Calculation of percentage of cases on file with an unnamed father in 100 one-man and 100 two-man cases (filiation cases) from South-West Germany in 1976–1981

Summary Applying the formula of Schulte-Mönting and Hummel to 100 one-man affairs (filiation cases) in South-West Germany between 1979 and 1981 gave a realistic prior probability of paternity of 0.837±0.0372. This means that in approximately 83.7% of all one-man affairs the man named by the mother to be the father of her child is indeed the father.For two-man affairs a realistic prior probability of paternity of 0.863±0.0369 was calculated on the basis of 100 two-man affairs in South-West Germany between 1976 and 1981. In other words, there is a probability of about 86.3% that a non-excludable man—irrespective of other factors—in a two-man affair is the real father of the child. In approximately 13.7% of two-man affairs neither the defendant nor the witness is the father, but a third unknown person. In about 85.7% of the two-man affairs in which a father of the child was named the defendant is in fact the father and in 14.3% the witness is the father.     

Mathematical aspects of the paternity index I=X/Y,especially in relation to the chance of non-exclusion of non-fathers

Summary In a previous paper the author mentioned some aspects of the paternity index I (=X/Y): Among false triplets the frequency of those with I equal to or higher than an (observed) I value of I ^x is considerably lower than 1/I ^x; among false triplets the mean value of I is equal to 1, and among non-excluded non-fathers it is equal to the inverse of the chance of non-exclusion; among true triplets the mean value of 1/I (=i) is equal to the chance of non-exclusion of non-fathers. In a statistical material rather strong deviations from some of these expectations were observed.In the present paper further characteristics of the distribution of I values were taken into consideration, and especially those that should hold if lnI would fit in with a normal distribution. It was supposed that with the aid of such a distribution the deviations mentioned above could be recognized as chance variability. It appears, however, that neither the logarithms of the paternity index, nor those of the zygosity index of twins (chosen as an analogous model that is more easily analysable than the paternity index) are really normally distributed. This, in turn, makes that estimates of probability of paternity, based on such a supposition, are of doubtful reliability. Besides it is concluded that also for other reasons other estimates than Essen-Möller's W (or I or i), as probability of first type errors, lead in practice to conclusions that are equally subdue to a priori suppositions as are W values and may be, in fact, much more erroneous than those.Special attention is paid to the statistical analysis of paternity studies with more than one alleged father, and it is concluded that in such cases the general formula that may be considered to be equivalent with Essen-Möller's formula for one-man paternity cases, i.e., W=X/(X+Y) or I/(I+1), must be W ₁=I ₁/(I+n); W ₂=I ₂/(I+n) etc. and certainly not W ₁=I ₁/(I+1); W ₂=I ₂/(I+1) etc.Dedicated to Prof. Dr. Erik Essen-Möller on the occasion of his 80th birthday     

Diagnosis of paternity for cases without mother and without both mother and putative father based on blood group findings from the relatives

Summary Formulas of the estimated likelihood ratio Y/X are derived for cases without mother as well as those without both mother and putative father, by using blood group findings of their relatives.The distribution curves of the relative frequencies of log(Y/X) for these cases are calculated with respect to 10⁴ families which are created by a Monte Carlo simulation. The extent of success in the paternity diagnosis is clarified by the statistical analysis based on these distribution curves.According to the above analysis, fairly high chance of success can be obtained in the diagnosis of such ambiguous cases without the plaintive mother and/or the putative father, if their relatives are alive. It is also concluded that the genetic information as to the parents of the deceased person increases the exclusion probability, whereas that as to the spouse and children increases the fraction of log(Y/X) > 1 for non-father, corresponding to the fraction where the Essen-Möller value is less than 9%.     

