Objective To investigate the value of transvaginal ultrasound in the diagnosis of endometrial polyps. Methods One hundred and ten patients diagnosed as endometrial polyps by transvaginal ultrasound and undergone operative hysteroscopy and histologic examination, were analyzed retrospectively.Results Among 110 cases 75 cases (68.2%) were accurately diagnosed by transvaginal ultrasound,while 35 cases (31.8%) were misdiagnosed.The diseases misdiagnosed included endometrium hyperplasia,intrauterine adhesions and submucousmyoma.Conclusions Combining clinical symptoms with ultrasonogram characters and optimal time of detection can reduce the misdiagnostic rate of endometrial polyps.

Objective To evaluate the value of color Doppler flow imaging(CDFI) in the diagonosis of placental site trophoblastic tumor(PSTT). Methods After being examined by transvaginal CDFI, four of six patients underwent curettage and two of them had hysterectomy and attached by chemical treatment. All the patients were verified to have a PSTT by pathology. Results The image of PSTT in CDFI included different size at different site, low resistence index (RI) of vessel around the lesion, and absence of vessel in the lesion. Conclusions The characteristic image in CDFI is helpful to the diagnosis of PSTT.

Objective To open the reset common bone and open ordinary osteosynthesis(MIPPO)(in effect in the treatment of high energy tibial fracture.Methods High energy tibial fracture in 42 cases of patients,according to the condition of the patient and the treatment were divided into two groups,using open reduction and bone treatment (open group,22 cases),treated with MIPPO technique(MIPPO group,20 cases).The indicators of operation,postop-erative complications and clinical efficacy of the two groups were observed.Results The operation time,intraopera-tive bleeding volume,fracture healing time of the MIPPO group were (75.2 ±9.7)min,(107.3 ±11.3)mL,(13.1 ± 3)weeks,which of the open group were (73.4 ±10)min,(208.5 ±16.3)mL,(18.2 ±4.7)weeks,the two groups had no statistically significant differences in operative time(P >0.05),two groups of blood loss,fracture healing time, the differences were statistically significant(t =23.153,4.143,all P <0.05);the complication rate in the MIPPO group was 10.0%,tibial shaft fracture healing function excellent rate was 95.0%.The complication rate of the open groupwas healing function excellent rate was 72.7%,36.4% tibial shaft fracture,there were significant differences between the two groups(χ2 =12.316,22.964,all P <0.01).Conclusion MIPPO technology in the treatment of high energy tibial shaft fractures,with less bleeding,fracture healing fast,and the characteristics of a significant effect, which is worth promoting.

Objective　To establish the normal growth velocity of fetal liver length and compare them with those of intrauterine growth retardation, pregnant diabetes and maternal-fetal blood types imcopatible. Method　Three hundred and five normal pregnant women and 24, 10, 16 pathological pregnant women of intrauterine growth retardation (IUGR), gestational diabetes and maternal-fetal blood types incompatible respectively had ultrasonographic measurement of fetal liver length at 18 to 42 weeks′ gestation. Results　Normal fetal liver length has a linear relation to gestational age, and showed a significantly rapid increase after 28th week with a growth rate of 1.76 mm per week, and 1.00 mm per week before 28th week (P<0.05). The growth rate of IUGR group before and after therapy were 1.19 mm and 1.23 mm per week, significantly lower than those of normal group (P<0.05). The growth rate of pregnant diabetes group before and after therapy were 1.63 mm and 1.63 mm per week, no statistical significance with normal group (P>0.05). The growth rate of maternal-fetal blood types incompatible group before therapy was 1.98 mm, showed no difference with normal group (P>0.05), but after therapy, the growth rate of fetal liver was 1.38 mm per week, significantly lower than normal group (P<0.05). Conclusion　Dynamic measurement of fetal liver length can help us to understand whether the fetus grow well in uterus and whether the treatments are effective.

Treatment and the clinical outcome of patients with head and neck cancer are determined by accurate staging and assessment of the cervical lymph nodes for metastases is an important step of this process. Ultrasonography, ultrasonography-guided fine needle aspiration (FNA), CT, MRI and PET/CT are used in the assessment of cervical lymph nodes. Ultrasonography guided FNA is advantageous in ease of application, minimumal invasiveness to patients, and less contraindications. Combined with cell block and molecular biology, FNA can be an effective tool for the diagnosis. The present article reviewed the diagnostic value of ultrasonography guided FNA in cervical lymph node assessment in patients with head and neck cancer.

Acute kidney injury (AKI) is caused by a variety of causes resulting in rapid decline in renal function and manifestingclinical syndrome, whether mild or severe kidney damage it caused, the permanent loss of renal function will exist; the mortality of patients with septic AKI is as high as over 70%. Renal replacement therapy (RRT) can significantly improve the clinical prognosis of patients with AKI and reduce its mortality. However, the selections of RRT treatment mode, dose and timing of start or stop exist a lot of controversies. In this report, as using RRT to treat critically ill patients with AKI is still a hot topic in academic research, the related literatures of RRT guidelines, score evaluation, renal function indexes and biological marker aspects were reviewed and summarized.

