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Objective To investigate the value of prenatal ultrasound in diagnosis of fetal posterior urethral valve (PUV) and the differential diagnosis of related diseases.Methods The antenatal ultrasonographic manifestations and the outcomes of 14 cases with congenital lower urinary tract obstruction (LUTO) in Shengjing Hospital of China Medical University from December 2014 to December 2016 were analyzed.The ultrasound features and differential diagnosis of fetal posterior urethral valve were summarized and analyzed.Results Fourteen male fetuses with LUTO were prenatally diagnosed.Eleven fetuses were diagnosed as PUV,I as urethral atresia,2 as megacystis and LUTO.Among the fourteen fetuses,11 were confirmed as PUV after delivery,1 as urethral atresia,2 as vesicoureteral reflux (VUR).One case among them was diagnosed as PUV,and latter proved to be VUR.In 2 cases among them,prenatal ultrasound indicated megacystis,but 1 case was proved to be PUV,and 1 case was VUR.The prenatal ultrasound of the PUV fetuses showed enlarged bladder and thickened bladder wall.Most of them were accompanied by the keyhole sign.Conclusion Prenatal ultrasound can assist in the diagnosis of PUV by analyzing the anatomy of the bladder and accompanying malformations,which provides valuable diagnostic information for the clinical practice.
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Objective To investigate the value of procalcitonin (PCT) for urosepsis secondary to ureteral calculus.Methods Samples of 68 ureteral calculi patients who were suspected of urosepsis were obtained for PCT level,C-reactive protein (CRP) level,blood routine examination,urinary sediment,blood culture and urine culture.Sixty-eighy patients were divided into urosepsis group and non-urosepsis group based on the urosepsis diagnostic standard.The age sex,stone location,stone size,blood WBC count,CRP level,PCT level and urine WBC count were compared between the 2 groups.PCT levels before and after treatment were also compared.Results The age,stone size in urosepsis group were significantly higher than those in non-urosepsis group.The PCT levels of patients in urosepsis group and non-urosepsis group were 19.09±25.15 μg/L and 2.09± 1.85 μg/L respectively before treatment,and there was a significant difference between the 2 groups (P＜0.05).The blood WBC counts (× 109/L) of patients in urosepsis group and non-urosepsis group were 11.00± 3.47 and 10.27±2.32 respectively before treatment (P＞0.05).The CRP levels of patients in urosepsis group and non-urosepsis group were 17.41±15.24 mg/L and 15.02±4.94 mg/L respectively before treatment (P＞0.05).The median urine WBC counts (per HPF) of patients in urosepsis group and non-urosepsis group were 54 and 47 respectively before treatment (P＞0.05).The PCT levels of patients in urosepsis group before and after treatment were 19.09 ± 25.15 μg/L and 1.06 ± 0.56 μg/L,and there was a significant difference (P＜0.05).Conclusion PCT has a definite value for early diagnosis of urosepsis,condition assessment and treatment guideline.
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Objective To innovate an early, rapid and efficient approach to the pmgnestic evaluation of sep-sis in order to lower the mortality. Method Forty-five septic rats, induced by cecal ligation and puncture, were divided into surviving group (n=23) and non-survival group (n=22) on six days after onset of sepsis. Serum samples were taken from septic and sham-operated rats (n=25) at 12 hours after surgery. HPLC/MS assays were performed to acquire the serum metabolic profiles, and radial basis function neural network (RBFNN) was em-ployed to build predictive model for prognostic evaluation of sepsis. Results The principal component analysis al-lows differentiating the rots of survive,non-survive and sham-operated from one another in respect of the pathologic characteristics. Six metabolites, linolenic acid, linoleic acid, oleic acid, stearic acid, docosahexaenoic acid and do-cosapentaenoic acid, related to the outcomes of septic rats were then structurally identified. A RBFNN model for outcome predication was built based upon the metabolic profile data from rat sera with the sensitivity of (96.1 ±3.6)% (n=10) and specificity of (91.0±4.3)% (n=10). Condusions HPLC/MS-based metabonomic approach combined with pattern recognition permits accurate outcome prediction of septic rats in the early stage. The proposed approach has advantages of rapid, low-cost and efficiency, and is isph-ing to be applied in clinical prognostic evaluation of septic patients.