多胎妊娠流产、早产高危因素及预防对策

目的：分析多胎妊娠流产、早产的高危因素,探讨宫颈环扎术预防高危人群流产、早产的临床效果.方法：选择2011-01～2012-05收治的多胎妊娠患者97例,经阴道宫颈彩超测量宫颈长度≤ 2cm,宫颈内口宽度＞1cm的47例作为高危组,其余50例为低危组,选择高危组47例中自愿行宫颈环扎术的26例作为高危环扎组,其余21例作为高危未环扎组.结果：高危环扎组流产1例（3.85%）,高危未环扎组流产7例（33.3%）,两者比较差异显著,高危环扎组早产9例（34.6%）,高危未环扎组早产8例（38.1%）,两者比较差异不明显.结论：利用经阴道宫颈彩超检查宫颈形态可筛查出多胎妊娠自然流产的高危人群,宫颈环扎术可显著降低多胎妊娠高危人群的流产率.     

彩色多普勒在宫外孕中的应用价值

目的 评价彩色多普勒在宫外孕诊断中的价值。方法 对临床拟诊的宫外孕62例患者经二维图像、彩色多普勒显像、频普多普勒技术分析与病理结果对照，分析其诊断的正确性。结果 62例超声诊断的宫外孕中55例正确诊断，诊断符合率为887％。结论 彩色多普勒诊断宫外孕具有重要价值。     

General formulas of the estimated likelihood ratio Y/X in the diagnosis of paternity of a deceased putative father

Summary When the putative father is dead his probable genotype, essential for estimate of likelihood ratio in the diagnosis of paternity, should be deduced from his relatives. In the present paper are described the general method for such deduction of probable genotype and the derivation of the formula of likelihood ratio. 10⁴ examples of the diagnosis of paternity of deceased father are examined using a Monte Carlo method and the distributions of relative frequencies of log(Y/X) are calculated for the true father and non-father. These results indicate that the present method of estimation of Y/X from relatives is quite useful for the diagnosis of paternity of a deceased putative father.     

MRI增强检查在早期子宫瘢痕妊娠中的诊断价值

目的 探讨MRI增强检查在早期子宫瘢痕妊娠(CSP)中的诊断价值,旨在提高诊断水平.方法 回顾分析30例经临床证实为早期CSP患者的MRI及临床资料,所有患者治疗前1周均进行盆腔MRI平扫,其中28例增加MRI增强扫描,观察CSP的MRI表现、强化特点及诊断准确率.结果 30例CSP平扫表现为子宫峡部前壁瘢痕处囊性或囊实性结节或肿块,瘢痕处肌层变薄,厚度约2～4 mm.其中囊状信号影7例;囊实性混杂信号影22例;混杂长短T2信号影1例.环形薄壁强化7例;结节状或带状强化21例.22例妊娠囊主要向宫腔内生长;8例妊娠囊突入薄弱肌层并向前突压迫膀胱.MRI平扫诊断准确28例(93.33％,28/30),MRI平扫及增强诊断准确27例(96.43％,27/28).结论 MRI平扫可显示CSP患者妊娠囊与瘢痕的关系,增强扫描对于妊娠囊内容物、蜕膜与胎盘组织及瘢痕厚度的显示优于平扫,可作为早期CSP诊断的有效补充.     

经腹超声与经阴道超声双向检查在早期妊娠诊断中的价值

目的 探讨经腹超声和经阴道超声在早期妊娠检查中的应用价值,以便寻找出早期妊娠的最佳检测方法.方法 选择停经31～42天,且HCG(人绒毛膜促性腺激素)为阳性或弱阳性,疑似早期妊娠的122例患者,年龄19～40岁,平均27.6岁,均行经腹超声和经阴道超声检查,分别观察子宫、妊娠囊、胚芽、胎心的情况,针对两次的检测结果进行比较.结果 122例患者中,经腹超声检测出妊娠囊、卵黄囊91例,检出率达到74.6％;经阴道超声检测出妊娠囊、卵黄囊120例,检出率达到98.4％.经腹超声检测出胚芽者58例,经阴道超声检测出胚芽者80例,经阴道超声与经腹超声相比可以更早检测出胚芽.在同时检测出胚芽的52例中,经腹超声的胎心检出率为23.1％,经阴道超声的胎心检出率为53.8％,经阴道超声与经腹超声相比胎心检出时间可以提前1周.结论 经阴道超声检测早期妊娠的灵敏度和准确性高于经腹超声,经腹超声和经阴道超声相结合是临床检测早期妊娠安全、准确的方法.     

