实时三维超声输卵管造影与X线造影诊断不孕症患者输卵管病变的价值比较

目的:比较实时三维超声输卵管造影与X线造影检查诊断女性不孕症患者输卵管病变的临床应用价值。方法:选择2014年3月至2016年12月我院诊治的不孕症患者60例作为研究对象,所有患者都于月经干净后3-7 d同时随机实施实时三维超声输卵管造影与X线造影检查,观察并记录造影图像质量与诊断结果,比较两种方法的诊断效果。结果:实时三维超声输卵管造影与X线造影的图像质量优良率分别为98.3%和86.7%,实时三维超声输卵管造影的图像质量明显高于X线造影(P0.05)。实时三维超声输卵管造影与X线造影诊断不孕症患者输卵管不通畅率分别为56.7%和46.7%,实时三维超声输卵管造影组显著高于X线造影组(P0.05)。输卵管通畅性评价金标准腹腔镜下通液术诊断发现输卵管不通畅35例,在此基础上实时三维超声输卵管造影与X线造影检查不孕症的敏感性分别为97.1%和80.0%,特异性均为100.0%,超声诊断的敏感性明显高于X线(P0.05)。结论:相对于X线造影,实时三维超声输卵管造影检查不孕症患者输卵管病变的图像质量更好,有利于疾病的判断,对输卵管通畅度判断更精确,利于后期治疗及疾病预防,还可提高诊断敏感性。     

不孕症女性三维子宫输卵管造影联合阴道二维超声的诊断意义

摘要 目的：探讨不孕症女性三维子宫输卵管造影联合阴道二维超声的诊断意义。方法：2019年3月至2020年10月选择在西安医学院第二附属医院和陕西省人民医院诊治的不孕症女性患者90例,所有患者都给予三维子宫输卵管造影联合阴道二维超声检查,记录成像质量与疼痛情况。以X线子宫输卵管造影为金标准,判断诊断价值。结果：检查过程中三维超声造影患者的疼痛评分高于二维超声,对比差异无统计学意义(P>0.05)。三维超声造影的成像质量优良率为100.0 %（90/90）,高于二维超声的93.3 %（84/90）,对比差异有统计学意义(P<0.05)。在90例患者中,三维超声造影判断为卵巢周围组织弥散1级59例,2级16例,3级10例,4级5例。三维子宫输卵管造影联合阴道二维超声判断为输卵管通畅55例,通而不畅25例,阻塞10例。X线子宫输卵管造影判断为输卵管通畅53例,通而不畅26例,阻塞11例,三维子宫输卵管造影联合阴道二维超声诊断的准确性为96.7 %(87/90)。结论：三维子宫输卵管造影联合阴道二维超声在不孕症女性的应用并不会增加患者疼痛,且能提高成像质量,也有利于合理评价与判断患者的输卵管通畅情况。     

三维子宫输卵管超声造影与X线子宫输卵管造影的检查的比较研究

为了进一步探讨三维子宫输卵管超声造影与X线子宫输卵管造影在临床上优缺点和应用价值,本研究对在我院收治的不孕症患者均进行了3D-HyCoSy、HSG检查,并与LSC诊断进行比较,以期在临床上为输卵管性不孕检查提供理论依据。本研究选取了62例不孕症患者,均先后进行了三维子宫输卵管超声造影(3D-HyCoSy)、X线子宫输卵管造影(HSG)及腹腔镜通染液实验(LSC)。对62例患者共124条输卵管行3D-HyCoSy检查表明,与LSC检查相比其Kappa值为0.774,p0.05,一致性好,诊断不通畅的灵敏度、特异性、阴性预测值、阳性预测值分别为97.87%、60.00%、90.00%和88.46%;而HSG检查表明,与LSC检查相比其Kappa值为0.774,p0.05,一致性好,诊断不通畅的灵敏度、特异性、阴性预测值、阳性预测值分别为98.93%、63.33%、89.42%和95.00%;进一步,将3D-HyCoSy与HSG检查诊断输卵管准确率进行比较,准确率分别为85.48%和84.68%,差异比较无统计学意义(p0.05)。我们的研究表明:三维子宫输卵管超声造影与X线子宫输卵管造影临床诊断的检查准确性相当,但三维子宫输卵管超声造影检查无创、无放射性,操作较为简便,且图像更为清晰,其造影剂还具有一定的舒通输卵管作用,总体诊断效果更好。     

