Purpose Full-term fetal weight is closely related to the choice of delivery mode and perinatal mortality rate.Our aim is to explore the feasibility of magnetic resource image (MRI) with three-dimensional reconstruction and volume measurement in estimating fetal weight and its accuracy compared to ultrasound (US) examination.Materials and Methods Analyzed the MRI volume measurement of 61 fetuses delivered within 7 days after M RI and ultrasound examination in our hospital between November 2013 and March 2016 using MRI three-dimensional reconstruction.The fetal weight estimated by MRI was calculated by the equation developed by Baker et al and the US estimation of fetal weight was performed according to Haldlock et al,the MRI and US estimation of fetal weight were compared.Results 60 fetuses were included and qualified MRI three-dimensional reconstruction models,one was excluded because of frequent movement.The MRI estimation of fetal weight and the birth weight correlated significantly (r=0.927,P＜0.05).The MRI estimation of fetal weight had a lower percentage of random error than US (3.4％ vs 5.0％,P＞0.05),as well as mean absolute error [(172+ 114) g vs (227± 171) g,P＜0.05],but a higher percentage of relative error ≤ 10％ than US (95.0％ vs 78.3％,P＜0.05),with an underestimation in 90.0％ fetuses compared with birth-weight.Concision Full-term fetal weight estimation by using MRI with three-dimensional reconstruction and volume measurement is feasible and more accurate than ultrasound,but lower than the actual weight.This method can be applied in estimating fetal weight in the case of ultrasound examination limited.

Objective Comparison of the levator ani muscles in three-dimensional (3D) MRI-based models in women with and without pelvic organ prolapse at rest to analyze the morphological characteristics of levator ani muscles in women with POP. Methods Twenty-five women with POP and 22 women with normal pelvic support were selected from Nanfang Hospital of Southern Medical University. Axial, sagittal, and coronal T2-weighted pelvic magnetic resonance scans were obtained with the women in the supine position.The 3D models were reconstructed from the source images. Morphological changes was compared within the two groups of levator ani muscles, and the 3D models were measured to determine the levator ani muscle volume (LVOL), levator plate angle (LPA), levator hiatus width (LH-W) and length (LH-L), distance between symphysis and levator sling muscle (LSG). Results There were no puborectalis avulsions in control, in POP, 3 cases of avulsions just in left, 3 cases of avulsions just in right, 7 cases in bilateral. The shape of iliococcygeus were all dome-shaped in control, 11 cases were U-shaped and 14 cases were dome-shaped in POP. The shape of levator hiatus were 7 cases of U-shape, 12 cases of V-shape, 3 cases of irregular in control; 5 cases of U-shape, 4 cases of V-shape, 16 cases of irregular in POP. POP versus control: LH-L: (68.0 ± 8.9) versus (61.6 ± 7.2) mm (P<0.05); LH-W: (41.4 ± 3.9) versus (38.0 ± 3.2) mm (P<0.05); LSG-L: (29.6 ± 7.4) versus (24.6 ± 3.7) mm (P<0.05); LSG-R: (28.4 ± 6.8) versus (23.9 ± 3.2) mm (P<0.05); LPA: (51.0 ± 11.3)° versus (40.6 ± 6.3)° (P<0.05); LVOL: (23.7 ± 5.8) versus (24.6 ± 5.0) cm3 (P>0.05). Conclusions It is possible to assess the morphologic changes of levator ani by using 3D MRI models objectively, our 3D data demonstrate larger in LVOL, LPA, LH-W, LH-L, LSG, and the changes in shape. It is helpful to diagnose and assess the specific situation of patients POP in clinic.

