Objective To evaluate the diagnostic value of combining real-time three-dimensional ultrasonography with three-dimensional power Doppler ultrasound for the patients with small ovarian masses.Methods One hundred and seven patients with small ovarian masses were examined with real-time three-dimensional ultrasonography and three-dimensional power Doppler ultrasound.The images and the relationship between benign and malignant small ovarian masses were analyzed.Results Benign and malignant small ovarian tumors had statistical differences in these three parameters:the envelope,inner wall and whether there being central vessels.The sensitivity and specificity of combining real-time threedimensional ultrasonography with three-dimensional power Doppler ultrasound to diagnose malignant small ovarian tumors were 92.9% and 97.3% respectively.Conclusions Combining real-time three-dimensional ultrasonography with three-dimensional color Doppler energy can be used to diagnose the small ovarian masses and provide valuable information to identify malignant ovarian tumors.A small ovarian tumor with incomplete envelope,irregular inner wall and there being central vessels indicated the possibility of being malignant.

Background:Therapeutic drug monitoring(TDM)has emerged as the important method for managing loss of response to infliximab.The effect of reactive and proactive TDM on clinical outcomes in inflammatory bowel disease(IBD)is uncertain.Aims:To evaluate the effect of proactive and reactive TDM of infliximab on the prognosis of patients with IBD.Methods:Clinical data of 99 IBD patients treated with IFX from January 2017 to October 2021 at the First Affiliated Hospital of Air Force Military Medical University were retrospectively analyzed,including 34 patients with proactive TDM and 65 patients with reactive TDM.The rate of treatment failure,IBD-related surgery or hospitalization were compared between the two groups.Logistic regression analysis was used to determine the independent risk factors of treatment failure.Results:The median follow-up of the patients was 21(13,32)months.The rate of treatment failure,IBD-related hospitalization rate of proactive TDM group were significantly lower than those of reactive TDM group(P<0.05),however,no significant difference in IBD-related surgery rate was found between two groups(P=0.081).Univariate analysis showed that ileocolonic resection before TDM,antibodies to infliximab(ATI)and reactive TDM might be correlated with treatment failure(P<0.05).Logistic regression analysis showed that reactive TDM(OR=5.829,95%CI:1.070-31.754,P=0.042)was the risk factor of treatment failure,and ileocolonic resection before TDM(OR=0.119,95%CI:0.019-0.736,P=0.022)was the protective factor of treatment failure.Conclusions:Compared with reactive TDM group,proactive TDM can significantly decrease the rate of treatment failure and IBD-related hospitalization rate.Reactive TDM is the risk factor of treatment failure,and ileocolonic resection before TDM is the protective factor of treatment failure.