妊娠期糖尿病胎儿脐动脉、大脑中动脉血流彩色多普勒超声检测诊断价值

目的对妊娠期糖尿病胎儿脐动脉、大脑中动脉血流彩色多普勒超声检测的诊断价值进行研究和分析。方法选择200例孕妇作为实验研究对象,其中100例孕妇为妊娠期糖尿病孕妇(实验组),100名孕妇为正常孕妇(对照组),选取时间为2016年5月—2019年5月。对两组孕妇的胎儿脐动脉和大脑中动脉血流进行彩色多普勒超声检测,对检测结果进行比较和分析。结果经过彩色多普勒对两组孕妇检测发现,对照组在脐动脉的搏动指数、阻力指数以及脐动脉舒张压血流峰速比值方面都要低于实验组,而在大脑中动脉的搏动指数、阻力指数以及脐动脉舒张压血流峰速比值方面都要高于实验组,组间数据对比差异有统计学意义(P<0.05)。结论通过对妊娠期糖尿病胎儿大脑中动脉及胎儿脐动脉血流的彩色多普勒超声检测,能够尽早的发现胎儿缺氧的情况,有利于及时采取临床手段对患者进行治疗。     

妊娠期糖尿病胎儿脐动脉、大脑中动脉血流彩色多普勒超声检测诊断价值

目的 探讨在妊娠期糖尿病胎儿脐动脉、大脑中动脉血流彩色多普勒超声检测诊断价值.方法 选取2011年12月-2013年9月来该院治疗的妊娠期糖尿病孕妇病例作为观察组及正常孕妇作为对照组各有62例,对两组胎儿脐动脉、大脑中动脉血流进行彩色多普勒超声检测,并对两组测定结果进行对比分析.结果 观察组妊娠糖尿病患者胎儿的UA-PI、S/D测定值明显比高于正常组,且MCA-PI、RI、S/D测定值明显低于正常组,经统计学处理有显著差异性(P＜0.05).结论 彩色多普勒超声能够准确检测出妊娠糖尿病患者胎儿的UA、MCA及PI、RI血流频谱的异常状况,从而为妊娠期糖尿病的诊断提供临床依据,便于及时处理,因此值得在临床上继续推广应用.     

妊娠期糖尿病胎儿脐动脉、大脑中动脉血流彩色多普勒超声检测诊断价值

目的探讨在妊娠期糖尿病胎儿脐动脉、大脑中动脉血流彩色多普勒超声检测诊断价值。方法选取2011年12月—2013年9月来该院治疗的妊娠期糖尿病孕妇病例作为观察组及正常孕妇作为对照组各有62例,对两组胎儿脐动脉、大脑中动脉血流进行彩色多普勒超声检测,并对两组测定结果进行对比分析。结果观察组妊娠糖尿病患者胎儿的UA-PI、S/D测定值明显比高于正常组,且MCA-PI、RI、S/D测定值明显低于正常组,经统计学处理有显著差异性（P〈0.05）。结论彩色多普勒超声能够准确检测出妊娠糖尿病患者胎儿的UA、MCA及PI、RI血流频谱的异常状况,从而为妊娠期糖尿病的诊断提供临床依据,便于及时处理,因此值得在临床上继续推广应用。     

彩色多普勒超声产前诊断胎儿单脐动脉及伴发胎儿畸形的意义分析

目的 探究彩色多普勒超声对胎儿单脐动脉及伴发胎儿畸形的临床诊断价值.方法 病例时段2018年1月-2019年12月间收治我院的单脐动脉胎儿60例,均进行彩色多普勒超声产前检查,结合检查结果 分析单脐动脉及伴发胎儿畸形情况.结果 60例单脐动脉胎儿经检查,显示单纯的单脐动脉44例(占比73.33%),并发胎儿畸形16例(占比26.67%);其中消化系统畸形3例、呼吸系统畸形2例、颜面部畸形3例、骨骼系统畸形2例、泌尿系统畸形1例、心血管系统畸形5例.结论 产前彩色多普勒超声检查对诊断鉴别单脐动脉及伴发胎儿畸形具有重要的作用,可为临床分娩方案的制定提供可靠依据,现实优生优育,临床价值较高.     

