analysis showed that 13 parameters were associated with SUI( all P ＜0 .05) . Logit P＝2 .014+1 .870× Z1 was established by multivariate logistic regression analysis . T he cut‐off value of the disease probability P determined by ROC curve was 0 .823 . T he predictive sensitivity of the model was 68 .1% ( 95% CI : 59 .6% －76 .6% ) ,specificity was 91 .2% ( 95% CI :86 .0% －96 .4% ) ,positive predictive value was 64 .3%( 95% CI : 55 .6% － 73 .0% ) and negative predictive value was 92 .5% ( 95% CI : 86 .2% － 98 .8% ) . Conclusions It is feasible to predict the risk of female stress urinary incontinence by transperineal real‐time three‐dimensional ultrasound combined with clinical factors . Although ,some limitations with the prediction model ,it has accuracy in predicting SUI with obvious symptoms .

Assessment of the feasibility of transperineal ultrasound combined with clinical factors in predicting female stress urinary incontinence factors / 中华超声影像学杂志

Objective@#To investigate the feasibility and accuracy of transperineal real-time three-dimensional ultrasound combined with clinical factors in predicting the risk of female stress urinary incontinence(SUI).@*Methods@#Three hundred and forty-eight female patients with SUI diagnosed were selected as the case group, and 102 healthy people in the same period were selected as the control group. All subjects underwent transperineal real-time three-dimensional ultrasound. The ultrasonic parameters of resting state, contraction and Valsalva were measured, and the clinical parameters such as age, height, weight, history of pregnancy and childbirth were collected. According to the time sequence, all the subjcets were divided into derivation cohort and verification cohort inproportion to 2∶1, single factor screening and logistic multiple regression analysis were carried out on 24 factors, and the risk model was established. The cut-off value of the disease probability P was determined by the ROC curve of the subjects, and then the accuracy of the cut-off value in predicting SUI was verified in the verification group.@*Results@#Single factor analysis showed that 13 parameters were associated with SUI(all P<0.05). Logit P=2.014+ 1.870×Z1 was established by multivariate logistic regression analysis. The cut-off value of the disease probability P determined by ROC curve was 0.823. The predictive sensitivity of the model was 68.1% (95%CI: 59.6%-76.6%), specificity was 91.2% (95%CI: 86.0%-96.4%), positive predictive value was 64.3% (95%CI: 55.6%-73.0%) and negative predictive value was 92.5% (95%CI: 86.2%-98.8%).@*Conclusions@#It is feasible to predict the risk of female stress urinary incontinence by transperineal real-time three-dimensional ultrasound combined with clinical factors. Although, some limitations with the prediction model, it has accuracy in predicting SUI with obvious symptoms.

The research of pelvic floor ultrasound in diagnosis of stress urinary incontinence / 中华超声影像学杂志

Objective To investigate the diagnostic parameters,criteria and diagnostic value of pelvic floor ultrasound in female stress urinary incontinence(SUI).Methods Simple factor logistic regression analysis was used to compare the difference of ultrasonic parameters between SUI patients(260 cases) and asymptomatic subjects(60 cases) to find the relevant diagnostic indexes,and to evaluate the diagnostic criteria and diagnostic value by the ROC curve.Results There were significant differences in urethral inclination angle and levator hiatus area in resting and bladder neck position,bladder position,urethral inclination angle,retrovesical angle,levator hiatus area in Valsalva state and urethral rotation angle,bladder neck mobility between the two groups (all P ＜ 0.05).There was no significant difference in age,BMI,bladder neck position,bladder position,retrovesical angle between resting in the two groups (all P ＞0.05).Using the ROC curve analysis,the cut-off points of urethral inclination angle and levator hiatus area in resting,bladder neck and bladder position,urethral inclination angle,retrovesical angle,levator hiatus area in Valsalva,bladder neck mobility and urethra rotation angle to diagnose SUI were 16.5°,13.5 cm2,3.5 mm,0.5 mm,29.5°,139.5°,19.5 cm2,24.5 mm,45.5°,respectively.The sensitivity/specificity were 54.6％/66.7％,49.2％/80.0％,68.1％/95.0％,64.2％/98.3％,67.3％/93.3％,73.5％/50.0％,68.8％/81.7％,70.0％/95.0％,67.2％/85.0％,respectively.The area under the curve were 0.625,0.668,0.855,0.854,0.817,0.622,0.811,0.866,0.817,respectively.Conclusions Pelvic floor ultrasound is a better way to diagnose stress urinary incontinence,and it provides an objective basis for the diagnosis of SUI.

Experimental study on anti-tumor effect of high intensity focused ultrasound ablation combined with liquid ;fluorocarbon nanoparticle on cervical cancer / 中华超声影像学杂志

Objective To investigate the therapeutic effect of high intensity focused ultrasound (HIFU) ablation combined with homemade liquid fluorocarbon nanoparticles on cervical cancer in nude mice.Methods The cell experiment was divided into three groups:a,control group;b,HIFU group;c, HIFU + PFB nanoparticle group,and the viability of cells was detected using CCK-8 reagent.The mice were also divided into three groups:A,0.9% NaCI group;B,HIFU + 0.9% NaCI group;C,HIFU + PFB nanoparticle group. The tumors were removed and underwent triphenyl tetrazolium chloride(TTC) staining,and the necrosis area was measured.Histopathological changes of the tumors were examined by light microscopy.Results After HIFU irradiation,the viability rate of group c was (40.5 ±9.7)%,it was lower than that of group b (77.7 ±8.5)% (P <0.05) and that of group a(100 ±4.8)% (P <0.05). TTC staining of tumor showed a large scale of necrotic tissue in group C.The necrosis ratio of the three groups was 0%,(34.14±12.2)% and (65.97 ±25.1)%,respectively (P <0.05).HE staining showed karyorrhexis or an absence of nuclei in group B and group C,which demonstrated the coagulation necrosis. Conclusions HIFU ablation combined with liquid fluorocarbon nanoparticles can effectively treat the xenograft model of the human cervical carcinoma in nude mice.

