Objective:To explore the risk factors of recurrence after laparoscopic myomectomy and provide references for clinical prevention and treatment.Methods:The clinical data of 216 patients who underwent laparoscopic myomectomy in Ningjin County People′s Hospital from June 2016 to December 2018 were analyzed retrospectively. The recurrence rate at 12 months after the operation was followed up, and the risk factors influencing the recurrence after laparoscopic myomectomy were screened by univariate analysis and multivariate Logistic regression model.Results:After followed up for 12 months after the operation, 24 cases had recurrence, with a recurrence rate of 11.11%(24/216). Univariate analysis showed that the recurrence after laparoscopic myomectomy was significantly correlated with surgical age, age at menarche, number of fibroids, uterine size, and gonadrotropin releasing hormone agonist (GnRH-a) treatment after the operation ( P<0.05), but was not significantly correlated with body mass index, fibroid size, fibroid type, and pregnancy after the operation ( P>0.05). Multivariate Logistic regression analysis showed that surgical age ≥ 35 years old ( OR=1.289, 95% CI 1.013-1.641), age at menarche <13 years old ( OR=1.765, 95% CI 1.167 - 2.669), and number of fibroids ≥ 2 ( OR=2.487, 95% CI 1.442 - 4.288) were independent risk factors for recurrence after laparoscopic myomectomy ( P<0.05), while GnRH-a treatment after the operation ( OR = 0.696, 95% CI 0.510-0.951) was its protective factor ( P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve of surgical age ≥ 35 years old, menarche age <13 years old, and number of fibroids ≥ 2 for predicting recurrence after laparoscopic myomectomy was 0.641 (95% CI 0.573 - 0.705), 0.719 (95% CI 0.654 - 0.778) and 0.622 (95% CI 0.554 - 0.687), and age at menarche had the greatest diagnostic efficiency. Conclusions:Surgical age ≥ 35 years old, age at menarche <13 years old, and number of fibroids ≥ 2 are independent risk factors for recurrence after laparoscopic myomectomy. Intraoperative ultrasound and postoperative GnRH-a treatment can help reduce the risk of postoperative recurrence.

Objective To explore the risk factors of diabetic nephropathy.Methods According to the excretion rate of proteinuria,90 patients were divided into 3 groups:normal diabetic proteinuria group (DM),diabetic micro-proteinuria group (DN1),and clinical diabetic proteinuria group (DN2).We compared patients'ages,diabetic course,cholesterol,triglyceride,glycosylated hemoglobin,high density lipoprotein cholesterol (HDL),low density lipoprotein cholesterol (LDL),serum p-selectin,serum C-reactive protein,urinary monocyte chemotactic protein,and proteinuria excretion rate.Logistic regression analysis was used to analyze the relation between DN and various factors.Results Differences among these groups were statistically significant in type 2 diabetic course,HDL,LDL,p-selectin,C-reactive protein,glycosylated hemoglobin,and urinary monocyte chemotactic protein (P ＜ 0.05).Logistic regression analysis showed that diabetic course,LDL,C-reactive protein,p-selectin,and urinary monocyte chemotactic protein were independent risk factor (OR values were 2.238,1.062,6.723,1.166,and 1.046).Conclusions Occurrence and severity of DN had relationship with course of diabetes,microvascular lesions,and inflammatory reaction.Emphasis on monitoring and evaluation of the DN-related factors would contribute to the prevention and treatment of DN.

Objective:To explore the levels of serum adiponectin,insulin growth factor Ⅰ (IGF-Ⅰ) and prealbumin in preterm infants,and analyze their correlation with preterm EUGR infant.Methods:321 cases of preterm infants who were born in our hospital and transferred to neonatal department in 24 hours from January,2014 to January,2016 were enrolled in the present study.According to the weight at discharge,they were divided into the EUGR group and the non EUGR group,the growth and development as well as the levels of serum adiponectin,IGF-Ⅰ and PA in the two groups were compared.Results:The occurrence rate of EUGR was 55.76％ (179/321) in the 321 cases ofpreterm infants;the weight of EUGR group was significantly lower than that of the non EUGR group at 42 th days and three months after birth(p＜0.05).The SDS of both groups were all negative,and that of EUGR group was significantly lower than non EUGR group (p＜0.05).The levels of serum adiponectin,IGF-Ⅰ and PA of both groups were significantly lower than the control group at seventh days of birth,and the PA level of EUGR group was significantly lower than non EUGR group (p＜0.05).There was no significant difference in the serum adiponectin and PA levels between 7 days and 14 days in EUGR group (P ＞ 0.05),however,the serum adiponectin and PA levels in the non EUGR group was obviously increased and significantly higher than that of the EUGR group (p ＜ 0.05).The level of IGF-Ⅰ in both groups keep unchanged during two weeks (P＞0.05).Conclusion:The lower levels of serum adiponectin,IGF-Ⅰ and PA were closely related to the EUGR of preterm infants,which could be used as biochemical indexes to early diagnosis of EUGR.

