Purpose To investigate the prenatal ultrasonic features of fetal hypospadias and to compare the diagnostic accuracy.Materials and Methods The clinical data of 28 patients with suspected or confirmed hypospadias were retrospectively analyzed.The prenatal ultrasonic features,missed diagnosis and misdiagnosis of the patients were analyzed,and the diagnostic accuracy of different ultrasonic features for hypospadias was compared.Results In 28 cases,21 cases of hypospadias were confirmed by examination after birth or induced abortion with 2 cases of missed diagnosis by ultrasound,and 7 cases of non hypospadias were misdiagnosed by prenatal ultrasound.The diagnostic accuracy rate of 2D ultrasound was 67.9％ (19/28),and that of 3D ultrasound combined with 2D ultrasound was 92.9％ (13/14).The diagnostic accuracy rates of ultrasonic features such as abnormal urinary jet,abnormal urethra,tulip sign,abnormal penis tip,scrotum separation with or without penoscrotal transposition and short penis were 100.0％ (6/6),92.9％ (13/14),88.2％ (15/17),83.3％ (5/6),25.0％ (1/4) and 33.3％ (1/3),respectively.Conclusion The ultrasonic features including abnormal urinary jet,abnormal urethra,tulip sign and abnormal penis tip have great value for prenatal diagnosis of fetal hypospadias.3D ultrasound is more intuitive than 2D ultrasound and provides more details.Comprehensive analysis of all ultrasonic features is helpful for prenatal diagnosis.

The ultrastructural localization of peptide substances——VP,SP,ENK,SRIFand distribution of peptidergic nerves in rat neurohypophysis were studied by elect-ron microscopy.The results showed that VP,SP,ENK and SRIF immunoreactiveproducts located in large granular vesicles(110-150 nm in diameter),at the surfaceof microvesicles and outer membrane of mitochondria.The VP-,SP-,ENK- andSRIF-containing nerve fibers distributed at periphery of capillaries and vicinity ofpituicytes.VP- and ENK- positive nerve terminals formed axo-axonic synapses withnegative terminals.Axo-axonic synapses also existed between two SRIF-positive ter-minals.In addition,ENK- and SP-positive terminals formed synaptoid structureswith pituicytes.The authors have discovered the VP-positive pituicytes for the firsttime.The scientific significances of present paper are as follows:(1)Several kinds ofpeptide such as VP,SP,ENK and SRIF have been identified in neurohypophysis atultrastructural level;(2)The discovery of VP-positive pituicytes and their peptide-rgic innervation imply that these structures probably participate in the regulation ofneurohormone releasing;(3)New morphological bases have been provided for theregulation of neurohormone releasing.

Using the immunohistochemical and immunoelectron microscopic methods, the localization and pattern of vasoactive intestinal polypeptidergic nerves in the wall of cerebral vessels were investigated. The results revealed that the VIP-like immunoreactive (VIPLI) fibres were located in the adventitia or at the adventitia-media border. No synaptic contacts were identified among the nerve terminals or between nerve terminal and smooth muscle cell. VIPLI terminals directly apposed to the smooth muscle cells with a distance of 100 nm.The observations mentioned above indicate that there is peptidergic innervation in the wall of the cerebral vessels besides traditional adrenergic and cholinergic innervations. The regulatory function of VIP-containing nerves to the cerebral vessels may be performed by affecting the smooth muscle directly through the nonsynaptic release. In addition, present study identified and discussed the distribution and function of substance P(SP) in the cerebral vessels.

Ultrastructures of the neurohypophysis in the rats have been studied by means of electron microscopy. Besides identifying the fact that the neurosecretory substances store in the nerve terminals and release into the blood, there are also axo-axonic synaptoid structures existed between neurosecretory terminals and neuro-glial synaptoid contacts between neurosecretory terminals and pituicytes. The characteristics of these contacts mentioned above are as follows: (1) the pre-and postsynaptic membranes are insignificantly thickened; (2) clustered microvesicles are close to and attach to the presynaptic membrane; (3) the synaptic cleft is about 20 nm wide and contains various amount of electron dense materials. The authors suggest that the two kinds of synaptoid structures and pituicytes are all involved in the regulation for the releasing of the neurosecretory substances.

