To explore the ultrasound characteristics of accessory cavitated uterine malformation (ACUM) and the causes of misdiagnosis, in order to better understand the disease and improve the diagnostic ability of radiologists.

We retrospectively collected clinical, pathological and imaging data of ACUM patients who were diagnosed after surgery at Peking Union Medical College Hospital from December2013 to December 2023. Besides, we analyzed ultrasound features of ACUM and the cause of misdiagnosis.

A total of 11 patients were included, with a mean age of diagnosis of (27.1±7.4)years. There was a mean interval of (6.1±5.5)years between menarche and onset of dysmenorrhea. Preoperative ultrasound showed that ACUM appeared as solitary lesions located under the insertion of the round ligament, with a mean maximum diameter of (3.0±1.0)cm. Lesions were round or oval (90.9%, 10/11) and not connected to the uterine cavity (100%, 11/11) with clear boundaries (72.7%, 8/11), presenting as regular thick-walled cystic-solid structures. Cystic areas were observed within the mass (100%, 11/11) with a ground-glass-like appearance (90.9%, 10/11) and hyperechoic endometrial lining (90.9%, 10/11). The surrounding of the mass showed hypoechoic or isoechoic areas resembling the muscular layer and circular or semi-circular vascularity was detected around the mass. No adenomyosis or other uterine lesions were found. Analysis of misdiagnosis: Among the 11 ACUM cases, 6 were correctly diagnosed by the initial ultrasound examination, and 5 cases by MRI. Two patients were misdiagnosed as residual horn uterus by MRI, despite ultrasound suggesting ACUM with visible bilateral uterine horns.

ACUM exhibits distinct ultrasound characteristics. When young women present with progressive dysmenorrhea and ultrasound reveals a regular cystic-solid mass with thick wall located under the round ligament insertion, ACUM should be considered.

Objective To investigate the protective and treatment role of ulinastatin(UTI)on con-trast-induced acute kidney injury(CIAKI)in the elderly with coronary heart disease(CHD)and chronic kidney diseases(CKD).Methods A total of 321 elderly CHD inpatients complicated with CKD undergoing coronary angiography admitted in the First Medical Center of Chinese PLA Gen-eral Hospital from November 2021 to November 2022 were enrolled consecutively and then divid-ed into UTI group(n=161)and hydration group(n=160).Their cardiac and renal function pa-rameters were collected and analyzed before and 2 d after intervention.The changes in above pa-rameters and incidence of CIAK were observed and compared between the two groups.Results In 2 d after intervention,the UTI group had significantly lower Scr,urea,CysC,homocysteine and NT-proBNP,but higher eGFR than the hydration group(P＜0.01).There were 62 patients(62/321,19.3％)developing CIAKI,including 17 from the UTI group and 45 from the hydration group,and statistical difference was observed in the incidence(10.6％vs 28.1％,P＜0.01).For the patients with comorbidities of hypertension,diabetes,hyperlipidemia and hyperuricemia,the incidence of CIAKI was obviously lower in the UTI group than the hydration group(P＜0.01).Multivariate logistic regression analysis showed that UTI was an independent protective factor for occurrence of CIAKI(OR=0.348,95％CI:0.180-0.673,P=0.001).Conclusion UTI can im-prove renal function and reduce the risk of CIAKI in elderly CHD patients with CKD.

Objective To explore the possibility of rhabdomyolysis and related organ damage in new recruits training in high temperature and high humidity environment by comparing the effects of different training environments on the laboratory indicators and electrocardiogram.Methods A total of 250 new recruits from a unit in Beijing and another 250 ones from a unit in Hainan were recruited and assigned into conventional environment group and high temperature and high humidity environment group,respectively.All of them were male,with an average age of 21.36±2.59 years.Before and in 4 weeks after training in the same subjects,their general information,blood and urine indicators,and electrocardiogram were collected.All data were statistically analyzed.Results The incidences of inflammatory reaction,myocardial injury,muscle injury,liver injury,and kidney injury were 45.76％,3.39％,12.71％,25.42％,and 12.71％,respectively,in the high temperature and high humidity environment group,which were all significantly higher than those in the conventional environment group(P＜0.05).The former group had an incidence rate of 6.78％,5.93％,8.47％,6.78％,and 2.54％,respectively,in sinus bradycardia,atrial premature beats,unspecific ST-T changes,left ventricular hypertension and short PR interval,and all of the rates were higher than those of the conventional environment group(P＜0.05).Conclusion The incidences of inflammatory reaction,myocardial injury,muscle injury,liver injury,kidney injury,and ECG abnormalities are more common in new recruits after military training in high temperature and high humidity environment.

