Objective To explore the application value of pelvic floor ultrasound measurement of musculi levator ani strain rate in evaluating postpartum pelvic floor muscles contractile force,and to analyze the correlation between the musculi levator ani strain rate and the evaluation results of surface electromyography of the pelvic floor muscles.Methods A total of 153 postpartum women who admitted to Wenzhou People's Hospital from January to October 2024 were selected as the subjects.All of them underwent pelvic floor ultrasound examinations 42 days after childbirth to obtain the area and anteroposterior diameter of levator ani hiatus in the resting and squeezing states,and calculate the contraction musculi levator ani strain rate.Meanwhile,surface electromyography assessment of the pelvic floor muscles was carried out.The correlation between the contraction musculi levator ani strain rate and the assessment results of surface electromyography of the pelvic floor muscles were compared,and the value of the contraction levator ani hiatus strain rate predicting the strength of the pelvic floor muscles was further evaluated.Results Among the 153 postpartum women,78 cases had stress urinary incontinence,and 75 cases had no obvious clinical symptoms.The potential of pelvic floor muscle fibers in those with urinary incontinence was significantly lower than that in those without clinical symptoms.In the state of anal contraction,the anteroposterior diameter and area of the levator ani hiatus of all research subjects were smaller than those in the resting state.Correlation between the contraction strain rate and the potential during the contraction phase of the pelvic floor muscles was significant positive(r＞0,P＜0.05).The areas under the curves of the contraction strain rates of the anteroposterior diameter and area of the levator ani hiatus in predicting the abnormal potentials during the contraction phase of type Ⅰ and type Ⅱ muscle fibers were 0.820,0.875 and 0.943,0.971,respectively,which showed high sensitivity and specificity.Conclusion By observing the size of musculi levator ani hiatus under different conditions,pelvic floor ultrasound can reflect the contractility of musculi levator ani,and they have significant correlation with strength of the pelvic floor muscles.It has certain value for the diagnosis of female pelvic floor dysfunction.

AIM:This study aimed to confirm the glycolytic inhibitory activity of 3-bromopyruvic acid(3BP)and to assess whether this inhibition could ameliorate hypoxia-induced pulmonary hypertension in rats.METHODS:PAH model rats were generated from normal SD rats via exposure to normal pressure and hypoxia.Intervention groups I and II(6 rats per group)were then intraperitoneally injected with 3BP(15 mg/kg),and the normal and hypoxia groups(6 rats per group)were given the same amount of normal saline for a total of 21 d.The average pulmonary artery pressure of the rats in each group was measured via right heart catheterisation,and hilar tissue measurements.The right ventricle(RV),left ventricle,and interventricular septum(LV+S)were weighed,and the ratio of RV/(LV+S)was calculated as an index of right ventricular hypertrophy.Right lower lung tissues were fixed in 4%paraformaldehyde-PBS buffer,sec-tioned in conventional paraffin(5 μm thick),stained with HE and Masson,photographed under a microscope.Then the thickness ratio of the tunica media and the area ratio of collagen fibres were calculated.The expression of pyruvate kinase isozyme type M2(PKM2),nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),and pyruvate de-hydrogenase(PDH)proteins in the hilar tissues of each group were detected by western blot,whereas interleukin-1β(IL-1β)and IL-18 contents were detected using ELISA,and lactic acid content was detected using a lactic acid kit.RE-SULTS:The results showed that 3-brpa effectively inhibited glycolysis and significantly improved hypoxia-induced pulmo-nary hypertension in rats.Compared with the hypoxia group,in intervention group II,PKM2 expression was decreased(P<0.05),PDH expression increased significantly(P<0.01),and NLRP3 expression was decreased(P<0.05).The IL-18 and IL-1β contents decreased(P<0.05 or P<0.01,respectively).Pulmonary hemodynamic indexes showed that the pro-portion of the right ventricle and the mean pressure of the pulmonary artery decreased(P<0.05 or P<0.01,respectively).The HE and Masson staining results showed that the thickness ratio of the tunica media and the area ratio of collagen fibres decreased significantly(P<0.01).Lactic acid content was significantly decreased(P<0.01).CONCLUSION:This study showed that 3BP can inhibit glycolysis and alleviate hypoxia-induced pulmonary hypertension in rats.

