三维能量多普勒超声联合血清HE4、TK1、YKL-40对绝经后出血患者子宫内膜癌的预测价值

摘要 目的：研究三维能量多普勒超声联合血清人附睾蛋白4（HE4）、胸苷激酶1（TK1）、甲壳质酶蛋白40（YKL-40）对绝经后出血患者子宫内膜癌的预测价值。方法：选择我院2019年10月～2022年10月收治的150例绝经后出血患者。将其按照病理检查结果的差异分为子宫内膜癌组31例与子宫内膜良性增生组119例。对所有患者均开展三维能量多普勒超声检查,并检测血清HE4、TK1、YKL-40水平。以受试者工作特征曲线（ROC）分析三维能量多普勒超声联合血清HE4、TK1、YKL-40水平预测绝经后出血患者子宫内膜癌的效能。结果：子宫内膜癌组血流指数（FI）、血管形成指数（VI）、血管形成-血流指数（VFI）以及由该三参数构建的综合指数I相较于子宫内膜良性增生组均更高（均P＜0.05）。子宫内膜癌组血清HE4、TK1、YKL-40水平相较于子宫内膜良性增生组均更高（均P＜0.05）。经ROC曲线分析发现：三维能量多普勒超声联合血清HE4、TK1、YKL-40水平预测绝经后出血患者子宫内膜癌的曲线下面积（AUC）、灵敏度、特异度以及约登指数均高于上述四项单独预测。结论：三维能量多普勒超声联合血清HE4、TK1、YKL-40水平预测绝经后出血患者子宫内膜癌的效能较佳。     

A study of blood flow in microvessels using biospeckle dynamics

Hydrodynamic properties of blood flows in small microvessels and the patterns of scattering of focused laser beams in such flows were studied. The processes of formation of dynamic biospeckles are considered. The relationship between the optical parameters and hydrodynamic characteristics of blood microflow are analyzed. A new method is proposed for measureming the plasma rate in small microvessels with the use of in vivo microscopy in combination with speckle microscopy.     

Influence of l-arginine supplementation on reproductive blood flow and embryo recovery rates in mares

Supplementation with l-arginine can increase uterine arterial blood flow and vascular perfusion of the preovulatory follicle in mares. Increased vascular perfusion of the preovulatory follicle has been correlated with successful pregnancy in mares. The objective of this study was to determine if supplemental l-arginine would increase ovarian arterial blood flow, vascular perfusion of the preovulatory follicle, and embryo recovery rates in mares. Mares were blocked by age and breed and assigned at random within block to l-arginine supplementation or control groups. Mares were fed l-arginine beginning 17 days before and through the duration of the study. Transrectal Doppler ultrasonography was used to measure ovarian arterial blood flow and vascular perfusion of the preovulatory follicle daily when it reached 35 mm and subsequent CL on Days 2, 4, and 6. Mares, on achieving a follicle of 35 mm or more were bred via artificial insemination and an embryo collection was attempted 7 days after ovulation. Treatment did not affect interovulatory interval (arginine-treated, 18.1 ± 2.6 days; control, 20.7 ± 2.3 days) or embryo recovery rate (arginine-treated, 54%; control, 48%). Mares treated with l-arginine had a larger follicle for the 10 days preceding ovulation than control mares (30.4 ± 1.2 and 26.3 ± 1.3 mm, respectively; P < 0.05) and vascular perfusion of the dominant follicle tended (P = 0.10) to be greater for the 4 days before ovulation. No differences were observed between groups in diameter or vascular perfusion of the CL. Resistance indices, normalized to ovulation, were not significantly different between groups during the follicular or luteal phase. Oral l-arginine supplementation increased the size and tended to increase perfusion of the follicle 1, but had no effect on luteal perfusion or embryo recovery rates in mares.     

三维能量多普勒超声鉴别宫颈过短孕妇先兆早产的作用研究

目的：使用三维能量多普勒超声比较先兆早产和无症状宫颈过短单胎孕妇的宫颈体积和血管指数。方法：预先扫描妊娠 24-34.6 周的300 例无症状健康孕妇的宫颈长度。将宫颈长度过短，小于孕周的10%的孕妇纳入无症状宫颈短组，测量该组孕妇宫 颈体积和血管指数（Ⅵ）、血管血流指数（VFI）和血流指数（FI）。先兆早产组患者入院的24 小时内测量同样的超声参数。记录孕妇 的体重指数、孕周、吸烟状况、经产状况、早产家族史、母亲为早产出生者以及之前的早产情况等数据。比较两组孕妇超声检查结 果和病史参数。结果：29 例无症状健康妇女（9.6%）宫颈较短。两组间的病史参数或宫颈长度无显著差异。先兆早产组的宫颈体积 较小（12.90 vs 17.168 cm3，P = 0.005）。无症状宫颈过短孕妇的VI 和VFI 均较低（VI：4.369% vs 15.939%，P<0.001；VFI：1.514 vs 4.878，P<0.001）。宫颈过短组的FI较高（33.581 vs 30.311，P=0.006）。结论：无症状宫颈过短组孕妇与先兆早产组孕妇之间的宫颈 长度类似，但两组间宫颈体积和血管指数存在差异。     

