经阴道常规超声结合剪切波弹性成像技术联合血清癌胚抗原对子宫内膜癌的诊断价值

探讨经阴道常规超声+剪切波弹性成像(SWE)技术联合血清癌胚抗原(CEA)对子宫内膜癌的诊断价值。选取子宫内膜病变患者152例,均接受病理检查、经阴道常规超声和SWE检查,并检测血清CEA水平。根据病理检查结果将患者分为恶性组和良性组。比较两组经阴道常规超声指标(子宫内膜厚度、RI、PI)、SWE指标(Emean、Esd、Emax)及血清CEA水平;ROC曲线分析各指标单独及联合诊断子宫内膜癌的价值。结果显示,89例患者诊断为子宫内膜癌(恶性组),63例患者诊断为子宫内膜良性病变(良性组)。恶性组子宫内膜厚度大于良性组,RI、PI均低于良性组,Emean、Esd、Emax及血清CEA水平均高于良性组(P<0.05)。子宫内膜厚度、Emean、Esd、Emax、CEA、RI、PI均是子宫内膜癌的危险因素(P<0.05)。联合诊断子宫内膜癌的AUC均高于单独诊断,说明经阴道常规超声+SWE技术联合血清CEA检测对子宫内膜癌具有较高诊断价值。     

经阴道彩色多普勒超声在子宫内膜病变诊断中的应用研究

目的探讨经阴道彩色多普勒超声在诊断子宫内膜病变中的临床价值。方法回顾性分析湖北省浠水县妇幼保健院自2014年1月—2015年6月收治的54例子宫内膜病变患者的临床资料,其中28例经阴道超声诊断患者设为观察组,26例经腹部超声诊断患者设为对照组,比较两组患者超声诊断结果与病理诊断结果的差异。结果观察组患者超声诊断总符合率为88.89%,明显高于对照组的61.11%,差异具有统计学意义(P0.05);观察组患者子宫内膜增生、子宫内膜息肉及子宫黏膜下肌瘤的诊断符合率分别为90.91%、93.33%、88.89%,明显高于对照组的63.64%、66.67%、55.56%,差异具有统计学意义(P0.05);两组患者萎缩性子宫内膜和子宫内膜癌的诊断符合率差异不明显,无统计学意义(P0.05)。观察组良性病变患者的血流信号显示率、动脉阻力指数分别为27.27%和(0.70±0.12)和恶性病变患者的100%、(0.35±0.08)差异明显,有统计学意义(P0.05)。结论经阴道超声检查诊断子宫内膜病变准确率明显高于经腹部超声检查,而且能够在一定程度上反映子宫内膜病变性质,具有较高的临床推广价值。     

药物流产后宫内残留物的腹部超声检测及其对清宫术时机的指导作用

本文对药物流产后宫内残留物的腹部超声检测及其对清宫术时机的指导作用进行了探讨。研究对象为2017年4月~2018年10月我院妇科收治的164例药物流产后宫内组织残留患者,所有患者均行经腹彩色多普勒超声检查,观察宫腔内异常回声团和宫内血流信号及频谱,并记录患者治疗情况和病理结果。依据患者保守治疗成功或转归清宫术分为成功组和转归组,采用多因素Logistic回归方程分析对保守治疗失败转归清宫术有影响的因素。结果显示,164例患者中,79例(48.17%)患者超声检查显示存在滋养血流,其中47例(59.49%)患者采取了清宫术治疗,其余32例(40.51%)患者保守治疗失败转归清宫术治疗;85例(51.83%)患者超声检查显示无滋养血流,其中73例(85.88%)采取保守治疗成功,其余12例(14.12%)患者保守治疗失败转归清宫术;成功组(n=73)和转归组(n=44)患者在就诊时阴道出血时间、阴道出血持续时间、流产次数、宫内残留物大小、滋养血流信号检出率等方面的比较,差异均具有统计学意义(P<0.05);多因素Logistic回归方程分析结果显示,就诊时阴道出血时间、残留物大小、流产次数、超声检查存在滋养血流均为保守治疗转归清宫术的独立影响因素(P<0.05)。本文结果证实,腹部超声检测显示宫腔内异常回声团块存在滋养血流信号,可作为药物流产不全患者行清宫术治疗的手术指征,有利于改善患者预后。     