Objective To investigate the clinical value of 18F-FDG PET/CT in staging,therapeutic response evaluation,relapse early detection and prognostic prediction of follicular lymphoma (FL).Methods Twenty-eight patients (12 males,16 females; average age 57 (36-82) years) with pathologically confirmed FL from December 2005 to January 2013 were enrolled.All patients underwent 18F-FDG PET/CT before treatment.The SUVmax of different staging groups,different pathological grade groups (high:3a+3b; low:1+2) was compared.Seventeen of 28 patients underwent PET/CT after chemotherapy and received phone follow-up (10-88 months) to monitor the progress of treatment.Survival difference was analyzed.Mann-Whitney u test,Wilcoxon signed-rank test and Kaplan-Meier survival analysis were used for data analysis.Results (1) The initial clinical staging without 18F-FDG PET/CT based on Ann Arbor standard changed in 4 cases (up-staging in 3 cases,down-staging in 1 case) after the PET/CT scan.The 18F-FDG uptake (SUVmax) in patients of stage Ⅰ/Ⅱ and stage Ⅲ/Ⅳ was 10.1±3.2 and 11.5±4.9,respectively (Z=-0.619,P＞0.05).The SUVmax in patients of the low grade group (6.9±3.6,n=15) was significantly lower than that of the high grade group (12.4±5.6,n=13) (Z=-3.706,P＜0.01).(2) 17 patients underwent PET/CT scan both before and after chemotherapy,the pre-treatment SUVmax and post-treatment SUVmax were significantly different in CR+PR group (10.8±5.1 vs 3.4±2.3; Z=-2.312,P＜0.05),while there was no significant difference in SD+PD group (11.2±6.9 vs 7.8±3.3; Z=-1.153,P＞0.05).There was a significant difference in the median progress-free survival time between the CR+PR group and the SD+PD group (48 months vs 26 months; x2 =4.207,P＜0.05).Conclusion 18F-FDG PET/CT has an advantage in clinical staging,therapeutic evaluation,relapse monitoring and prognosis predicting of FL.

Objective To investigate the prognostic value of interim and post-therapy 18F-FDG PET/CT in patients with DLBCL.Methods A retrospective analysis was conducted in 110 patients (62males,48 females; median age 52 years) with newly diagnosed DLBCL.Forty-two patients underwent interim PET/CT after 4 cycles chemotherapy,44 patients underwent post-therapy PET/CT after 6-8 cycles of chemotherapy,and 24 patients underwent both interim PET/CT and post-therapy PET/CT.Interim and post-therapy PET/CT status (i.e.,positive or negative) were visually interpreted according to criteria of the International Harmonization Project.Three-year progression-free survival (PFS) and 3-year overall survival (OS) was compared between the subjects with positive or negative PET/CT results.x2 test and KaplanMeier analysis were used for data analysis.Results Interim 18F-FDG PET/CT results were positive in 28cases and negative in 38 cases.The median PFS and OS were 20 and 28 months in patients with positive scan results,those were 37 and 39 months in patients with negative results,respectively.Three-year PFS and 3-year OS rates were 17.9％(5/28) and 35.7％(10/28) in patients with positive interim PET/CT results,those were 52.6％ (20/38) and 55.3％ (21/38) in patients with negative results (x2 =8.285,P ＜0.01,x2=2.473,P＞0.05,respectively).Post-therapy 18F-FDG PET/CT results were positive in 20 cases and negative in 48 cases.Median PFS and OS were 21 and 26 months in patients with positive results,those were 54 and 57 months in patients with negative results.Three-year PFS and 3-year OS rates were 20.0％(4/20) and 25.0％ (5/20) in patients with positive results at post-therapy PET/CT,those were 77.1％(37/48) and 83.3％ (40/48) in patients with negative results (x2=19.215,21.462,both P＜0.01).Conclusions Post-therapy 18F-FDG PET/CT is useful to predict prognosis of patients with DLBCL.However,the value of interim PET/CT may be limited in terms of prognosis prediction.

Objective To summarize the imaging manifestations of 18F-FDG PET/CT in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).Methods From January 2008 to June 2012,31 patients (18 males,13 females,average age:42 years) with sHLH were enrolled.All patients were divided into 3 groups:malignancy associated HLH (MAHLH) group (n =13),infection associated HLH (IAHLH) group (n =13) and rheumatosis associated HLH (RAHLH) group (n =5).They all underwent 18F-FDG PET/CT and SUVmax of lesions in each group was calculated.One-way analysis of variance and two-sample t test were used to analyze the SUVmax.Results Twenty-three patients were found splenomegaly with high FDG uptake,including 4 RAHLH patients,9 IAHLH patients and 10 MAHLH patients.The splenetic FDG uptake values (SUVmax) of RAHLH,IAHLH and MAHLH groups were 3.16±0.61,5.67±3.37 and 6.04±3.06,respectively (F=1.051,P＞0.05).The SUVmax of enlarged lymph nodes in IAHLH (n=8) and MAHLH groups (n =7) was 5.35± 1.69 and 10.14±5.24,respectively (t =-2.456,P＜0.05).Increased uptake in bone marrow was found in 17 patients,including 1 RAHLH patient,7 IAHLH patients and 9 MAHLH patients.The SUVmax of bone marrow in IAHLH and MAHLH patients was 5.31±2.05 and 6.36± 3.71 respectively (t=-0.670,P＞0.05).There were 10 cases of hepatomegaly,but only 4 of them had intense FDG uptake (SUVmax 4.9-10.2).The SUVmax of RAHLH,IAHLH and MAHLH groups was 3.02± 1.31,5.62±2.45 and 8.15±4.38,respectively (F=9.123,t=2.562,5.236,3.030,all P＜0.05).Conclusions RAHLH mostly showed splenomegaly with high FDG uptake,IAHLH and MAHLH both showed splenomegaly with lymph node and bone marrow invasion.The SUVmax of MAHLH was the highest.18F-FDG PET/CT imaging manifestations of sHLH may be helpful to improve the diagnostic accuracy.