OBJECTIVES: This study evaluated the prognostic power of serum uric acid (UA) in predicting adverse events in elderly acute coronary syndrome (ACS) patients with diabetes mellitus (DM). METHODS: The analysis involved 718 ACS patients ‍>80 years old whose general clinical data and baseline blood biochemical indicators were collected prospectively from January 2006 to December 2012. These patients were classified into two groups based on DM status, and then followed up after discharge. The Kaplan-Meier method was used for major adverse cardiac event (MACE) rates and all-cause mortality. Multivariate Cox regression was performed to analyze the relationship between UA level and long-term clinical prognosis. Receiver operating characteristic (ROC) curves were analyzed to predict the cutoff value of UA in elderly ACS patients with DM. There were 242 and 476 patients in the DM and non-DM (NDM) groups, respectively, and the follow-up time after discharge was 40‒120 months (median, 63 months; interquartile range, 51‒74 months). RESULTS: The all-cause mortality, cardiac mortality, and MACE rates in both DM and NDM patients were higher than those in the control group ( CONCLUSIONS Serum UA level is a strong independent predictor of long-term all-cause death and MACE in elderly ACS patients with DM.

Objective: To study the effect of levosimendan treatment in patients of dilated cardiomyopathy (DCM) with different heart fraction. Methods: A total of 145 DCM patients were enrolled, based on left ventricular ejection fraction (LVEF), the patients were divided into 3 groups: Mild heart failure (HF) group, the patients with LVEF≤45%,n=15, Moderate HF group, LVEF≤40%,n=58 and Severe HF group, LVEF≤30%,n=72. LVEF, left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD) and blood levels of BNP were examined and compared at prior and 7 days after levosimendan treatment respectively. Results: Compared with prior treatment, fater7 days of levosimendan medication, LVEF was elevated at certain degree in all 3 groups, while the statistic improvement was only found in Severe HF group (26.06±3.59) % vs (24.79±2.81) %,P<0.05; LAD and LVEDD had no obvious changes with levosimendan medication in all 3 groups,P>0.05. After levosimendan treatment, blood levels of BNP were decreased in all 3 groups as in Mild HF group (604.80±631.87) pg/ml vs (1252.17±1435.39) pg/ml, Moderate HF group (2369.78±2478.59) pg/ml vs (3206.90±2677.15) pg/ml and Severe HF group (4879.63±5302.42) pg/ml vs (6004.46±5041.59) pg/ml, allP<0.05. The differences of BNP level between prior and after levosimendan treatment, the ratio for BNP reduction were similar among 3 groups, allP>0.05. Conclusion: Levosimendan may, in short term, improve the cardiac function in DCM patients with mild, moderate and severe HF with similar degree; while it could not really change the cardiac structure.

Objective To explore the association between urinary microalbumin-to-creatinine ratio (ACR) and brachial-ankle pulse wave velocity (baPWV) in hypertensive patients.Methods A total of 877 primary hypertension patients were enrolled in this trial from September 2009 to December 2012,and were randomly recruited and patients were divided into normal ACR group (ACR ＜ 30 mg/g,n =723),microalbuminuria group (30 mg/g ≤ ACR ＜ 300 mg/g,n =136) and macro-albuminuria group (ACR ≥300 mg/g,n =18).baPWV was measure by automatic pulse wave velocity measuring system.Results The baPWV values in patients of micro-albuminuria group and macro-albuminuria group were significantly higher than in the normal ACR group (all P ＜ 0.05).The baPWV value of macro-albuminuria group was significantly higher than in the micro-albuminuria group (P ＜ 0.05).Linear correlation analysis revealed that ACR was positively correlated with baPWV (r =0.413,P ＜ 0.01).Multiple linear regression analysis showed that ACR independently correlated with baPWV in patients with primary hypertension (β =0.29,R2 =0.112,P ＜ 0.01) after adjusting for age,sex,body mass index,systolic blood pressure,diastolic blood pressure,blood glucose,total cholesterol,low density lipoprotein,high density lipoprotein and triglyceride.Using ACR ＜ 30 mg/g and ACR ≥ 30 mg/g as dichotomous variable,binary logistic regression analysis showed that ACR≥30 mg/g was also a risk factor of the ascending baPWV in primary hypertension patients (OR:1.73,95％ CI:1.62-2.98) after adjusting the traditional cardiovascular risk factors.Conclusion ACR is positively correlated to baPWV in primary hypertension patients,and the ascending baPWV is a risk factor of early renal dysfunction in primary hypertension patients.

OBJECTIVETo understand the characteristics of recreational drug users' behaviors and social network, as well as their potential impact to the transmission of sexual transmitted infections (STI).

METHODSQualitative interview was used to collect information on rough estimation of population size and behavior change before and after recreational drug use. A total of 120 participants were recruited by convenient sampling from April to October, 2013 in a community of Qingdao city. Blood specimens were taken for HIV/syphilis serological testing and social network analysis was performed to understand the characteristics of their behavior and social network.

RESULTSAll participants used methamphetamine and 103 of them showed social connection. The prevalence of syphilis and HIV were 24.2% (29/120) and 2.5% (3/120) respectively. The estimated size of recreational drug users was big with a wide diversity of occupations and age range, and males were more frequent than females. Drug use may affect condom use and frequent drug users showed symptom of psychosis and neuro-toxicities. The size of social network was 2.45 ± 1.63 in the past 6 months, which indicated an increasing trend of the sexual partner number and risky behaviors.