TVS和CEUS诊断子宫内膜良恶性病变的价值

本次研究的目的是探讨子宫内膜良恶性病变中,经阴道超声检查(TVS)和超声造影(CEUS)的鉴别诊断价值。选取确诊的子宫内膜病变患者108例,给予TVS和CEUS检查。经病理学检查,恶性病变60例,良性病变48例;CEUS诊断子宫内膜良恶性病变的灵敏性、准确性和阴性预测值明显高于TVS检查(P<0.05);恶性病变和良性病变阻力指数(RI)、达峰时间(TTP)与峰值强度(Peak)有明显差异(P<0.05);Ⅲ~Ⅳ和Ⅰ~Ⅱ期RI、TTP和Peak有明显差异(P<0.05);RI、Peak和TTP诊断子宫内膜恶性病变的ROC曲线下面积分别为0.740、0.789和0.856,P<0.05。相比较TVS,CEUS鉴别诊断子宫内膜良恶性疾病有较好的价值,值得临床应用。     

三维超声波诊断子宫发育异常的临床价值

目的总结分析三维超声波在子宫发育异常诊断中的应用价值。方法选择2010年6月—2012年11月期间广东省佛山市高明区人民医院产科收治的疑似或确诊为子宫发育异常的215例患者为研究对象,均给予阴道三维超声波扫描显示子宫形态及内膜、子宫颈等情况,对比分析各种异常子宫的形态体征,并与二维超声波进行对比,总结分析三维超声诊断子宫发育异常的优势所在,以期为临床诊断提供有效指导。结果 215例患者经三维超声波扫描诊断为:单角子宫40例、双角子宫56例、双子宫17例、弓形子宫59例、纵膈子宫43例。超声图像特征:单角子宫型宫腔冠状面图像显示发育一侧的宫角,无残角者正常三角形消失,残角子宫冠状面一侧显示发育不完全的实质性块状。双子宫扫描中盆腔内存在两个子宫影,而且两个子宫均有内膜。双角子宫冠状面可见宫底中央明显凹陷,子宫内膜为蝶翅样。纵膈子宫冠状面超声显示子宫外形基本正常。弓形子宫冠状面超声扫描可见子宫形态基本正常,但宫底肌层变厚、宫腔稍微向下凹陷。结论三维超声波动态扫描成像诊断子宫发育异常具有明显优势,还能对子宫发育异常情况进行分类分型,这对临床制定针对性治疗方案具有重要指导作用,可提高预后,值得推广使用。     

经阴道多普勒彩色超声联合血清人绒毛膜促性腺激素对子宫瘢痕妊娠的诊断价值分析

本研究拟探讨经阴道多普勒彩色超声联合血清人绒毛膜促性腺激素(β-HCG)对子宫瘢痕妊娠(CSP)的诊断价值。选取2018年4月~2019年4月于我院妇产科就诊的疑似子宫瘢痕妊娠患者56例作为研究对象,同时行阴道多普勒彩色超声和血清β-HCG水平检查,经手术和(或)病理组织学检查确诊。结果显示,CSP患者经阴道多普勒彩色超声特征征象包括子宫前壁下段肌层可见孕囊、孕囊与膀胱之间的子宫肌层变薄、孕囊周边高速低阻信号。CSP患者48 h血清β-HCG增加幅度低于非CSP患者(t=7.425,P=0.000)。48 h血清β-HCG增加幅度的ROC曲线下面积为0.919,最优界值为64.22%,此时诊断的敏感度为80.00%,特异性为88.90%。与手术和(或)病理检查相比,单一诊断和联合诊断的一致性均较好,且对CSP的诊断的敏感度、特异度、阳性预测值、阴性预测值、准确率比较,差异均无统计学意义(P>0.05)。两种检查手段可以互为参考,降低误诊率与漏诊率。     

