Prediction of benign and malignant ovarian tumors using Resnet34 on ultrasound images.

OBJECTIVE: To develop deep learning (DL) prediction models using transvaginal ultrasound (TVS), transabdominal ultrasound (TAS), and color Doppler flow imaging (CDFI) of TVS (CDFI_TVS) to automatically predict benign or malignant ovarian tumors. METHODS: This retrospective study included women with ovarian tumors who underwent ultrasound between August 2018 and October 2022. Histopathological analysis was used as a reference standard. The dataset was preprocessed by clipping, flipping, and rotating images to generate a larger, more complicated, and diverse dataset to improve accuracy and generalizability. The dataset was then divided into training (80%) and test (20%) sets. The weights of the models, modified from the residual network (ResNet) with the TVS, TAS, and CDFI_TVS images (hereafter, referred to as DLTVS , DLTAS , and DLCDFI_TVS , respectively) were developed. The area under the receiver operating characteristic curve (AUC) analysis in the test set was used to compare the predictive value of DL for malignancy. RESULTS: A total of 2340 images from 1350 women with adnexal masses were included. DLTVS had an AUC of 0.95 (95% CI: 0.93-0.97) for classifying malignant and benign ovarian tumors, comparable with that of DLTAS (AUC, 0.95; 95% CI: 0.91-0.98; p = 0.96) and DLCDFI_TVS (AUC, 0.88; 95% CI: 0.84-0.93; p = 0.02). Decision curve analysis indicated that DLTVS performed better than DLTAS and DLCDFI_TVS . CONCLUSION: We developed DL models based on TVS, TAS, and CDFI_TVS on ultrasound images to predict benign and malignant ovarian tumors with high diagnostic performance. The DLTVS model had the best prediction compared with the DLTAS and DLCDFI_TVS models.

[Effect of Different Fertilization Treatments on Methane and Nitrous Oxide Emissions from Rice-Vegetable Rotation in a Tropical Region, China].

The study of the effects of different fertilization treatments on soil methane (CH4) and nitrous oxide (N2O) emissions in rice-vegetable rotation systems is of great significance to supplement the research gap on greenhouse gas emissions in tropical regions of China. In this study, four fertilization treatments were set up during the pepper season:phosphorus and potassium fertilizer application (PK); nitrogen, phosphorus, and potassium (NPK) application; half application of nitrogen, phosphorus, and potassium plus half application of organic fertilizer (NPK+M); and application of organic fertilizer (M). There was no fertilizer application during the following early rice season. The objective of our study was to investigate the rules of CH4 and N2O emissions under different fertilization treatments in the pepper growth season, and the effects of different fertilization treatments in the pepper growth season on rice yield, and CH4 and N2O emissions in the following early rice growth season. The close static chamber-gas chromatography method was applied to determine soil CH4 and N2O emissions. We measured crop yield, estimated global warming potential (GWP), and calculated greenhouse gas emission intensity (GHGI). Our results showed that:① the cumulative CH4 emission under the four fertilization treatments ranged between 0.9 kg·hm-2 to 2.7 kg·hm-2 during the pepper growth season and between 5.5 kg·hm-2 to 8.4 kg·hm-2 during the early rice growth season. Compared with NPK, NPK+M and M reduced the cumulative CH4 emission in the pepper growth season by 35.3% and 7.6%, respectively; however, NPK+M and M increased the cumulative CH4 emission in the early rice season by 37.5% and 55.1%, respectively. There was a significant difference in cumulative CH4 emission between M and NPK in the early rice growth season. ② The cumulative N2O emission under the four fertilization treatments varied from 0.5 kg·hm-2 to 3.0 kg·hm-2 in the pepper growth season and from 0.3 kg·hm-2 to 0.5 kg·hm-2 in the early rice growth season. The cumulative N2O emission was significantly decreased by 33.7% in NPK+M and by 16.0% in M, compared with that in NPK. In the early rice growth season, the cumulative N2O emission was decreased by 23.5% by NPK+M but was increased by 9.1% by M. There was no significant difference in the cumulative N2O emission among the four fertilization treatments. ③ The yields of pepper and early rice under the four fertilization treatments were 3055.6-37722.5 kg·hm-2 and 5850.9-6994.4 kg·hm-2, respectively. Compared with that in NPK, NPK+M and M significantly increased pepper yield. The GWP under the four fertilization treatments in the pepper-early rice rotation system varied from 508.0 kg·hm-2 to 1864.4 kg·hm-2. Compared with NPK, NPK+M significantly decreased GWP by 25.7% and M insignificantly decreased GWP by 5.7%. The pepper growth season with the four fertilization treatments contributed to 69.2%-78.1% of the total GWP, and N2O contributed to 77.3%-85.3% of the total GWP. The GHGI ranged between 0.03 kg·kg-1 and 0.09 kg·kg-1 in the pepper growth season and between 0.04 kg·kg-1 and 0.24 kg·kg-1 in the early rice growth season. Compared with that in NPK, both M and NPK+M significantly reduced the GHGI by 71.5% and 54.7%, respectively, in the pepper growth season. In the early rice season, NPK+M significantly decreased the GHGI by 44.0%, but M non-significantly decreased the GHGI by 20.8%. The peak in N2O emission in the tropical pepper-early rice rotation system appeared after fertilization, and N2O emissions primarily occurred in the pepper growth season. However, CH4 emission was mainly concentrated in the early rice season. Considering the overall enhancing effects on crop yield and mitigation of greenhouse gas emissions, the co-application of chemical and organic fertilizers (NPK+M) can be recommended as an optimal fertilization practice to mitigate greenhouse gas emissions and maintain crop yield in pepper-rice rotation systems of Hainan, China.