Objective:To discuss the effects of biofeedback dialysis mode of blood volume monitoring on cardiac function in the maintenance hemodialysis (MHD) patients with intra-dialytic hypotension (IDH).Methods:40 patients who underwent maintenance hemodialysis in Suzhou Hospital Affiliated to Nanjing Medical University from September 2018 to December 2020 and had IDH for many times were selected. They were divided into standard dialysis (SHD) group and biofeedback dialysis mode of blood volume monitoring (BVM) group, with 20 cases in each group. In the first 12 weeks of the first stage, the patients in both groups were treated with standard dialysis, and in the second 12 weeks, they were treated with maintenance hemodialysis according to standard dialysis and biofeedback dialysis mode of blood volume monitoring. The incidence of IDH and the changes of blood pressure before and after dialysis, body weight, ultrafiltration volume, B-type brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPW), inlet ventricular septal defect (IVSD), mitral valve flow spectrum E/A value (E/A) and left ventricular mass index (LVMI) were observed.Results:(1) In the second stage of treatment, the number of IDH requiring nursing intervention in BVM group was significantly lower than that in SHD group ( P<0.05). (2) The difference of blood pressure change in BVM group during the second stage of treatment was significantly lower than that in the first stage and SHD group ( P<0.05). (3) In the second stage of treatment, the ultrafiltration volume of patients in BVM group was significantly higher than that in the first stage, and the BNP and body weight were significantly lower than that in the first stage (all P<0.05). However, the body weight, BNP and ultrafiltration volume of patients in SHD group had no significan change in the two stages of treatment (all P>0.05). (4) After treatment, the LVID, LVPW, IVSD and LVMI in BVM group were significantly lower than those before treatment, and LVEF and E/A were significantly higher than those before treatment (all P<0.05). However, there was no significant change in echocardiographic indexes in SHD group before and after treatment (all P>0.05). Conclusions:The biofeedback dialysis mode of blood volume monitoring can significantly reduce the occurrence of IDH, and this dialysis mode can effectively improve the cardiac function of MHD patients with hypotension.

BACKGROUNDHypoxia promotes tumor angiogenesis and hypoxia-inducible factor-1 alpha (HIF-1α) plays a pivotal role in this process. Recently identified pro-angiogenic factor, semaphorin4D (Sema4D) also promotes angiogenesis and enhances invasive proliferation in some tumors. Furthermore, tumor-associated macrophages (TAMs) can increase the expression of HIF-1α and Sema4D in cancer cells and thus influence tumor growth and progression. The purpose of this study was to evaluate the effect of TAMs on the expression of Sema4D and HIF-1α and the impact of biologic behavior in colon cancer cells.

METHODSImmunohistochemistry was used to analyze HIF-1α and Sema4D expression in 86 curatively resected colon cancer samples and 52 normal colon tissues samples. The relationship between their expression and clinicopathological factors was analyzed. Furthermore, macrophage-tumor cell interactions, such as metastasis, angiogenesis, were also studied using in vitro co-culture systems. Statistical analysis was performed using SPSS 17.0 software (SPSS Inc., USA). Differences between two groups were analyzed with Student's t test.

RESULTSHIF-1α (58%) and Sema4D (60%) were expressed at a significantly higher level in tumors than in normal tissues (P < 0.01, for both). Furthermore, HIF-1α and Sema4D expression was significantly correlated with lymphatic metastasis, specific histological types and TNM stages (P < 0.05), but not with age and tumor size (P > 0.05). Sema4D expression was correlated with that of HIF-1α (r = 0.567, P < 0.01). TAMs markedly induced HIF-1α and Sema4D expression in colon cancer cells and subsequently increased their migration and invasion.

CONCLUSIONSHIF-1α and Sema4D expression are closely related to lymphatic metastasis, specific histological types and TNM stages in colon cancer. Furthermore, TAMs promote migration and invasion of colon cancer cells and endothelial tube formation, possibly through up-regulation of HIF-1α and Sema4D.

Adult ; Aged ; Antigens, CD ; genetics ; metabolism ; Cell Line, Tumor ; Colonic Neoplasms ; genetics ; metabolism ; Female ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Immunohistochemistry ; Macrophages ; immunology ; metabolism ; Male ; Middle Aged ; Neoplasm Metastasis ; genetics ; pathology ; Semaphorins ; genetics ; metabolism