目的 观察胎儿脊柱冠状椎体裂的超声声像表现,探讨其临床转归.方法 2018年1月—2021年12月河南省人民医院孕中期超声检查诊断胎儿脊柱冠状椎体裂的单胎妊娠孕妇107例,观察二维及三维超声声像资料,遗传学检查结果,终止妊娠情况.未终止妊娠者孕晚期行超声复查,并随访至产后1年,观察冠状椎体裂愈合情况.结果 (1)107例胎儿二维及三维超声脊柱矢状切面见纵行、横切面上横形无回声裂隙将椎体分为前后2部分.单椎体受累42例(39.3％),多椎体受累65例(60.7％);胸椎受累63例(58.9％),腰椎受累25例(23.4％),颈椎受累3例(2.8％),颈椎及胸椎同时受累2例(1.9％),胸椎及腰椎同时受累14例(13.1％);孤立性冠状椎体裂69例(64.5％),非孤立性冠状椎体裂38例(35.5％).38例非孤立性冠状椎体裂中15例合并前半椎体矢状裂,二维超声仅可见冠状裂隙,三维超声冠状面及横切面见前半椎体矢状裂.(2)56例行无创DNA检测,均提示低风险;30例行羊水穿刺,检出染色体异常6例(孤立性冠状椎体裂、非孤立性冠状椎体裂各3例),均为胸椎受累.(3)30例终止妊娠者中行遗传学检查25例,其中染色体异常6例.77例继续妊娠者中10例失访,17例孕晚期未复查超声,50例孕25～37(32.1±3.8)周复查超声,结果显示25例椎体冠状裂消失,20例累及椎体无变化但裂隙变窄呈细线样或点状,5例累及椎体及裂隙较前无明显变化,其中2例合并半椎体畸形、脊柱侧凸.(4)67例随访至出生后1年,25例孕晚期超声提示冠状裂消失者未见脊柱侧凸及其他异常;余42例出生1年内行脊柱X线或MRI检查,40例冠状椎体裂消失,1例L1及L3椎体冠状椎体裂合并半椎体畸形、脊柱侧凸,1例多个椎体冠状裂合并半椎体畸形、脊柱侧凸.结论 冠状椎体裂好发于胸、腰椎,多数可于孕晚期及出生后自愈,合并半椎体畸形、脊柱侧凸者不易愈合,产前行二维联合三维超声对评估胎儿脊柱发育情况有一定价值.

目的 分析孕早期超声诊断胎儿中枢神经系统(central nervous system,CNS)结构畸形的价值,探讨CNS结构畸形与染色体异常的关系.方法 孕早期超声筛查发现CNS结构畸形胎儿62例,均进行遗传咨询,采集胎儿绒毛、羊水或引产胎儿少量皮肤组织行染色体微阵列分析.记录胎儿CNS结构畸形产前超声表现,统计染色体异常检出率,分析CNS结构畸形与染色体异常的关系.结果 62例CNS结构畸形中,全前脑21例,露脑畸形19例,脑膨出8例,无脑畸形4例,脊柱裂4例,脉络丛囊肿2例,双侧侧脑室增宽2例,第四脑室囊状扩张1例,草莓型头颅1例.62例中42例为复合性CNS结构畸形,合并心脏畸形23例,面颈部畸形15例,肢体畸形6例,泌尿生殖系统畸形4例,胸肺部畸形2例,胃肠道畸形2例.染色体微阵列分析检出染色体异常20例,其中染色体数目异常14例,致病性拷贝数变异6例.复合性CNS结构畸形胎儿染色体异常检出率[42.86％(18/42)]高于单纯性CNS结构畸形胎儿[10.00％(2/20)](x2=6.693,P=0.009);全前脑胎儿染色体异常检出率[52.38％(11/21)]高于其他CNS结构畸形胎儿[21.95％(9/41)](x2=5.885,P=0.015).结论 复合性CNS结构畸形、全前脑畸形胎儿染色体异常检出率较高;孕早期超声检出CNS结构畸形尤其是全前脑畸形和复合性CNS结构畸形,一定程度上可预测胎儿染色体异常风险.