Ultrasound analysis of the effect of second delivery on pelvic floor function in Chinese women.

In our study, patients who had a second delivery were categorised into the following 4 groups. Pelvic floor ultrasound data were compared during the 6th week after the second delivery. The incidence of cystoceles was highest in group A and lowest in group D. In addition, groups A and B had a higher rate of rectoceles or perineum descent. Similarly, the areas of the levator hiatus were higher in Groups A and B during Valsalva manoeuvres. The area of the levator hiatus from the resting state to the Valsalva manoeuvre effect had the greatest change in Group A. A comparison of the PR thickening rates among the four groups did not reveal significant differences. All second delivery methods can cause varying degrees of pelvic organ prolapse and decreased pelvic floor function; however, vaginal delivery as the second delivery mode may have a more significant effect in Chinese women.Impact StatementWhat is already known on this subject? Different modes of delivery have significantly different effects on female pelvic floor function. Pregnancy beyond 35 weeks of gestation has an effect on female pelvic floor function, irrespective of the mode of delivery.What do the results of this study add? This study analysed the impact of different delivery modes on Chinese female pelvic floor function. Parous women who underwent different modes of second delivery all demonstrated different degrees of pelvic organ prolapse, as well as pelvic floor function decline.What are the implications of these findings for clinical practice and/or further research? Our study will provide basic research of Chinese female pelvic floor function after a second delivery, which will be of clinical significance around the world, as well as in China. China will keep promoting further delivery as the aging population is increasing. If the developing countries want to promote the second delivery around the women, they have basic research and data to instruct the females.

[Effects of Water and Fertilization Management on CH4 and N2O Emissions in Double-rice Paddy Fields in Tropical Regions].

