1.Comparison of Ultrasound Prediction Methods for Fetal Body Mass and the Effect of Pregnancy Weight Gain on Its Accuracy
Chaoling XIE ; Chuan QIN ; Songping LIU
Journal of Practical Obstetrics and Gynecology 2024;40(3):208-212
Objective:To compare the accuracy of 11 ultrasound parameters prediction formulas for fetal body mass,and to explore the effect of gestational weight gain(GWG)on the accuracy of ultrasound prediction of fetal body mass.Methods:A total of 502 single and full-term postpartum women who gave birth from August 2020 to December 2020 at Jinshan Hospital,Fudan University were collected.The gestational weight gain,fetal ultrasound measurement indicators within 7 days before delivery,and newborn birth weight were calculated and analyzed.The accuracy of multiple ultrasound prediction formulas were calculated and analyzed.According to the criteria for weight gain during pregnancy,the reasonable weight gain during pregnancy was 12.5-18.0 kg for singleton pregnancies with pre-pregnancy(body mass index)BMI<18.5 kg/m2,11.5-16.0 kg for those with BMI 18.5-24.9 kg/m2,7.0-11.5 kg for those with BMI 25.0-29.9 kg/m2,and 5.0-9.0 kg for those with BMI≥30.0 kg/m2.The cases were divided into the group with insufficient GWG(125 cases),the normal group(202 cases),and the group with too much GWG(175 cases)to analyze the effect of different GWG on the accuracy of ultrasound pre-diction of fetal body mass.Results:Among the 11 ultrasound parameter formulas for predicting fetal body mass,the HadlockⅢformula predicted fetal body mass with an absolute error of 186.64±149.28 g and a relative error of(5.52±4.18)%,which was the smallest error among 11 prediction formulas,with a statistically significant difference(P<0.05).The absolute and relative error compliance rates were 72.31%,86.25%,respectively,both of which were the highest,and the difference was statistically significant(P<0.05).When the HadlockⅢformula was used to predict birth weight in the insufficient GWG group,the normal group,and the group with too much GWG,the absolute errors were 190.23±136.69 g,148.12±99.39 g,228.54±189.57 g,and the relative errors were(5.95±4.25)%,(4.40±2.78)%,(6.49±5.09)%,respectively,and the differences were statistically significant(P<0.05).Conclusions:The accuracy of Hadlock Ⅲ formula in predicting fetal body mass is better than that of other formulas,but its accuracy can be affected by GWG,and it is necessary to consider multiple as-pects when estimating fetal body mass in clinical practice.
2.Characterization of menstruation and intestinal flora in patients with polycystic ovary syndrome combined with metabolic syndrome
Chaoling XIE ; Yanyan XING ; Jingwei LI ; Jinzhi LI ; Mingqing LI ; Songping LIU
Chinese Journal of Reproduction and Contraception 2024;44(8):808-815
Objective:To investigate the significance of menstrual abnormalities in polycystic ovary syndrome (PCOS) for the prediction of future combined metabolic syndrome (MS) and compare the differences in intestinal flora structure between patients with MS and those without.Methods:A case-control study was used to select 111 patients with PCOS who attended the outpatient clinic of the Department of Obstetrics and Gynecology of Jinshan Hospital affiliated to Fudan University between February 2021 and December 2023, and they were divided into the group of PCOS not combined with MS ( n=74, recorded as the NMS group) and the group of PCOS combined with MS ( n=37, recorded as the MS group). The menstrual-related information and stool specimens of all cases were collected to analyze the menstrual characteristics of the two groups and their predictive significance for PCOS combined with MS; and the intestinal flora of the two groups were analyzed by 16S rDNA high-throughput sequencing. Results:The age of menstrual changes [(23.47±4.73) years], time of menstrual changes occurring after menarche [(9.85±5.11) years], and duration of menstrual changes [(3.43±2.78) years] in the NMS group were statistically significantly different when compared with those in the MS group [(20.71±3.61) years, P=0.020; (7.04±3.34) years, P=0.025; (7.63±3.47) years, P<0.001]. The rate of menstrual abnormality, scanty menstruation and amenorrhea were higher in the MS group than in the NMS group, and the difference in the ratio of the composition of the menstrual pattern between the two groups was statistically significant ( P=0.036). The differences in the rates of menstrual abnormalities 8 years later after menarche between the two groups were statistically significant (all P<0.05), and the ORs from 8 to 13 years after menarche were 2.76 (95% CI: 1.07-7.11), 3.68 (95% CI: 1.28-10.56), 3.27 (95% CI: 1.13-9.41), 3.07 (95% CI: 1.06-8.87), 4.20 (95% CI: 1.16-15.21), 11.57 (95% CI: 1.48-90.49), respectively; the difference in the rate of menstrual abnormality between the two groups with menstrual alteration duration of more than 4 years was also statistically significant (all P<0.05), and the ORs for menstrual alteration duration of 4-9 years were 8.89 (95% CI: 2.14-36.99), 11.88 (95% CI: 3.07-46.02), 16.56 (95% CI: 4.15-66.13), 11.25 (95% CI: 2.88-32.95), 7.80 (95% CI: 2.04-29.84), and 10.00 (95% CI: 1.91-52.48), respectively. The α-diversity index of intestinal flora was lower in the MS group than in the NMS group, but the difference was not statistically significant ( P>0.05). At the phylum level, there was a statistically significant difference in the abundance of intestinal flora between the two groups ( P<0.001), the abundance of Bacteroidetes was lower in the MS group than in the NMS group, and the abundance of the Firmicutes was similar in the two groups. At the genus level, there was a statistically significant difference in the abundance of intestinal flora between the two groups ( P<0.001), the abundance of Bifidobacterium decreased and the abundance of Streptococcus and Escherichia increased in the MS group compared with those in the NMS group. Conclusion:Abnormal menstruation 8 years later after menarche in patients with PCOS is predictive of future MS, and its predictive effect increases with age, but does not change significantly with the duration of disease in abnormal menstruation. The structure of the intestinal flora of patients with MS in PCOS is indeed significantly different from that of those without MS.