Objective To evaluate the clinical value of 18F-FDG PET-CT in monitoring response to therapy in patients with follicular lymphoma (FL) staging Ⅲ-Ⅳ.Methods The clinical data of 20 patients with FL were analyzed retrospectively.All patients underwent PET-CT at three times:baseline,after 3-4 cycles of chemotherapy,and end of treatment.Kaplan-Meier method was used to analyze the survival of patients.Results 14 patients achieved CR at the interim PET-CT,all patients achieved CR at post therapy PET-CT:all patients were alive with no evidence of disease in the follow-up.2 patiens achieved PR at the interim PET-CT,and 1 patient achieved CR,and 1 patient was PD,at post therapy PET-CT,all patients were relapsed in the follow-up.4 patients achieved PD,and all patients were changed the chemotherapy plan.At post therapy PET-CT,2 patients achieved CR,1 patient achieved PR,and 1 patient was PD,1 patient was no evidence of disease,2 patients were relapsed,and another was died in the follow-up.The negative predictive values (NPV) of the interim and the post therapy PET-CT were 100 ％ (14/14),88.2 ％ (15/17) respectively.The interim PET-CT was no significantly correlated with PFS (P =0.135),while the post therapy PET-CT was significantly correlated with PFS (P =0.0006).Conclusion 18F-FDG PET-CT is useful to monitor response to chemotherapy in patients with FL staging Ⅲ-Ⅳ,and set personalized treatment plan.

Objective To evaluate the value of quantitative analysis of contrast‐enhanced ultrasonography (CEUS) in differentiating acute rejection(AR) from acute tubular necrosis(ATN) of transplant kidney. Methods Total of 67 kidney recipients were examined with conventional US and CEUS. Biopsies were performed in 37 patients, 26 patients were with AR, 11 with ATN, 30 patients as control group. The hemodynamic parameters (PSV and RI) were measured on infrarenal artery with conventional US, while CEUS quantitative analysis was performed on the cortex, pyramid and interlobar artery by time‐intensity curve (TIC). TIC parameters including rise time (RT ), time to peak (TTP), mean transit time (mTT ) were compared among three groups. In addition, the reproducibility of TIC parameters was evaluated. Results The RI in AR group was significantly higher than that in control group, but there were no significant differences of RI between AR and ATN groups. TIC parameters including RT, TTP were with high reproducibility (ICC> 0 7.5). Compared to the other two groups, the RT and TTP of the pyramid, ΔRTm‐c, and ΔTTPm‐c were significantly longer in AR group, the receiver operating curves (ROC) analysis demonstrated that ΔRTm‐c had the highest accuracy and RI had the lowest accuracy for detecting AR(areas under the curve were 0 7.86, 0 7.56, 0 7.49, 0 7.36 and 0 4.98, respectively). High sensitivity and specificity(78 3.% and 73 5.%, respectively) were shown when using 4 6.2 s as a cutoff point of ΔRTm‐c to diagnose AR. Conclusions Quantitative analysis of CEUS could detected the changes of the microcirculation perfusion in kidney grafts with AR and ATN, which might be superior in the diagnosis of AR compared with conventional US.

Objective To study the value of quantitative analysis of contrast-enhanced ultrasound in diagnosing acute rejection of kidney graft.Methods Sixty-seven patients with normal kidney grafts and thirty-five patients with acute rejection were recruited.In conventional ultrasound,the peak systolic velocity (PSV) and resistance index (RI) of segmental artery and interlobar artery were measured.In quantitative analysis of contrast-enhanced ultrasound,four regions of interest including renal cortex,medulla,segmental artery and interlobar artery were drew and three parameters including rising time(RT),time to peak(TTP) and mean transit time(mTT) were obtained.In addition,the difference in RT,TTP and mTT between the renal cortex and interlobar artery,as well as medulla and interlobar artery were calculated.Results The differences of PSV in interlobar artery between the two groups were statistically significant (P ＜0.05).The time-intensity curves of the whole kidney grafts,and the difference in RT and TTP between the renal cortex and interlobar artery were statistically different between two groups (P ＜0.05).Conclasions Quantitative analysis of contrast-enhanced ultrasound proved a quantitative method for diagnosing kidney allograft acute rejection.