Objective To evaluate the value of 3-D reconstruction in multi-detector spiral CT urography (MDCTU) for diagnosing upper urinary tract diseases (UUTDs) by means of both diagnostic sensitivity and ROC curve. Methods A total of 41 patients with UUTD were collected. All of them took MDCTU as well as reconstructions including MPR, MIP and VR. Compared with golden standards, the diagnostic value of MDCTU, MPR, MIP and VR were evaluated using both diagnostic sensitivity and ROC curve. Results a) A total of 49 upper urinary tract lesions were detected in those 41 patients; b) For UUTD, the localization diagnostic sensitivities of MPR, MIP, and VR were 48/49 (98.0%), 27/49 (53.2%), and 19/49 (38.8%), respectively; while their qualitative diagnostic sensitivities were 47/49 (95.9%), 17/49 (34.7%), and 13/49 (26.5%), respectively; the differences between MPR and the others were significantly (Plt;0.05); c) For distinguishing benign from malignant lesions, the Az value (area under ROC curve) of MPR, MIP, and VR were 0.998, 0.736 and 0.669, respectively; the differences between MPR and the others were significant (Plt;0.05); and d) MPR was completely the same as MDCTU in both diagnostic sensitivity and Az value. Conclusion The common 3-D reconstructions in MDCTU were different in value. MPR is highest in the diagnostic efficiency, which is similar to MDCTU, and is regarded as the basis of diagnosis; while MIP and VR are more stereo and intuitive. So it shows that the comprehensive application of CTU 3-D reconstructions has important value for diagnosing UUTD and distinguishing benign from malignant.
Objective To discuss the prevalence of melamine-induced urolithiasis in infants and its development and to formulate more effective diagnosis and treatment. Methods A total of 402 cases of melamine-induced infantile urolithiasis were retrospectively analyzed with basic information, blood, urine, urinary B-mode ultrasonic diagnosis, treatment options and prognosis for infant urolithiasis. Results A total of 402 cases of infants had an excessive melamine milk feeding history, in which there were 9 self-discharged cases. The largest calculus diameter was 4 mm × 5 mm × 6 mm. The smallest calculus diameter was 0.5 mm × 0.5 mm × 1 mm. The average calculus diameter was 1 mm × 2 mm × 2 mm. There were 30 cases of abnormal serum creatinine, 27 of abnormal urea, 2 of abnormal uric acid, and urine occult blood positive for 167 cases. There were 395 cases which were administrated medical treatment; 7 cases were administrated surgical treatment; 6 cases had obstructive renal failure. Conclusion Infants whose age is more than six months but less than 12 months with a history of exposure to melamine have the larger risk of urolithiasis. B-mode ultrasonic diagnosis is practically significant on early screening urolithiasis. It is effective to perform surgical treatment for obstructive renal failure caused by calculus.
Objective To investigate the incidence of urolithiasis in infants aged 0-3 years old fed by milk powder tainted with melamine in the middle area of the Anhui province, as well as its relationship to gender, age, milk powder consumption and drinking water. Methods Questionnaires were distributed to 1079 infants who were screened for urolithiasis by ultrasound examination from September 25, 2008 to October 17, 2008. Data was collected by Epidata and analyzed by SPSS 13.0 software. Results A total of 646 (59.87%) male infants and 433 (40.13%) female infants underwent ultrasound examination in Anhui Provincial Hospital. Of these, 86 infants were diagnosed with urolithiasis with an incidence of 7.97%, including 62 males (72.09%) and 24 females (27.91%). The mean age of those infants with urolithiasis was 1.85±0.77, and all of calculus was located in kidney. The relationship between the incidence of urolithiasis and gender, age, drinking water, feeding bottle sanitation, birth status, as well as the amount of milk powder intake was assessed by using the Pearson Chi-square test. Results showed that significant differences were noted in the incidence of urolithiasis among infants of different genders or with different drinking water sources (Plt;0.05). The result of multiple logistic regression analyses indicated that gender was related to the incidence of urolithiasis (Plt;0.05). The incidence of urolithiasis in female infants was only 58.7% of that in male infants (OR 0.587, 95%CI 0.359 to 0.959). Conclusion The incidence of urolithiasis in infants aged 0-3 years of old in the middle area of Anhui province is relatively high and has anatomical specificity. Further data during the follow-up of these cases should be collected.
Objective To investigate the medication usage in 55 children with urinary tract stones due tomelamine contaminated milk powder who were treated in West China Second University Hospital, Sichuan University werecollected. Methods The hospital’s patient records for the 55 melamine poisoning cases leading to urinary tract stones.Using Assess and excel software to analyze the frequency and sum of drug use, as well the average daily costs and per capitacost for patients. Results For the 55 cases of urinary tract stones, a total of 19 categories and 117 kinds of drugs were used. It was been found that Herba Lysimachiae granules were the most used medicine. The most costly was Cefminox, and finally the drug used in the highest quantity was 0.9 percent sodium chloride injection, the drug cost distribution is unevenness.Conclusions The rationality valuation for children medication lacks of international vulgate index, methodology and needs more basic research. It is worth to study the burden of children with basic disease.
