Objective To quantitatively study the correlation of the distance of pulmonary valve to pulmonary artery bifurcation (DPVB) of normal fetuses in second and late trimester with the fetal biometric parameters using fetal echocardiography.Methods The distances of pulmonary valve to pulmonary artery bifurcation in end-systole (DPVBs) and in end-diastole (DPVBd) were measured in a standard short axis view or right ventricular outflow tract view using fetal echocardiography on 419 normal fetuses.The gestation ages ranged from 20 to 35+ weeks.Fetal non-cardiac biometric parameters including biparietal diameter (BPD),femoral length (FL) and gestation age (GA) based on menstrual age,pulmonary valve annulus diameters (PA) at end-systole were measured.The correlation between DPVBs,DPVBd and non-cardiac biometric parameters were analyzed.Results In normal fetuses,the DPVBs was (1.14±0.24)cm with a range of 0.67 to 1.61 cm,the DPVBd was (0.93±0.20)cm with a range of 0.53 to 1.33 cm.The DPVBs and DPVBd were increased with the growth of GA,and were positively correlated with GA,BPD,FL and PA (r=0.827,0.798,0.793,0.769;0.802,0.764,0.773 and 0.771,respectively,all P<0.001).The linear regression equations between DPVBs,DPVBd and GA,BPD,FL,PA were:Y=0.054×GA-0.369,Y=0.184×BPD-0.179,Y=0.217×FL+0.011,Y=1.602×PA+0.156,Y=0.045×GA-0.330,Y=0.152×BPD-0.157,Y=0.182×FL-0.018,Y=1.380×PA+0.080.Conclusions In normal fetuses,the DPVBs and DPVBd increase with the growth of GA,and have good correlation with GA,BPD,FL and PA,respectively.Normal reference ranges of DPVBs and DPVBd have been provided.These normative data may become a new tool for assessment of fetal heart,especially has potential applications in screening of complex congenital heart defects.

Objective:To establish the prediction model of postoperative Gleason score (GS) risk of prostatic cancer (PCa), and to compare the diagnostic efficacy of the model and each independent risk factor for PCa medium-high risk group.Methods:The clinical data of 362 patients who accepted transrectal prostate biopsy in the Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from January 2018 to December 2019 were analyzed retrospectively, and a total of 343 patients with prostate cancer who met the enrollment criteria were selected. According to the GS grading system, these patients were divided into low risk group, moderate risk group and high risk group. At first, the single factor analysis and Spearman rank correlation were used to find out the effective indicators with good correlation with GS risk. Then, multiple linear regression equation was applied for multi-factor analysis to obtain the independent risk factors and the prediction model for predicting GS risk, and then the ROC curve was used to compare the diagnostic efficacy of each independent risk factor and prediction model for PCa medium-high risk group.Results:In the single factor analysis, the differences of all indicators in GS risk were statistically significant (all P<0.05). In the correlation analysis with GS risk, except for the indicators of prostate volume (all P>0.05), the other indexes had linear correlations with the different risks of GS (all P<0.05). Among them, the total prostate specific antigen and two-dimensional ultrasound (2D-US) score showed moderate positive correlations( rs=0.402, 0.579, all P<0.001), contrast enhanced ultrasound (CEUS) score showed a high positive correlation ( rs=0.709, P<0.001), and the rest indexes showed low positive correlations. Multiple linear regression was used to obtain two independent risk factors of 2D-US score ( X1) and CEUS score ( X2) for the prediction of GS risk, then, a prediction model was established: Y=0.863+ 0.066 X1+ 0.27 X2, the corresponding linear coefficient differences were statistically significant(all P<0.05). By the ROC analysis, the areas under the curves of 2D-US score, CEUS score and the prediction model were 0.838, 0.906 and 0.907, respectively. Conclusions:2D-US score and CEUS score are independent risk factors for predicting postoperative GS risk, and the diagnostic efficacy of the prediction model is higher than those of the 2D-US score and CEUS score for the medium-high risk group.