Paddy soils are widely considered a main source of methane (CH4) and nitrous oxide (N2O). Comprehensively evaluating CH4 and N2O emissions from double-rice systems in tropical regions with different water irrigation and fertilizer applications is of great significance for addressing greenhouse gas emissions from such systems in China. In this study, eight treatments were evaluated:conventional irrigation-PK fertilizer (D-PK), conventional irrigation-NPK fertilizer (D-NPK), conventional irrigation-NPK+organic fertilizer (D-NPK+M), conventional irrigation-organic fertilizer (D-M), continuous flooding-PK fertilizer (F-PK), continuous flooding-NPK fertilizer (F-NPK), continuous flooding-NPK+organic fertilizer (F-NPK+M), and continuous flooding-organic fertilizer (F-M). CH4 and N2O emissions in double-rice fields in tropical region of china were monitored in situ by closed static chamber-chromatography method and crop yields as well as global warming potential (GWP) and greenhouse gas intensity (GHGI) were determined. The results show that:① The cumulative CH4 emissions from early rice and late rice are 10.3-78.9 kg·hm-2and 84.6-185.5 kg·hm-2, respectively. Compared with F-PK and F-NPK treatments, F-NPK+M and F-M treatments significantly increased the cumulative emissions of CH4 from early rice season. Under the same fertilizer conditions, the cumulative CH4 emissions under continuous flooding condition were significantly higher than that under conventional irrigation condition. Irrigation and fertilization had extremely significant effects on CH4 emission in the early rice season. ② The cumulative N2O emissions across all treatments were 0.18-0.76 kg·hm-2 in early rice season and 0.15-0.58 kg·hm-2in late rice season, respectively. During early rice season, compared with F-PK, F-NPK significantly increased the cumulative N2O emission; however, compared with D-PK, D-NPK, D-NPK+M, and D-M treatments significantly increased the cumulative N2O emissions. Compared with F-PK, other three treatments under continuous flooding condition significantly increased N2O cumulative emission in late rice season; compared with D-PK, D-NPK, and D-M treatment significantly increased the cumulative N2O emission. Irrigation and fertilization had significant impacts on N2O emissions in late rice season, and fertilization had significant impacts on N2O emission in early rice season. ③ Early and late rice yields were 7310.7-9402.4 kg·hm-2 and 3902.8-7354.6 kg·hm-2, respectively. Early rice yields in both F-NPK and F-M treatments were significantly higher than those in F-PK, D-PK, and D-NPK treatments. Compared with PK, the other three fertilization treatments under the same irrigation condition significantly increased late rice yield. The GWP and GHGI in early rice season were 580.8-2818.5 kg·hm-2and 0.08-0.30 kg·kg-1, respectively. There was no significant difference in GWP among four fertilizer treatments under conventional irrigation condition in the early rice season. However, F-NPK+M and F-M treatments had a significant increase in GWP compared with F-PK. The GHGI in F-NPK+M and F-M treatments were significantly higher than that in other treatments. The GWP and GHGI in late rice season were 3091.6-6334.2 kg·hm-2 and 0.50-1.23 kg·kg-1, respectively. Irrigation significantly affected GWP and GHGI in both early and late rice seasons but fertilization had no significant impact on GWP and GHGI in late rice season. ④ Correlation analysis results showed that soil NH4+-N content and soil temperature below 5 cm soil layer had an extremely significant negative correlation with CH4 emissions. Soil pH was extremely significant positive correlated with CH4 emissions but significantly negatively correlated with N2O emission. Soil NH4+-N and NO3--N concentrations were extremely significantly negatively correlated with N2O emission. Given crop yield, GWP, GHGI, and D-NPK+M can be recommended for local water and fertilizer management to reduce greenhouse gas emissions while maintaining rice yields.

Thyroid structure, function and iodine status by pregnancy trimester in Harbin, China.

BACKGROUND AND OBJECTIVES: Thyroid disease in pregnancy can have devastating effect on the fetus. In Harbin, China, there is insufficient knowledge about the incidence of and contributing factors to thyroid disease in pregnancy. This study investigates whether urine iodine concentration (UIC), as a proxy for iodine intake, affects the thyroid structure and/or function during each trimester. METHODS AND STUDY DESIGN: Data of 24000 pre-pregnant women were collected from January 2017 to August 2019. Serum thyroid hormone levels were measured, and thyroid ultrasonography was performed. If thyroid ultrasonography and thyroid function findings were normal before pregnancy and were abnormal after pregnancy, the current gestational age was recorded and the UIC was measured. Finally, a total of 500 participants were included in the study. RESULTS: There were significant differences in the incidence of abnormal thyroid structure and function between trimester groups (p<0.05). Thyroid nodular lesions were the most common abnormal ultrasound finding, and positive thyroid peroxide antibodies (TPOAb) were the most common abnormal thyroid function test results. There were significant differences in the median UIC between trimester groups (p<0.001); the median UIC decreased with increasing gestational age. The incidence of abnormal thyroid structure or function was not significantly different across UIC groups (p>0.05). CONCLUSIONS: In women from Harbin, thyroid structural or functional abnormalities commonly occur in the second and third trimesters of pregnancy. Thyroid nodular lesions and positive TPOAb are the commonest thyroid abnormalities. The median UIC significantly declines with increasing gestational age. Pregnant women in Harbin have iodine-deficient states.

Urine iodine level and multiple risks are associated with thyroid structural abnormalities among adults in Heilongjiang Province, China.