胎儿大脑前、中动脉及脐动脉血流预测胎儿早期缺氧

将200例高危妊娠孕妇随机分为高危组、低危组各100例。采用彩色多普勒超声（CDFI）检测其大脑前动脉（ACA）、中动脉（MCA）及脐动脉（UMA）血流频谱的波形收缩期流速峰值Vs（S）、舒张期流速峰值Vd（D）、阻力指数（RI）、UMA S／D值及围生儿缺氧指数。结果高危组ACA、MCA、RI低于低危组,UMA S／D值高于低危组（P〈0．01）。两组RI正常126例,围生儿结局异常10例;RI异常74例,结局异常41例。除1例死亡外均预后良好。提示联合检测胎儿ACA、MCA、RI及UMA S／D值可及早评价胎儿缺氧情况。     

孕中晚期胎儿超声正常奇静脉内径参考值及其临床意义

目的:建立孕中晚期正常胎儿奇静脉内径参考值范围及其随孕周改变的规律,并探讨其对奇静脉扩张及下腔静脉离断的产前诊断价值。方法:连续性入选2010年8月至2013年12月,于北京安贞医院行产前超声心动图检查,且不合并明显结构性畸形胎儿6 323例,排除孕周<20周或>40周胎儿5例,在二维超声条件下测量奇静脉内径并探索奇静脉随孕周变化的回归方程。另外,回顾性分析9例经病理解剖或产后随访证实奇静脉扩张的超声心动图特征。结果:1正常胎儿奇静脉内径从孕20周平均值0.6mm至孕40周平均值3.0mm随孕周增加呈线性增长(r=0.983,P<0.01);2正常胎儿奇静脉内径与孕周的线性回归方程:D=(0.116×GA)-1.568(D为奇静脉内径,GA为孕周);38例奇静脉扩张继发于下腔静脉离断(其中2例合并左心房异构),1例继发于下腔静脉右心房开口处轻度狭窄。结论:孕中晚期正常胎儿奇静脉内径参考值范围及其随孕周变化规律的建立有助于提高对奇静脉扩张及下腔静脉离断的产前诊断率。     

监测胎儿脐动脉及大脑中动脉血流指数对预测胎儿预后的价值

胎儿在宫内的状况和围产儿的病死率、病残率密切相关。监测胎儿脐动脉血流 (UA)及大脑中动脉血流 (MCA)可在一定程度上反映胎儿在宫内的状况。 2 0 0 1年 1月至 2 0 0 1年 1 0月我们对部分 UA及MCA进行了检测 ,并与胎儿出生情况进行比较 ,以探讨 UA及 MCA的改变对预测胎儿预后的价值。1　资料与方法1 .1　临床资料　选择孕 3 7～ 40周的单胎初孕产妇85 2例为对照组。研究组 73例 ,为胎儿出生时具备下列因素之一从而诊断为胎儿宫内窘迫的孕妇 :1新生儿出生后 1分钟 Apgar评分 <7分。2胎儿出生体重低于同孕周胎儿标准体重第 1 0百分位…     

超声检测在重型α-地中海贫血产前筛查的应用进展

［摘要］　　地中海贫血是热带、亚热带等地区常见常染色体单基因遗传性疾病,中国南方尤其两广地区为高发区,其中重型α-地中海贫血有致死性,产前诊断和遗传咨询是减少其出生的首要办法。超声是产前无创筛查该病的最常用技术,心胸比值、大脑中动脉峰值流速、脐静脉内径等超声指标对筛查重型α-地中海贫血价值较高,但部分重型α-地中海贫血胎儿往往在晚孕期才出现异常超声表现。因此寻找更敏感的超声征象及指标,对在产前筛查出重型α-地中海贫血胎儿、缩小侵入性检查人群范围并及时终止妊娠意义重大。该文就产前筛查重型α-地中海贫血相关超声征象及指标进行了综述。     

脐动脉血流速度测定在脐带绕颈胎儿分娩方式选择中的应用

20 0 0年 6～ 2 0 0 0年 1 1月 ,我们对在我院分娩的40 5例单胎、头位、孕期达 37周以上的孕妇 ,产前进行脐动脉血流速度测定 ,以探讨其对脐带绕颈产妇分娩方式选择的应用价值。1　资料与方法1 .1　一般资料　本组 40 5例产妇的年龄为 2 3～ 42岁 ,平均 2 6.0± 2 .5岁 ;孕周 37～ 43周 ,平均 39.2±2 .3周。其中初产妇 393例 ,经产妇 1 2例。1 .2　方法　产妇休息 1 5分钟后稍左侧卧位 ,先用 B超确定胎位及头颈位置 ,后用广州三瑞公司生产的SFR- 60 8A型多普勒脐动脉血流速度检查仪沿胎儿颈部探查 1周 ,探查方向从胎儿颈部腹侧至颈部背侧…     