Objective:To investigate the clinical value of monitoring serum complement C1q/tumor necrosis factors-associated protein 3 (CTRP3) and lipoprotein-associated phospholipase A2(Lp-PLA2) levels in patients with coronary heart disease, especially patients with acute myocardial infarction (AMI).Methods:This case-control study included 99 patients with angina pectoris aged (60.4±10.4) years, 105 patients with AMI aged (61.7±14.3) years, and 60 healthy individuals aged (43.6±9.5) years. Serum CTRP3 was detected by ELISA, and Lp-PLA2 was detected by automatic biochemical analyzer. Logistic regression analysis was performed to determine the correlation between CTRP3, Lp-PLA2 in angina pectoris and AMI patients. The diagnostic efficiency of each index was analyzed by receiver operating characteristic (ROC) curve.Results:Serum Lp-PLA2 was significantly higher in AMI group than in angina pectoris group ([313.1±68.1] U/L vs [205.8±71.4] U/L, P<0.001), while CTRP3 was significantly lower in AMI group than in angina pectoris group ([64.2±18.5] μg/L vs [84.8±25.0] μg/L, P<0.001). Logistic regression showed that serum CTRP3 was negatively correlated with AMI ( OR=0.964, 95% CI 0.935-0.993, P=0.019), and Lp-PLA2 was positively correlated with AMI ( OR=1.020, 95% CI 1.008-1.032, P=0.001). ROC analysis showed that the AUC (95% CI) of AMI diagnosed by CTRP3 was 0.753 (0.685-0.821), P<0.001; the AUC (95% CI) of AMI diagnosed by Lp-PLA2 was 0.884 (0.833-0.935), P<0.001; the AUC (95% CI) of diagnosis efficacy by combined indices was 0.910 (0.870-0.950), P<0.001. Conclusions:Lower serum CTRP3 and higher serum Lp-PLA2 levels are associated with increased risk for AMI. Combined detection of both indices can improve the diagnostic efficacy of AMI.

Objective:To compare the diagnostic values of C-TIRADS, ACR-TIRADS and EU-TIRADS.Methods:According to the classification methods of the 3 guidelines, the ultrasonographic features of 283 thyroid nodules from 266 patients in Sir Run Run Shaw Hospital from January 2019 to June 2020 were analyzed retrospectively. The pathological results were taken as the gold standard, the malignant percentage of different classification was calculated, the ROC curve was plotted, the area under the ROC curve (AUC) and the best diagnostic cut-off value were calculated, and the diagnostic values of the three guidelines were compared. According to the FNA recommendations of the guidelines, the recommended number of thyroid nodules and the detection rate of malignant nodules in different guidelines were analyzed.Results:The AUCs of C-TIRADS, ACR-TIRADS and EU-TIRADS were 0.80, 0.66, 0.61, respectively. The AUC of C-TIRADS was higher than those of ACR-TIRADS and EU-TIRADS ( P<0.001, P<0.001). The best diagnostic cutoff values of C-TIRADS, ACR-TIRADS and EU-TIRADS were 4C, 5 and 5, respectively. Under the critical points, the sensitivities of the 3 guidelines were 95.27%, 98.10%, 99.53%, the specificities were 54.17%, 33.33%, 20.83%, respectively. There was no significant difference in the number of FNA recommendations among the 3 guidelines(all P>0.05), their FNA recommendations were highly consistent (Kappa>0.9). Conclusions:The diagnostic value of C-TIRADS in the classification of benign and malignant thyroid nodules is higher than those of ACR-TIRADS and EU-TIRADS. The best critical value for diagnosis of thyroid nodules is C-TIRADS 4C. The three guidelines are similar in the number of FNA recommendations and the detection rate of malignancy.

To investigate the characteristics of traditional Chinese medicine (TCM) syndromes and their elements in people with subhealth fatigue.

