Overactive bladder(OAB) is a clinical syndrome which mainly defined by urinary urgency,and it is mainly diagnosed by clinical manifestations.The pathophysiological mechanisms include detrusor overactive,urethral instability and other neurological or psychiatric factors.Obviously,the dysfunction of detrusor and urethral sphincter can not be diagnosed accurately that consequently affects the treatment significantly by clinical symptoms.Recently,the urodynamic evaluation is recommended for more precise diagnose of OAB.In addition,it has been reported that urinary nerve growth factor and autonomic nervous system function could be used to diagnose OAB in children.The updated techniques diagnosis of OAB in children are summarized in this review.

Objective To explore the usage of anatomic al M-mode echocardiography in observing pulmonary artery motion curve of pulmonary hypertension patients.Methods The subjects included 21 pulmonary hypertension patients complicated with tricuspid valve insufficiency, and 21 controls whose age and gender matched with the patient group. The inner diameter of main pulmonary artery and right atrium, acceleration time of pulmonary valve Doppler signal and maximum velocity of tricuspid insufficiency (ACTpv) were measured during routine echo examination. From the maximum velocity of tricuspid insufficiency the pulmonary artery systolic pressure (PASP) was calculated. The pulmonary artery motion curve and pulsating amplitude of pulmonary artery wall (PAWPA) was observed and measured with a home-made anatomical M-mode echocardiography with instrument. Results PAWPA in the patient group was lower, and simultaneously complicated with broader pulmonary artery, larger right atrium and shorter ACTpv in comparison with normal group (all P

To study the diagnosis of pulmonary stenosis (PS) in patients with the secundum atrial septal defects(ASD) by the measurement of maximal velocity through pulmonary valve (Vpv max ). There were 98 cases with secundum ASD, and 27 cases with secundum ASD and PS diagnosed by echocardiography(TTE). All the cases with secundum ASD were confirmed by surgery. The diagnosis of 19 cases out of 27 cases as diagnosed by TTE were confirmed by surgery, and the other 8 cases were simple secundum ASD. These results suggested that the two dimensional echocardiography and Vpv max should be utilized in order to achieve a better diagnostic accuracy in the diagnosis of PS in the patients with ASD, and PS should be considered if the Vpv max increased to 2 65 to 3 25m/s.

Objective To investigate the effect of patient positioning on the Duplex ultrasound evaluation of great saphenous vein reflux elicited by the pneumatic cuff method. Methods FFifty great saphenous veins (GSV) with relfux (relfux group) and iffteen with no prior history of venous disease (healthy group) were examined by duplex scanning in the supine, 20 degrees reverse-trendelenburg (RT-20), 40 degrees reverse-trendelenburg (RT-40) and standing position. Each GSV was assessed for relfux at three venous sites:two centimeter below the sapheno-femoral junction (SFJ), the greater saphenous vein in the mid thigh (MGV) and the greater saphenous vein in the upper calf (CGV). Pneumatic cuff compression pressure of conifned 100 mmHg (1 mmHg=0.133 kPa) was used onto the calf to elicit relfux. The incidence of positive venous relfux was calculated. The statistical differences of the peak relfux velocity and duration of relfux in four positions were analyzed. Results TThe relfux elicited in the standing position was set as the gold standard. In healthy group, there was no false positive results of relfux in supine, RT-20 and RT-40 positions. In relfux group, false negative results were found at all venous sites when limbs were examined in supine position [false negative rate:59%(19/32), 22%(11/50), 24%(12/50)]. At RT-20 and RT-40 positions, the incidence of venous relfux reached 100% at MGV and CGV, and false negative cases were only detected at SFJ [false negative rate:12%(4/32), 12%(4/32)]. The relfux time in standing, supine, RT-20 and RT-40 positions were (7.75±3.23) s, (5.27±3.66) s, (8.67±3.72) s, (8.55±3.93) s respectively. There were signiifcant differences among different positions in reflux time (F=56.9, P<0.01). In detail, no significant differences were identified between standing position and RT-20 or RT-40 position (q=1.51, 1.33 respectively, both P > 0.05), except for supine position (q=4.11, P<0.01). Peak relfux velocity in standing, supine, RT-20 and RT-40 positions were (55.26±22.24) cm/s, (22.87±12.03) cm/s, (38.46±16.30) cm/s, (45.13±19.21) cm/s respectively. There were also signiifcant differences among different positions in peak relfux velocity (F=13.7, P<0.01). Comparing the supine, RT-20 and RT-40 positions with standing position, differences of the peak relfux velocity between them were all statistically signiifcant (q=12.71, 6.59, 3.98 respectively, all P<0.01). Conclusions When GSV reflux was examined by pneumatic cuff compression, false negative rate was higher in the supine position. RT-20 and RT-40 position were effective to detect GSV relfux, espically for GSV at mid-thigh and upper calf.