实时三维超声造影对输卵管伞端通畅性及功能的评价效果

目的:探讨实时三维超声造影对输卵管伞端通畅性及功能的评价效果。方法:选取我院2019年6月到2021年6月收治的120例因不孕症自愿接受RT 3D-HyCoSy检查的患者作为研究对象,对所有患者分别应用静态三维与实时三维超声造影,并以腹腔镜下美兰通染液检查作为金标准,记录与分析相关指标。结果:120例患者共240条输卵管,美兰通染液检查诊断发现输卵管通畅58条,阻塞/粘连182条,实时三维超声造影检查发现通畅51条,阻塞/粘连189条,静态三维通畅44条,阻塞/粘连196条,实时三维超声造影与静态三维联合通畅56条,阻塞/粘连184条。实时三维超声造影与静态三维联合诊断组、实时三维超声造影组这两组的准确度、特异度、灵敏度、阳性预测值、阴性预测值均高于静态三维组(P<0.001);120名患者通过临床综合诊断发现,35例一侧输卵管阻塞患者,64例双侧输卵管阻塞患者,21例双侧输卵管通畅患者,不同输卵管通畅性三组患者推注压力、VAS评分、造影剂注入量、造影剂返流量对比差异显著(P<0.05)、通畅与阻塞患者造影剂通过输卵管间质部时间及造影剂通过输卵管伞端时间对比差异显著(P<0.05)。结论:对于不孕症患者应用RT 3D-HyCoSy,经检查输卵管伞端粘连和通畅性,进而诊断输卵管通畅性,为不孕症的诊断与治疗提供一定的参考意见。此外,应用实时三维超声造影与静态三维超声能提升输卵管伞端通畅性诊断率,值得临床应用推广。     

四维子宫输卵管超声造影假阳性与假阴性的原因分析

目的:调查与分析四维子宫输卵管超声造影假阳性与假阴性的原因。方法:选择2015年6月到2019年8月在本院妇产科临床初步诊断为输卵管不孕症患者125例,所有患者都给予X线子宫输卵管碘油造影(Hysterosalp ingography,HSG)与四维子宫输卵管超声造影,记录诊断效果、不良反应,判断假阳性与假阴性的发生原因。结果:在125例患者中,HSG诊断输卵管通畅33例,通而不畅72例,阻塞20例;四维超声造影诊断为输卵管通畅33例,通而不畅74例,阻塞18例。将HSG检查作为金标准,四维超声造影检查输卵管阻塞准确率93.6%,Kappa值=0.929(P<0.05),出现假阳性与假阴性共8例。四维超声造影检查期间发生的阴道少量出血、造影剂过敏、恶心呕吐、腹痛等不良反应发生率为2.4%,显著低于HSG检查的13.6%(P<0.05)。单因素分析结果显示合并糖尿病、产次、初潮年龄、孕次与四维子宫输卵管超声造影的假阳性与假阴性显著相关(P<0.05);多因素Logistic回归分析结果显示合并糖尿病、产次、初潮年龄为导致四维子宫输卵管超声造影假阳性与假阴性的主要原因(P<0.05)。结论:四维子宫输卵管超声造影可实时动态观察输卵管通畅情况,应用安全性也比较好,但是也存在假阳性与假阴性情况,合并糖尿病、产次、初潮年龄为导致四维子宫输卵管超声造影假阳性与假阴性的主要原因。     

全氟显4D-HyCoSy与3D-HyCoSy对输卵管性不孕症患者的诊断效果评价

摘要 目的：探讨与评价全氟显子宫输卵管四维超声造影（4D-HyCoSy）与经阴道三维超声输卵管造影（3D-HyCoSy）对输卵管性不孕症患者的诊断效果。方法：选择2018年8月到2021年11月选择在本院诊治的女性不孕症患者84例作为研究对象,都给予全氟显4D-HyCoSy与3D-HyCoSy诊断,记录图像质量与不良反应发生情况。金标准为腹腔镜检查,判断诊断效果。结果：在84例患者中,全氟显4D-HyCoSy的图像质量优良率为100.0 %,高于3D-HyCoSy的92.9 %（P<0.05）。全氟显4D-HyCoSy诊断为输卵管通畅14例,输卵管通而不畅23例,输卵管阻塞47例。3D-HyCoSy诊断：22例输卵管通畅,21例输卵管通而不畅,41例输卵管阻塞。腹腔镜诊断：15例输卵管通畅,21例输卵管通而不畅,48例输卵管阻塞。全氟显4D-HyCoSy、3D-HyCoSy对输卵管性不孕症患者的诊断敏感性为100.0 %（36/36）、97.2 %（35/36）,特异性为97.9 %（47/48）、83.3 %（40/48）。84例患者在全氟显4D-HyCoSy、3D-HyCoSy检查期间发生的不良反应主要为阴道出血、恶心呕吐、腹部疼痛等,不良反应发生率对比无差异（P>0.05）。全氟显4D-HyCoSy对输卵管性不孕症患者的诊断敏感性与3D-HyCoSy对比无差异（P>0.05）,诊断特异性高于3D-HyCoSy（P<0.05）。结论：相对于3D-HyCoSy,全氟显4D-HyCoSy在输卵管性不孕症患者的应用能提高图像质量优良率,具有很好的安全性,还具有更好的诊断特异性。     

