This study was conducted to describe our first experience using transvaginal 4‐dimensional (4D) hysterosalpingo‐contrast sonography with SonoVue (Bracco International BV, Amsterdam, the Netherlands) for diagnosis of fallopian tube patency. The study was prospective and conducted in a university hospital setting. The sonographic procedures included 2‐dimensional transvaginal sonography for evaluating uterine and ovarian mobility, observing intubation, and determining the initial plane and 4D hysterosalpingo‐contrast sonography for observing periovarian and pelvic diffusion. Ninety‐six outpatients visiting infertility clinics underwent 4D hysterosalpingo‐contrast sonography. All patients finished the examination successfully. A total of 192 fallopian tubes were assessed, of which 95 (49.5%) were classified as type A (the tube was patent, and the contrast agent flowed smoothly through it), 72 (37.5%) as type B (the tube was patent, but the contrast agent did not flow smoothly inside it), and 25 (13.0%) as type C (blocked). Sixteen patients underwent laparoscopy or laparoscopy combined with hysteroscopy; 28 tubes (87.5%) were concordant with laparoscopy. The sensitivity, specificity, positive predictive value, negative predictive value, and Youden index for 4D hysterosalpingo‐contrast sonography versus laparoscopy were 81.8%, 90.5%, 81.8%, 90.5%, and 0.72 respectively. In total, 92.7% of patients did not require a hospital stay after 4D hysterosalpingo‐contrast sonography, and none need resuscitation. The others stayed in the hospital for clinical observation because of a severe vasovagal reaction or severe pain but received only bed rest without any medical treatment. Forty patients (41.7%) felt slight pain; 39 (40.6%) felt moderate pain; and 15 (15.6%) had a vasovagal reaction. No procedure or postprocedure complications occurred in any patient. In conclusion, 4D hysterosalpingo‐contrast sonography with SonoVue is an available screening method for assessment of tubal patency and is tolerable for most patients.

Transvaginal 4-D hysterosalpingo-contrast sonography with SonoVue (TV 4-D HyCoSy) is the preferred imaging method for evaluating tubal patency. However, venous intravasation in 4-D HyCoSy may affect the diagnosis of tubal patency. The objective of this study was to analyze influencing factors of venous intravasation during TV 4-D HyCoSy. This study included 643 infertile patients who underwent TV 4-D HyCoSy. We analyzed the relationship between the incidence of venous intravasation and patients' basic clinical data, endometrial thickness, inspection timing (clean day of menstruation) and tubal patency. A total of 169 (26.28%) patients exhibited intravasation during TV 4-D HyCoSy. The following are risk factors for venous intravation: secondary infertility, type C + C, type B + C and type B + B in bilateral fallopian tubal patency grouping; endometrial thickness 5.45 mm; and taking TV 4-D HyCoSy after menstruation 6 d. Infertility duration, intrauterine lesions, a history of pelvic inflammatory disease and a history of pelvic surgery were uncorrelated with venous intravasation. To reduce the incidence of venous intravasation, TV 4-D HyCoSy should be performed 7À10 d after menstruation or when endometrial thickness is thicker than 5.45 mm.

Objective: Previous studies have shown that central obesity is associated with chronic kidney disease (CKD). We hypothesized that the association of central obesity with CKD is modified by the presence of inflammation. To test this hypothesis, we performed this study. Methods: This was a cross-sectional study in southern China. Waist-to-height ratio (WHtR) was used as a central obesity index and C-reactive protein (CRP) was used as an index for inflammation. CKD was defined as estimated glomerular filtration rate(eGFR) <60 ml/min/1.73m² or albuminuria-to-creatinine ratio (ACR) >30mg/g. Multivariable logistic regressions were used and logistic regression models were adjusted for potential confounders and other components of metabolic syndrome. Results: 1834 subjects were included in the current study. WHtR, body mass index and waist circumference were significantly associated with the level of CRP. When adjustment for potential confounders, only central obesity with a higher CRP level was associated with CKD (Relavitve-risk Ratio, 95% CI: 1.68, 1.03 - 2.75, P = 0.04). In multivariate logistic models, WHtR was associated with CKD. The odd ratio for WHtR (every SD increment), was 1.38 (95% CI 1.15, 1.66, P < 0.001). Further adjustment for log-transformed CRP had an impact on the odd ratios. Conclusion: Central obesity is associated with CKD, independently of other MetS components. Central obesity is also associated with inflammation and the presence of inflammation modifies the associations of central obesity and CKD. This study is based on a community-based chinese population, and the results may only be applicable for Chinese population.

ObjectiveTo investigate the long-term effects of mild H1N1 influenza infection on the pulmonary function of a cohort of patients.MethodsForty-eight patients, all diagnosed with influenza A virus subtype H1N1 in 2009, were retrospectively included in this study. Each patient in the study was monitored for 11-13 months by standard pulmonary function examination. The examination included monitoring respiratory tract infection symptoms (cough, expectoration or gasping) and vital signs. Long-term changes in symptoms and changes in vital signs were correlated back to and compared with the severity of the initial H1N1 influenza infection.ResultsOne year post discharge, mild to moderate pulmonary dysfunction was observed in the majority of patients. Further, 54.2% of patients had signs of severe abnormal pulmonary function, including diffusion disorder (33.3%) and small airway dysfunction (33.3%). Fourteen patients presented with respiratory tract infection symptoms; 12 with abnormal pulmonary function and two with normal pulmonary function. Our results indicated that the change in pulmonary function at one year post discharge was not significantly correlated with the severity of H1N1 influenza.ConclusionSigns and symptoms of abnormal pulmonary function accompanied by respiratory tract infection symptoms remain for some patients after one year following discharge from the hospital for mild influenza A virus subtype H1N1 infection. These patients should continue to be monitored for any changes in condition and symptoms and rehabilitation treatment should be provided when necessary.