BACKGROUND:Orthotopic lung transplantation model in a rat is the key to investigate the chronic rejection after lung transplantation. However, the precise surgical technique and difficult operation limit the application of the model. OBJECTIVE:To improve the process of anesthesia and lung transplantation, and to establish a rapid, safe and reversible rat lung transplantation model. METHODS:A total of 42 rats were used to establish the model, including 21 donor models and 21 receptor models. The donor lung was excised by median sternotomy with dissection of the left lung and implantation of cuffs (intravenous catheters cut into 1.5 mm sections). The left lung was implanted in the recipient by lateral thoracotomy using the cuffs for anastomoses. The duration of surgery and success rate of transplantation were recorded and calculated. RESULTS AND CONCLUSION:The survival rate of rats after lung transplantation was 100%. The time of left donor lung extraction was (35.3±5.1) minutes in average. The time of placing cuff in donor lung was (12.5±4.6) minutes in average. The surgical procedure time of recipient was (50.2±3.3) minutes. The time of arteriovenous and bronchus casing anastomosis was (27.7±6.2) minutes. After pulmonary artery and vein blood flow was disparked, the whole lung turned red rapidly, blood perfusion was sufficient, venous returned unimpeded;after mechanical ventilation resumed, al graft lungs expanded wel . This improved anesthesia and lung transplantation technique in rats can provide a valid, reliable and reproducible animal model for studying immune responses and rejection in lung transplantation.

Objective To investigate the clinical value of serum VEGF levels in the diagnosis and treatment of colon cancer.Methods Serum VEGF was detected by ELISA,and CEA and CA199 concentration were detected by CLEIA in 66 patients with colon cancer,55 patients with colon benign diseases and 50 health persons.The value of individual and joint detection for VEGF in colon cancer was evaluated.Analysis had been done on relationships between serum VEGF and pathology,treatment effects and prognosis.Results The levels of serum VEGF in colon cancer group [(318.5±148.6) ng/L] were significantly higher than those in control group [(125.7±49.4) ng/L] and benign colon diseases [(136.9±52.6) ng/L] (t =8.830,8.805,all P ＜ 0.01).There was a positive correlation between serum levels of VEGF and depth of tumor size,tumor invasion,lymph node metastasis and TNM stage (P ＜ 0.01).The susceptibilities of VEGF,CEA,CA199 were 61％,45 ％,53 ％.The sensitivity of detection was improved to 86 ％ when the combined detection of VEGF,CEA and CA199 (x2 =11.237,P ＜ 0.01).The serum levels of VEGF in patients with colon cancer was significantly decreased after treatment in the 3,7,10 day compared with that before operation [(272.3±88.1),(236.8±77.4),(173.1±59.9) vs (318.5±148.6) ng/L,t=2.173,P ＜ 0.05; t =3.961,P ＜ 0.01; t=7.464,P ＜ 0.01],respectively.Conclusion The VEGF was related to the onset and progression and metastasis of colon cancer.It has clinical significancy for diagnosis of colon cancer and judgment of curative effect and prognosis.

0.05 ) when two doctors measured the same group patients with the same method. The coefficient of variation of IVRTd was bigger than that of IVRTm when two doctors measured the same group patients with two different methods. In four sets of data, three ones showed significant difference(P

