1.Clinical application of single breath-holding left ventricle artificial intelligence assisted compression sensing T 2-weighted dark blood imaging sequence
Xianghu YAN ; Yi LUO ; Lingping RAN ; Shiyu ZHANG ; Liming XIA ; Lu HUANG
Chinese Journal of Radiology 2023;57(1):48-53
Objective:To explore the feasibility of cardiac T 2 weighted dark blood sequence (T 2W-DB) based on artificial intelligence assisted compression-sensing(ACS) in clinical cardiac MR examination, compared with the conventional cardiac fast spin-echo T 2W-DB sequence. Methods:A total of 38 patients referred for cardiac MR examination in Tongji Hospital were enrolled prospectively from August to December 2021. The conventional T 2W-DB scan and the single-shot ACS T 2W-DB scan were acquired at continuous short-axial slices covering the whole left ventricle in all patients, and the acquisition time of each scan was recorded. The image quality of the two sequences was evaluated by the objective quantitative parameters and the subjective scoring methods, respectively. The signal to noise ratio (SNR), the contrast to noise ratio of the interventricular septum to blood pool (CNR), and the sharpness of the images were calculated. The subjective scoring was to evaluate the overall image quality, the effect of blood pool suppression, the visibility of right ventricular free wall, left ventricular free wall, and interventricular septum with a 5-point Likert scale. The intraclass correlation coefficient and Kendall W were calculated to evaluate the interobserver agreement of the objective quantitative parameters and subjective scoring. The paired t-test or Wilcoxon test was used to compare the difference in acquisition time, objective quantitative parameters and subjective scoring between the conventional T 2W-DB and the single-shot ACS T 2W-DB. Results:The inter-observer agreement between the single-shot ACS T 2W-DB and conventional T 2W-DB was good in all the objective quantitative parameters and subjective scoring of image quality ( P<0.05 for all). Compared with conventional T 2W-DB, acquisition time of single-shot ACS T 2W-DB was remarkably shortened [(85.8±14.7) s vs. (16.9±3.0) s, t=35.42, P<0.001]. Compared with SNR (66.4±29.0) and CNR(61.8±28.6) of conventional T 2W-DB, single-shot ACS T 2W-DB had significantly higher SNR(110.8±36.8, t=-8.13, P?0.001) and CNR(88.2±31.1, t=-5.89, P?0.001). Compared with conventional T 2W-DB, single-shot ACS T 2W-DB had better blood pool inhibition effect (4.6±0.6 vs. 4.7±0.5, Z=-2.64, P=0.008). There was no significant difference in overall image quality, visibility of right ventricular free wall, left ventricular free wall, and interventricular septum between the two sequences( P>0.05 for all). Conclusions:In cardiac MR examination, compared with the conventional T 2W-DB sequence, the single-shot ACS T 2W-DB sequence can significantly shorten the acquisition time and obtain better image quality.
