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Objective:To explore the application value of ultrasonic measurement of the pubic symphysis distance in predicting pubic symphysis diastasis(PSD) during delivery.Methods:A total of 262 pregnant women from June 2021 to July 2022 who delivered at Suzhou Wuzhong People′s Hospital and Jiangyin People′s Hospital were retrospectively analyzed. The patients were divided into PSD group of 26 cases and normal pregnant women group (control group) of 234 cases according to whether or not PSD was confirmed during postpartum follow-up. Relevant data of the two groups were collected, including the biparietal diameter and femoral length of the fetus within 7 days before delivery, the pubic symphysis distance of pregnant women when the cervix was not dilated, pubic symphysis distance when the cervix dilated to 5 cm during the first stage of delivery, and the pubic symphysis distance after delivery, the age of the pregnant woman, the gestational week, the number of pregnancies, and the birth weight of the fetus. The differences of the above relevant data between the two groups were compared.Spearman correlation analysis was used to analyze the correlation between various parameters. The occurrence of postpartum PSD, and Logistic regression was used to analyze the predictive value of various parameters on the occurrence of postpartum PSD. ROC curve was used to analyze the diagnostic efficacy of each parameters to predict PSD.Results:The fetal birth weight, number of pregnancies, pubic symphysis distance in three time points in the PSD group were significantly higher than those in the control group (all P<0.05). The age of the pregnant women was negatively correlated with the occurrence of postpartum PSD ( rs=-0.152, P=0.014). The fetal birth weight, the number of pregnancies, the pubic symphysis distance in the cervix no-dilated and the first stage of labor were positively correlated with the occurrence of postpartum PSD( rs=0.160, 0.166, 0.678, 0.581, all P<0.05). Logistic regression analysis showed that the increase of pubic symphysis distance before labor would increase the risk of postpartum PSD, and the difference was statistically significant ( OR=2 506.028, 95% CI=14.293-439 402.630, P=0.003). The increase of pubic symphysis distance at the first stage of labor increased the risk of postpartum PSD, with a statistically significant difference ( OR=10 704.027, 95% CI=33.830-3 386 803.429, P=0.002). The ROC curve analysis showed that the area under the curve of the pubic symphysis distance in the cervix no-dilated and the first stage of labor for the diagnosis of PSD were 0.896 and 0.917 respectively, the sensitivity were 0.731 and 0.885, the specificity were 0.940 and 0.829, and the corresponding critical values were 0.87 cm and 1.06 cm respectively. The area under the curve of the combination of the two parameters for the diagnosis of PSD was 0.930, the sensitivity was 0.885, and the specificity was 0.876. Conclusions:Ultrasonic measurement of pubic symphysis distance during delivery can predict the occurrence of postpartum PSD in pregnant women and can provide a basis for the occurrence and treatment of postpartum pubic symphysis separation in pregnant women.
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Objective To study the effect of storage duration on compressive mechanical properties of rabbit patellar, so as to provide references for in vitro ligament storage.Methods The compressive mechanical properties of rabbit patellar ligament storaged at -20 ℃ at different storage durations (in 36 d) were tested with the universal tensile test machine. The microscopic morphology of collagen fibers was observed under the scanning electron microscopy (SEM). The enthalpy and denaturation temperature of collagen fibers were measured with differential scanning calorimetry (DSC).Results With the increase of storage duration, the compressive stress of the patellar ligament at 40% strain increased from 19 kPa to 112 kPa and then decreased to 57 kPa. SEM observation showed that the cross-linking of collagen fibers was initially strengthened and then weakened. DSC results showed that the enthalpy increased from 59.47 J/g to 67.10 J/g and then decreased to 54.43 J/g. The denaturation temperature increased from 67.62 ℃ to 77.28 ℃ and then decreased to 64.10 ℃.Conclusions When rabbit patellar ligament is stored at -20 ℃, with the increase of storage duration, the compressive stress of rabbit patellar ligament at 40% strain increases at first and then decreases. This change may be due to the variation of cross-linking level of collagen fibers. The stronger the cross-linking of collagen fibers, the stronger the compressive mechanical properties will be.