彩超联合人绒毛膜促性腺激素β诊断早期宫外孕的研究

本文探讨经阴道彩色多普勒超声、人绒毛膜促性腺激素β(β-hCG)在早期异位妊娠诊断中的价值。选取异位妊娠患者78例作为观察组,根据超声影像特征,其中环状征型、混合包块型和典型孕囊型分别为15例、24例和39例;选取正常妊娠者140例作为对照组。两组均行经阴道彩色多普勒超声检查,采用电化学发光法检查血清β-hCG水平。结果显示,与对照组比较,观察组子宫内膜厚度和血清β-hCG水平降低(P<0.05);环状征型、典型孕囊型和混合包块型患者血清β-hCG水平比较差异有统计学意义(P<0.05);血清β-hCG水平联合子宫内膜厚度预测异位妊娠的ROC曲线下面积为0.901(P<0.05)。经阴道彩色多普勒超声联合β-hCG在异位妊娠诊断中有较好的效果,同时异位妊娠患者β-hCG水平与彩超影像特征有一定关系。     

近红外光谱技术结合主成分分析法用于子宫内膜癌的诊断

应用近红外光谱技术结合化学计量学方法研究了子宫内膜癌组织近红外光谱特征提取和早期诊断的可行性. 测定了154 例子宫内膜组织切片的近红外光谱, 选取适宜的波段和光谱预处理方法进行主成分分析, 很好地区分了癌变、增生和正常子宫内膜组织切片, 并且分辨出处于不同分化期的组织切片, 为子宫内膜癌的早期诊断提供了可靠依据. 该法快速、简便, 有望发展成为一种新型的肿瘤无创诊断方法.     

药物治疗异位妊娠临床观察及护理

通过对34例米非司酮配伍氨甲喋呤(MTX)治疗异位妊娠临床观察及护理，提出在非手术治疗异位妊娠时，必须密切观察各项生命体征变化，注意病人腹痛、阴道流血情况，定期检测血HCG、尿HCG的变化，做好用药和出院指导；使疾病在安全、可靠、简便和有效的非手术治疗下得以痊愈。     

经阴道超声和经腹部超声测量瘢痕妊娠的瘢痕厚度与实际厚度的相关性分析

采用阴道超声和腹部超声检测瘢痕妊娠患者瘢痕厚度,分析两种超声方式检测结果与患者实际厚度的相关性。选取本院收治的424例剖宫产后瘢痕子宫妊娠患者进行研究,分析阴道和腹部超声检测结果和手术观察结果间的相关性。检查发现,阴道超声检出率,以及与手术数据的相关系数,均明显优于腹部超声,证明阴道超声与手术观察结果的相关性更强,P<0.05,差别具有统计学意义;经Logistic回归分析结果显示,阴道超声检测的瘢痕厚度与手术观察结果的符合度更高,P<0.05,差别有统计学意义。本研究结果证明阴道超声和腹部超声相比,前者的检测结果与手术观察结果更为相符,能够准确显示出患者子宫前壁下段有无瘢痕问题,提升确诊率。     

短波近红外在体荧光分子成像技术最新进展

癌症的诊断迄今所依赖的主要是一些离体检测方法以及超声波、X射线透视、X射线CT、核磁共振成像和PET等影像学技术. 癌症的确诊则以肿瘤组织或病变细胞的形态和其它宏观特征为依据, 这往往是一个侵入性和耗时的过程, 不适于癌症的早期诊断. 这些影像学技术目前也大都难以发现分子水平上的问题. 因此, 迄今癌症的早期诊断仍然是医学界面临的一个空前挑战. 光学成像方法, 特别是荧光成像方法具有对人体无害、非侵入、高灵敏和可进行在体多目标成像的优点, 随着荧光指示物的不断拓展和检测方法的不断创新, 有望在分子和细胞水平上实现癌症的早期诊断. 本文重点介绍了几项有较重要价值及工作在短波近红外区域的在体荧光成像技术的新进展.     

Fourier-transform infrared spectroscopy discriminates a spectral signature of endometriosis independent of inter-individual variation

Endometriosis is the growth of endometrial tissue outside of the uterine cavity. Its aetiology remains obscure, and it is difficult to diagnose ranging from asymptomatic to debilitating disease. Mid-infrared (IR) spectroscopy has become recognised as a potential clinical diagnostic tool. Biomolecules absorb mid-IR (4000 cm(-1) to 400 cm(-1)) and from this, a biochemical-cell fingerprint in the form of an absorbance spectrum can be derived. We set out to determine if IR spectroscopy could be used to identify underlying biochemical differences between endometrial tissues growing outside of the uterus (ectopic) from endometrial tissue of the uterus (eutopic). For comparative purposes, endometrial tissues from endometriosis-free women were also obtained (benign eutopic). Attenuated total reflection Fourier-transform IR (ATR-FTIR) spectroscopy or transmission FTIR microspectroscopy was employed for spectral acquisition. Principal component analysis (PCA)-linear discriminant analysis (LDA) was used for chemometric analysis. A clear segregation was exhibited between the three categories independent of inter-individual confounding differences. Importantly, there was a marked difference between eutopic endometrial tissue from patients with or without endometriosis. This indicates that IR spectroscopy coupled with multivariate analysis (e.g., PCA-LDA) may provide a non-invasive diagnostic tool for endometriosis. By analysing the underlying biochemistry of these endometrial tissues, this approach may facilitate a better understanding of this pathology.     