血常规检测结果对鉴别诊断缺铁性贫血、地中海贫血价值观察

目的对缺铁性贫血、地中海贫血两种贫血类型利用血常规检测结果鉴别诊断,并分析其临床价值。方法选取2018年9月-2019年7月在我院治疗的108例贫血患者,根据其贫血类型,将其分为缺铁性贫血组、地中海贫血组。同时,选取同期健康体检者54例作为健康对照组。所有受检者均进行血常规检测。结果与健康对照组相比,贫血组患者的Hb、RBC、MCV、MCH、MCHC更低,RDW更高,差异明显(P<0.05)。贫血组间对比,地中海贫血组患者的Hb、MCHC明显高于缺铁性贫血组,RDW、RBC、MCV、MCH明显低于缺铁性贫血组(P<0.05)。结论缺铁性贫血、地中海贫血患者的血常规检测结果差异明显,可作为临床诊断、鉴别的重要依据,具有推广价值。     

Insulin levels in the umbilical vein and in the umbilical artery of newborns of normal and gestational diabetic mothers

Summary Insulin levels (by double antibody radioimmunological assay) were studied in the venous blood of mothers at vaginal delivery and in the umbilical vein and artery of their newborns. — In 14 normal mothers the insulin levels after 10 hours fasting were 18.5±3.6 U/ml (mean±S.E.M.). In their newborns (mean: 3.420 kg, all < 4.000 kg, 38–41 weeks gestation) the insulin levels were low and similar in the umbilical vein (5.6±0.7 U/ml) and in the umbilical artery (6.6±0.7 U/ml). The plasma glucose levels in the mothers were 99.7±3.9 mg/100 ml and in the umbilical vein 77.3±3.7 mg/100 ml and the umbilical artery 65.5±3.2 mg/100 ml. They were significantly different from each other. — Eleven normal mothers receiving a glucose infusion (ca. 15 g/3 hours) during delivery had 42.0±9.9 U/ml insulin in their venous blood. In their newborns with a normal birth-weight (mean: 3.585 kg, all < 4.000 kg) the insulin levels were not increased either in the umbilical vein (7.0±1.0 U/ml) or in the artery (7.9±1.0 U/ml). The plasma glucose levels in the mothers were 128.0±7.7 mg/100 ml, and in the umbilical vein 105.0±7.5 mg/ 100 ml and in the umbilical artery 88.8±8.6 mg/100 ml. The plasma glucose levels were significantly different from each other. — In six infants with large birthweight (> 4.100 kg) born to untreated mothers with gestational diabetes the insulin levels were superior to the values found in normal newborns. In three of these infants, born to mothers who did not receive a glucose infusion, the insulin levels in the umbilical vein were 38, 42 and 13 U/ml, and in the artery they were 17, 34.5 and 18.5 U/ml. The other three mothers received a glucose infusion, their newborns had in the umbilical vein an insulin level of 15.5, 65 and 19 U/ml and in the artery 20, 72.5 and 14 U/ml. — In conclusion, the normal infant at birth has a low insulin level, which is equal in the umbilical vein and artery. In 6 heavy infants born to untreated latent diabetic mothers, the insulin levels were significantly higher than in normals, and the levels in the umbilical vein and the artery were different from one another. This latter data on hyperinsulinism is discussed in relation with hyperplasia of the islets of Langerhans observed in stillborn infants of mothers with insulin-dependant diabetes or gestational diabetes.Aspirant du Fonds National de la Recherche Scientifique     

Case of congenital bronchial atresia detected by fetal ultrasound

Congenital bronchial atresia is an anomaly characterized by a mucocele associated with a blindly terminating segmental or lobar bronchus. We report on a case of congenital atresia of the left superior segmental bronchus (B6) followed by fetal ultrasonography, which showed a large simple cyst with a surrounding small echogenic area. A large cyst and persistent lung fluid in the affected segment were noted in the early neonatal period.     