BACKGROUND AND OBJECTIVES: The prevalence of adult thyroid structural abnormalities has increased significantly worldwide. However, no study has examined the thyroid structure and urine iodine levels of adults in Heilongjiang Province in the last decade. Therefore, this study aims to investigate the rate and risk factors of thyroid structural abnormalities among the residents of this province. METHODS AND STUDY DESIGN: A probability proportional sampling method was used, and a total of 3,645 individuals in Heilongjiang Province were included. The subjects was asked to complete a thyroid ultrasound and fill out a questionnaire. Furthermore, urine iodine levels and salt iodine content were determined, and multivariate logistic regression was used to identify the independent risk factors for thyroid diseases. RESULTS: The prevalence of thyroid structural abnormalities in Heilongjiang Province was 56.0%. Univariate analysis showed that there were significant differences between the structural abnormalities group and the normal thyroid group in terms of sex, age, body mass index, hypertension, diabetes, smoking, alcohol consumption, frequency of seafood consumption and pickled food consumption, employment status, and urine iodine level (p<0.05). Multivariate analysis showed that the following were independent risk factors of thyroid disease: female, increased age, hypertension, diabetes, cigarette smoking frequent seafood consumption, employment, and urine iodine levels. CONCLUSIONS: The prevalence of thyroid structural abnormalities in adults in Heilongjiang Province was relatively high. Therefore, to help prevent the occurrence of thyroid disease in adults in Heilongjiang Province, the risk factors of thyroid structural abnormalities should be better understood.

Contrast-Enhanced Ultrasonography in Sclerotherapy for Ovarian Endometrial Cyst.

We investigated contrast-enhanced ultrasonography (CEUS) characteristics related to the perfusion pattern and parameters of the time-intensity curve of ovarian endometrial cysts (OECs) pre- and post-sclerotherapy. Forty-three patients with one-sided, single, untreated OECs underwent CEUS pre- and post-sclerotherapy. OEC wall thickness was measured by 2-D ultrasonography and CEUS, and CEUS enhancement patterns and time-intensity curve parameters before and after sclerotherapy were compared. OEC wall thickness remained essentially unchanged post-sclerotherapy. Wall thickness was significantly larger on 2-D ultrasonography than on CEUS. The OEC wall exhibited rapid enhancement and slow clearance both pre- and post-sclerotherapy. Wash-in and wash-out times remained unchanged. The wall exhibited iso-enhancement pre-sclerotherapy, but low and partially uneven enhancement post-sclerotherapy. Post-treatment, time to peak was delayed, peak intensity was reduced and perfusion slope was decreased. The contrast agent arrival time and area under the curve remained similar. CEUS enhancement patterns and quantitative parameters were altered post-sclerotherapy; thus, treatments involving sclerosing agent retention can help to improve the efficacy of sclerotherapy for OEC.

Four-dimensional hysterosalpingo-contrast sonography with auxiliary hydrogen peroxide examination for the diagnosis of fallopian tube patency following interventional treatment of ovarian ectopic cysts.

OBJECTIVE: The present study aimed to explore the practical value of using four-dimensional hysterosalpingo-contrast sonography with auxiliary hydrogen peroxide examination which is necessary for the diagnosis of fallopian tube patency following treatment of ovarian ectopic cysts. METHODS: A retrospective analysis of hysterosalpingography (HSG) examination data from 71 patients who had received sonography-guided interventional treatment for ovarian ectopic cysts at the Fourth Affiliated Hospital of Harbin Medical University was carried out. The 71 cases were divided into three groups. Four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) with the contrast agent SonoVue was carried out in the first group (4D-HyCoSy group), hydrogen peroxide (H2O2) examinations were carried out in the second group (H2O2 group), and the final group consisted of patients who underwent 4D-HyCoSy followed by an auxiliary H2O2 examination where necessary (4D-HyCoSy/H2O2 group). Results of these examinations were then compared to those of a standard HSG examination using lipiodol radiography that had been carried out a month beforehand. RESULTS: (1) The rates of diagnostic accordance with standard HSG examination results for the 4D-HyCoSy, H2O2, and 4D-HyCoSy/H2O2 groups were 86.9, 70.5 and 91.8% respectively. The H2O2 group accordance rate was significantly lower than that of the other two groups (p < 0.05). (2) Compared to the tubal patency results of the standard HSG examination, the sensitivity, specificity, positive predictive value, negative predictive value, and Youden index of the 4D-HyCoSy group were 83.3, 89.3, 83.3, 89.3, and 0.73% respectively. For the H2O2 group, these values were 66.7, 73.9, 70, 70.8, and 0.41%, respectively, and for the 4D-HyCoSy/H2O2 group were 90, 93.5, 90, 93.5, and 0.84%, respectively. All of these values were significantly higher in the 4D-HyCoSy/H2O2 group than in the other two groups. CONCLUSIONS: The use 4D-HyCoSy with auxiliary H2O2 examination for the diagnosis of tubal patency is safe, non-invasive, and easy to carry out. It can also improve the diagnostic accuracy rate of 4D-HyCoSy and H2O2 examinations used on their own.