经阴道超声对早期未破裂型宫外孕的诊断价值

目的探讨经阴道超声在早期未破型宫外孕中的诊断价值。方法对我院2008年1月至2009年10月经阴道经腹超声对照检查并经手术病理证实的62例早期未破型宫外孕资料进行回顾分析。结果经阴道超声检查确诊59例（95%）,根据声像图特点分为输卵管环型33例（53%）,非特异性包块型20例（32%）,胎心胎囊型6例（9.6%）,无特征性声像图3例（5%）。经腹部超声检查确诊31例（50%）。结论经阴道超声分辨率高,图像清晰,是诊断早期未破型宫外孕的首选方法。     

超声增强型血流显像技术在早孕合并部分不典型葡萄胎诊断中的价值

目的分析早孕合并部分不典型葡萄胎的二维和增强型血流显像(e-Flow)声像图特征,以提高早孕合并部分不典型葡萄胎的诊断率。方法回顾性分析经刮宫和病理检查证实早孕合并部分不典型葡萄胎24例的二维和e-Flow声像图特征。结果刮宫前超声提示早孕合并部分不典型葡萄胎17例,7例误诊。17例早孕合并部分不典型葡萄胎的二维声像图表现:①子宫略大于或等于正常妊娠月份,宫腔内妊娠囊变小、形态失常,妊娠囊周围可见细小、形态不规则的类蜂窝状无回声区;②宫腔内等或稍高回声团,部分病例可见少量不规则液暗区,无或仅有少量水泡状暗区。17例早孕合并部分不典型葡萄胎的e-Flow表现:宫腔病灶内以及相邻肌壁间可探及丰富血流信号。结论不典型葡萄胎声像图复杂,需要结合临床各项指标;二维超声对不典型葡萄胎无特异性,e-Flow显像可以在宫腔内异常回声团记录到低速血流信号,因此e-Flow技术对部分不典型葡萄胎有较高的诊断价值。     

MEBO预防妊娠纹的临床体会

目的：探讨预防妊娠纹的方法。方法：876例孕妇随机分成2组，5个月后，在孕妇的腹部分别涂MEBO和甘油，每日2到3次，直到妊娠终止。结果：两组总有效率和显效率有明显差异（P＜0.01）fig（1）。结论：美宝能促进受损的真皮再生，预防、减少瘢痕的形成。     

脑胎盘率联合无应激胎心监护对高危妊娠结局的诊断意义

 目的 探讨胎儿脑胎盘率(cerebroplacental ratio,CPR)联合无应激胎心监护(non stress test,NST)对高危妊娠结局的诊断意义。方法 选取2018-12至2020-02在石家庄市第六医院产检并分娩的单胎高危妊娠患者120例为研究对象。平均孕周28-41周,进行超声检测胎儿脐动脉(umbilical artery,UA)和大脑中动脉(middle cerebral artery,MCA)血流,测得CPR,同时行产前NST。对母儿分娩结局:羊水污染、胎儿窘迫、剖宫产、助产(产钳/胎吸);新生儿结局:1 min Apgar评分＜7分、血气 pH＜7.25、入住NICU进行比较。比较不同方法对高危妊娠不良妊娠结局评估的效能,主要包括灵敏度、特异度、阳性预测值及阴性预测值。结果 根据NST与CPR结果分为4组:A组(NST与CPR均正常),B组(NST异常),C组(CPR异常),D组(NST与CPR均异常)。D组中胎儿窘迫 21例(80.77%)、羊水污染23例(88.46%)、剖宫产24例(92.31%)、助产(产钳/胎吸)3例(11.54%)、1 min Apger评分＜7分17例(65.38%)、血气pH＜7.25 16例(61.54%)、入住NICU 18例(69.23%),明显高于其他3个组,且差异有统计学意义(P<0.05)。CPR联合胎心监护对不良妊娠结局预测的灵敏度为97.01%、特异度为93.78%、阳性预测值为91.06%、阴性预测值为97.27%,均高于单纯使用CPR及胎心监护。结论 CPR与NST联合应用对高危妊娠中异常情况诊断及时、准确、安全、有效,可有效避免不良妊娠结局的发生,在高危妊娠管理中具有重要意义,值得临床推广。     