2.Perinatal outcome of selective fetal reduction in twin pregnancies assisted by IVF/ICSI
Ruowen ZU ; Shiyu RAN ; Huan WU ; Wei ZHENG ; Chen YANG ; Shuheng YANG ; Yihui KUANG ; Mengna LI ; Mengyi CAO ; Jing WU ; Yichun GUAN
Chinese Journal of Reproduction and Contraception 2023;43(4):393-398
Objective:To investigate the perinatal outcome of selective fetal reduction of dizygotic twins pregnancies after double embryo transferred assisted by in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI). Methods:The clinical data of patients with single birth who underwent IVF/ICSI after double embryo transferred from September 1, 2005 to July 31, 2020 in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The patients were divided into three groups according to the occurrence of fetal reduction: 80 cases of dizygotic twins to singleton by selective fetal reduction (group A), 832 cases of dizygotic twins to singleton by spontaneous fetal reduction (group B), and 6 178 cases of singleton (group C). Using group A as the reference, after approximately propensity score matching (PSM) with 1∶4 ratio, 289 cases in group B and 271 cases in group C were obtained. The differences in baseline data and perinatal outcomes between group A and group B or group C were analyzed.Results:1) Before PSM, there were statistically significant differences in patients' age, previous fertility history, type of infertility, and stage of embryo transferred between group A and group B or group C (all P<0.05); after PSM, there were no statistically significant differences in baseline data between group A and group B or group C (all P>0.05). 2) After PSM, the premature birth rate was higher in group A than in group B [17.5% (14/80) vs. 8.7% (25/289), P=0.023] and the gestational weeks [(38.18±1.98) weeks vs. (38.64±1.83) weeks, P=0.034] were lower; group A had higher incidence rates of premature birth [17.5% (14/80) vs. 7.7% (21/271), P=0.011] and premature rupture of membranes [5.0% (4/80) vs. 0.4% (1/271), P=0.002] than those in group C, but gestational weeks [(38.18±1.98) weeks vs. (38.85±1.47) weeks, P=0.002] and birth weight [(3 253.07±475.73) g vs. (3 384.89±479.54) g, P=0.029] were lower. Conclusion:Perinatal outcomes of selective fetal reduction of dizygotic twins pregnancies after assisted by IVF/ICSI were poor. Selective fetal reduction in multiple pregnancies is not the best remedy. The strategy of selective single embryo transfer should be adopted to effectively reduce the rate of multiple pregnancies and improve maternal and infant outcomes.
3.Perinatal outcomes of singleton live birth resulting from human assisted reproductive technology: a retrospective propensity score matching cohort study
Wei ZHENG ; Bingnan REN ; Chen YANG ; Shiyu RAN ; Huan WU ; Rui WANG ; Shanshan DOU ; Ran SHEN ; Jingyi HAN ; Peixin LI ; Yichun GUAN
Chinese Journal of Reproduction and Contraception 2023;43(6):559-565
Objective:To compare perinatal outcomes of singleton live births between human assisted reproductive technology (ART) and spontaneously conceived (SC).Methods:This study was a retrospective cohort study, collecting data on patients who delivered and obtained singleton live birth in the Obstetrics Department of the Third Affiliated Hospital of Zhengzhou University between 2008 and 2019. A total of 1 727 ART patients were included in this study, and 5 181 SC patients who delivered during the same day were matched at a ratio of 1∶3. After matching according to delivery time, the baseline data of the two groups were matched using 1∶1 propensity score matching (PSM), and finally 1 439 patients were included in the ART and SC groups, respectively. The primary outcome measure was the healthy baby rate, and the secondary outcome measures were perinatal outcomes such as the incidences of hypertensive disorders of pregnancy, gestational diabetes and preterm delivery rate.Results:After PSM, healthy baby rate was lower in the ART group compared with the SC group [77.28% (1 112/1 439) vs. 70.67% (1 017/1 439), P<0.001]. Pregnancy complications, including the incidence of gestational diabetes, intrahepatic cholestasis syndrome during pregnancy, abnormal thyroid function during pregnancy, oligohydramnios, placenta previa, cesarean delivery, and placental efficiency, were statistically different between the two groups (all P<0.05). The neonatal outcomes, including gestational age, preterm delivery rate, very preterm delivery rate, incidence of small for gestation age and neonatal intensive care unit admission rate were statistically different between the two groups (all P<0.05). The results of multivariate logistic regression analysis showed that ART and pregnancy complications were risk factors for healthy baby ( OR=0.81, 95% CI:0.67-0.97, P=0.020), however, placental efficiency was a protective factor for healthy baby ( OR=1.73, 95% CI:1.59-1.88, P<0.001). Conclusion:Perinatal outcomes were safer in the SC group than in the ART group.