Contrast-Enhanced Sonographic Features Before and After Interventional Treatment of Ovarian Endometrial Cysts.

OBJECTIVES: The purpose of this study was to assess contrast-enhanced sonography features before and after interventional treatment of ovarian endometrial cysts. METHODS: We retrospectively analyzed 53 patients with ovarian endometrial cysts who underwent contrast-enhanced sonography before and after interventional treatment to assess the sonographic features of the cysts at these different times. The sonographic features and quantitative parameters for the cysts were compared before and after treatment. RESULTS: The wash-in mode showed rapid annular enhancement of the cyst wall and slow wash-out with even and uneven enhancement types. Compared to the internal iliac artery, the enhancement intensity was weaker, and the wash-in and wash-out times were longer in the cyst wall; furthermore, all 5 quantitative parameters differed between the cyst wall and internal iliac artery. The wash-in and wash-out characteristics of the cysts before and after interventional treatment were almost identical. The enhancement was primarily even before treatment and uneven after treatment; the enhancement intensity was low in all cases. Although the wash-in time before and after treatment did not differ, the wash-out time for the cysts before treatment was significantly lower than that observed after treatment. Two quantitative parameters differed before and after treatment. CONCLUSIONS: The contrast-enhanced sonographic features and quantitative parameters for the walls of ovarian endometrial cysts differed before and after ultrasound-guided interventional treatment. These characteristics could be valuable for evaluating the efficacy of interventional treatment of ovarian endometrial cysts.

Differentially expressed gene profiles in the serum before and after the ultrasound-guided ethanol sclerotherapy in patients with ovarian endometriomas.

OBJECTIVES: To detect the differentially expressed genes and subsequently identify disease-related signatures and potential biomarkers for patients with ovarian endometriomas in the serum before and after the ultrasound-guided ethanol sclerotherapy in patients with ovarian endometriomas. DESIGN AND METHODS: Venous blood samples were collected from nine patients with ovarian endometriomas before and after ultrasound-guided ethanol sclerotherapy, and the serum were isolated after centrifugation. NimbleGen human gene expression microarrays analysis was conducted to analyse gene ontology categories (GO terms) and signalling pathways of differentially expressed genes. The accuracy of some typical genes from microarray analysis was verified by quantitative PCR (qPCR). RESULTS: Approximately 45,033 genes were analysed by NimbleGen human gene expression microarrays, which identified 447 genes that showed differential expressions before and after therapy. Of these, 225 genes were up-regulated and 222 genes were down-regulated. The GO terms of the down-regulated genes were strongly associated with the pathogenesis of ovarian endometriomas; 15 down-regulated genes showed overlaps in both signalling pathways and GO terms. Among these, six genes showed statistical significance including IL6, CD36, JUNB, B4GALT1, HES1, and NR4A1, which were also validated by qPCR analysis. CONCLUSIONS: There were differentially expressed genes in the serum before and after ultrasound-guided ethanol sclerotherapy in patients with ovarian endometriomas. Notably, the expressions of IL6, CD36, JUNB, B4GALT1, HES1, and NR4A1, which are strongly associated with the pathogenesis of ovarian endometriomas, were significantly down-regulated after ethanol sclerotherapy. This may not only help us understand EMs pathogenesis, but also provide potential biomarkers for verifying the effects of ethanol sclerotherapy.

Association of IL-1α rs17561 and IL-1 RN rs315952 polymorphisms with Tourette syndrome: a family-based study.