Mechanical properties of the fetal ductus venosus and umbilical vein

Summary During fetal circulatory compromise, velocity pulsations in the precordial veins increase and are commonly transmitted through the ductus venosus into the umbilical vein, indicating a serious prognosis. The nature of the pulsations and their transmission into the periphery, specifically the umbilical vein, is poorly understood. We present information on the mechanical properties of fetal veins as a basis for describing the pulse wave propagation. Five fetal sheep livers with connecting veins (gestational age 0.8–0.9) were studied in vitro. The transmural pressure, obtained with a fluid-filled catheter, was reduced stepwise from 10.3 to 0mmHg, and the diameter determined by ultrasonography. Each data set was fitted to an exponential function to determine the stiffness parameter and the area at a standard pressure, which we proposed to be 5 mmHg for the fetal venous circulation. The stiffness parameter was 6.2 ± 1.8 at the ductus venosus outlet, 3.4 ± 1.3 at the ductus venosus inlet, and 4.0 ± 1.0 in the umbilical vein. Correspondingly, values for compliance and pulse wave velocity for the three venous sections were established for a physiological pressure range. The estimated pulse wave velocity of 1–3m/s is comparable with values estimated for veins in adults. The mechanical properties of fetal veins are comparable with those described for veins later in life. The stiffness parameter represents the elastic properties at all pressure levels and conveniently permits inference of compliance and pulse wave velocity.T.K. was supported by the British Heart Foundation and the Norwegian Research Council.     

Comparison of normal and diseased pulmonary artery morphology by intravascular ultrasound and histological examination

The study was performed to determine the morphological characteristics of normal and diseased pulmonary arteries by ultrasound (intravascular ultrasound, IVUS) and histology. Forty-nine cadaver segments of pulmonary arteries from 16 postmortem patients were imaged in vitro by IVUS and compared to matched histological sections. The pulmonary vasculature of 11 patients with pulmonary hypertension was investigated in vivo by IVUS. In the in vitro study, 34 of a total of 143 histological sections of the segmental pulmonary arteries showed fibrotic wall components; the remaining 109 sections had regular components. Imaged by IVUS, the wall of the regular and fibrotic arteries revealed a single layer histologically, representing the intima, media, adventitia and connective tissue. Adjacent lung tissue could be detected by IVUS and was confirmed by the histological section. In three patients with a history of chronic embolic pulmonary hypertension, IVUS revealed thrombi or a double vessel wall layer. Histologically, the material extracted after pulmonary thromboendarterectomy in two patients showed wall-adherent thrombus features of early organization. In all other patients only a single wall layer was seen. The vessel walls (intima, media, adventitia and connective tissue) of regular and slightly fibrosed pulmonary arteries show only a single layer. Wall-adherent organized thrombi in chronic embolic pulmonary hypertension can be detected by IVUS as a second inner vessel layer. Thus IVUS may represent an additional tool for detecting chronic embolic pulmonary hypertension when the results of pulmonary angiography or computed tomography are not definite.     

Melatonin concentration in the umbilical artery and vein in human preterm and term neonates and neonates with acute fetal distress

In order to assess the existence of a rhythmic secretion of melatonin (aMT) in newborns and whether this rhythm is affected by neonatal stress, we studied 112 newborns classified in three groups: normal babies delivered at term, preterm infants born before the 38th week, and babies with fetal distress. Melatonin was measured by RIA in the umbilical artery and vein at the time of birth. Melatonin levels in umbilical arterial and venous blood showed a diurnal rhythm in all groups. Melatonin levels in umbilical cord artery and vein were closely related. Nocturnal melatonin levels were increased in newborns with acute fetal distress in comparison with normal term and preterm neonates. These results suggest that (1) a rhythm of aMT secretion exists in newborns, although it cannot be determined whether this rhythm is of maternal or fetal origin and (2) neonatal stress (acute fetal distress) increases aMT production during the night in comparison with normal term and preterm neonates.     