Economic growth, urban development and the prosperity of the automobile industry have driven a huge shift in global urban transportation from walking to public transportation and then to automobiles. Private mobility has become an important part of residents’ daily trips. Cities, especially automobile-dependent cities, face a variety of negative impacts such as increased commuting distances, higher congestion costs, traffic accidents, traffic pollution including climate change, etc. Therefore, how to balance the relationship between people’s growing demand for private motorization with the development of urbanization, modernization and motorization and the huge economic, social and environmental costs brought about by them, so as to realize the sustainable development of cities and transportation, is the main problem facing cities around the world. The entry focuses on trends in the sustainable development of urban transportation such as restrictions in private car ownership and use, electrification of urban transportation, intelligent transportation systems (including shared mobility, customized buses and Mobility as a Service/MaaS) and transit-oriented development (TOD). China, as the largest global automobile producer and consumer, represents and leads the growth and evolution of other emerging countries.

Objective:To investigate the normal parameter values of transvaginal E-Cervix cervical elastography of primipara and explore the correlation between E-Cervix parameters and gestational age.Methods:A total of 301 primiparas underwent E-Cervix by transvaginal ultrasound in Henan Provincial People′s Hospital from March 2019 to January 2021, they were divided into 6 groups according to generational weeks: group A (11-13 + 6W), group B (14-17 + 6W), group C (18-21 + 6W), group D (22-25 + 6W), group E (26-29 + 6W), group F (30-33 + 6W). Real-time E-Cervix parameters were obtained, including elasticity contrast index (ECI), hardness ratio (HR), internal ostium (IOS), and external ostium (EOS), strain ratio of the internal and external cervical ostium (IOS/EOS), and the correlations between E-Cervix parameters and the gestational week were analyzed. Results:The normal reference ranges of parameters ECI, IOS, EOS, HR and IOS/EOS were obtained, their 95% reference values in groups A to F were as follows: ECI (1.84-3.38, 2.13-4.50, 2.25-4.12, 2.06-3.96, 2.04-5.15, 2.36-5.53), HR (85.85%-88.72%, 77.31%-80.92%, 74.41%-78.50%, 71.13%-74.35%, 64.49%-68.56%, 63.57%-68.23%), IOS (0.12-0.21, 0.14-0.34, 0.14-0.31, 0.19-0.40, 0.19-0.56, 0.21-0.49), EOS (0.12-0.30, 0.14-0.34, 0.16-0.41, 0.20-0.39, 0.22-0.58, 0.22-0.54), IOS/EOS (0.55-1.12, 0.52-1.45, 0.56-1.26, 0.54-1.38, 0.54-1.52, 0.65-1.46). The differences of ECI, HR, IOS and EOS in different groups were statistically significant (all P<0.05). Spearman correlation analysis results showed that ECI, IOS, and EOS were positively correlated with gestational week( rs=0.524, 0.689, 0.609; all P<0.01). HR was negatively correlated with gestational week ( rs=-0.755, P<0.01). The regression equations of ECI, HR, IOS and EOS were Y=0.06X+ 52.214, Y=99.25-1.07X, Y=8.63E-3X+ 0.05, Y=7.94E-3X+ 0.1, respectively. Conclusions:The normal parameters values of E-TVES are summarized.It provides effective support in data for cervical evaluation in the preterm prediction and success of labor induction.