AIM: Immune system dysregulation has been implicated to play a key role in pathogenesis of Tourette syndrome (TS). IL-1α and IL-1RN are important inflammatory cytokines that mediate the inflammation. In this study, we investigated the relationship between single-nucleotide polymorphisms (SNPs) of IL-1α and IL-1RN and the susceptibility to TS in Chinese Han population. METHODS: A total of 276 children with TS and their parents were recruited in the study. All DNA from our subjects were genotyped for SNPs of IL-1α rs17561 and IL-1RN rs315952 using predesigned TaqMan SNP genotyping assay. The genetic contributions of two polymorphisms were evaluated using transmission disequilibrium test (TDT) and haplotype relative risk (HRR) design. In addition, to increase the efficiency of the test, the haplotype-based HRR (HHRR) was performed. RESULTS: No significant differences were observed in allelic and genotypic frequency of rs17561 in IL-1α and rs315952 in IL-1RN between the transmitted group and non-transmitted group (for IL-1α rs17561: TDT=0.890, df=1, P=0.402; HRR=1.011, X(2)=3.016, P=0.082, 95% CI=0.999-1.024; for IL-1RN rs315952: TDT=0.095, df=1, P=0.805; HRR=0.984, X(2)=0.008, P=0.929, 95% CI=0.695-1.394). Similarly, the analysis of HHRR also did not support a significant association (for IL-1α rs17561: HHRR=1.226, X(2)=0.915, P=0.339, 95% CI=0.807-1.863; for IL-1RN rs315952: HHRR=0.963, X(2)=0.094, P=0.759, 95% CI=0.758-1.225). CONCLUSION: Our results suggest that IL-1α rs17561 and IL-1RN rs315952 polymorphisms may not be associated with susceptibility to TS in Chinese Han population. However, the results still need to be replicated in a larger sample size and different populations.

rs2043211 polymorphism in CARD8 is not associated with Tourette syndrome in a family-based association study in the Chinese Han population.

BACKGROUND: Previous studies showed that postinfectious autoimmunity and immune deficiency played an important role in the pathogenesis of Tourette syndrome. CARD8 can suppress activity of NF-ΚB activated by inflammatory mediators. OBJECTIVE: To study the association between the rs2043211 polymorphism in CARD8 and susceptibility to Tourette syndrome in Chinese Han population. METHODS: We recruited 279 patients diagnosed with Tourette syndrome and their parents for the study. Genotyping for CARD8 rs2043211 single-nucleotide polymorphism was performed using predesigned TaqMan single-nucleotide polymorphism genotyping assay. The genetic contribution of this single-nucleotide polymorphism was evaluated using transmission disequilibrium test and haplotype relative risk and the haplotype-based haplotype relative risk. RESULTS: The results of the allelic and genotypic distribution of rs2043211 polymorphism in CARD8 showed that both the Tourette syndrome patients group and the parents group are in Hardy-Weinberg equilibrium. No significant differences were observed in the mutant allele transmission (transmission disequilibrium test = 1.107, df = 1, p = 0.322). Results of haplotype relative risk analysis showed that no statistical significant difference was found in the genotypic frequency (AA/AT/TT) of Tourette syndrome patients passed from parents (haplotype relative risk = 1.152, χ(2 )= 0.494, p = 0.482, 95% CI = 0.777-1.708). Similarly, the analysis of haplotype-based haplotype relative risk was also not to support a statistically significant association in allelic frequency (A/T) of Tourette syndrome patients passed from parents (haplotype-based haplotype relative risk = 1.130, χ(2 )= 1.037, p = 0.308, 95% CI = 0.893-1.429). CONCLUSION: Our results suggest CARD8 might not play a role in the pathogenesis of Tourette syndrome in Chinese Han population. However, the results still need to be tested in a larger sample and different populations.

Correlation between ovarian chocolate cyst and serum carbohydrate antigen 125 level and the effect of ultrasound-guided interventional sclerotherapy on serum carbohydrate antigen 125 level.

