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 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 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 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 clinical value of 18F-FDG PET-CT imaging on monitoring recurrence, metastasis and therapeutic decision-making in small intestinal adenocarcinoma patients after radical surgery. Methods Twenty-two patients were enrolled, who underwent surgical operation before received PET-CT scan. PET-CT findings were retrospectively observed to compare with the results of follow-up [postoperative pathology and (or) long-term clinical follow-up]. The roles of PET-CT on therapeutic decision-making were then investigated. Results Among 22 patients, 14 cases were finally diagnosed as recurrence and (or) metastasis, the other 8 cases as disease-free survival after long-term follow-up. According to PET-CT, 13 cases were diagnosed as recurrence and (or) metastasis (including 12 true-positive and 1 false-positive), and 9 cases were negative (including 2 false-negative). The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET-CT were 85.7 % (12/14), 87.5 % (7/8), 86.4 %(19/22), 92.3%(12/13) and 77.8%(7/9), respectively. The therapeutic decisions were changed in 10 patients (10/22, 45.5 % ) based on PET-CT results. Conclusion 18F-FDG PET-CT has an important clinical value on the detection of recurrence and (or) metastasis of small intestinal adenocarcinoma, which is an ideal method of monitoring.

Objective To explore the potential value of contrast-enhanced ultrasonography (CEUS) in diagnosis of renal pelvic carcinoma. Methods The ultrasonogram of conventional ultrasound and CEUS were analyzed retrospectively in 22 patients of renal pelvic carcinoma proved pathologically. The size, echo, boundary and color flow signal of renal pelvic lesions were observed with conventional ultrasound. The enhancement modality and phase of tumors were also observed with CEUS, including wash-in and wash-out time, as well as the perfusion appearances. Results The maximum diameters ranged from 1.5 cm to 8.5 cm in 22 renal pelvic tumors. Conventional ultrasound detected flat mass in 7 tumors, irregular mass in 15 tumors; the same side hydronephrosis in 11 patients. Color Doppler flow imaging (CDFI) disclosed fairly rich flow signal of 5 tumors, a small amount of flow signal around tumor in 9 tumors and no-flow signal in the rest tumors. CEUS detected the cortical phase enhancement in all renal pelvic tumors, including synchronously enhancement in 8 tumors and delayed enhancement in 14 tumors. In peak time, hypoechogenicity compared to the normal renal cortex was showed in 18 tumors, hyperechogenicity in 3 tumors and isoechogenicity in 1 tumor. Fast wash-out in medulla phase was displayed in 20 tumors, isochronously wash-out in 1 tumor and delayed wash-out in 1 tumor. The diagnostic accuracy of the conventional ultrasound and CEUS was 63.64% (14/22) and 81.82% (18/22), respectively. Conclusion CEUS can depict blood flow supply and improve the diagnostic rate of renal pelvic carcinoma.

Objective To compare the medical selection standards of flying cadets in the nervous and mental system between Air Force of PLA(PLAAF) and the US Air Force(USAF), and to offer suggestions on revising PLAAF medical standards for flying cadets .Methods All our candidates who had participated in the final medical selection of flying cadets were subjected to neurological examinations , and determined as qualified or not according to USAF Medical Standards Directory.Results 123 people were disqualified during the neurological examination , accounting for 1.1% of the total. According to USAF Medical Standards Directory , 13 of them were disqualified , 24 of them were qualified , and 86 of them needed a second examination .There was marked difference between disqualification rates of PLAAF and USAF .Conclusion There are some differences in medical selection standards for flying cadets in the nervous and mental system between PLAAF and USAF, and we could revise PLAAF standards using USAF standards for reference .

Objective To evaluate the diagnostic value of virtual touch tissue quantification (VTQ) in the diagnosis of renal allograft fibrosis.Methods The renal allografts of 82 patients with biopsies or nephrectomy were assessed by virtual touch quantification.The renal allograft fibrosis was categorized according to the 2005 updated Banff criteria for a G0～G3 grade.All the results were compared among four groups.Results The mean SWV values in G0～G3 were (2.39 ± 0.31)m/s,(2.45 ± 0.34)m/s,(2.58 ± 0.18) m/s,(3.11 ± 0.40)m/s,respectively.There were no significant differences in the mean SWV value between G0 and G1 group,or between G1 and G2 group(P ＞0.05).There were significant differences in the mean SWV value between G0～G2 and G3 group,or between G0 and G2 group(P ＜0.05).Stiffness of renal allograft was significantly correlated to the mean SWV value (Spearman r =0.671,P ＜0.001).According to the area under the ROC curve,the sensitivity and specificity of SWV (area under ROC curve =0.847,cut-off=2.64 m/s) for grade ≥G2 was 78.9％ and 79.5％ respectively.Conclusions Stiffness measured by VTQ reflects the interstitial fibrosis in renal allograft.VTQ technique might be a new tool to identify patients with chronic allograft injury.