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Objective To study the effect of three kinds of commonly used liquid culture media for in vitro cell experiments on elastic modulus of breast cancer cells, so as to provide references for developing novel diagnosis and treatment approach of tumour based on mechanics principles. Methods The elastic modulus and adhesion force of breast cancer cells MCF7 to atomic force microscopy (AFM) probes in phosphate buffered solution(PBS), Dulbecco’s modified eagle media (DMEM) and DMEM+10% fetal bovine serum (FBS) were measured using AFM technology. Results The elastic moduli of breast cancer cells in PBS, DMEM and DMEM+10% FBS were 2.59, 2.11 and 1.59 kPa, respectively. The cell adhesion forces in the above three kinds of liquid medium environment were 63.81, 66.09 and 121.97 pN, respectively. Cell adhesion force in DMEM+10%FBS was significantly different from that of the other two kinds of liquid media. Conclusions There are significant differences in elastic modulus of breast cancer cells in three kinds of liquid media. The difference between DMEM and DMEM+10%FBS might be caused by the different adhesion force caused by serum proteins in the media, and the difference between DMEM and PBS might be attributed to the difference in pH of the media.
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Objective To compare the efficacy and safety of hypobaric and hyperbaric bupivacaine in combined spinal - epidural anesthesia for elderly patients with lower extremity surgery. Methods A total of 72 patients underwent lower limb surgery were randomly divided into control group and observation group according to the digital table,36 patients in each group. The patients were given hypobaric or hyperbaric bupivacaine in combined spinal-epidural anesthesia. The anesthesia effect during surgery and hemodynamics related indicators were compared between the two groups,and the intraoperative and postoperative anesthesia-related adverse reactions were recorded. Results The excellent and good rate of sedation in the observation group was 88. 91% (32/36),which in the control group was 91. 67% (33/35),the difference was not statistically significant (χ2 =0. 16,P=0. 69). The incidence rates of adverse events of the observation group,including back pain,urinary retention and neurological symptoms were significantly lower than those of the control group (all P<0. 05). Conclusion The effect of hypobaric bupivacaine is excellent,the effect of hemodynamics is small,the postoperative circulatory system is relatively stable,the operation safety is better,it is superior to the middle and elderly patients with lower limb surgery anesthesia.
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Objective To compare the efficacy and safety of hypobaric and hyperbaric bupivacaine in combined spinal - epidural anesthesia for elderly patients with lower extremity surgery. Methods A total of 72 patients underwent lower limb surgery were randomly divided into control group and observation group according to the digital table,36 patients in each group. The patients were given hypobaric or hyperbaric bupivacaine in combined spinal-epidural anesthesia. The anesthesia effect during surgery and hemodynamics related indicators were compared between the two groups,and the intraoperative and postoperative anesthesia-related adverse reactions were recorded. Results The excellent and good rate of sedation in the observation group was 88. 91% (32/36),which in the control group was 91. 67% (33/35),the difference was not statistically significant (χ2 =0. 16,P=0. 69). The incidence rates of adverse events of the observation group,including back pain,urinary retention and neurological symptoms were significantly lower than those of the control group (all P<0. 05). Conclusion The effect of hypobaric bupivacaine is excellent,the effect of hemodynamics is small,the postoperative circulatory system is relatively stable,the operation safety is better,it is superior to the middle and elderly patients with lower limb surgery anesthesia.
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Objective To investigate the pathological findings and diagnosis value of CT and MRI in detec-tion of primary centralnervous system lymphoma (PCNSL)so as to improve diagnostic accuracy of the condition. Methods The results of CT and MRI for 32 patients with PCNSL were analyzed retrospectively,and the results were compared with the finally obtained surgical-pathological examination.Results Of 32 cases,the foci were single in 29 cases and multiple in 4 cases,and there were 41 foci in total.Most foci were located near the surface or middle line of brain.On CT scan appearances,most foci were hyperdensity or slightly hyperdensity masses with the well definite margin,on MRI,it showed low signal of T1 -weighted imaging (T1 WI)and slightly increased non-uniform signal of T2 -weighted imaging (T2 WI).All the foci were equally and markedly enhanced after enhancement.The diagnostic coincident rate of combination diagnosis (93.8%)was significantly higher than that of CT (71.9%)and MRI (75.0%)(χ2 =7.234 6,P=0.003 2;χ2 =6.953 8,P=0.003 7).Conclusion CT,MRI have characteristic mani-festation for PCNSL,and according to the manifestation of CT,MRI,predilection site,mass effect,and combined with pathological examination,which can effectively improve the sensitivity and accuracy of diagnosis.