联合应用2D-HyCoSy和4D-HyCoSy诊断不育症妇女输卵管通畅性的效果

为探讨经阴道二维子宫输卵管超声造影(2D-Hy Co Sy)联合四维子宫输卵管超声造影(4D-HyCoSy)诊断不育症妇女输卵管通畅性的效果,本研究选取80例(160例输卵管)不育症妇女作为研究对象,分别接受2D-HyCoSy和4D-HyCoSy检查,以腹腔镜下通液检查作为金标准,观察两种超声造影检查及二者联合应用诊断输卵管通畅性的价值。结果显示,2D-Hy CoSy诊断输卵管闭塞的灵敏度为74.51%、特异度为81.65%、漏诊率为25.49%、误诊率为18.35%;4D-Hy CoSy诊断输卵管闭塞的灵敏度为84.31%、特异度为88.07%、漏诊率为15.69%、误诊率为11.93%;2D-HyCoSy联合4D-HyCoSy诊断输卵管闭塞的灵敏度为98.04%、特异度为92.66%、漏诊率为1.96%、误诊率为7.34%。本研究说明2D-HyCoSy联合4D-HyCoSy诊断输卵管通畅性较二者单独应用具有更高的灵敏度和特异度,具有临床广泛推广的潜在价值。     

超声监视子宫输卵管造影的临床研究

目的:探讨超声监视子宫输卵管造影(sonohysterosalpingography,SHSG)在临床中的实用价值.方法:对86例不孕症患者行阴道超声监视子宫输卵管生理盐水造影,观察宫腔、输卵管通畅情况,宫腔检查结果与宫腔镜(hysteroscopy,HS)检查宫腔的结果做比较,输卵管检查结果与宫腹腔镜联合检查作比较.结果:SHSG检查的86例不孕患者中发现子正常宫腔58例,宫内膜息肉样改变12例,子宫内膜异常增生11例,粘膜下子宫肌瘤2例,子宫粘连2例,纵隔子宫1例.宫腔镜检查发现宫腔正常56例,异常宫腔30例.SHSG灵敏度为80.00%,特异度为92.86%.另外SHSG检查发现44条输卵管通畅,49条通而不畅,79条梗阻.将SHSG与宫腹腔镜检查宫腔及输卵管结果分别进行统计学分析,显示两组均无明显差异(P>0.05).结论:SHSG方法简单,诊断可靠,操作方便,可重复,动态观察,痛苦小,安全可靠,可以作为女性不孕症的筛检方法之一.     

经输卵管注药介入治疗慢性盆腔炎性疼痛及阻塞性不孕的路径探讨和疗效观察

目的为探索治疗慢性盆腔痛及不孕的理想方法,本文尝试通过输卵管注药介入治疗盆腔炎性后遗症等疼痛疾病及输卵管阻塞性不孕,观察其疗效并对输卵管这条自身路径进一步拓宽利用进行实践论证。方法应用NCI—I型数字化输卵管通液诊断治疗仪对56例盆腔炎性等疼痛、伴有不孕或计划妊娠的患者结合超声监测通液诊断,根据输卵管通畅程度分别给予盆腔注药或输卵管疏通后介入治疗。结果56例盆腔疼痛患者仅有19例输卵管通畅,37例输卵管阻塞（不全阻塞25例,11例不通）,占66．1％。治疗后通畅组盆腔疼痛消失16例,治愈率为84．2％;不全阻塞组疼痛减轻20例,好转率为76．9％,其中14例患者输卵管得以疏通;不通组45．5％（5／11）病情好转,输卵管疏通率为63。6％（7／11）;通畅组疼痛治愈率明显高于不全阻塞和不通组（P〈0．05）。盆腔炎性疼痛治愈率和输卵管疏通率分别为45．5％和82．4％,内异症等疼痛组为13．0％和65.0％,后者虽不及前者理想（P〈0．05）,但确有60．9％患者疼痛好转。本文输卵管阻塞疏通率为72．9％,慢性盆腔疼痛治疗有效率达87．5％。结论输卵管是一条与生俱来的自身生理通道,可拓宽利用诊治盆腔疾病。NCI—I型数字化输卵管通液诊断治疗仪盆腔注药介入治疗是一种准确易行、安全无创、科学有效的诊治盆腔炎性等疾病的方法。实践证明,疏通这条路径不仅在阻塞性输卵管不孕方面起到了至关重要的临床作用,对治疗盆腔炎性后遗症等慢性盆腔疼痛疾病也有较高的研究价值,值得进一步探索和应用,并有广阔的前景和发展空间。     