4.Perinatal outcome of selective fetal reduction in twin pregnancies assisted by IVF/ICSI
Ruowen ZU ; Shiyu RAN ; Huan WU ; Wei ZHENG ; Chen YANG ; Shuheng YANG ; Yihui KUANG ; Mengna LI ; Mengyi CAO ; Jing WU ; Yichun GUAN
Chinese Journal of Reproduction and Contraception 2023;43(4):393-398
Objective:To investigate the perinatal outcome of selective fetal reduction of dizygotic twins pregnancies after double embryo transferred assisted by in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI). Methods:The clinical data of patients with single birth who underwent IVF/ICSI after double embryo transferred from September 1, 2005 to July 31, 2020 in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed. The patients were divided into three groups according to the occurrence of fetal reduction: 80 cases of dizygotic twins to singleton by selective fetal reduction (group A), 832 cases of dizygotic twins to singleton by spontaneous fetal reduction (group B), and 6 178 cases of singleton (group C). Using group A as the reference, after approximately propensity score matching (PSM) with 1∶4 ratio, 289 cases in group B and 271 cases in group C were obtained. The differences in baseline data and perinatal outcomes between group A and group B or group C were analyzed.Results:1) Before PSM, there were statistically significant differences in patients' age, previous fertility history, type of infertility, and stage of embryo transferred between group A and group B or group C (all P<0.05); after PSM, there were no statistically significant differences in baseline data between group A and group B or group C (all P>0.05). 2) After PSM, the premature birth rate was higher in group A than in group B [17.5% (14/80) vs. 8.7% (25/289), P=0.023] and the gestational weeks [(38.18±1.98) weeks vs. (38.64±1.83) weeks, P=0.034] were lower; group A had higher incidence rates of premature birth [17.5% (14/80) vs. 7.7% (21/271), P=0.011] and premature rupture of membranes [5.0% (4/80) vs. 0.4% (1/271), P=0.002] than those in group C, but gestational weeks [(38.18±1.98) weeks vs. (38.85±1.47) weeks, P=0.002] and birth weight [(3 253.07±475.73) g vs. (3 384.89±479.54) g, P=0.029] were lower. Conclusion:Perinatal outcomes of selective fetal reduction of dizygotic twins pregnancies after assisted by IVF/ICSI were poor. Selective fetal reduction in multiple pregnancies is not the best remedy. The strategy of selective single embryo transfer should be adopted to effectively reduce the rate of multiple pregnancies and improve maternal and infant outcomes.
5.Perinatal outcomes of singleton live birth resulting from human assisted reproductive technology: a retrospective propensity score matching cohort study
Wei ZHENG ; Bingnan REN ; Chen YANG ; Shiyu RAN ; Huan WU ; Rui WANG ; Shanshan DOU ; Ran SHEN ; Jingyi HAN ; Peixin LI ; Yichun GUAN
Chinese Journal of Reproduction and Contraception 2023;43(6):559-565
Objective:To compare perinatal outcomes of singleton live births between human assisted reproductive technology (ART) and spontaneously conceived (SC).Methods:This study was a retrospective cohort study, collecting data on patients who delivered and obtained singleton live birth in the Obstetrics Department of the Third Affiliated Hospital of Zhengzhou University between 2008 and 2019. A total of 1 727 ART patients were included in this study, and 5 181 SC patients who delivered during the same day were matched at a ratio of 1∶3. After matching according to delivery time, the baseline data of the two groups were matched using 1∶1 propensity score matching (PSM), and finally 1 439 patients were included in the ART and SC groups, respectively. The primary outcome measure was the healthy baby rate, and the secondary outcome measures were perinatal outcomes such as the incidences of hypertensive disorders of pregnancy, gestational diabetes and preterm delivery rate.Results:After PSM, healthy baby rate was lower in the ART group compared with the SC group [77.28% (1 112/1 439) vs. 70.67% (1 017/1 439), P<0.001]. Pregnancy complications, including the incidence of gestational diabetes, intrahepatic cholestasis syndrome during pregnancy, abnormal thyroid function during pregnancy, oligohydramnios, placenta previa, cesarean delivery, and placental efficiency, were statistically different between the two groups (all P<0.05). The neonatal outcomes, including gestational age, preterm delivery rate, very preterm delivery rate, incidence of small for gestation age and neonatal intensive care unit admission rate were statistically different between the two groups (all P<0.05). The results of multivariate logistic regression analysis showed that ART and pregnancy complications were risk factors for healthy baby ( OR=0.81, 95% CI:0.67-0.97, P=0.020), however, placental efficiency was a protective factor for healthy baby ( OR=1.73, 95% CI:1.59-1.88, P<0.001). Conclusion:Perinatal outcomes were safer in the SC group than in the ART group.