Objective To investigate the relationship between cysteinyl leukotriene and clinical response to antileukotriene treatment,and to help select a clinical pharmacologic scheme.Methods Seventy-eight cases with acute mild-moderate asthma were treated with montelukast in a four-week trial.Asthmatic symptom score,usage of ?_2 receptor agonist,percentage of eosinophil,serumal IgE concentration,spirometry and urinary leukotriene E_4(uLTE_4)were measured pre- and post-treatment.Logistic analysis was used to access the various clinical parameters correlated with the response to montelukast.Results There were 48 responders and 30 nonresponders.The uLTE_4 level from the responders was higher than that of nonresponders(P0.05).Subjects with a uLTE_4 level of ≥1 200 pg/mL were11.5 times more likely to respond to montelukast than those with

Objective To explore the Csx/Nkx 2.5 gene expression in the heart during the embryonic period and its mutation in subjects with congenital heart disease(CHD). Methods Immunohistochemistry was used to reveal the Csx/Nkx 2.5 gene expression, and PCR-SSCP-silver staining and DNA sequencing for mutation. Sixty-three embryos or fetus, 126 children with congenital heart diseases and 30 normal controls were included in the study. Results Elevated expression of Csx/Nkx 2.5 gene was found in atrium and trabecular of ventricle. After 16 weeks of gestation, the expression in atrium was stable, while slightly reduced in the trabecular. The expression in the ventricle was lower than that in the atrium in early embryonic stage followed by continuous increase which was most remarkable in 13~16 weeks and kept stable after 16 weeks. No expression of Csx/Nkx 2.5 was detected in epicardium. Three different kinds of gene polymorphisms in the third base of the 21st amino acid codon were found in all subjects:A,G,A/G. Conclusions Gene Csx/Nkx 2.5 plays an important role during the fetal heart development and its expression varies in different parts of the heart during different period in fetal development. Neither the sporadic nor the CHD cases showed any mutations in this study.

Objective　To assess fetal cardiac hypertrophy and ventricular function in fetuses of diabetic mothers. Methods　Study group was consist of 23 fetuses of diabetic pregnancies. Control group was consist of 108 fetuses of normal pregnancies. Cardiac size was measured by ultrasound as inter-ventricular septal (IVS) thickness and ventricular diastolic and systolic (VD and VS) dimensions and perimeter. Cardiac function was expressed as ventricular shortening fraction 1 (VSF1) (ventricular diastolic perimeter -ventricular systolic perimeter/ventricular diastolic perimeter)and ventricular shortening fraction 2 (VSF2) (ventricular diastolic dimension-Ventricular systolic dimension/ventricular diastolic dimension).Fetal birth weight was recorded. Results　 IVS of study group （6.1±0.7） mm, which was significantly thicker than IVS of control group （4.4±0.7） mm. Left ventricular diastolic dimension (LVDD) and Left ventricular systolic dimension (LVSD) of study group were （3.3±0.8）cm2 and （2.2±0.6） cm2, which were greater than those of control group （2.6±0.6） cm2 and （2.0±0.5） cm2. Right ventricular diastolic dimension (RVDD) and Right ventricular systolic dimension (RVSD) of study group were （3.9±0.7） cm2　and （2.6±0.7） cm2, which were also greater than those of control group （3.5±0.5） cm2 and （2.4±0.7） cm2. Left ventricular shortening fraction 1 of left ventricular (LVSF1) of study group was 0.20±0.07, which was greater than that of control group （0.12±0.04）. LVSF2 of study group was 0.35±0.11，which was greater than that of control group too （0.23±0.10）. Right ventricular shortening fraction 1 of left ventricular (RVSF1) of study group was 0.19±0.05，which was greater than that of control group （0.13±0.11）. RVSF2 of study group was 0.33±0.09，which was greater than that of control group （0.23±0.14）. Estimated fetal birth weight of study group was （4 076±608） g, which was greater than that of control group （3 440±377） g. Conclusion　These findings showed that fetal hyperinsulinemia result in fetal weight increasing, global cardiac enlarger inter-ventricular septal thickness larger and revealed hypercontractillty of ventricle in fetuses of diabetas mothers.

Objective To investigate the value of transvaginal contrast-enhanced ultrasonography (CEUS)in the diagnosis of adnexal masses.Methods Thirty patients with adnexal mass were examined by conventional 2D imaging and contrast tuned imaging(CnTI)technology.The results were compared with pathological results and the CEUS features wet concluded.Results There were 21 cases of benign adnexal masses and 9 cases of ovarian malignancies among 30 patients.The CnTI technology can distinguish between solid and cystic parts in masses.CEUS showed that malignant tumor had the high microvessel density and these vessels were irregular in shape.Partial malignant masses had the characteristic in-out phases in CnTI imagine.Conclusions Transvaginal CEUS is benefit to improve the accuracy of diagnosis of pelvic adnexal masses.