Objective To investigate the incidence of urolithiasis in the children who ingested milk powder tainted with melamine in the Chengdu area. Methods A total of 5 795 infants were screened for urolithiasis by ultrasound examination from September 17, 2008 to December 9, 2008. The data were analyzed using SPSS 13.0 software.Results Twenty-four children were diagnosed with urolithiasis with an incidence of 0.41%, including 12 males and 12 females. The mean age of those children with urolithiasis was 2.35±1.68 years old. No significant difference was shown in the incidence of urolithiasis between males and females (Pgt;0.05). The incidence of urolithiasis in the infants aged 0-3 was significantly higher than that in the children who were more than 3 years old (Plt;0.05). Conclusion The incidence of urolithiasis in the infants aged 0-3 in Chengdu and the surrounding areas is relatively high. Further data should be collected during the follow-up of these cases.
【摘要】 目的 探讨婴幼儿常见泌尿系统先天发育异常的超声特征。 方法 回顾性分析2008年9月17日-2010年6月1日体检的婴幼儿中所发现的各种泌尿系统先天性发育异常的超声表现。 结果 发现泌尿系统先天性发育异常88例，其中肾缺如50例，多房性肾囊性变10例，多囊肾2例，肾旋转不良1例，重复肾10例，输尿管囊肿6例，异位肾7例，融合肾2例。 结论 婴幼儿常见的泌尿系统先天性发育异常有较特异的超声表现，超声检查是筛查婴幼儿泌尿系统先天性发育异常的首选影像学检查方法。【Abstract】 Objective To study the ultrasonic characteristics of congenital malformation of infantile urinary system. Methods We analyzed various ultrasonic appearances of congenital malformation of infantile urinary system in our hospital in the recent two years retrospectively. Result We found 88 cases of congenital urinary system malformation in all infants, including 50 cases of renal agenesis, 10 cases of multi-cystic kidney, 2 cases of policystic kidney, 1 case of malrotation of kidney, 10 cases of duplex kidney, 6 cases of ureter cyst, 7 cases of ectopic kidney, and 2 cases of fused kidney. Conclusion Special ultrasonic appearances can be detected for congenital malformation of infantile urinary system, so ultrasound can be regarded as the first-line iconographical examination for the disease.
ObjectiveTo investigate the feasibility of quantitative detection of WBC count and bacteria count with UF-1000i urinary sediment analyzer in rapid screening for urinary tract infection by receiver operator characteristic (ROC) curve. MethodsFrom August to December 2013, we used quantitative bacterial culture and UF-1000i automatic urine sediment analyzer respectively to examine asepsis urine specimens of 218 patients with suspected urinary tract infection. Among them, there were 95 males and 123 females, with an average age of 54.7 years old. ResultsAmong the 218 urinary samples, 65 were culture positive specimens. With positive urine culture as the gold standard for making ROC curve, the area under ROC curve for WBC count and bacterial numbers by UF-1000i urine sediment analyzer were respectively 0.839 and 0.894. The cut-off values of Youden index for optimal WBC cell count and bacterial count were ≥31.0/μL and 38.8/μL, respectively. When the above numbers were used as cut-off values, the WBC count sensitivity and specificity were 78.3% and 80.4%, the positive likelihood ratio was 3.99, and the negative likelihood ratio was 1.11. And the bacterial count sensitivity and specificity were 84.3% and 80.6%, the positive likelihood ratio was 4.30, and the negative likelihood ratio was 0.80. ConclusionUsing white blood cell count ≥31/μL and bacterial count ≥38.8/μL detected by UF-1000i urine sediment analyzer as the cut off values of noninvasive screening indexes has a very important value in screening for urinary tract infection in the early stage, determining whether there is a need for urine culture, and guiding clinical rational application of antibiotics
This article describes a novel Multifunctional and Transparent Urinary System Model (MTUSM),which can be applied to anatomy teaching, operational training of clinical skills as well as simulated experiments in vitro. This model covers kidneys, ureters, bladder, prostate, male and female urethra, bracket and pedestal,etc. Based on human anatomy structure and parameters, MTUSM consists of two transparent layers i.e. transparent organic glass external layer,which constraints the internal layer and maintains shape of the model, and transparent silica gel internal layer, which possesses perfect elasticity and deformability. It is obvious that this model is preferable in simulating the structure of human urinary system by applying hierarchical fabrication. Meanwhile, the transparent design, which makes the inner structure, internal operations and experiments visual,facilitates teaching instruction and understanding. With the advantages of simple making, high-findelity, unique structure and multiple functions, this model will have a broad application prospect and great practical value.