Objective:To analyze the correlation of perifollicular blood flow parameters with follicle development, embryo quality and pregnancy outcome in in vitro fertilization and embryo transfer (IVF-ET). Methods:A retrospective case-control study was conducted to analyze the data of 112 infertile patients who underwent IVF-ET admitted to the Department of Reproductive Medicine of Zhumadian Central Hospital from October 2020 to October 2022. Perifollicular blood flow parameters [peak systolic velocity/end diastolic velocity (S/D), resistance index (RI), pulsatility index (PI) and peak systolic velocity (PSV)] were measured by vaginal color doppler ultrasound. A total of 1 156 follicles were extracted, they were divided into high-quality follicle group ( n=208), and non-high-quality follicle group ( n=948) according to follicle development, high-quality embryo group ( n=161) and non-high-quality embryo group ( n=995) according to embryo quality, pregnant group ( n=37) and non-pregnant group ( n=75) according to pregnancy outcome. The S/D, RI, PI and PSV of the groups were compared. The correlation indexes of PSV peak velocity among different perifollicular blood flow were compared, and the correlation between PSV and follicle development and embryo quality in non-high-quality follicle group, non-high-quality embryo group and non-pregnant group was analyzed by Pearson method. Results:PSV in high-quality follicle group [(11.26±0.94) cm/s] was significantly higher than that in non-high-quality follicle group [(10.31±0.78) cm/s, P<0.001], but there were no significant differences in S/D, RI and PI between high-quality follicle group and non-high-quality follicle group (all P>0.05). PSV was significantly higher in the high-quality embryo group [(13.38±1.19) cm/s] than in the non-high-quality embryo group [(12.02±0.85) cm/s, P<0.001], but there were no significant differences in S/D, RI and PI between high-quality embryo group and non-high-quality embryo group (all P>0.05). PSV of pregnant group [(15.14±1.25) cm/s] was significantly higher than that of non-pregnant group [(8.27±0.75) cm/s, P<0.001], and there were no significant differences in S/D, RI and PI between pregnant group and non-pregnant group (all P>0.05). There were no statistically significant differences in age, infertility duration, body mass index, basal follicle-stimulating hormone level, total dosage and duration of gonadotropin used among different perifollicular blood flow PSV peak velocity (all P>0.05), but there were statistically significant differences in the number of high-quality follicles, the number of high-quality embryos and the level of β-human chorionic gonadotropin (β-hCG) [<9 cm/s: 1.05±0.23, 0.73±0.14, (3.05±0.61) U/L;9-10 cm/s: 1.35±0.35, 0.85±0.16, (22.14±5.78) U/L; >10 cm/s: 2.01±0.41, 1.12±0.20, (71.33±8.63) U/L; all P<0.001]. Pearson correlation analysis showed that PSV was positively correlated with follicle diameter, embryo quality score and blood β-hCG level ( r=0.767, P<0.001; r=0.750, P<0.001; r=0.700, P<0.001) in non-high-quality follicle group, non-high-quality embryo group,non-pregnant group. Conclusion:Perifollicular blood flow parameter PSV is correlated with IVF-ET follicle development, embryo quality and pregnancy outcome, which can provide an important reference for clinical evaluation of follicle development, embryo quality and pregnancy outcome.

Objective:To analyze the correlation of perifollicular blood flow parameters with follicle development, embryo quality and pregnancy outcome in in vitro fertilization and embryo transfer (IVF-ET). Methods:A retrospective case-control study was conducted to analyze the data of 112 infertile patients who underwent IVF-ET admitted to the Department of Reproductive Medicine of Zhumadian Central Hospital from October 2020 to October 2022. Perifollicular blood flow parameters [peak systolic velocity/end diastolic velocity (S/D), resistance index (RI), pulsatility index (PI) and peak systolic velocity (PSV)] were measured by vaginal color doppler ultrasound. A total of 1 156 follicles were extracted, they were divided into high-quality follicle group ( n=208), and non-high-quality follicle group ( n=948) according to follicle development, high-quality embryo group ( n=161) and non-high-quality embryo group ( n=995) according to embryo quality, pregnant group ( n=37) and non-pregnant group ( n=75) according to pregnancy outcome. The S/D, RI, PI and PSV of the groups were compared. The correlation indexes of PSV peak velocity among different perifollicular blood flow were compared, and the correlation between PSV and follicle development and embryo quality in non-high-quality follicle group, non-high-quality embryo group and non-pregnant group was analyzed by Pearson method. Results:PSV in high-quality follicle group [(11.26±0.94) cm/s] was significantly higher than that in non-high-quality follicle group [(10.31±0.78) cm/s, P<0.001], but there were no significant differences in S/D, RI and PI between high-quality follicle group and non-high-quality follicle group (all P>0.05). PSV was significantly higher in the high-quality embryo group [(13.38±1.19) cm/s] than in the non-high-quality embryo group [(12.02±0.85) cm/s, P<0.001], but there were no significant differences in S/D, RI and PI between high-quality embryo group and non-high-quality embryo group (all P>0.05). PSV of pregnant group [(15.14±1.25) cm/s] was significantly higher than that of non-pregnant group [(8.27±0.75) cm/s, P<0.001], and there were no significant differences in S/D, RI and PI between pregnant group and non-pregnant group (all P>0.05). There were no statistically significant differences in age, infertility duration, body mass index, basal follicle-stimulating hormone level, total dosage and duration of gonadotropin used among different perifollicular blood flow PSV peak velocity (all P>0.05), but there were statistically significant differences in the number of high-quality follicles, the number of high-quality embryos and the level of β-human chorionic gonadotropin (β-hCG) [<9 cm/s: 1.05±0.23, 0.73±0.14, (3.05±0.61) U/L;9-10 cm/s: 1.35±0.35, 0.85±0.16, (22.14±5.78) U/L; >10 cm/s: 2.01±0.41, 1.12±0.20, (71.33±8.63) U/L; all P<0.001]. Pearson correlation analysis showed that PSV was positively correlated with follicle diameter, embryo quality score and blood β-hCG level ( r=0.767, P<0.001; r=0.750, P<0.001; r=0.700, P<0.001) in non-high-quality follicle group, non-high-quality embryo group,non-pregnant group. Conclusion:Perifollicular blood flow parameter PSV is correlated with IVF-ET follicle development, embryo quality and pregnancy outcome, which can provide an important reference for clinical evaluation of follicle development, embryo quality and pregnancy outcome.