血清HCG、孕酮联合检测在早期先兆流产治疗中的价值分析

目的通过研究探讨血清β-HCG、孕酮联合检测在早期先兆流产治疗中的临床价值。方法随机选取广东省中山市东升镇东升医院2015年1月—2016年9月期间收治的100例早期先兆流产患者作为研究对象,并按随机数字分组法将所有入选患者分为观察组与对照组(各50例),观察组给予血清β-HCG、孕酮联合检测,对照组仅给予血清孕酮检测,分析比较两组患者检验的有效率。结果观察组经联合检测后血清β-HCG、孕酮水平较仅给予血清孕酮检测对照组的水平低(P0.05);观察组经血清β-HCG、孕酮联合检测后临床检验有效率显著优于仅给予血清孕酮检测的对照组,其临床检验的敏感度、阴性预测值及诊断准确率均显著优于仅给予血清孕酮检测的对照组(P0.05)。结论血清β-HCG、孕酮联合检测具有较高的诊断准确率,在早期先兆流产诊断中更具有指导意义,有利于临床根据血清β-HCG、孕酮检测值采取有效治疗措施。     

Detection of immunogenic parasite and host-specific proteins in the sera of active and chronic individuals infected with Toxoplasma gondii

Toxoplasma gondii infection in pregnant women may result in abortion and foetal abnormalities, and may be life-threatening in immunocompromised hosts. To identify the potential infection markers of this disease, 2-DE and Western blot methods were employed to study the parasite circulating antigens and host-specific proteins in the sera of T. gondii-infected individuals. The comparisons were made between serum protein profiles of infected (n=31) and normal (n=10) subjects. Antigenic proteins were identified by immunoblotting using pooled sera and monoclonal anti-human IgM-HRP. Selected protein spots were characterised using mass spectrometry. Prominent differences were observed when serum samples of T. gondii-infected individuals and normal controls were compared. A significant up-regulation of host-specific proteins, α(2)-HS glycoprotein and α(1)-B glycoprotein, was also observed in the silver-stained gels of both active and chronic infections. However, only α(2)-HS glycoprotein and α(1)-B glycoprotein in the active infection showed immunoreactivity in Western blots. In addition, three spots of T. gondii proteins were detected, namely (i) hypothetical protein chrXII: 3984434-3 TGME 49, (ii) dual specificity protein phosphatase, catalytic domain TGME 49 and (iii) NADPH-cytochrome p450 reductase TGME 49. Thus, 2-DE approach followed by Western blotting has enabled the identification of five potential infection markers for the diagnosis of toxoplasmosis: three are parasite-specific proteins and two are host-specific proteins.     

Autoradiographic study on the distribution of suprofen in rats of both sexes

The tissue distribution of 14C-labeled DL-2-(4-(2-thienylcarbonyl) phenyl) propionic acid (suprofen) after po administration was studied in male, female, and pregnant rats by whole-body autoradiography. 14C localized rapidly in such highly vascularized tissues as liver, kidney, and lung as well as heart in rats of both sexes, but no significant uptake was found in the central nervous system. About half of the 14C in the liver and kidney was found to be unchanged suprofen; smaller amounts of 2-(4-(2-thienylhydroxymethyl)phenyl)propionic acid and 2-(4-carboxyphenyl)propionic acid were also detected. In pregnant rats, a low level was found in the uterus and placenta; the drug penetrated the fetuses to only a limited degree. No appreciable radioactivity was found in rat tissues 24 h after dosing.     