经阴道彩色多普勒超声评价药物治疗输卵管妊娠的价值

目的:探讨经阴道彩色多普勒超声(TVCDFI)评价药物保守治疗输卵管妊娠的价值。方法:应用TVCDFI观察中西医结合保守治疗输卵管妊娠30例,患者治疗前及治疗后1周、2周、1月行阴道超声检查,并记录输卵管妊娠包块的二维声像图特征及多普勒血流动力学参数。结果:输卵管妊娠包块治疗前血流信号丰富,治疗后血流信号逐渐减少,差异具有显著性意义(P<0.005)。治疗1月后附件区包块收缩期峰值流速及舒张末期流速较治疗前明显减慢,P<0.001。治疗2周及1月后附件区包块阻力指数较治疗前明显升高,P<0.001。结论:输卵管妊娠包块大小、血流信号的丰富程度、血流流速的降低及阻力指数的增高以及盆腔积液量的多少是疗效评价客观的、有价值的指标。TVCDFI评价输卵管妊娠疗效有临床推广价值。     

中止妊娠前子宫动脉栓塞术预防宫内大出血应用价值

目的 探讨中止妊娠前子宫动脉栓塞术(UAE)预防宫内大出血的应用价值,评估UAE术对患者再孕有无影响.方法 回顾性分析2011年1月至2015年7月采用UAE术预防宫内大出血患者82例临床资料,观察术后引产和清宫临床效果,追踪患者性激素水平,月经和再孕情况.结果 82例患者中止妊娠前接受UAE术,预防子宫大出血有效率为93.91％ (77/82),保宫率为98.78％ (81/82);术后75例获随访3个月,71例月经恢复正常,9例再孕,无一例出现严重并发症或后遗症.结论 中止妊娠前UAE术能有效预防宫内大出血并保留子宫,方法安全有效,临床应用价值高.     

子宫动脉灌注化疗及栓塞在治疗剖宫产切口瘢痕妊娠中的应用价值

目的探讨经子宫动脉灌注化疗及栓塞术治疗剖宫产切口瘢痕妊娠的应用价值。方法 23例剖宫产后切口瘢痕妊娠病例,在DSA引导下经双侧子宫动脉按血供比例分配灌注甲氨蝶呤100mg进行灌注杀胚,再以明胶海绵栓塞,术后24～48h行清宫术。结果全部病例均顺利完成双侧子宫动脉灌注化疗及栓塞术,术后24h复查血清β-HCG水平较术前平均下降87.77%,阴道出血停止,清宫术中出血10～200ml,平均40ml,无严重并发症发生。结论经子宫动脉灌注可明显提高胚囊局部甲氨蝶呤的血药浓度,有效杀伤和消除胚胎组织,栓塞后阻断胚胎血供,达到降低子宫切除和丧失生育能力的风险,缩短住院时间,是治疗剖宫产切口瘢痕妊娠安全、有效的方法。     