The diagnostic technology of acute stroke by microwave imaging has the advantages of being non-ionizing, fast, small, and low-cost. Therefore, this technology is expected to become an auxiliary or alternative means to CT and MRI technology. As the signal transmitting and receiving device of the microwave imaging system, the antenna has an important influence on the performance of the imaging system. At present, there are many antennas with different performances used in imaging systems, but there is a lack of clear evaluation criteria for them. In this paper, several typical antennas were introduced, their advantages and disadvantages from the perspective of bandwidth and near-field were analyzed, and the common requirements of imaging systems for antennas and the performance indicators of various types of imaging systems were summarized. Moreover, the development trend of antenna technology for microwave imaging was pointed out to provide a reference for the study of stroke microwave imaging technology.

Objective To investigate the risk factors of postoperative fecal contamination in children pa-tients with Hirschsprung's disease(HSCR),and to construct and evaluate the risk predictive model.Methods The clinical data in 377 children patients with HSCR in 3 class 3A hospitals in Guangxi from Janu-ary 2016 to June 2021were retrospectively analyzed by adopting the convenience sampling method.The pa-tients were divided into the modeling group(n=264)and testing model group(n=113)with a ratio of 7∶3.The risk factors of postoperative fecal soiling were analyzed by the single factor and multiple factors,and the risk predictive model was constructed.The receiver operating characteristic(ROC)curve was used to detect the discriminative ability of the model and the H-L test was used to determine the goodness of fit of the mod-el.The model was prospectively validated in 21 children patients with HSCR from August to December 2021.Results Among 377 children patients with HSCR,the fecal soiling occurred in 131 cases with a incidence rate of 34.75％.The constructed predictive model of fecal contamination risk after HSCR operation:logit(P)=-2.385+1.697 × special type of megacolon+0.929 × Soave+0.105 × length of bowel resection+2.065 × il-literate caregivers+0.808 × caregivers'implementation of postoperative diet+0.867 × postoperative defecation training by caregivers.The area under the curve(AUC)in the modeling group was 0.849,the Yoden index was 0.53,the optimal critical value of the model was 0.32,the sensitivity was 76.00％,and the specificity was 77.00％.The H-L test,X2=6.649,P=0.575.AUC of the testing model group was 0.736,the sensitivity was 81.25％,and the specificity was 78.46％.The prospective validation results showed that the sensitivity and specificity of the model were 66.67％and 100％respectively.Conclusion The constructed model has good i-dentification and predictive ability.

Objective: To investigate the evaluating ability of real-time three-dimensional contrast-enhanced ultrasound (RT-3D-CEUS) for morphology of hepatocellular carcinoma (HCC) before radiofrequency ablation (RFA) treatment. Methods: Sixty patients with 88 targeted lesions were enroll in this study, who have received RFA in Hangzhou Xiasha Hospital. The pretreatment imaging data of CEUS and RT-3D-CEUS were retrospective analysis. Morphological features were assessed according to the size and shape of the lesions, and were compared between two modalities with the post-treatment response as the reference standard. Results: The size of lesion measured by CEUS and RT-3D-CEUS was similar in 70 out of 88 lesions (group A). In the other 18 lesions, the size measured by RT-3D-CEUS was larger than that by CEUS (group B). For the shape analysis, 38 lesions were spheroid by CEUS and 34 lesions by RT-3D-CEUS; 47 lesions were oval by CEUS and 41 lesions by RT-3D-CEUS; 3 lesions were irregular by CEUS and 13 lesions by RT-3D-CEUS. There were 78 lesions which shape assessed by two modalities consistently (group A′), and the other 10 lesions with inconsistent shape by two modalities (group B′). Three months follow-up results showed that 4 lesions appeared tumor residue (5.7%) in group A′ and 6 lesions (33.3%) in group B′. There was significant difference between these two groups (P=0.004). In the group A′, there were 6 lesions (7.7%) showed tumor residue, and 4 lesions (40.0%) in group B′. The difference between these two groups was also significant (P=0.012). Conclusion RT-3D-CEUS could be used to assess the size and shape of HCC accurately which is associated with the response of RFA.