Comparison between two-point and three-point compression ultrasound for the diagnosis of deep vein thrombosis

Lower extremity deep vein thrombosis (DVT) is a frequent cause of admission to the emergency departments (ED). Although the gold standard for diagnosis is the Duplex ultrasound examination, the current study used for diagnosis of DVT in the ED by emergency physicians is the point-of-care compression ultrasound (POCUS). To compare the sensitivity and specificity of the two-point and three-point compression ultrasound (2PCUS and 3PCUS respectively) for diagnosis of lower extremity DVT in an ED management. We prospectively recruited outpatients who were admitted to the ED with suspected lower extremity DVT. Each patient underwent 2PCUS and 3PCUS performed by a trained ED physician. The ED physician recorded the results and then referred the patient to the vascular clinic for the Duplex ultrasound examination. 195 patients recruited to this study between July 2015 and June 2016 in the ED of Rabin Medical Center-Beillinson Hospital, Israel. DVT was diagnosed by Duplex examination in 48 of 195 patients (24.6%). There were significant correlations among the findings regarding the deep veins on both the 2PCUS and 3PCUS tests and on the Duplex examination (p?<?0.001). DVT at any vein was correctly diagnosed with the 2PCUS in 38 of48 patients with positive findings on Duplex examination and incorrectly diagnosed (false positive) in 2 of 133 patients without DVT (sensitivity 82.76%, specificity 98.52%). DVT was correctly diagnosed with the 3PCUS in 43 of 48 DVT and incorrectly diagnosed (false positive) in 2 of133 patients without DVT (sensitivity 90.57%, specificity 98.52%). The sensitivity of the 3PCUS was significantly higher than the 2PCUS (p?<?0.001), while the specificity was similar. A short training is satisfactory for achieving a good clinical capability to identify DVT by ED physicians. The 3PCUS examination preformed in the ED, is a noninvasive, accurate and quick diagnostic test for evaluation of patients presenting with signs and symptoms suggestive of a DVT. By Using 3PCUS, the ED physicians may decrease time to diagnosis, definitive care and length of stay in the ED.     

早产胎儿脐血和脐带间充质干细胞分离培养的比较

目的对比早产胎儿脐血和脐带间充质于细胞（MSCs）的培养成功率,探讨早产胎儿MSCs获取的最佳途径。方法无菌条件下采集早产胎儿（不足37周）脐血,密度梯度离心法分离单个核细胞,采用贴壁培养法获得脐血MSCs;将脐带剪成1mm^3大小组织块,采用组织块贴壁法获得脐带MSCs;分别观察脐血和脐带MSCs的生物学特性,免疫荧光法检测MSCs表面标记物的表达情况。结果采用Mesencult^TM培养基,早产胎儿脐血MSCs培养成功率为100％,脐带MSCs培养成功率为67％,明显低于脐血MSCs;早产胎儿脐血和脐带MSCs均表达CD29、CD44和CD90不表达造血干细胞表面标志CD34。结论早产胎儿脐血中较易获得MSCs,为临床移植治疗提供了理想的细胞来源。     

A comparative study on the mechanical properties of the umbilical vein and umbilical artery under uniaxial loading

PurposeCoronary Artery Disease (CAD) is the main cause of mortalities worldwide. The Saphenous Vein (SV) and Umbilical Vein (UV) are the most common veins using for treatment as a Coronary Artery Bypass Graft (CABG). The mechanical properties of UV owing to its long-term patency for CABG are deemed important. However, there is a lack of knowledge on the mechanical properties of UV. In this study, the linear (Young's modulus and maximum stress) and nonlinear (hyperelastic material coefficients) mechanical properties of 8 human umbilical vein and umbilical artery (UA) are investigated using a series of uniaxial tensile tests. The nonlinear mechanical behavior of UV/UA is computationally investigated using hyperelastic strain energy density functions, including Mooney-Rivlin and Ogden. A hyperelastic constitutive model is selected to best fit the axial behavior of the UV/UA.ResultsThe results reveal that the Young's modulus and maximum stress of UA are 342% and 19% more than that of UV, respectively. The Mooney-Rivlin material model is selected to represent the nonlinear behavior of the UV and UA which can be used in future biomechanical simulations of the umbilical vein and umbilical artery.ConclusionsThe higher mechanical properties of umbilical artery compared to umbilical vein might have related to the amount of elastin and collagen content on the UA wall. The results of this study could be utilized to understand the extension and rupture mechanism of UV and UA, and has implications for interventions and surgeries, including balloon-angioplasty, bypass, and stenting.