Logistic回归模型对不明位置妊娠患者早期异位妊娠的预测价值

目的:初步建立预测不明位置妊娠患者(PUL)早期异位妊娠(EP)的Logistic回归模型,评价该模型的应用价值。方法:对妊娠试验阳性的受检者常规进行经阴道能量多普勒超声检查(TV-PDU),对子宫内膜形态学及内膜下血流动力学参数进行测定,联合临床、生化资料行单变量非条件Logistic回归分析,筛选出有意义的变量,在此基础上行多变量Logistic回归,对有意义的研究因素采用逐步法,经优化组合后建立预测EP的Logistic回归模型并进行模型稳定性验证。利用ROC曲线确定诊断阈值和评估各单项指标及其不同指标组合的诊断价值。结果:最终197例(28.8%)为PUL患者,184例资料完整,62例(33.7%)确诊为EP,90例(48.9%)为宫内早孕,32例(17.4%)为宫内早孕流产。多变量Logistic回归分析显示只有4种超声参数对于鉴别EP有统计学意义(P<0.001),以此而建立了三个Logistic回归模型,Youden指数分别为81.2、95.2和97.6,以内膜形态 内膜厚度 对称性 内膜下动脉血流(M3)这一指标组合最优,联合评价诊断价值最高,模型稳定性较好,其ROC曲线下面积(AUC)最大,灵敏度98.4%,特异度99.2%,阳性预测值98.4%,阴性预测值99.2%。结论:Logistic回归分析为研究子宫内膜形态学、血流动力学与EP之间的关系提供了有效的方法,TV-PDU检查早期PUL患者子宫内膜的多变量Logistic回归模型可更早期地估测EP,在临床上无创性预测早期妊娠结局的危险性是可行的。     

二维超声与三维超声相结合对妊娠早期胎儿腭裂的诊断价值

目的 探讨二维超声与三维超声相结合对妊娠早期胎儿腭裂的诊断价值。方法回顾性分析260例孕11＋0~13＋6周胎儿的颜面部及鼻后三角的二维超声及三维超声重建图像,后者包括三维断层超声成像（ tomographic ul-trasound imaging,TUI）及透明模式成像。对比观察及分析颜面部腭及鼻后三角的完整性。结果二维超声及三维超声（断层超声成像及透明模式成像）均可获得颜面部正中矢状切面、冠状切面及横切面;可观察鼻后三角及腭的连续性。发现腭裂3例,漏诊1例。结论二维及三维超声相结合明显提高了鼻后三角及腭的显示率。观察腭及鼻后三角的连续性是否中断是诊断妊娠早期胎儿硬腭裂的重要指标。     

Biostatistical evaluation of blood group,HLA and DNA findings in Jeffreys' immigrant test-case using special kinship and DNA algorithms

Summary In the immigration case cited by Jeffreys et al. (1985), the biostatistical evaluation of blood group findings in 16 systems and of HLA-A,B findings for the mother and child, using a special kinship algorithm developed by Ihm and Hummel (1975), produced a probability of maternity of the Ghanaian-born putative mother of W = 6%; the probability of maternity for her sister was W = 94%. Using the DNA multilocus probes 33.15 and 33.6 and the bandsharing technique, the authors analysed band patterns from the putative mother and child as well as another 3 children of the same woman. It was concluded that the putative mother was the mother of all 4 children. An evaluation of the band patterns using the multi-di-allelism model and the kinship algorithm in accordance with the Essen-Möller principle produced: W = 99.99999999999999991%, or, if the ----- constellations were not considered, W = 99.99998%.     

核因子-κB在正常妊娠和妊娠期肝内胆汁淤积症胎盘中表达的意义

目的:探讨正常和妊娠期肝内胆汁淤积症(ICP)胎盘组织中核因子-κB(NF-κB)表达的意义。方法:采用组织微阵列技术和免疫组织化学染色方法检测正常胎盘(30例)和ICP胎盘(轻度28例,重度19例)组织中NF-κB p65蛋白的表达水平。结果:NF-κB p65在正常胎盘和ICP胎盘绒毛表面合体滋养细胞胞浆和胞核内呈阳性表达,绒毛间质的血管平滑肌和内皮细胞内表达较少;ICP重度组单位胎盘面积IOD最高(95.69±13.49),ICP轻度组次之(71.37±7.74),正常胎盘最低(57.54±4.13),三组间差异显著(P<0.01)。结论:ICP胎盘组织NF-κB表达明显增高,且与ICP的疾病程度有关,NF-κB激活与ICP发生发展过程有关。