6.Research progress of pharmacological effects and security of Yuebawei
Shiyu WAN ; Ran HUANG ; Depo YANG ; Yang YANG ; Xiyu CHEN ; Qinhua CHEN ; Quanxi MEI
China Pharmacy 2022;33(23):2921-2925
Yuebawei refers to 8 kinds of genuine medicinal materials in south China area,namely Citri Grandis Exocarpium, Citrus reticulata, Amomum villosum, Pogostemon cablin, Morinda officinalis, Aquilaria sinensis, Citrus medica and Polygonum multiflorum. The results of this review show that, the pharmacological effects of Yuebawei are very extensive. It has significant effects in relieving cough and phlegm, anti-bacterial and anti-inflammatory, enhancing immunity, anti-oxidation, antidepressant, immune regulation and regulating gastrointestinal function. Its development and application prospects are broad, but most of the existing pharmacological studies stay on pharmacodynamic studies. In the aspect of the safety research of Yuebawei, there are few studies on the safety of other medicinal materials, except for the liver toxicity of P. multiflorum; at the same time, there are few comparative studies on the therapeutic advantages of Yuebawei and other local medicinal materials in clinical application. It is necessary to strengthen the research on the material basis of pharmacological action mechanism, and safety and efficacy observation of clinical medication for Yuebawei, so as to provide scientific basis for the development of new drugs and clinical promotion and application of Yuebawei.
7.Comparative analysis of perinatal outcome of intracytoplasmic sperm injection and frozen-thawed embryo transfer between donor and autologous oocytes
Chen YANG ; Wei ZHENG ; Shuheng YANG ; Mingkun MU ; Simin SUN ; Bingnan REN ; Ruowen ZU ; Shiyu RAN ; Huan WU ; Yihui KUANG ; Caixia ZHANG ; Yichun GUAN
Chinese Journal of Reproduction and Contraception 2022;42(5):462-468
Objective:To investigate the obstetric outcomes of intracytoplasmic sperm injection and frozen-thawed embryo transfer (ICSI-FET) between donor and autologous oocytes.Methods:A retrospective cohort study was conducted to analyze the clinical data of pregnant patients who underwent ICSI-FET in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from June 2016 to January 2020. Totally 73 patients with donor oocytes, and 550 patients who used autologous oocytes in the same period, and the patients were matched at 1∶3 with propensity score matching (PSM), then there were 47 patients in donor group and 131 patients in autologous group. The general conditions and obstetric outcomes were compared among donor group and autologous group. Multivariate logistic regression and linear regression were applied to analyze the factors affecting perinatal complications.Results:The bilateral antral follicle count (3.08±4.78) and basal estradiol level [(71.55±45.29) pmol/L] in donor group were significantly lower than those in autologous group [14.95±6.42, (132.84±74.89) pmol/L, all P<0.001]. The birth weight of singleton in donor group [(2 916.48±537.55) g] was lower than that in autologous group [(3 326.67±503.43) g], and there was significant difference ( P<0.001). There were no significant differences in premature birth rate [21.28% (10/47) vs. 16.03% (21/131), P=0.416] and incidence of hypertensive disorder complicating pregnancy [12.77% (6/47) vs. 7.63% (10/131), P=0.448] between donor group and autologous group, but both of them had an increasing trend in donor group. Oocyte-donated ICSI-FET reduced the birth weight of singleton (MD=-388.225, 95% CI=-625.914--150.537, P=0.002). Conclusion:The perinatal outcome of oocyte-donated ICSI-FET is relatively safe, but the birth weight of singleton is lower than that of self-oocyte ICSI-FET.