CONCLUSIONRecreational drug use could increase the size of social network among sex partners, the frequency of risky sexual behaviors and syphilis prevalence, which indicate a high risk of HIV/STI among this population as well as a huge burden of disease prevention and control in the future.

Adolescent ; Drug Users ; Female ; HIV Infections ; Humans ; Male ; Methamphetamine ; Prevalence ; Risk-Taking ; Sexual Partners ; Social Support ; Syphilis ; Unsafe Sex

Objective To understand the characteristics of recreational drug users′behaviors and social network, as well as their potential impact to the transmission of sexual transmitted infections (STI). Methods Qualitative interview was used to collect information on rough estimation of population size and behavior change before and after recreational drug use.A total of 120 participants were recruited by convenient sampling from April to October , 2013 in a community of Qingdao city.Blood specimens were taken for HIV/syphilis serological testing and social network analysis was performed to understand the characteristics of their behavior and social network.Results All participants used methamphetamine and 103 of them showed social connection.The prevalence of syphilis and HIV were 24.2%( 29/120 ) and 2.5%(3/120) respectively.The estimated size of recreational drug users was big with a wide diversity of occupations and age range , and males were more frequent than females .Drug use may affect condom use and frequent drug users showed symptom of psychosis and neuro-toxicities.The size of social network was 2.45 ± 1.63 in the past 6 months, which indicated an increasing trend of the sexual partner number and risky behaviors .Conclusion Recreational drug use could increase the size of social network among sex partners , the frequency of risky sexual behaviors and syphilis prevalence , which indicate a high risk of HIV/STI among this population as well as a huge burden of disease prevention and control in the future .

Objective To understand the characteristics of recreational drug users′behaviors and social network, as well as their potential impact to the transmission of sexual transmitted infections (STI). Methods Qualitative interview was used to collect information on rough estimation of population size and behavior change before and after recreational drug use.A total of 120 participants were recruited by convenient sampling from April to October , 2013 in a community of Qingdao city.Blood specimens were taken for HIV/syphilis serological testing and social network analysis was performed to understand the characteristics of their behavior and social network.Results All participants used methamphetamine and 103 of them showed social connection.The prevalence of syphilis and HIV were 24.2%( 29/120 ) and 2.5%(3/120) respectively.The estimated size of recreational drug users was big with a wide diversity of occupations and age range , and males were more frequent than females .Drug use may affect condom use and frequent drug users showed symptom of psychosis and neuro-toxicities.The size of social network was 2.45 ± 1.63 in the past 6 months, which indicated an increasing trend of the sexual partner number and risky behaviors .Conclusion Recreational drug use could increase the size of social network among sex partners , the frequency of risky sexual behaviors and syphilis prevalence , which indicate a high risk of HIV/STI among this population as well as a huge burden of disease prevention and control in the future .

Objective To investigate the effect and mechanism of compound glycyrrhizin on airway inflammation in asthmatic rats. Methods Forty wistar rats were randomly divided into health group (group Ⅰ), asthma group(group Ⅱ), treating group (group Ⅲ) and treating control group (group Ⅳ) (n=10 in each group). Group Ⅱ, group Ⅲ and group Ⅳ received intraperitoneal injection of ovalbumin (OVA) and aluminum hydroxide gel for sensitization and OVA aerosol by ultrasonic nebulization for challenge, in addition, group Ⅲ re-ceived intraperioneal injection of 200 μg of compound glycyrrhizin 1 hour before OVA aerosol challenging every time, and group Ⅳ were in-jected with normal saline instead of compound glycyrrhizin. Group Ⅰ were injected and nebulizated with normal saline instead of OVA and alu-minlum hydroxide. All rats were sacrificed at the 6th hour after the last challenging, venous blood and bronchoalveolar lavage fluid(BALF) were collected, the IgE in venous blood were determined and the concentration of IL-4, IL-5, IL-13 and IFN-γ in BALF were detected, the cells in BALF were counted and detached. Results The concentration of IgE, IL-4, IL-5, IL-13 and the count of neutrophilic granulocytcs, lymphocytes, cosinophils in group Ⅱ were significantly higher than those in group Ⅰ and group Ⅲ(P<0.01), and the concentration of IFN-γ in group Ⅰ and group Ⅳ were significantly lower than those in group Ⅰ and group Ⅲ(P <0.01). There was no significant difference be-tween group Ⅱ and group Ⅳ(P >0. 05). The concentration of IgE, IL-4, IL-5, IL-13 and the count of neutrophilic granulocytes, lympho-cytes, cosinophils in group Ⅲ were higher than those in group Ⅰ, and the concentration of IFN-γ and the count of mononucleat macroplile cells in group Ⅲ were lower than those in group Ⅰ, but there were no significant difference(P>0.05). Conclusion Compound giycyrrhiz-in alleviated the airway inflammation and reduced the airway hyperresponsiveness in asthmatic rats, which mechanism may be related to regu-lating the balance of Th1/Th2 cytokines, suppressing the immune ability of Th2 and promoting the immune ability of Th1.