Complete and partial luteinized unruptured follicle syndrome after ovarian stimulation with clomiphene citrate/human menopausal gonadotrophin/human chorionic gonadotrophin

A total of 31 clomiphene citrate/human menopausal gonadotrophin(HMG)/human chorionic gonadotrophin (HCG)-stimulated cyclesin 28 patients were investigated to determine the fate of eachof the matured follicles. A standard stimulation regimen wasadhered to, and ultrasound as well as hormonal monitoring wasperformed. All follicles were measured by vaginal ultrasoundat –12, +35 and +45 h relative to HCG administration andat 7 days after HCG administration. Of the 220 follicles, 107(48.6%) ruptured. The number of ruptured follicles per cyclewas correlated with the mid-luteal progesterone concentration(r = 0.63, P = 0.0005). The probability of follicular rupturewas related to follicular diameter at 12 h before HCG administration;6% of follicles <12 mm in diameter ruptured compared with87% of follicles 18–19 mm. A complete luteinized unrupturedfollicle (LUF) syndrome was observed in six cycles (20%). Inthese cycles, follicular growth and oestradiol, progesterone,luteinizing hormone (LH) and follicle stimulating hormone (FSH)concentrations at 12 h before HCG administration were similarto those in cycles with follicular rupture. However, mid-lutealprogesterone concentrations were lower in complete LUF cycles(46.97 ± 8.95 nmol/1 versus 108.74 ± 12.27 nmol/1;P = 0.02). These data demonstrate that in stimulated cyclesmany follicles, usually the smaller ones, fail to rupture, evenafter HCG administration. Complete LUF syndrome, despite a strongexogenous ovulatory signal, and the absence of any differencein peri-ovulatory hormonal parameters, indicates that the defectcausing LUF resides in the follicle itself and/or hormonal changesduring the follicular phase.     

Real-time identification and archiving of micro-embolic Doppler signals using a knowledge-based DSP system

Identification of micro-emboli in the cerebral circulation using transcranial Doppler ultrasound provides valuable clinical information, but, currently, embolic signal detection and analysis are significantly limited because they mainly rely on costly off-line analysis by human experts. In this study, a reliable, high-resolution, real-time automated system for the detection and archiving of embolic signals was designed and implemented using expert system theory and modern DSP technology. Preliminary tests were conducted to evaluate the functions and the performance of the system using data from ten carotid endarterectomy patients and two normal volunteers. Using the widely accepted 7 dB threshold for human reliability and a human expert, majority-decision gold standard, the real-time system reached sensitivity and specificity of 93.6% and 99.3%, respectively, which were close to the results obtained by three human experts under ideal laboratory conditions (90.1% and 99.8%, 98.4% and 99.9%, 98.9 and 99.9%). The new system has the potential to be used either as a bedside monitoring and signal acquisition device, or as a laboratory investigation tool.     

经阴道彩色多普勒超声对子宫腺肌瘤的诊断价值

目的：探讨经阴道彩色多普勒超声对子宫腺肌瘤的诊断价值。方法：选取许昌中医院2020年1月至2022年1月期间收治的80例子宫腺肌瘤患者为研究对象,对上述患者实施经阴道彩色多普勒超声诊断,获得对应的诊断结果,随后将该结果和术后病理分析结果进行比较,最终得出诊断效果。结果：本研究80例子宫腺肌瘤患者中,经阴道彩色多普勒超声检出75例,漏诊或误诊5例,诊断准确率为93.75%;经阴道彩色多普勒检查诊断为子宫腺肌瘤的75例患者中,按照发病部位划分,有10例(13.33%)子宫腺肌瘤出现在子宫前壁区域,65例(86.67%)出现在子宫后壁部位;按照病情特点划分,有63例(84.00%)为单发子宫腺肌瘤,12例(16.00%)为子宫腺肌瘤合并子宫肌瘤。此外,75例患者中有3例患者并发卵巢内膜异位症。75例患者的子宫动脉血流阻力指数为0.75±0.05、搏动指数为1.37±0.04、舒张期峰值速度为(5.83±0.14)cm·s^-1、收缩期峰值速度为(71.74±0.25)cm·s^-1。结论：经阴道彩色多普勒超声可通过超声特征、血流分布、多普勒频谱特点,准...     

超声在小儿急腹症中的应用价值和经验探讨

目的研究彩色多普勒在小儿消化系统急腹症中的应用价值。方法回顾性分析阐述2019年1-12月期间医院收治的136例急腹症患儿的超声检查和临床资料,分析彩色多普勒超声诊断的符合率。结果彩色多普勒超声诊断急性肠系膜淋巴结炎符合率92.86%,急性阑尾炎符合率90.91%,肠套叠符合率97.44%,肠旋转不良伴中肠扭转符合率100%,肠梗阻符合率100%。结论彩色多普勒超声在诊断小儿急腹症中具有较高的符合率,是小儿急腹症首选的检查方法。     

The impact of school exclusion zone planning guidance on the number and type of food outlets in an English local authority: A longitudinal analysis

The use of planning policy to manage and create a healthy food environment has become a popular policy tool for local governments in England. To date there has been no evaluation of their short-term impact on the built environment. We assess if planning guidance restricting new fast food outlets within 400 m of a secondary school, influences the food environment in the local authority of Newcastle Upon Tyne, UK. We have administrative data on all food outlets in Newcastle 3 years pre-intervention 2012–2015, the intervention year 2016, and three years’ post-intervention 2016–2019. We employ a difference-in-difference approach comparing postcodes within the school fast food outlet exclusion zone to those outside the fast-food exclusion zones. In the short term (3 years), planning guidance to limit the number of new fast-food outlets in a school exclusion zone did not have a statistically significant impact on the food environment when compared with a control zone.     