Objective:To investigate the ultrasonographic characteristics and misdiagnosis of hepatic pregnancy.Methods:The clinical data and preoperative ultrasound characteristics of 2 cases of hepatic pregnancy admitted to the Affiliated Hospital of Jining Medical College were retrospectively summarized, and related literatures were retrieved from January 1, 1956 to December 31, 2021.Results:A total of 37 cases of hepatic pregnancy were included, among which 35 cases showed liver nodules on ultrasound examination, which were classified into four types: pregnancy cystic (24 cases), thick-walled cystic echo (6 cases), heterogeneous hyperecho (3 cases) and mixed cyst solid echo (2 cases), the exact diagnosis coincidence rate of each type was 100%, 4/6, 1/3, 0, respectively. Among the 35 liver nodules, 29(82.8%) cases were diagnosed correctly by ultrasound, 1 case was misdiagnosed as choriocarcinoma liver metastasis, 1 case was misdiagnosed as hepatic hemangioma, and 4 cases were diagnosed as liver nodules without suggestive diagnosis. No liver nodules were found in the other 2 cases, including 1 case misdiagnosed as retroperitoneal hematoma and 1 case misdiagnosed as ruptured ovarian cyst.Conclusions:Ultrasonography of hepatic pregnancy may show pregnancy sac, thick-walled cystic echo, hyperecho and mixed echo in liver. The first type is easy to be diagnosed accurately by ultrasound, while the other types are easy to be misdiagnosed. Combined with clinical conditions and the result of enhanced computed tomography (CT), the correct diagnosis rate of hepatic pregnancy can be improved.

Objective:To investigate the characteristic of ultrasound in diagnosing fetal intestinal volvulus.Methods:From April 2015 to May 2018, four cases of fetal intestinal volvulus indicated by prenatal ultrasound in the Affiliated Hospital of Jining Medical College and confirmed either by autopsy or by postnatal surgery, were retrospectively analyzed. A total of 11 ultrasound scans had been performed on the four cases, and the dynamic and static ultrasound features were summarized. Pregnancy outcomes and concomitant malformations were also followed up. Descriptive statistical analysis was used.Results:The direct ultrasonographic patterns of intestinal volvulus in the four cases were "whirlpool" signs (six times), clockwise wrapping of branch vessels of the superior mesenteric vein and the superior mesenteric artery (five times), and "coffee bean" sign (three times); the indirect signs included dilated small intestine (11 times), ascites (eight times), polyhydramnios (five times), peritoneal calcification(four times), pseudocysts(once). Out of the 11 ultrasound examinations, early-stage volvulus was detected on three occasions, all with "whirlpool" signs and clockwise wrapping of branch vessels of the superior mesenteric vein and the superior mesenteric artery. As the disease progressed to the meconium peritonitis stage, indirect signs emerged while the initial two signs can diminished. Postnatal surgery or autopsy after labor induction confirmed the segmental volvulus in the four cases, of which three were complicated by intestinal atresia. No intestinal malrotation was found.Conclusion:Typical direct signs and atypical indirect signs could be identified in the sonogram findings of fetal volvulus, and are important for diagnosing fetal volvulus.

Objective:To summarize the ultrasound manifestations of submucosal cleft palate, and explore the diagnostic value of prenatal ultrasound for submucosal cleft palate.Methods:A total of 21 146 pregnant women who underwent fetal ultrasound examination in the second and third trimesters in the Affiliated Hospital of Jining Medical University from January 2013 to May 2018 were collected. They were all singleton pregnancy. The ultrasound image which was the horizontal plate of the palatine bone at the posterior border of the fetal hard palate was routinely obtained. The presence of bone loss at the posterior border of the hard palate was defined as a positive case. Then the palate targeted ultrasound examinations of the positive cases were performed to observe the continuity of the soft palate. The ultrasound images of positive cases were compared with the results of induction or delivery, and their postpartum diagnosis and treatment were tracked.Results:A total of 44 simple cleft palate were detected in 21 146 fetuses, including 23 dominant cleft palate and 21 submucosal cleft palate. Two cases of 21 submucosal cleft palate were induced because of other deformities, the other 19 cases were born. The follow-up of the 19 submucosal cleft palate cases showed that 15 cases visited to stomatology department before 3 years of age, and 2 cases of newborns with dominant cleft palate were misdiagnosed as submucosal cleft palate by prenatal ultrasound, and the other13 of them were clinically diagnosed as submucosal cleft palate. The ultrasound of the submucosal cleft palate showed there was no inverted "V" -shaped bone in the posterior edge of the hard palate which was connected by a membranous connection, and the soft palate was complete, but the center of soft palate was thinner or even present membranous hyperechoic in ultrasound.Conclusions:Submucosal cleft palate has characteristic ultrasound features, and prenatal ultrasound make a diagnosis and provide some basis for obtaining early diagnosis and treatment after birth.