Objective To explore the application value of pelvic floor ultrasound measurement of musculi levator ani strain rate in evaluating postpartum pelvic floor muscles contractile force,and to analyze the correlation between the musculi levator ani strain rate and the evaluation results of surface electromyography of the pelvic floor muscles.Methods A total of 153 postpartum women who admitted to Wenzhou People's Hospital from January to October 2024 were selected as the subjects.All of them underwent pelvic floor ultrasound examinations 42 days after childbirth to obtain the area and anteroposterior diameter of levator ani hiatus in the resting and squeezing states,and calculate the contraction musculi levator ani strain rate.Meanwhile,surface electromyography assessment of the pelvic floor muscles was carried out.The correlation between the contraction musculi levator ani strain rate and the assessment results of surface electromyography of the pelvic floor muscles were compared,and the value of the contraction levator ani hiatus strain rate predicting the strength of the pelvic floor muscles was further evaluated.Results Among the 153 postpartum women,78 cases had stress urinary incontinence,and 75 cases had no obvious clinical symptoms.The potential of pelvic floor muscle fibers in those with urinary incontinence was significantly lower than that in those without clinical symptoms.In the state of anal contraction,the anteroposterior diameter and area of the levator ani hiatus of all research subjects were smaller than those in the resting state.Correlation between the contraction strain rate and the potential during the contraction phase of the pelvic floor muscles was significant positive(r＞0,P＜0.05).The areas under the curves of the contraction strain rates of the anteroposterior diameter and area of the levator ani hiatus in predicting the abnormal potentials during the contraction phase of type Ⅰ and type Ⅱ muscle fibers were 0.820,0.875 and 0.943,0.971,respectively,which showed high sensitivity and specificity.Conclusion By observing the size of musculi levator ani hiatus under different conditions,pelvic floor ultrasound can reflect the contractility of musculi levator ani,and they have significant correlation with strength of the pelvic floor muscles.It has certain value for the diagnosis of female pelvic floor dysfunction.

AIM:This study aimed to confirm the glycolytic inhibitory activity of 3-bromopyruvic acid(3BP)and to assess whether this inhibition could ameliorate hypoxia-induced pulmonary hypertension in rats.METHODS:PAH model rats were generated from normal SD rats via exposure to normal pressure and hypoxia.Intervention groups I and II(6 rats per group)were then intraperitoneally injected with 3BP(15 mg/kg),and the normal and hypoxia groups(6 rats per group)were given the same amount of normal saline for a total of 21 d.The average pulmonary artery pressure of the rats in each group was measured via right heart catheterisation,and hilar tissue measurements.The right ventricle(RV),left ventricle,and interventricular septum(LV+S)were weighed,and the ratio of RV/(LV+S)was calculated as an index of right ventricular hypertrophy.Right lower lung tissues were fixed in 4%paraformaldehyde-PBS buffer,sec-tioned in conventional paraffin(5 μm thick),stained with HE and Masson,photographed under a microscope.Then the thickness ratio of the tunica media and the area ratio of collagen fibres were calculated.The expression of pyruvate kinase isozyme type M2(PKM2),nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),and pyruvate de-hydrogenase(PDH)proteins in the hilar tissues of each group were detected by western blot,whereas interleukin-1β(IL-1β)and IL-18 contents were detected using ELISA,and lactic acid content was detected using a lactic acid kit.RE-SULTS:The results showed that 3-brpa effectively inhibited glycolysis and significantly improved hypoxia-induced pulmo-nary hypertension in rats.Compared with the hypoxia group,in intervention group II,PKM2 expression was decreased(P<0.05),PDH expression increased significantly(P<0.01),and NLRP3 expression was decreased(P<0.05).The IL-18 and IL-1β contents decreased(P<0.05 or P<0.01,respectively).Pulmonary hemodynamic indexes showed that the pro-portion of the right ventricle and the mean pressure of the pulmonary artery decreased(P<0.05 or P<0.01,respectively).The HE and Masson staining results showed that the thickness ratio of the tunica media and the area ratio of collagen fibres decreased significantly(P<0.01).Lactic acid content was significantly decreased(P<0.01).CONCLUSION:This study showed that 3BP can inhibit glycolysis and alleviate hypoxia-induced pulmonary hypertension in rats.

Objective:To evaluate the qualitative and quantitative diagnostic value of transvaginal contrast-enhanced ultrasonography for benign and malignant adnexal masses.Methods:Forty-nine patients with adnexal masses detected by routine ultrasound examination at Wenzhou People's Hospital from January 2021 to December 2022 were included in this study. Initially, transvaginal two-dimensional ultrasound, two-dimensional ultrasound integrated with color Doppler, and contrast-enhanced ultrasonography were used to accurately classify the masses as benign or malignant. Using postoperative pathology as the gold standard, the qualitative diagnostic accuracy of various detection methods was compared. Subsequently, the receiver operating characteristic curve analysis was performed to assess the quantitative diagnostic accuracy of transvaginal contrast-enhanced ultrasonography-related parameters in distinguishing between benign and malignant adnexal masses.Results:Among the 49 patients, 10 were diagnosed with malignant tumors. The diagnostic accuracy of contrast-enhanced ultrasonography was 93.88% (46/49), with a sensitivity of 90.00% (9/10), a specificity of 94.87% (37/39), a positive predictive value of 81.82% (9/11), and a negative predictive value of 97.37% (37/38). The results of the diagnostic difference assessment (McNemar test) revealed that there was no significant difference between two-dimensional ultrasound ( χ2 = 0.37, P = 0.546), two-dimensional ultrasound combined with color Doppler ( χ2 = 0.17, P = 0.683), and contrast-enhanced ultrasonography ( χ2 = 0.00, P = 1.000), and the gold standard test results. The consistency assessment (Kappa test) revealed that the diagnostic results of contrast-enhanced ultrasonography exhibited the highest concordance with the gold standard, with a Kappa value of 0.82 ( P < 0.001). Furthermore, the receiver operating characteristic curve analysis indicated that the initial increase time, peak intensity, and mean transit time in contrast-enhanced ultrasonography demonstrated high quantitative diagnostic accuracy. The areas under the curve were 0.83, 0.82, and 0.84, respectively, and the diagnostic cutoff values were 17.30 s, 21.65 dB, and 92.60 seconds, respectively. Conclusion:Contrast-enhanced ultrasonography exhibits diagnostic value in the differential diagnosis of benign and malignant adnexal masses, both qualitatively and quantitatively. This method can provide valuable insights for further treatment.

