Objective To explore the value of MRI combined with transvaginal ultrasonography in the diagnosis of cesarean scar pregnancy.Methods Appearances of MRI and transvaginal ultrasonography of cesarean scar pregnancy confirmed by surgery and pa-thology in 30 patients were retrospectively reviewed,and the diagnostic value of MRI and transvaginal ultrasonography in the cesare-an scar pregnancy were compared and analyzed.Results MRI and transvaginal ultrasonography clearly demonstrated the gestational sac at cesarean scar of lower uterine in 30 patients including cystic sacs in 22 and solid ones in 8.Both MRI and transvaginal ultra-sonography showed 5 gestational sacs were located at the myometrium and 1 7 extended to uterine cavity.Intrauterine hemorrhage was detected by MRI in 12 patients and by transvaginal ultrasonography in 8.Transvaginal ultrasonography found 14 yolk sacs and 12 embryonic buds with embryonic heartbeat in 8.However,MRI cannot differentiate yolk sac from embryonic bud,and not judge the embryonic heartbeat.Preoperatively,28 patients were diagnosed as caesarean scar pregnancy and other 2 were as trophoblastic tumor by MRI with an accuracy rate of 93%;meanwhile,27 were diagnosed as caesarean scar pregnancy and other 3 as trophoblastic tumor by transvaginal ultrasonography with an accuracy rate of 90% .There was no statistical difference in diagnostic efficiency be-tween MRI and transvaginal ultrasonography (P >0.05).Conclusion The diagnoses of cesarean scar pregnancy by both MRI and transvaginal ultrasonography is highly consistent with pathological results.The combination of two imaging modalities may maxi-mize their advantages and provide more detailed information for rapid diagnosis of cesarean scar pregnancy.

BACKGROUND:It has been found that abnormal apoptosis of bone tissue cells induced by abnormal iron metabolism plays an important role in the progression of osteoporosis. OBJECTIVE:To investigate the effect of naringin on iron metabolism and cell apoptosis in bone tissue of rats with osteoporosis. METHODS:Fifty 2-month-old female Sprague-Dawley rats were randomly divided into five groups with 10 rats in each group:sham group,osteoporosis group,naringin low-dose group,naringin high-dose group,and naringin high-dose+DKK-1 group.Except for the sham group,rat models of osteoporosis were established by removing bilateral ovarian tissues in the other groups.At 8 weeks after modeling,rats in the naringin low-and high-dose groups were given 100 and 400 mg/kg/d naringenin by gavage,respectively,and rats in the naringenin high dose+DKK-1 group were given 400 mg/kg/d naringin by gavage and subcutaneous injection of 25 mg/kg/d DKK-1,an inhibitor of the Wnt1 signaling pathway,for 7 consecutive days.Relevant indexes were detected after administration. RESULTS AND CONCLUSION:Compared with the osteoporosis group,naringin could enhance the bone mineral density and serum calcium and superoxide dismutase levels in rats(P<0.05),and reduce the serum levels of osteocalcin,malondialdehyde,and phosphorus(P<0.05),while DKK-1 could partially inhibit the interventional effect of naringin(P<0.05).Results from Micro-CT scanning,hematoxylin-eosin and TUNEL staining showed that compared with the osteoporosis group,naringin significantly improved bone microstructure and reduced the rate of cell apoptosis,while DKK-1 partially inhibited the interventional effect of naringin.Immunofluorescence staining results showed that compared with the osteoporosis group,naringin could reduce the oxygen content,anti-tartaric acid phosphatase expression,and elevate the expression of alkaline phosphatase in active tibia tissues(P<0.05),while DKK-1 could partially inhibit the interventional effect of naringin(P<0.05).Results from Prussian blue staining and immunohistochemical staining showed that compared with the osteoporosis group,naringin reduced iron deposition in bone and liver tissues as well as the expression of transferrin receptor 1(P<0.05),and elevated the protein expression of ferroportin 1(P<0.05)in bone tissue,and DKK-1 partially inhibited the intervention of naringin(P<0.05).PCR and western blot assay of tibia specimens showed that compared with the osteoporosis group,naringin decreased the expression of anti-tartrate acid phosphatase,transferrin receptor 1 and Bax(P<0.05),and elevated the expression of alkaline phosphatase,ferroportin 1,Bcl-2,Wnt1 and β-catenin(P<0.05),while DKK-1 partially inhibited the interfering effect of naringin(P<0.05).To conclude,naringin inhibits the progression of osteoporosis by reducing iron deposition and apoptosis rate in bone tissue,which may be related to the activation of the Wnt1 signaling pathway.