8.Comparative analysis of perinatal outcome of intracytoplasmic sperm injection and frozen-thawed embryo transfer between donor and autologous oocytes
Chen YANG ; Wei ZHENG ; Shuheng YANG ; Mingkun MU ; Simin SUN ; Bingnan REN ; Ruowen ZU ; Shiyu RAN ; Huan WU ; Yihui KUANG ; Caixia ZHANG ; Yichun GUAN
Chinese Journal of Reproduction and Contraception 2022;42(5):462-468
Objective:To investigate the obstetric outcomes of intracytoplasmic sperm injection and frozen-thawed embryo transfer (ICSI-FET) between donor and autologous oocytes.Methods:A retrospective cohort study was conducted to analyze the clinical data of pregnant patients who underwent ICSI-FET in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from June 2016 to January 2020. Totally 73 patients with donor oocytes, and 550 patients who used autologous oocytes in the same period, and the patients were matched at 1∶3 with propensity score matching (PSM), then there were 47 patients in donor group and 131 patients in autologous group. The general conditions and obstetric outcomes were compared among donor group and autologous group. Multivariate logistic regression and linear regression were applied to analyze the factors affecting perinatal complications.Results:The bilateral antral follicle count (3.08±4.78) and basal estradiol level [(71.55±45.29) pmol/L] in donor group were significantly lower than those in autologous group [14.95±6.42, (132.84±74.89) pmol/L, all P<0.001]. The birth weight of singleton in donor group [(2 916.48±537.55) g] was lower than that in autologous group [(3 326.67±503.43) g], and there was significant difference ( P<0.001). There were no significant differences in premature birth rate [21.28% (10/47) vs. 16.03% (21/131), P=0.416] and incidence of hypertensive disorder complicating pregnancy [12.77% (6/47) vs. 7.63% (10/131), P=0.448] between donor group and autologous group, but both of them had an increasing trend in donor group. Oocyte-donated ICSI-FET reduced the birth weight of singleton (MD=-388.225, 95% CI=-625.914--150.537, P=0.002). Conclusion:The perinatal outcome of oocyte-donated ICSI-FET is relatively safe, but the birth weight of singleton is lower than that of self-oocyte ICSI-FET.
9.Assessment of Diagnostic Accuracy of the 2013 Edition of BI-RADS Ultrasound Lexicon in Diagnosing Breast Categories 3 to 5 Lesions
Yue HU ; Yaping YANG ; Ran GU ; Shiyu SHEN ; Fengtao LIU ; Hongli WANG ; Jingsi MEI ; Fengxi SU
Journal of Sun Yat-sen University(Medical Sciences) 2017;38(4):618-621
[Objective] The objective of this study was to evaluate the diagnostic accuracy of the 2013 edition of Breast Imaging Reporting and Data System (BI-RADS) ultrasound lexicon in diagnosing breast categories 3-5 lesions.[Methods] Using our breast ultrasound database from June 2014 to June 2016,we identified 4428 BI-RADS category 3 to 5 lesions with a known pathological diagnosis in 4 428 adult women.The positive predictive value (PPV) of each BI-RADS category was calculated based on the pathological diagnoses and compared with the reference range provided by the American College of Radiology (ACR).[Results] 4 428 lesions from 4428 patients were included in this study.The PPV of each BI-RADS category waswithin the reference range provided by the ACR in 2013.1198 (27.1%) pathological malignant/borderline results were found in the 4 428 lesions,the other 3 230 (72.9%)lesions were diagnosed with benign results.Among the malignant/borderline lesions,the rate of lymph node metastasis gradually increased as the BI-RADS categories were upgraded.Malignant lesions with a diagnosis ofinvasive ductal carcinoma or invasive lobular carcinoma showed an increasing distribution trend from category 3 to 5.[Conclusion] The 2013 editionof BI-RADS ultrasound lexiconhas good diagnostic accuracy and efficiencyin clinical practice.

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