Objective To assess the ability of the new software SonoAVC to measure follicular volume and to compare these volume calculations with those made by conventional methods. Methods Three-dimensional ultrasound imaging was used to acquire volumetric data from the ovaries of 50 women undergoing controlled ovarian stimulation as part of in-vitro fertilization treatment. SonoAVC was used to automatically measure the volume of follicles and virtual organ computer-aided analysis(VOCAL) was also applied to measure volume, which was used as the standard of volume measurement. And the three perpendicular diameters (xyz diameters) of follicles were manually measured by conventional two-dimensional(2D) ultrasound, which were used to estimate volume using the sphere formula. And the validity of each technique was compared using limits of agreement. Results One hundred and seventy-six follicles were studied. SonoAVC and VOCAL provided highly accurate and repeatable follicular volume measurements in all cases. Volumes estimated from manually derived follicular diameter measurements were less accurate and repeatable. VOCAL took more time in follicular volume of measurement than SonoAVC and conventional 2D displays. Conclusions SonoAVC provides highly accurate, repeatable,and efficient measurements of follicular volume.

Cell Line, Tumor ; Humans ; Matrix Metalloproteinase 2 ; analysis ; Matrix Metalloproteinase 9 ; analysis ; Melanoma ; enzymology ; Skin Neoplasms ; enzymology

Objective To investigate the prevalence of renal insufficiency and its associated factors in type 2 diabetes mellitus with normoalbuminuria using estimated glomerular filtration rate ( eGFR) .Methods We retrospectively analyzed 10-year data of chronic complications in type 2 diabetics in-patient from the Chinese Diabetes Society.eGFR was estimated using the equation from Modification of Diet in Renal Disease(MDRD) study.The clinical characteristics as well as associated factors for low eGFR were analyzed among the normoalbuminuric type 2 diabetic patients.Results A total of 1351 type 2 diabetic patients were included, 755 patients with normoalbuminuria, 466 patients with microalbuminuria and 130 patients with macroalbuminuria respectively.Among the patients, 310 (22.9% ) had low eGFR (GFR <60 ml · min~(-1) · 1.73 m~(-2) ) , 19.7% (149/755) in the patients with normoalbuminuria, 21.9% (102/466) in microalbuminuria and 45.4% ( 59/130 ) in macroalbuminuria Patients with normoalbuminuria and low eGFR suffered more chronic complications than those with normoalbuminuria and normal eGFR, mainly retinopathy, cerebrovascular diseases and sensory neuropathy.Stepwise logistic regression analysis revealed that age ( OR = 1.042, P < 0.001), diabetic duration ( OR = 1.038, P = 0.045), systolic blood pressure (OR = 1.017, P < 0.001) were independently associated with renal impairment among the patients with normoalbuminuria.Body mass index ( OR = 0.868, P < 0.001) and HbAlc (OR =0.898, P =0.021) were also related with renal insufficiency.Conclusion A considerable proportion in type 2 diabetic patients without albuminuria may exist renal impairment, and eGFR estimation could benefit the evaluation of renal function in such patients.

ObjectiveTo observe the effect of mild hypothermia on vital signs of the elderly patients with anterior circulation brain infarction (massive hemispheric infarction) and hyperpyrexia.Methods46 elderly patients with massive hemispheric infarction and hyperpyrexia within the first 24 hours after onset were randomly divided into the control group and the hypothermia group with 23 cases in each group. The patients of the hypothermia group were treated with mild hypothermia therapy (33℃～35℃). Those of the control group were treated with routine hypothermal treatment. The temperature and heart rate of all patients were measured after 10 days; the prognosis was evaluated according to mortality and scores of Neurological Deficit Scale (NDS).ResultsFor patients of the hypothermia group, the temperature and heart rate significantly reduced, death rate was significantly lower, the neurological function distinctly improved and prognosis was better than the control group after 10 days treatment ( P<0.05).Conclusion Mild hypothermia is safe and effective to elderly patients with massive hemispheric infarction and hyperpyrexia.

Humans ; Medicine, Chinese Traditional ; methods

BACKGROUND: After local injection of Botulinum toxin type-A (BoTX-A), not only the function of the neuromuscular conjunction was affected, but also the changes occurred remote from the injected site. F-waves result from the back fire of the motoneuron activation, which may indirectly reflect the functional state of the motoneurons.OBJECTIVE: To evaluate the remote effect of local BoTX-A injection by F-wave test.DESIGN: Self-control study based on patients with movement disorders.SETTING: Neruologic clinic in a university hospital.PARTICIPANTS: Twenty-six patients with movement disorders not received previous local BoTX-A were selected from Neurological Clinic in Renmin Hospital of Wuhan University between September 2002 and July 2003, including 19 cases with hemificiospasm, 5 Meige syndrome and 2 torticollis spasmodicus.INTERVENTIONS: F- and M-waves of ulnar and tibial nerves were recorded before 1, 12 - 24 weeks after local injection of BoTX-A in 26 patients.MAIN OUTCOME MEASURES: The following parameters were analyzed:latency(ML) and amplitude (Mamp) of M-wave, minimal (Fmin) and average latency (Fave), amplitude of negative peak(Famp), duration (Fdur), persistence (Fpcr) and chronodispersion (Fchr) of F-wave.RESULTS: No definite F-response of ulnar nerve stimulation was obtained 1 week after injection in 3 HFS patients (5 nerves) . Fave prolonged significantly on ulnar and tibal nerve and Fdur increased significantly on ulnar nerve 1 week after injection, but there was no significant difference 12 - 24 weeks later, compared with before injection. No significant correlation of the altered F-wave parameters was found with the dosage of BoTX-A.CONCLUSION: Fdur and Fave could sensitively assess the remote effect,which correlates with distance away from the injected muscle, rather than the dosage of BoTX-A.

