Objective To compare the effectiveness of two different modes of follicular aspiration(FA)guided by transvaginal ultrasound(TVU)in infertile patients with clomiphene citrate(CC)-resistant polycystic ovary syndrome(PCOS).Methods From December 2005 to December 2007,85 patients with CC-resistant PCOS were randomly divided into two groups.Group Ⅰ(thorough treatment)had the every possible small follicles being punctured and aspirated,while group Ⅱ(routine operation)only had the larger follicles being operated.These patients were monitored with TVU and testing the steroid hormone levels.The effect of the two methods on the hormone levels and rates of ovulation and pregnancy were analyzed.Results After the treatments,the cumulative rates of ovulation and pregnancy in the group Ⅰ were higher than those in the group Ⅱ 83.3%(25/30)vs 42.1%(16/38),?2=11.903,P=0.001;43.3%(13/30)vs 13.2%(5/38),?2=7.843,P=0.005].Moreover,the levels of luteinizing hormone(LH)and testosterone(T)were decreased significantly after the treatment in group Ⅰ (17.68?3.11)vs(11.58?1.84),t=9.220,P=0.000;(3.41?2.14)vs(1.47?1.29),t=3.937,P=0.000],whereas those in group Ⅱ were not improved markedly (17.76?4.51)vs(16.11?3.53),t=0.229,P=0.062;(3.88?1.54)vs(3.72?1.27),t=0.995,P=0.326].Conclusions Thorough treatment that has the every possible small follicle being punctured and aspirated can significantly improve the endocrinological abnormalities,and increase the rates of ovulation and pregnancy in patients with CC-resistant PCOS.

Objective To estimate the diagnostic value of the patients of intrauterine pregnancy abortion (IUPA) of pregnancies of unknown location (PUL) with transvaginal power Doppler ultrasound (TV-PDU) combining Logistic regression model and receiver operating characteristics (ROC) curve.Methods Endometria of PUL were detected by TV-PDU during the early pregnancy.Serum β-HCG and progesterone were analyzed meanwhile.All variables were researched by multiple factors Logistic regression.Logistic regression equationg were established.ROC curve was constructed and the cut-off value of endometrial mnographic findings and clinical data to diagnose intrauterine pregnancy abortion were studied.The accuracy of every univariate and multivariable were evaluated and the validity and stability of the Logistic regression equation were tested.Results The RI value and PSV were included in the multivariate model 1 (M1),while the serum progesterone,type of endometrial resonance and gestation age were included in the multivariate model 2(M2).The area under the curve of M1,M2 were 0.887,0.976,respectivdy.Youden index and positive predictive value were 90.8%,87.5% and 12.213,8.000,respectively.Specificity and positive predictive value of M2 was lower than M1 which had a hisher accuracy.Diagnostic value were increased obviously by the use of M1 and M2 comparing with univariate and the stability was all righL Conclusions Possibility of IUPA could be predicted by TV-PDU simply,atraumaticly and efficiently.A close rehaion is found between the hemodypnmic parameter of endometria and the IUPA.

Purpose To quantitatively analyze the blood perfusion parameters after kidney transplantation with acute and chronic rejection by using contrast-enhanced ultrasonography (CEUS), in order to provide rapid assessment for rejection prognosis. Materials and Methods Thirty-one patients with kidney transplantation were followed up and divided into three groups according to clinical symptoms and graft biopsy results:normal group (n=6), acute rejection group (n=12) and chronic rejection group (n=13). CEUS was carried out to assess renal microcirculation perfusion. Results CEUS showed that the normal renal parenchyma was enhanced homogeneously whilst the rejected parenchyma was enhanced heterogeneously. The differences of area under the curve among the three groups was statistically signiifcant (F=37.102, P<0.01), with normal group >chronic rejection group > acute rejection group. The peak intensity in normal group was higher than that in acute rejection group (P<0.01), but it showed no difference with that in chronic group. In acute and chronic rejection groups, the arrival time and the time to peak intensity in interlobar artery and cortex were all later than those in normal group (P<0.05). The ascending slope of TIC in segmental artery, interlobar artery and cortex in the two rejection groups was both signiifcantly less than that in normal group. Conclusion CEUS is a valuable diagnostic tool in the evaluation of microcirculation perfusion in kidney graft, and can provide important reference for the prognosis of acute and chronic rejection after kidney transplantation.

INTRODUCTION: There are limited studies exploring functional improvement in relation to characteristics of patients who, following acute hospital care, receive inpatient rehabilitation in community hospitals. We evaluated the association of acute hospital admission-related factors with functional improvement on community hospital discharge. METHODS: We conducted a retrospective cohort study among patients who were transferred to community hospitals within 14-day post-discharge from acute hospital between 2016 and 2018. Modified Barthel Index (MBI) on a 100-point ordinal scale was used to assess functional status on admission to and discharge from the community hospital. We categorised MBI into 6 bands: 0-24, 25-49, 50-74, 75-90, 91-99 and 100. Multivariable logistic regression models were constructed to determine factors associated with categorical improvement in functional status, defined as an increase in at least one MBI band between admission and discharge. RESULTS: A total of 5,641 patients (median age 77 years, interquartile range 69-84; 44.2% men) were included for analysis. After adjusting for potential confounders, factors associated with functional improvement were younger age, a higher MBI on admission, and musculoskeletal diagnosis for the acute hospital admission episode. In contrast, a history of dementia or stroke; lower estimated glomerular filtration rate; abnormal serum albumin or anaemia measured during the acute hospital episode; and diagnoses of stroke, cardiac disease, malignancy, falls or pneumonia; and other chronic respiratory diseases were associated with lower odds of functional improvement. CONCLUSION Clinicians may want to take into account the presence of these high-risk factors in their patients when planning rehabilitation programmes, in order to maximise the likelihood of functional improvement.
Aftercare ; Aged ; Female ; Hospitals, Community ; Humans ; Inpatients ; Male ; Patient Discharge ; Retrospective Studies ; Stroke/complications* ; Stroke Rehabilitation

The ultrasonic manifestations of benign and malignant breast imaging-reporting and data system(BI-RADS)4 lesions overlap in some degrees,is able to result in unnecessary biopsy or untimely therapy.Accurate classifying the nature of BI-RADS 4 breast lesions can provide reliable references for clinical decision-making.The progresses of application of new ultrasonic technologies,including automated breast volume scanner,superb micro-vascular imaging,elastography,contrast-enhanced ultrasound and artificial intelligence for assisting diagnosis of BI-RADS 4 lesions were reviewed in this article.