Therapeutic Observation of Acupuncture in Treating Vertebrobasilar Ischemia / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture at the nine acupoints on nape in treating vertebrobasilar ischemia (VBI). Methods Totally 100 VBI patients were randomized into a treatment group and a control group, 50 in each group. The treatment group was intervened by acupuncture at Fengfu (GV 16), Fengchi (GB 20), Wangu (GB 12), Tianzhu (BL 10), and Jiaji (EX-B 2, C3);while the control group was by oral administration of Nimodipine tablets. The parameters in Transcranial Doppler (TCD) and Dizziness Assessment Rating Scale (ADRS) were observed before and after intervention, and the clinical efficacies were compared. Results The TCD parameters were significantly changed in the treatment group after intervention (P<0.05). The TCD parameters [Vs (RVA), Vd (BA, LVA), Vm (BA, RVA), PI (BA)] were significantly changed in the control group after intervention (P<0.05). After intervention, there were significant differences in comparing the TCD parameters [Vs (BA, LVA, RVA), Vd (BA, RVA), Vm (BA, LVA), PI (BA)] between the two groups (P<0.05). The DARS average scores were significantly changed in both groups after 7-day treatment (P<0.01). The DARS average scores after the whole intervention were significantly different from that after 7-day treatment in both groups (P<0.01). There were significant differences in comparing the DARS average scores between the two groups after 7-day intervention and after the whole intervention (P<0.01). The recovery-markedly effective rate and total effective rate were respectively 76.0%and 98.0%in the treatment group versus 44.0%and 96.0%in the control group, and there was a significant difference in comparing the recovery-markedly effective rate (P<0.05). Conclusions Acupuncture at the nine nape acupoints is an effective method in treating VBI.

Reproducibility of the transperineal real-time three-dimensional ultrasound for evaluation of normal female pelvic floor structure / 中华超声影像学杂志

Objective To study the repeatability and consistency of normal female pelvic floor structure using transperineal real‐time three‐dimensional ultrasound .Methods Forty‐two cases of normal adult female were evaluated by two different experience operator ,using the real‐time three‐dimensional ultrasound diagnostic apparatus .The bladder neck movement degrees and the levator hiatus area were observed after Valsalva condition .Differences between the groups were compared .Intraclass correlation coefficient (ICC) ,the coefficient of variation (CV) and Bland‐Altman analysis of consistency were evaluated . Results The bladder neck movement degrees and the levator hiatus area measured by the experienced operator (operator 1) and less experienced operator(operator 2) were (18 4.8 ± 5 8.4)cm and (17 7.9 ± 5 4.8) cm ,(17 5.3 ± 3 9.5)cm2 and (17 3.1 ± 4 3.2)cm2 ,respectively .There was no significant difference between the two operators ( P > 0 0.5) .The intra‐ICC were 0 8.9 and 0 9.0 ,CV were 7 2.6% and 3 0.3% .Experienced operator repeatability (ICC= 0 9.9 ,0 9.4) was slightly higher than the less experienced researchers (ICC 0 9.2 ,0 8.1) .The analysis results of Bland‐Altman image showed good consistency between two different operators .Conclusions The current study proves real‐time three‐dimensional ultrasound is a reproducible method for female pelvic floor structure assessment ,and the reproducibility is very well .The detection performance of experienced operator slightly better than the one with less experience ,strengthen the training of junior doctors may further improve the accuracy of measurement .

Application of transperineal ultrasound in female typing of cystocele / 中华超声影像学杂志

Objective To investigate the application value of transperineal ultrasound in female patients with cystocele.Methods Transperineal ultrasound were performed in 36 female patients with cystocele and the bladder neck movement degrees (BND),retrovesical angle and the degree of urethral rotation were observed at maximum Valsalva.The ultrasonic manifestation of 36 female patients with cystocele were summarized.Results On maximal Valsalva bladder neck mobility all increased in 36 patients,32 patients with open retrovesical angle (≥140°) and 30 female patients with urethral rotation ≥ 45°.There were 6 cases with type Ⅰ,bladder neck was lower than inferoposterior margin of the symphysis pubis,cystocele with open retrovesical angle (≥140°) and urethral rotation ＜45°.There were 26 cases with type Ⅱ,bladder neck was lower than inferoposterior margin of the symphysis pubis,cystocele with open retrovesical angle (≥140°) and urethral rotation ≥45°.There were 4 cases with type Ⅲ,bladder was lower than inferoposterior margin of the symphysis pubis,cystocele with intact retrovesical angle (＜ 140°) and urethral rotation ≥45°.Conclusions The transperineal ultrasound can be used for classification of cystocele in female patients and which may provide more reliable information for clinical diagnosis.