Influence of ultrasonic stimulation on the growth and proliferation of Oryza sativa Nipponbare callus cells

Ultrasound acts as an alternative stress on cells or tissues. In this study it is aimed to investigate the effect of ultrasonic stimulation on the growth and proliferation of Oryza sativa Nipponbare cells (rice callus) in suspension culture. After the samples were stimulated by ultrasound at 28 kHz, we measured their growth and proliferation by using a colorimetric MTT ((3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay as well as fresh weights of the cells. Growth curves were obtained by fresh weights in the suspension culture after ultrasonic agitation for different time from 2 to 120 s. In MTT method, the optical density was determined at 570 nm in the cell suspension on 10 days after the ultrasonic agitation. Up to 5 s agitation OD₅₇₀ increased; it decreased for more prolonged stimulation. We found that ultrasonic stimulation could promote the growth and proliferation of O. sativa Nipponbare cells in suspension culture with the optimal stimulation of 5 s, while with longer agitation, its growth and proliferation was inhibited. The mechanism may be that the ultrasound activated or destroyed the cellular structure, such as cell membrane, cytoskeleton and mitochondria in which many enzymes and ion channels are affected. In addition, the enhancement of cell wall and cell membrane fluidity might be one of the factors to promote the cell growth in 5-s ultrasonic stimulation.     

DNA and protein changes caused by disease in human breast tissues probed by the Kubelka-Munk spectral functional

Malignant, fibroadenoma, normal and adipose breast tissues were studied using diffuse reflectance spectroscopy. The absorption spectra of the breast tissues were extracted from the diffuse reflectance spectra using the Kubelka-Munk function (K-M function). The spectral features of the K-M function were identified and compared with those of the absorption spectra. The spectral features of the K-M function were assigned to DNA, protein, beta-carotene and hemoglobin (oxygenated and deoxygenated) molecules in the breast tissue. The amplitudes of the K-M function averaged from 275 to 285 nm and from 255 to 265 nm and were found to be different for malignant, fibroadenoma and normal tissues. These differences were attributed to changes in proteins and DNA. A set of critical parameters was determined for separating malignant tissues from fibroadenoma and normal tissues. This approach should hold for other tissue types such as cervix, uterus and colon.     

Thermal stability of rat uterus during development

Summary The age dependence of thermal denaturation was monitored in rats anaesthetized after they're born at 7^th, 14^th, 21^st, 28^th, 35^thand 42^nddays. The samples were stored in rigor or physiological saline solution. The DSC scans in the early age groups show a low temperature exotherm (connective tissues: from gel to liquid crystal transition) and one endotherm (it is very probably the myosin). During further development the endotherms became more and more complex (due to the development of contractile system). At 42 days the scans seem to be similar to the adult ones. In the two buffers the endotherms markedly differ showing that the ATPase activity is present. In adult uterus, treated with nucleotides or estrogen, this activity significantly differs from the skeletal muscle. On the basis of our results we suppose, that the age dependent changes are decisive processes in the development of rat uterus.     

Long-term body retention and tissue distribution of platinum in cisplatin treated cancer patients

Platmum levels have been determined in 145 samples from 24 tissues and 7 types of tumours from patients, treated with cisplatin. Sampled were 27 males (average age: 36 y, range: 22–63) and 19 females (average age: 52 y, range: 17–69), with an average total intravenous dose of 820 mg and 545 mg cisplatin, respectively. Samples were obtained via biopsy and autopsy, mostly 4–15 weeks after the last cisplatin administration. The long-term clearance of platinum from the tissues analyzed could be described by a first-order process with a half-life in the range of 175–300 days. The platinum fraction involved in the longterm total body clearance is estimated to be 22–38% of the total dose administered. However, the platinum clearance from a mature teratoma appeared to be much slower as measurable levels were detected 7.6 years after administration of the drug. The highest long-term platinum accumulations were found in liver, uterus, testes, ovary, and thyroid, and the lowest in brain and blood.     

Direct and Rapid Electrochemical Determination of Total Surfactants in Amniotic Fluid for Assessment of Foetal Lung Maturity

Abstract

The characteristic response in the polarographic current-time curves, observed by the inhibition of the oxygen reduction process by adsorption of phospholipids at the mercury-solution interface, is used for the direct and rapid analysis of surfactants content in amniotic fluid samples. Good correlations were obtained between the described method and two well established routine methods used for estimation of foetal lung maturity in prenatal diagnosis of the respiratory distress syndrome.