37所医院消化内镜超声探头清洗消毒现况调查

目的 了解目前国内消化内镜超声探头的清洗消毒现状及存在的问题。方法 采用问卷调查的方式对全国范围内37所医院的消化内镜超声探头清洗和消毒灭菌情况进行调查。结果 70.27%的医院内镜超声探头数量为1~3条,奥林巴斯品牌最多（72.97%）,48.65%的医院内镜中心每日使用探头的患者例数为0~5例;83.78%的医院采用专人清洗消毒内镜超声探头,人员主要以护理员为主（51.35%）;清洗方法以"酶洗-擦洗-擦干"为主（89.19%）,清洗时间以>1 min为主（62.16%）;83.78%的医院内镜超声探头消毒方式为化学消毒剂浸泡,其中以邻苯二甲醛（70.27%）和全浸泡消毒（48.65%）为主;消毒时间以≥ 5 min为主（56.76%）;27.03%的医院对内镜超声探头进行灭菌,其中以"一用一灭菌"（21.62%）和过氧乙酸浸泡10 min（10.81%）为主;消毒灭菌后的内镜超声探头主要放置在内镜储存柜（56.76%）;78.38%的医院对当日拟使用的内镜超声探头进行再次消毒;56.76%的医院从未对消毒后的内镜超声探头进行消毒效果监测。结论 37所医院对内镜超声探头清洗和消毒灭菌情况存在一定差异,建议尽快制定内镜超声探头清洗消毒相关国家标准,规范内镜超声探头的清洗消毒流程。     

超声弹性成像联合BI-RADS分类在乳腺微小癌诊断中的临床价值

目的:探讨在乳腺微小癌诊断中联合应用超声弹性成像及数据系统(BI-RADS)分类的临床价值。方法:选择2018年3月~2019年3月本院接收的疑似乳腺微小癌的96例患者作为研究对象。均进行超声弹性成像检查、BI-RADS分类,以病理检查结果为诊断金标准,比较单项检查与联合检查的准确率、灵敏度、特异度。结果:数据显示,在96例疑似乳腺微小癌患者中,共80例患者经病理检查确诊为乳腺微小癌,同时乳腺钼靶联合超声检查的准确性、灵敏度均高于单项检测,数据之间的差异有统计学意义(P<0.05)。此外,单项与联合检测的特异度对比,差异无统计学意义(P>0.05)。结论:在乳腺微小癌诊断中联合应用超声弹性成像及BI-RADS分类检查,可有效提高诊断准确性及灵敏度,对早期疾病诊断、临床治疗具有重要意义。     

复发性剖宫产瘢痕部位妊娠的临床分析

目的探讨复发性剖宫产瘢痕部位妊娠(RCSP)发生的相关因素及处理。方法选取2015年1月至2021年1月于川北医学院附属医院妇产科确诊的463例CSP并行聚焦超声消融(FUAS)或子宫动脉介入栓塞(UAE)联合宫腔镜手术治疗患者,随访其再妊娠情况,失访72例,成功随访391例,117例再次妊娠,24例为RCSP。回顾性分析RCSP患者的临床资料和处理方式。结果391例CSP患者,122例行FUAS联合宫腔镜手术,34例再次妊娠,5.9%(2/34)为RCSP;269例行UAE联合宫腔镜手术,83例再次妊娠,26.5%(22/83)为RCSP。UAE组RCSP发生率高于FUAS组,差异有统计学意义(P<0.05)。24例RCSP患者,22例行FUAS联合宫腔镜手术,2例行UAE联合宫腔镜手术,均一次性治疗成功。RCSP患者中,79.2%(19/24)剖宫产≥2次,87.5%(21/24)人工流产≥2次,70.8%(17/24)子宫下段瘢痕厚度≤3 mm。结论既往多次剖宫产史、多次人工流产史、子宫下段瘢痕厚度偏薄及CSP初次治疗方式可能与CSP复发相关。FUAS联合宫腔镜手术是CSP及RSCP的适宜治疗方式。     

二维超声评价原发性肾病综合征预后的价值

目的　探讨二维超声对原发性肾病综合征预后的判断价值。方法　根据临床检查结果将 12 0例原发性肾病综合征患者分为 3组 ,并与二维超声检查结果进行相关性分析。结果　完全缓解组的肾脏超声检查结果与对照组比较无显著性差异 (P >0 .0 5 ) ,部分缓解组的肾脏超声检查结果与对照组比较有显著性差异 (P <0 .0 5 ) ,无效组的肾脏超声检查结果与对照组比较有非常显著性差异 (P <0 .0 1)。结论　二维超声检查原发性肾病综合征患者的肾脏无异常时预后良好 ,而肾脏缩小越明显 ,肾皮质回声越强 ,则预后越差。     

“超声信息管理系统”中的数据整合

介绍“超声信息管理系统”中的数据整合研究。医院数学化仪器和计算机信息系统的使用积累了大量的数据,本文针对“高血压进程与心脏形态变化的关系”这一主题,重组计算机内的积累病例数据,在建立数据仓库和实现数据挖掘方面做了一些尝试。