Objective:To explore the genetic etiology of fetuses with high suspicion of congenital skeletal malformation detected by prenatal ultrasound.Methods:This retrospective study collected 21 pregnant women with highly suspected fetal skeletal malformation indicated by ultrasound (the couples had no skeletal malformation) at Institute of Medical Genetics, Henan Provincial People's Hospital from January 2019 to August 2020. Amniotic fluid/umbilical cord blood of the fetus and peripheral blood of the couples were obtained for karyotype analysis, chromosomal microarray analysis, and whole-exome sequencing. Sanger sequencing was performed for the "pathogenic" "suspected pathogenic" "variants of uncertain significance" variants detected by whole exome sequencing. Genetic etiology of the 21 fetuses was described.Results:A total of five chromosomal abnormalities were detected, including four cases of trisomy 21 and one trisomy 18. Chromosome microarray analysis detected one case of abnormal copy number variation, 16 p11.2 microdeletion syndrome. Ten cases of monogenic diseases were found by whole exome sequencing and eight genes were involved ( SGMS2, FGFR3, DYNC2H1, WDR35, TBX5, COL2A1, FGFR2, and ALPL). Totally, 14 variations were detected, among which seven were novel variations (c.8129T>A, c.7126G>A, c.10307_10320del, and c.2641G>T in DYNC2H1 gene; c.3085G>A and c.491G>A in WDR35 gene; c.1070G>T in COL2A1 gene). Conclusions:For fetus, whose parents have no skeletal malformation, highly suspected of congenital malformation of skeletal system by prenatal ultrasound, genetic factor is the primary reason, including chromosomal abnormalities, copy number variations, and monogenic mutations.

目的 观察可疑颅内结构异常胎儿颅脑冠状面二维超声声像特征,探讨其对胎儿胼胝体发育不全的分型诊断价值.方法 单胎妊娠孕妇106例,常规产前超声检查发现胎儿可疑颅内结构异常后,行胎儿颅脑冠状面二维超声检查,观察胎儿胼胝体膝冠状面、第三脑室冠状面、侧脑室三角区冠状面二维超声声像特征.8例继续妊娠者于孕期行胎儿头颅MRI检查,产后行小儿头颅MRI检查;98例终止妊娠者中94例引产前行胎儿头颅MRI检查,10例引产后行头颅病理解剖.以头颅MRI或病理解剖结果为标准,评估颅脑冠状面二维超声对胎儿胼胝体发育不全的分型诊断价值.结果 胎儿颅脑冠状面二维超声诊断完全型胼胝体缺失61例,声像表现为膝冠状面、第三脑室冠状面、侧脑室三角区冠状面分别未显示胼胝体膝部、干部、压部,诊断准确率为100.00％(61/61);诊断部分型胼胝体缺失40例,声像表现为膝冠状面和第三脑室冠状面可分别显示胼胝体膝部、干部,侧脑室三角区冠状面未显示胼胝体压部,或仅膝冠状面可显示胼胝体膝部,第三脑室冠状面及侧脑室三角区冠状面未显示胼胝体干部、压部,诊断准确率为95.24％(40/42);诊断胼胝体发育不良1例,声像表现为膝冠状面、第三脑室冠状面、侧脑室三角区冠状面可分别显示胼胝体膝部、干部、压部,但其厚度变薄,诊断准确率为33.33％(1/3).2例胎儿颅脑冠状面二维超声未发现胼胝体异常,胎儿头颅MRI及病理解剖结果均为部分型胼胝体缺失;2例胎儿颅脑冠状面二维超声及胎儿头颅MRI检查均未发现胼胝体异常,产后小儿头颅MRI检查诊断为胼胝体发育不良.结论 颅脑冠状面二维超声对胎儿胼胝体发育不全分型的诊断价值较高,部分型胼胝体缺失主要表现为侧脑室三角区冠状面未显示胼胝体压部.

目的 探讨孕11～13+6周行超声检查在胎儿前腹壁畸形诊断中的应用价值.方法 9 608例孕11～13+6周孕妇,均行超声检查,对检出胎儿前腹壁畸形者行染色体核型分析,随访观察超声检出正确率.结果 超声检出胎儿前腹壁畸形57例(0.59％),其中脐膨出34例、腹裂3例、体蒂异常9例、Cantrell五联征6例、梅干腹综合征4例、泄殖腔外翻综合征1例;52例终止妊娠(脐膨出胎儿31例、腹裂胎儿1例、体蒂异常胎儿9例、Cantrell五联征胎儿6例、梅干腹综合征胎儿4例、泄殖腔外翻综合征胎儿1例),5例(脐膨出胎儿3例、腹裂胎儿2例)继续妊娠;随访结果示9 556例继续妊娠者超声漏诊6例,误诊2例,检出准确率为90.1％.结论 孕11～13+6周行超声检查对胎儿前腹壁畸形有较高的检出正确率.