Objective To investigate the clinical significance of two-dimensional ultrasound parameters combined with transvaginal color doppler(TVCD)blood flow classification for evaluating cesarean scar pregnancy(CSP).Methods The clinical data of 81 patients with CSP who were diagnosed by pathology in operation from April 2020 to November 2021 were retrospectively analyzed.TVCD examina-tion was performed before operation.The patients were divided into successful group and failed group.The ultrasonic parameters including the length diameter of gestational sac,the remnant muscularis thickness(RMT)of the anterior isthmus,and the blood flow classification around the gestational sac of the two groups were compared.Receiver operating characteristic(ROC)curve were used for analysis and e-valuation.Results Among 81 CSP patients,66 patients were successful,and 15 patients were failure.with a success rate was 81.48％.The length diameter of gestational sac in the failed group was larger than that in the successful group,and RMT of the anterior isthmus was thinner than that in the successful group.The blood flow classification was mainly grade Ⅲ,and the differences were statistically signifi-cant(P＜0.05).ROC curve results for prediction of surgical efficacy showed that the predictive power of single index with blood flow classification was higher,and the combination of the three factors has the highest prediction efficiency.Conclusion Two-dimensional ultrasound parameters combined with TVCD blood flow classification have a certain value in predicting the curative effect of CSP surgery,which is helpful to improve the clinical curative effect and ensure medical safety.

Objective To investigate the clinical significance of two-dimensional ultrasound parameters combined with transvaginal color doppler(TVCD)blood flow classification for evaluating cesarean scar pregnancy(CSP).Methods The clinical data of 81 patients with CSP who were diagnosed by pathology in operation from April 2020 to November 2021 were retrospectively analyzed.TVCD examina-tion was performed before operation.The patients were divided into successful group and failed group.The ultrasonic parameters including the length diameter of gestational sac,the remnant muscularis thickness(RMT)of the anterior isthmus,and the blood flow classification around the gestational sac of the two groups were compared.Receiver operating characteristic(ROC)curve were used for analysis and e-valuation.Results Among 81 CSP patients,66 patients were successful,and 15 patients were failure.with a success rate was 81.48％.The length diameter of gestational sac in the failed group was larger than that in the successful group,and RMT of the anterior isthmus was thinner than that in the successful group.The blood flow classification was mainly grade Ⅲ,and the differences were statistically signifi-cant(P＜0.05).ROC curve results for prediction of surgical efficacy showed that the predictive power of single index with blood flow classification was higher,and the combination of the three factors has the highest prediction efficiency.Conclusion Two-dimensional ultrasound parameters combined with TVCD blood flow classification have a certain value in predicting the curative effect of CSP surgery,which is helpful to improve the clinical curative effect and ensure medical safety.

Objective To assess the clinical value of three-dimensional hysterosalpingo-contrast sonography (3D Hy-CoSy)in patients with tubal infertility. Methods A total of 274 patients with infertility(totally 539 the fallopian tubes)from September 2011 to March 2013 in our hospital,all patients were choose 3~7 days after menstruation clean,Transvaginal three-dimensional ultrasound imaging by injecting SonoVue through the uterine tube,with dynamic obser-vation of fallopian tube in imaging mode,by adopting of transvaginal three-dimensional ultrasound imaging reconstruc-tion technology evaluate tubal patency. The result of transvaginal three-dimension ultrasound imaging among 67 cases were compared with laparoscopic Meilan hydrotubation or X-ray hysterosalpingography (HSG). Results Among 539 oviducts, 230 oviducts were diagnosed patency by HyCoSy,224 oviducts were incompletehy obstructed, and 85 oviducts were completely obstructed among which 7 were hydrosalpinx; 3 out of 274 cases were contrast medium reflux into myometrium and venous plexus nearby; The sensitivity of 3D HyCoSy was 86.67%,which compared with the re-sults of HSG and laparoscopy,specificity was 100%,positive predictive value was 96.30%, negative predictive value was 98.25%. Conclusion 3D-HyCoSy in the diagnosis of fallopian tube patency is simple, safety and effective,fully and accurately displaying the shape of uterine tube . This technique is hopeful to become an effective method to diag-nose patients with tubal infertility.