有回声型超声造影在诊断婴儿幽门肥厚性狭窄中的优势

为研究并讨论有回声型超声造影剂在诊断婴儿幽门肥厚性狭窄中的优势。本研究随机抽取2014年4月至2015年12月在本院就诊的40例疑诊IHPS的呕吐患儿,入选患儿均行超声造影、普通超声及X线造影检查。与手术治疗、药物保守治疗后的确诊结果相比,超声造影、普通超声检查和X线造影对IHPS患儿的诊断符合率分别为97.50%、92.50%和92.50%,Youden指数分别为88.89%、82.44%和74.55%,Kappa值分别为0.925、0.805和0.776,超声造影检查对IHPS的诊断效果明显优于普通超声检查和X线造影检查。由此得出结论,超声造影显示的幽门管结构层次较普通超声更加清晰,可以为外科手术提供更准确的参数测量值,避免术中切开深度过大造成不必要的伤害;超声造影较X线无辐射,通过实践可以证实超声造影能够完全取代X线造影,可以作为诊断IHPS时普通超声检查的补充或者替代。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.     

Composition and diversity of bird communities in Swedish farmland–forest mosaic landscapes

CapsuleThe amount of forest (at local and landscape scales) and occurrence of residual habitats at the local scale are shown to be the major factors influencing bird community composition in farmland–forest landscapes in central Sweden.

Aims To investigate the importance of local habitat and landscape structure for breeding birds in farmland–forest landscapes in central Sweden.

Methods Breeding birds were censused at 292 points. A detailed habitat mapping was made within 300 m of the points. Within a 300–600 m radius only two major habitats (forests and arable fields) were identified.

Results Cluster analyses of bird communities identified three site types that also differed in habitat composition: (i) partially forested sites in forested landscapes; (ii) heterogeneous sites with residual habitats in mosaic landscapes; and (iii) field-dominated farmland sites in open landscapes. A total of 19 of 25 farmland bird species (restricted to farmland or using both farmland and forest) had the highest abundance in farmland sites with mosaics of forest and farmland, while only six farmland species had the highest abundance in field-dominated sites. The bird community changed from being dominated by farmland species to being dominated by forest species (common in forest landscapes without farmland) at small proportions (10–20%) of forest at the local scale. A major difference in habitat composition between heterogeneous and field-dominated sites was the occurrence of different residual habitats (e.g. shrubby areas and seminatural grasslands). These habitats seemed to influence bird community composition more than land-use, despite covering <10% of the area. Seminatural grasslands were important for bird community composition and species-richness, but grazing seemed to be less important. Among different land-use types, cereal crops were the least preferred fields. Set-asides with tall vegetation and short rotation coppices were positively associated with species-richness of farmland birds.

Conclusion In general, the composition of the landscape was important for bird community composition, although amount and distribution of forests, occurrence of residual habitats and land-use of fields at the local scale had the strongest influence on bird community composition. The possible implications of these patterns for managing farmland–forest landscapes are discussed.     

Chemical constituents from the fruits of Rhus typhina L. and their chemotaxonomic significance

This work describes the isolation and characterization of twenty-nine compounds from the fruits of Rhus typhina L., including eleven flavonoids (1–11), eleven phenols (12–22), two pentacyclic triterpenes (23–24), two organic acids (25–26), one lumichrome (27), one courmarin (28) and one pyrimidine (29) on the basis of their spectroscopic data. Compounds apigenin (1), daidzein (4), orobol (5), 3′, 5, 5′, 7-tetrahydroxyflavanone (6), naringenin (7), butein (8), (-)-catechin (9), quercetin-3-O-α-L-(3″-O-galloyl)-rhamnoside (11), 2-hydroxybenzoic acid (13), 4-hydroxybenzaldehyde (14), vanillin (15), methyl 3,4-dihydroxybenzoate (16), 3,5-dihydroxybenzamide (18), tyrosol (19), caffeic acid (20), 3-(2,4,6-trihydroxyphenyl)-1-(4-hydroxyphenyl)-propan-1-one (21), phlorizin (22), friedelin (23), oleanolic acid (24), 4,4-dimethyl-heptanedioic acid (25), anthranilic acid (26), lumichrome (27), scoparone (28) and uracil (29) have not been recorded before in this plant. This is the first report on the occurrence of compounds 4–7, 9, 11, 13–14, 16, 18–21, 25–29 from the genus Rhus. Moreover, the chemotaxonomic significance of these isolated compounds was also summarized.