In this paper,we consider the bounded parallel-batching scheduling problem with drop-line jobs to minimize the total completion time.In the problem,a parallelbatching machine can handle up to b jobs simultaneously as a parallel batch,where b is the batch capacity,and the processing time of a batch is equal to the longest processing time of the jobs assigned to it.For drop-line jobs,the completion time of each job is equal to the sum of the starting time of the batch containing the job and the processing time of the job.That is,if a batch B has a starting time S,then the starting time of each job Jj contained in batch B is defined to be S,and its completion time is defined as S + pj,where pj is the processing time of job Jj.For our problem,we first study some properties of the optimal schedules.Then,based on these properties,we present a dynamic programming algorithm running in O(nb(b-1)) time.

目的:探讨对宫颈癌患者选择经阴道彩色多普勒超声的方法实施诊断后获得的临床效果.方法:选择我院2014年04月-2016年06月收治的宫颈癌患者43例作为本次影像学诊断的观察组;同期选择健康体检人员43例作为本次影像学诊断的对照组;临床对两组影像学诊断对象均选择彩色多普勒超声的方法进行疾病诊断.对最终的声像图特点加以分析.结果:在宫颈偏大比例方面,宫颈癌Ⅱ期患者同对照组体检人员比较,表现为显著升高(P<0.05);在高回声出现概率方面,宫颈上皮内癌变患者同对照组体检人员比较,表现为显著升高(P<0.05);在低回声出现概率方面,宫颈原位癌患者、宫颈癌Ⅱ期患者同对照组体检人员比较,表现为显著升高(P<0.05);在血流阻力指数方面,宫颈癌Ⅰ期患者、宫颈癌Ⅱ期患者同对照组体检人员比较,表现为显著升高(P<0.05).结论:对于宫颈癌患者,临床对疾病的基本表现加以了解后,合理选择经阴道彩色多普勒超声的方法实施疾病诊断,可为宫颈癌临床治疗方案的研究创建有利基础,最终显著提高宫颈癌疾病患者的临床治疗效果.

目的 探讨声诺维与生理盐水宫腔声学造影(sonohysterography,SHG)对宫腔占位性病变的诊断价值.方法 不孕症患者1 015例,实时三维子宫输卵管造影检查中先后应用声诺维及生理盐水SHG成像,观察宫腔内有无占位性病变;声诺维及生理盐水SHG检查后2个月内,1 015例中128例行宫腔镜检查.以宫腔镜检查结果为金标准,统计声诺维及生理盐水SHG对宫腔占位病变的诊断价值,并进行比较.结果 宫腔镜检查发现宫腔占位病变58例,其中内膜息肉40例,宫腔粘连带8例,宫腔息肉并粘连带7例,黏膜下肌瘤3例;声诺维SHG发现宫腔占位病变37例,其中内膜息肉23例,宫腔粘连带8例,宫腔息肉并粘连带3例,黏膜下肌瘤3例,诊断宫腔占位病变的符合率为66％、灵敏度为44％、特异度为84％;生理盐水SHG发现宫腔占位病变57例,其中内膜息肉38例,宫腔粘连带10例,宫腔息肉并粘连带6例,黏膜下肌瘤3例,诊断宫腔占位病变的符合率为84％、灵敏度为88％、特异度为90％;生理盐水SHG诊断宫腔占位性病变的符合率、灵敏度、特异度均高于声诺维SHG,差异有统计学意义(P＜0.05).结论 生理盐水SHG对宫腔占位病变的诊断效能优于声诺维SHG.

城市群是在工业化和城市化进程中形成的一种高级空间组织形式,能在区域范围内调整资源配置、实现经济的共同增长。因此,为了扭转目前中部塌陷的局面,实现中部崛起,中原城市群发展战略应运而生。构建了城市群竞争力指标体系,在运用SPSS16.0统计软件和主成分分析的基础上进行分析,提出有利于中原城市群综合竞争力提升的政策建议。