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Objective@#To determine imaging features that may help predict the presence of placenta accreta, placenta increta or placenta percreta on prenatal MRI scanning in order to identify the most diagnostic findings.@*Methods@#The prenatal MRI scan data of placenta accreta, placenta increta or placenta percreta (placenta implantation group, n=15) and normal placenta(placenta normal group, n=15) diagnosed and treated by surgical pathology from January 2010 to December 2017 in the People's Hospital of Huadu District were retrospectively analyzed.Two expert MRI doctors were blinded to the patients' true diagnosis and were asked to score a total of 10 MRI features of the placenta and adjacent structures.The interrater reliability was assessed using kappa statistics.The features with a moderate kappa statistic or better(kappa>0.40 ) were then compared with the true diagnosis for each observer.@*Results@#Eight of the scored features had an interobserver reliability of kappa>0.40: placenta previa(κ=0.89); abnormal uterine bulging(κ=0.57); intraplacental hemorrhage(κ=0.45); the presence of dark intraplacental bands on T2W imaging(κ=0.76); flow-empty blood vessels in placenta(κ=0.67); border on placenta and uterus blurring(κ=0.63); heterogeneity of signal intensity on T2-weighted(T2W) imaging(κ=0.53); and continuity of myometrium was interrupted(κ=0.64). Using Fisher's two-sided exact test, there were statistically significant differences between the proportion of patients with placental invasion and those without placental invasion for three of the features: abnormal uterine bulging(P=0.015, P=0.011); heterogeneity of T2W imaging signal intensity(P=0.006, P=0.013); and presence of dark intraplacental bands on T2W imaging(P=0.032, P=0.010).@*Conclusion@#MRI can be a useful adjunct to ultrasound in diagnosing placenta accreta prenatally.Three features that are seen on MRI in patients with placental invasion appear to be useful for diagnosis: uterine bulging; heterogeneous signal intensity within the placenta; and the presence of dark intraplacental bands on T2W imaging.
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Objective To determine imaging features that may help predict the presence of placenta accreta , placenta increta or placenta percreta on prenatal MRI scanning in order to identify the most diagnostic findings . Methods The prenatal MRI scan data of placenta accreta,placenta increta or placenta percreta (placenta implantation group,n＝15) and normal placenta (placenta normal group,n＝15) diagnosed and treated by surgical pathology from January 2010 to December 2017 in the Peopleˊs Hospital of Huadu District were retrospectively analyzed.Two expert MRI doctors were blinded to the patientsˊtrue diagnosis and were asked to score a total of 10 MRI features of the placenta and adjacent structures.The interrater reliability was assessed using kappa statistics.The features with a moderate kappa statistic or better ( kappa ＞0.40 ) were then compared with the true diagnosis for each observer. Results Eight of the scored features had an interobserver reliability of kappa ＞0.40:placenta previa (κ＝0.89);abnormal uterine bulging(κ＝0.57);intraplacental hemorrhage (κ＝0.45);the presence of dark intraplacental bands on T2 W imaging( κ＝0.76); flow －empty blood vessels in placenta ( κ＝0.67); border on placenta and uterus blurring(κ＝0.63);heterogeneity of signal intensity on T 2 －weighted( T2 W) imaging(κ＝0.53);and continuity of myometrium was interrupted ( κ＝0.64).Using Fisherˊs two －sided exact test, there were statistically significant differences between the proportion of patients with placental invasion and those without placental invasion for three of the features:abnormal uterine bulging ( P＝0.015,P＝0.011);heterogeneity of T2 W imaging signal intensity ( P＝0.006,P＝0.013);and presence of dark intraplacental bands on T 2 W imaging(P＝0.032,P＝0.010).Conclusion MRI can be a useful adjunct to ultrasound in diagnosing placenta accreta prenatally.Three features that are seen on MRI in patients with placental invasion appear to be useful for diagnosis : uterine bulging; heterogeneous signal intensity within the placenta;and the presence of dark intraplacental bands on T 2 W imaging.
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AIM: To investigate the association of osteoprotegerin ( OPG) gene single nucleotide polymor-phisms (SNPs), 163A/G (rs3102735) and 245T/G (rs3134069), with susceptibility to rheumatoid arthritis (RA) in Chinese Han population .METHODS:A total of 205 patients with RA and 171 healthy control subjects were enrolled into this study.Genotyping was performed by polymerase chain reaction-based restriction fragment length polymorphism and subsequently confirmed by DNA sequencing .Odds ratio ( OR) and 95%confidence intervals ( CI) were calculated for the risk genotypes and alleles .RESULTS: OPG gene polymorphisms 163A/G and 245T/G were conformed to the Hardy-Weinberg equilibrium .The statistical differences in the genotypes of AA , AG and GG at 163A/G locus were found in RA and controls.The G allele was associated with an increased risk of RA , with OR of 1.219 (95%CI:1.066~2.339).No significant difference was observed between RA group and control group with respect to genotypic and allelic frequencies of OPG gene 245T/G (P>0.05).CONCLUSION:The OPG gene 163A/G SNP may be associated with RA susceptibility , and G allele may be the risk factor for developing RA .
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Objective To investigate the kinds of isolates and the causes of bloodsream infection.Methods A total of 4 459 blood samples were cultured by BacT/Alert 3D240. The isolates were identified by API system.Results 247 strains were isolated from 246 patients. The isolates included Gram-negative bacteria (66.0%), Gram-positive bacteria (30.4%) and fungi(3.6%). E. coli, Salmonella paratyphi A , Salmonella typhi and Staphylococcus sp. not-Staphy. aureus were the main pathogen. The causes of bloodstream infection resulted from non-surgical disease, surgical disease, and others were 82.5%, 4.1% and 13.4%, respectively. The major symptom of blood infection was fever, which was presented in 41.5% of positive blood culture cases. 77.6% of Salmonella sp. was isolated from the patients of the department of respiratory and the department of emergency. E. coli was mainly isolated from the patients of the department of nephrolgy, haemotology and surgical department. Staphycoccus sp.not-Staphy. aureus was mainly isolated from the patients of the department of respiratory and pediatrics. The positive blood culture rate in 12,24,36,48,72,96 h were 24.4%,74.0%,87.4%,93.1%,97.2%, and 99.2% respectively.The coincidence rate of positive blood culture detected under microscope and identified by API system was ~99.6%. Conclusion Automated blood culture systems were important apparatus for diagnosis of bloodstream infection.