3.Characterization of menstruation and intestinal flora in patients with polycystic ovary syndrome combined with metabolic syndrome
Chaoling XIE ; Yanyan XING ; Jingwei LI ; Jinzhi LI ; Mingqing LI ; Songping LIU
Chinese Journal of Reproduction and Contraception 2024;44(8):808-815
Objective:To investigate the significance of menstrual abnormalities in polycystic ovary syndrome (PCOS) for the prediction of future combined metabolic syndrome (MS) and compare the differences in intestinal flora structure between patients with MS and those without.Methods:A case-control study was used to select 111 patients with PCOS who attended the outpatient clinic of the Department of Obstetrics and Gynecology of Jinshan Hospital affiliated to Fudan University between February 2021 and December 2023, and they were divided into the group of PCOS not combined with MS ( n=74, recorded as the NMS group) and the group of PCOS combined with MS ( n=37, recorded as the MS group). The menstrual-related information and stool specimens of all cases were collected to analyze the menstrual characteristics of the two groups and their predictive significance for PCOS combined with MS; and the intestinal flora of the two groups were analyzed by 16S rDNA high-throughput sequencing. Results:The age of menstrual changes [(23.47±4.73) years], time of menstrual changes occurring after menarche [(9.85±5.11) years], and duration of menstrual changes [(3.43±2.78) years] in the NMS group were statistically significantly different when compared with those in the MS group [(20.71±3.61) years, P=0.020; (7.04±3.34) years, P=0.025; (7.63±3.47) years, P<0.001]. The rate of menstrual abnormality, scanty menstruation and amenorrhea were higher in the MS group than in the NMS group, and the difference in the ratio of the composition of the menstrual pattern between the two groups was statistically significant ( P=0.036). The differences in the rates of menstrual abnormalities 8 years later after menarche between the two groups were statistically significant (all P<0.05), and the ORs from 8 to 13 years after menarche were 2.76 (95% CI: 1.07-7.11), 3.68 (95% CI: 1.28-10.56), 3.27 (95% CI: 1.13-9.41), 3.07 (95% CI: 1.06-8.87), 4.20 (95% CI: 1.16-15.21), 11.57 (95% CI: 1.48-90.49), respectively; the difference in the rate of menstrual abnormality between the two groups with menstrual alteration duration of more than 4 years was also statistically significant (all P<0.05), and the ORs for menstrual alteration duration of 4-9 years were 8.89 (95% CI: 2.14-36.99), 11.88 (95% CI: 3.07-46.02), 16.56 (95% CI: 4.15-66.13), 11.25 (95% CI: 2.88-32.95), 7.80 (95% CI: 2.04-29.84), and 10.00 (95% CI: 1.91-52.48), respectively. The α-diversity index of intestinal flora was lower in the MS group than in the NMS group, but the difference was not statistically significant ( P>0.05). At the phylum level, there was a statistically significant difference in the abundance of intestinal flora between the two groups ( P<0.001), the abundance of Bacteroidetes was lower in the MS group than in the NMS group, and the abundance of the Firmicutes was similar in the two groups. At the genus level, there was a statistically significant difference in the abundance of intestinal flora between the two groups ( P<0.001), the abundance of Bifidobacterium decreased and the abundance of Streptococcus and Escherichia increased in the MS group compared with those in the NMS group. Conclusion:Abnormal menstruation 8 years later after menarche in patients with PCOS is predictive of future MS, and its predictive effect increases with age, but does not change significantly with the duration of disease in abnormal menstruation. The structure of the intestinal flora of patients with MS in PCOS is indeed significantly different from that of those without MS.
4.Triple fusion PET/MRI in location of epileptogenic focus in patients with focal cortical dysplasia
Yi JIN ; Chaoling JIN ; Yumin ZHENG ; Tian LIANG ; Sheng XIE ; Xiaoxuan LI ; Dantao PENG ; Pei RONG ; Dongyan WU
Chinese Journal of Neuromedicine 2021;20(9):915-920
Objective:To explore the value of triple fusion positron emission tomography (PET)/MRI in location of epileptogenic focus in patients with focal cortical dysplasia (FCD).Methods:Three patients with refractory partial epilepsy, admitted to our hospital from December 2016 to June 2017, were chosen in our study. The raw MRI and PET images of these patients were processed using Freesurfer and FSL image processing softwares. After extraction and coregistration, precise PET/MRI fusion images were obtained; and the grey-white matter dividing line was highlighted on this fusion image to form triple-fusion images to observe the hypometabolic area and clarify the location.Results:Triple-fusion images of these 3 patients were acquired. In patient 1, a marked decrease in metabolism was noted in the gyrus region delineated by the gray-white matter boundary in the right cingulate gyrus. In patient 2, the area with slightly increased local signal in the right superior frontal gyrus (MRI FLAIR sequence) was the area with reduced metabolism. In patient 3, an area of local decreased metabolism was noted in the right cingulate gyrus. The preoperative evaluation of all 3 patients showed that the above areas were epileptic foci; the patients were followed up for 2 years after surgical resection, no clinical seizures occurred in all patients, and antiepileptic drugs were gradually stopped. All 3 patients were diagnosed as having FCD by postoperative pathology.Conclusion:Triple fusion PET/MRI is a powerful way to assist FCD diagnosis, especially for those FCD cases which are difficult to be diagnosed by other imaging methods, and has a potential clinical application value in epilepsy patients.

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