Functional assessment of moisture influenced cadaveric tympanic membrane using phase shift‐resolved optical Doppler vibrography

An elevated relative moisture in the external ear canal and middle ear cavity may predispose to chronic otorrhea and related infections along with abnormal tympanic membrane (TM) vibration patterns. Therefore, phase shift‐resolved optical Doppler vibrography (ODV) was used for vibration assessments of moisture influenced cadaveric TM. ODV was applied to generate time resolved cross‐sectional and volumetric vibrographs of a cadaveric TM, driven acoustically at several frequencies. In order to analyze the effect of moisture on TM, homogenous moisture conditions were provided by soaking the cadaveric TM specimens in 1× phosphate buffer saline with a pH of 7.4. The TM specimen was exposed to a rapidly switchable frequency generator during the ODV image acquisition. The experiment was conducted for 3 hours and the cadaveric TM was exposed to each frequency with an interval of 30 minutes. Acquired phase shift‐resolved ODV assessments revealed a depth dependent vibration tendency between the applied frequencies, along with a decline in the moisture level of the cadaveric TM specimen. Thus, the ODV method can aid our understanding of sound conduction in the middle ear, thus supporting the diagnosis of TM diseases.     

CDFI在儿童过敏性紫癜致急性双下肢静脉瓣膜功能不全中的应用

目的:探讨CDFI在儿童过敏性紫癜至下肢静脉瓣膜功能不全中的应用,以提高临床认识。方法:对经临床诊断过敏性紫癜引发下肢静脉瓣膜功能不全5例患儿图像资料给以回顾、归纳总结。结果:5例患儿下肢深静脉表现血液流速稍减慢,CDFI呈节阶段性红蓝相间血流,频谱多普勒呈节段性基线上下血流频谱。结论:CDFI为儿童急性过敏性紫癜致急性双下肢静脉瓣膜功能不全,提供了早期、无创和具有高敏感性、特异性的检查方法,对临床的诊治有重要价值。     

Doppler evaluation of maternal and fetal vessels during normal gestation in rabbits

The aim of this work was to evaluate the hemodynamic changes in the utero-placental arterial vessels in rabbits (Orictolagus cuniculus) throughout pregnancy as well as those in the umbilical cord, aorta, and caudal vena cava of fetuses to establish their normal reference ranges for systolic peak velocity (SPV), end diastolic velocity (EDV), pulsatility index (PI), and resistance index (RI). The blood flow waveforms were monitored every 4 d in 10 rabbits from Day 10 of pregnancy onward by means of color and pulsed wave Doppler ultrasonography using a 5.5-7.5 MHz microconvex transabdominal probe. The utero-placental blood flow was characterized by steep increases and decrease in the SPV with a slow diastolic wave and relatively high EDV, whereas that of the umbilical artery was discontinuous until Day 22 of pregnancy, when a diastolic waveform was also detectable. From Day 10 to 22 of pregnancy, the fetal aorta blood flow was discontinuous, but thereafter a diastolic peak was measurable. The blood flow of the fetal caudal vena cava was characterized by a systolic peak followed by a small diastolic peak. Throughout the gestation, the SPV and the EDV of maternal and fetal vessels increased (α < 0.05), whereas the PI and the RI decreased (α < 0.05), except for the utero-placental vessels. This work confirms that the rabbit could also be a valid experimental animal model to study, by Doppler ultrasonography, functional hemodynamic changes of the fetuses and placenta vessels in both normal and pathophysiologic conditions.     

Near-bottom performance of the Acoustic Doppler Velocimeter (ADV) – a comparative study

In a laboratory flume, a comparative study on the near-bottom performance of the Acoustic Doppler Velocimeter (ADV) was conducted. Two different ADV systems were tested for different configurations and two flow velocities (9 cm s⁻¹, 18 cm s⁻¹). The results were compared with synchronous measurements with a Laser Doppler Anemometer (LDA). Near-bottom velocity measurements with the ADV have to be interpreted carefully as the ADV technique underestimates flow velocities in a zone close to the sediment. The height of this zone above the sediment varies with different ADV systems and configurations. The values for nominal sampling volume height (SVH) given by the software often underestimate the true, effective sampling volume heights. Smaller nominal SVH improve the ADV near-bottom performance, but the vertical extent of the zone in which the ADV underestimates flow by more than 20% may be larger than true SVH/2 by a factor of 2 (=true SVH). When the measurement volume approaches the bottom, ADV data quality parameters (signal-to-noise-ratio (SNR) and signal amplitude) exceeding the average ‘open water’ level, are clear indicators that the ADV has begun to underestimate the flow velocity. Unfortunately, this is not a safe indicator for the range of reliable measurements as the ADV may begin to underestimate velocities even with unchanged ‘open water’ data quality parameters. Thus, one can only recommend avoiding measurements below a distance from the bottom that was defined empirically comparing the ADV and the LDA velocity profiles. This distance is 2.5 times nominal sampling volume height for the tested ADV systems and experimental settings.