Objective To study the characteristics of bone mineral density and bone metabolism in elderly men.Methods 220 male elderly hospitalized patients were selected and divided into three groups according to age:65-74 years group,75-84 years group and 85-94 years group.Bone mineral density and bone metabolic biochemical makers including serum parathyroid hormone (PTH),bone gla-protein (BGP) and 25-dihydroxy vitamin D (25-OH VD) were detected.Results The prevalence of osteoporosis was increased along with ageing in three groups (6.8％,12.0％ vs.22.9％,respectively,F=4.986,P＜0.05).The characteristics of bone metabolism showed that serum PTH level was increased and serum levels of BGP,25-OH VD were decreased along with ageing (F =4.986,3.245,5.997,all P＜0.05),and the levels of BGP,25-OH VD were generally decreased in elderly men.Conclusions The prevalence of osteoporosis is high in elderly men.Bone metabolism can be used as the auxiliary index for osteoporosis risk assessment,which is helpful for the early diagnosis of primary osteoporosis.

Objective To investigate the factors associated with vision and hole closure for idiopathic macular hole (IMH) after vitrectomy surgery.Methods Eighty-nine eyes of 89 patients with IMH were enrolled in this retrospective study.There were 15 males and 74 females.The patients aged from 42 to 82 years,with the mean age of (64.13 ± 7.20) years.All subjects underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations.The BCVA ranged from 0.01 to 0.4,with the mean BCVA of 0.12 ± 0.09.The MH stages was ranged from 2 to 4,with the mean stages of 3.56 ± 0.77.The basal diameter ranged from 182 μm to 1569 μm,with the mean basal diameter of (782.52± 339.17) μm.The treatment was conventional 25G pars plana vitrectomy combined with phacoemulsification and intraocular implantation.Fortyone eyes received internal limiting membrane peeling and 48 eyes received internal limiting membrane grafting.The follow-up ranged from 28 to 720 days,with the mean follow-up of (153.73 ± 160.95) days.The visual acuity and hole closure were evaluated on the last visit and the possible related factors were analyzed.Results On the last visit,the BCVA ranged from 0.02 to 0.8,with the mean BCVA of 0.26±0.18.Among 89 eyes,vision improved in 45 eyes (50.56％) and stabled in 44 eyes (49.44％).Eighty-six eyes (96.63％) gained MH closure but 3 eyes (3.37％) failed.By analysis,patients of early stages of MH and smaller basal diameter of MH will gain better vision outcome (t=2.092,2.569;P＜ 0.05) and patients of early stage MH will gain high hole closure rate after surgery for IMH (t=-5.413,P＜0.05).However,gender,age,duration,preoperative BCVA,surgery technique,gas types and follow-up time had no relationship with the effect after surgery for IMH (P＞0.05).Conclusions Stages of MH and basal diameter of MH may be the factors associated with the visual outcome for idiopathic macular hole after surgery.However,age,gender,duration,surgery patterns,gas types and followup time showed no effects on operational outcomes.

Objective To investigate the value of MRI combined with serum CA125 test in the diagnose of ovarian tumor.Methods To investigate the MRI and serum CA125 level of healthy control group (40 cases),benign tumor group (52 cases),and the malignant tumor group (43 cases).Results Of 95 patients with ovarian masses,CA125 was detected in the malignant patients with the sensitivity of 79.3 ％,specificity of 72.6 ％ and accuracy of 75.1％.MRI was 73.8 ％,81.2 ％,and 82.6 ％ respectively.Combined with CA125 and MRI was 69.4 ％,97.3 ％,and 88.6 ％.Youden' s index of combined detection was significantly higher than single detection (MRI combined with CA125 and single MRI u =1.97,P =0.012 5,and CA125 u =1.96,P =0.012 0).Conclusion MRI combined with CA125 could improve the accuracy of diagnosis ovarian neoplasm in clinic.

Objective To evaluate the remote effect of local injection of botulinum toxin by use of the F-wave measures. Methods The F-wave responses as well as M-waves were recorded before injection, and at 1 week,12 to 24 weeks after local injection of botulinum toxin type-A (BTX-A) in 26 patients, including 19 with hemi-facial spasm (HFS),5 Meige syndrome and 2 torticollis spasmodicus (TS).The following parameters were analyzed: M-wave latency (ML) and amplitude (Mamp), F-wave minimal latency(Fmin) and average latency(Fave),amplitude (Famp), duration (Fdur), persistence (Fper) and chronodispersion (Fchr). The above parameters were obtained through the electric stimulation of ulnar and tibial nerves, and recorded from the abductor digiti minimi and extensor digitorum brevis, respectively. Results No definite F-wave was obtained by electric stimulation of ulnar nerve at 1 week after injection in 3 HFS patients (5 nerves). The Fave recorded from electric stimulation of ulnar and tibial nerves prolonged significantlyand Fdur from ulnar nerve increased significantly at 1 week after injection, but were not significantly different from those of pre-injection when recorded at 12 to 24 weeks after injection. No significant correlation of the altered F-wave parameters was found with the dosage of BTX-A. Conclusion Fdur and Fave could sensitively assess the remote effect of the local injection of BTX-A, the remote effect might be correlated with the distance between injected muscle and tested muscle, rather than the dosage of BTX-A.