【Objective】 To explore the emergency treatment of penoscrotal avulsion injury based on the American Association for Surgery and Trauma (AAST) penoscrotal injury grade. 【Methods】 Data of 30 patients with penoscrotal avulsion injury treated in our hospital with in-situ suture, skin grafting or skin flap during Oct.2003 and Dec.2017 were reviewed. 【Results】 Among the 30 patients, 29 received emergency surgery, including in-situ suturein 15 grade Ⅰ-Ⅲ cases, skin graft in 8 grade Ⅳ-Ⅴ cases, and skin flap in 6 cases;1 case received delayed operation due to wound infection on admission. In the perioperative period,25 cases had more than 90% wound healing, 3 cases had 70% wound healing after wound dressing change, and 2 cases had complete necrosis. Second-stage skin graft yielded satisfactory penoscrotal appearance. 【Conclusion】 According to the specific conditions of patients, reasonable surgical methods can be selected. For grade Ⅰ-Ⅲ patients, in-situ suture can be used, while for grade Ⅳ-Ⅴ patients, wound condition, age, fertility and other factors should be taken into consideration so as to preserve the function of testis to the maximum extent.

Objective To assess the value of CT in the detection of spontaneous rupture of hepatocarcinoma as well as to assess CT finging of hepatocarcinoma rupture.Methods Clinical manifestation and CT findings of spontaneous rupture of hepatocarcinoma in 22 cases proved surgically and pathologically were reviewed. CT characters of variable pathological changes of ruptured hepatocarcinoma and its relationship to the rupture of hepatocarcinoma were also analyzed. The analysis involved the status of liver cirrhosis, ascites, intrahepatic locations of the tumor, extent of extrahepatic protrusion and central necrosis of the tumor.Results All ruptured tumours were located at the periphery of the liver, 12 cases had a protruding contour. The maximum diameter of tumours ranged from 2 to 16 cm. Discontinuity of the hepatic surface was seen in 16 cases,necrosis of core was seen in 12 cases. 3 cases with non-ruptured masses also showed contrast medium flow over the perihepatic border during the arterial phase. 2 cases showed a haematoma with attenuated rim inside the mass, but rupture was found during surgery. 1 case show detached broken bits drifting in mass ascites. In 5 cases, CT images during the arterial phase showed a non-enhancing low attenuating lesion with focal discontinuity and peripheral rim enhancement. Conclusion The accuracy of CT diagnosis of spontaneous rupture of hepatocarcinoma is very high. Moreover, CT is a necessary imaging modality in diagnosis of ruptured hepatocarcinoma suspected by clinical findings.

Objective To study the MRI characteristics of osteoblastoma and to discuss its diagnostic value. Methods Nine patients with osteoblastoma proved by pathology were examined with T_2WI, nonenhanced T_1WI and Gd-DTPA enhanced T_1WI MR imaging before operation MR finding were analyzed. Results Of nine patients, tumor originated from spine in five patients, from skull in three patients and from pelvis in one patient. Of these patients, benign osteoblastoma were in six patients and malignant were in three patients. On MRI, the tumor was an expanded osteolytic lesion, osteoid production formation was low or equal signal intensity on T_1WI and medial or high signal intensity on T_2WI. MRI showed low signal intensity of the calcification or ossification in osteoblastoma on T_2WI, and low or equal signal intensity on T_1WI. The ossified ring of tumor was low signal intensity on both T_1- and T_2WI. The adjacent soft tissue masses were showed on MRI. All patients given gadolinium showed enhancement within the osteoid production and the adjacent soft tissue mass, and no enhancement with ossification and calcification, cystoid and the ossified ring on MRI. The boundary of malignant osteoblastoma was obscure, and adjacent tissue could be invaded.Conclusion MR imaging can show all the characteristics of osteoblastoma well . It is of important value in diagnosis, operative orientation and staging of osteoblastoma, especially for the lesion originated from spine and skull.