AIM: This study was to investigate the correlation between ovarian chocolate cysts and serum carbohydrate antigen (CA)-125 levels and to demonstrate the effect of ultrasound-guided interventional sclerotherapy (UGIS) on serum CA-125 levels. METHODS: Based on the serum CA-125 level, as determined by chemiluminescence detection prior to UGIS, 105 patients with ovarian chocolate cysts were divided into the normal group (CA-125 ≤ 35 U/mL, 45 patients) and the abnormal group (35 U/mL < CA-125 ≤ 200 U/mL, 60 patients). There were six clinical indicators including age, disease duration, dysmenorrhea history, child-bearing history, abortion history and surgical history. The ultrasonography characteristics were cyst diameter, cyst wall thickness and the side on which the cyst occurred. The correlations between serum CA-125 levels pretreatment and the clinical indicators and ultrasonography characteristics was analyzed. The serum CA-125 levels pretreatment, 3 months post-treatment and 6 months post-treatment were compared. RESULTS: The pretreatment serum CA-125 levels of the 105 patients positively correlated with disease duration (r = 0.3932, P = 0.0040), dysmenorrhea history (r = 0.2351, P = 0.0111), cyst diameter (r = 0.3415, P < 0.0001) and cyst wall thickness (r = 0.4263, P < 0.0001). Compared with the pretreatment level, the mean serum CA-125 level in the abnormal group at 3 months post-treatment was significantly lower (P < 0.01), and at 6 months post-treatment, the mean serum CA-125 level had decreased to a normal level (P < 0.01). CONCLUSION: UGIS significantly decreased abnormal serum CA-125 levels in patients with ovarian chocolate cysts.

Clinical effectiveness of multiple-drug injection treatment in unruptured ectopic pregnancies: a retrospective study.

OBJECTIVES: To study the effect of local interventional treatment of unruptured ectopic pregnancies with multiple-drug injection guided by color Doppler sonography. METHODS: In this retrospective analysis, 49 patients with an unruptured ectopic pregnancy were treated with two different local injection methods administered under sonographic guidance. The patients were divided into single-drug (n = 23) and multiple-drug (n = 26) injection groups, and they received a locally administered injection of methotrexate alone or a combination including methotrexate, hemocoagulase, antibiotics, and anti-inflammatory drugs, respectively. Overall, local injection treatment was successful in 44 patients. The 5 patients with failed treatment underwent laparotomy about 1 week after single-drug injection. Serum ß-human chorionic gonadotropin (ß-hCG ) levels, ectopic pregnancy mass sizes, blood flow at various points after treatment, the incidence of pelvic bleeding, and the time for serum ß-hCG levels to return to normal and the mass to resolve were analyzed in the remaining 44 patients. RESULTS: Single-drug treatment was successful in 18 patients; 10 of 23 had low to moderate pelvic bleeding after treatment, and 5 were referred for surgery. All 26 patients were successfully treated by multiple-drug injection. Only 2 patients had a small amount of pelvic bleeding. Differences between groups were statistically significant (P < .05) for surgery rates, the incidence of pelvic bleeding, transient increases in serum ß-hCG levels, mean days to normal ß-hCG levels, mean days of mass resolution, and mean mass diameters 1 to 6 weeks after treatment. CONCLUSIONS: Local multiple-drug injection under color Doppler guidance is a new, safe, and effective method for treating unruptured ectopic pregnancies. It accelerates the serum ß-hCG decline and facilitates mass resolution. This regimen is associated with a very low rate of pelvic bleeding, improves the success rate of conservative treatment, and, therefore, has value as an important clinical application.

Ultrasound-guided interventional therapy for recurrent ovarian chocolate cysts.

The aim of this study was to determine the effectiveness of ultrasound-guided interventional therapy in the treatment of postoperative recurrent chocolate cysts. The 198 patients enrolled in this study were divided into three groups. In group 1, the saline washing group, the cavity of the cyst was washed thoroughly with warm saline. In group 2, the ethanol short-time retention group, after washing with saline, the cyst was injected with 95% ethanol with a volume of half of the fluid aspirated from the cyst. Ten minutes later, the rest of the ethanol was aspirated. In group 3, the ethanol retention group, the procedures were the same as with the ethanol short-time retention group, except that 95% of the ethanol was retained in the cyst. An ultrasound examination was performed in the third, sixth and 12th months after therapy. The chocolate cyst cure rate was significantly higher in the ethanol retention group (96%, 66/69) than in the ethanol short-time retention group (82%, 56/68) and no case was cured in the first group (saline washing). We conclude that ultrasound-guided injection and 95% ethanol retention are an effective therapy for the treatment of postoperative recurrent chocolate cysts.