Objective To study the changes of Young's modulus value of the renal cortex,vertebral body and sinus when there was a different degree of acute renal artery stenosis.Methods 10 Japanese white rabbits were used for this study.The left renal artery was dissected.An ultrasound probe was placed on the left kidney,Young's modulus of the renal cortex,vertebral body and sinus were recorded using shear wave ultrasound elastic imaging technique during three stages:when the renal artery was intact (0％ stenosis),tied with a suture (＞ 50％ stenosis),and ligated (100％ stenosis).Renal tissue elasticity with different degrees of renal artery stenosis were compared.Pathological study was carried out in the kidneys,each with either 0％,＞ 50％ or 100％ renal artery stenosis.Results The mean values of Young's modulus from the renal cortex,vertebral body and sinus with different degrees of renal artery stenosis were as follows:0％ stenosis,(16.31 ±1.70) kPa,(13.38± 1.63) kPa,and (12.75±2.26) kPa;＞ 50％ stenosis,(14.16±2.34) kPa,(11.49±2.70) kPa,and (10.72±2.56) kPa;100％ stenosis,(11.35 ± 1.48) kPa,(8.39± 1.29) kPa,and (7.08 ± 1.52) kPa.The mean value of Young's modulus from the renal cortex was significantly higher than those from the renal vertebral body and sinus (P ＜ 0.05).The mean values of Young's modulus from different parts of the kidney decreased progressively with an increase in renal artery stenosis (P ＜ 0.05).The pathological study demonstrated that with the increase in the severity of renal artery stenosis,glomerular volume,renal interstitial capillary diameter and red blood cells decreased.When renal artery stenosis reached 100％,there was patch degeneration and inflammatory cell infiltration within the renal interstitium,and mild degeneration of tubular epithelial cells with obscure cell borders.Conclusions The value of Young's modulus from the renal cortex was higher than those from the renal pyramid and sinus in rabbits.The values of Young's modulus from the renal cortex,pyramid and sinus decreased with an increase in the severity of renal artery stenosis,which suggest that,in the study of the elasticity of the kidney,the renal artery blood flow dynamic state can obviously affect the value of the elasticity of the kidney.

Objective To evaluate the diagnostic value of ultrasound-guided pleural biopsy combined with thoracic biochemical detections in malignant and tuberculous pleural effusions. Methods Sixty-four patients with moderate or large pleural effusions and pleural thickening received the ultrasound-guided diagnostic pleural biopsy. All patients had chest CT enhancement scans to find out the suspicious pleural thickening preoperatively, facilitating the selection of puncture sites by ultrasound. Pleural tissue samples were sent for pathological examinations immediately. After successful achievements of pleural biopsy, ultrasound-guided aspiration or drainage was performed to alleviate symptoms, more importantly, to get pleural effusions for biochemical analysis. Biological results including carcinoembryonic antigen(CEA), CA125, CYFRA21 and lactate dehydrogenase(LDH) in malignant and tuberculous effusions were analyzed by group design t tests. The positive rates of CEA, CA125, CYFRA21, LDH in malignant and tuberculous effusions were compared by chi square tests. Results Pleural tissues in all cases were got by one pleural biopsy procedure. The strategy of pleural biopsy we used in this study had a successful rate reaching 100%(64/64), and 73% (46/64) patients had a definitive diagnosis as malignant or tuberculous effusion. Twenty-seven cases were diagnosed as malignant effusions and thirty-seven cases as tuberculous effusions based on the deifnitive clinical diagnosis. The positive rates of CEA, CA125, CYFRA21, LDH in malignant effusions were 100%(27/27), 100%(27/27), 100%(27/27), 89%(24/27) respectively, and 0%(0/37), 84%(31/37), 78%(29/37), 76%(28/37) respectively in tuberculous effusions. The positive rate of CEA between malignant and tuberculous effusions differed signiifcantly (χ2=64.0, P < 0.01), so did CA125 (χ2=3.1, P < 0.01) and CYFRA21(χ2=4.8, P<0.01). The average levels of CEA, CA125, CYFRA21, LDH in pleural effusion were (727.1±658.8)μg/L, (795.2±1249.6)×103 U/L, (296.2±320.7)μg/L, (1077.9±1058.5) U/L respectively, and (1.7±1.1)μg/L, (336.3±208.6)×103 U/L, (20.7±14.9)μg/L, (309.2±182.7) U/L in tuberculous effusions.There were signiifcant differences in CEA, CYFRA21 and LDH concentrations among malignant and tuberculous effusions (t=45.1, 27.4, 18.8 respectively, all P<0.01). Conclusion Ultrasound-guided pleural biopsy combined with CEA, CYFRA21 and LDH in pleural effusions had an important value in the etiological diagnosis of pleural effusions, while CA125 showed little value in the differential diagnosis.

Objective To assess the clinical outcome of varicose veins with incompetent great saphenous vein(GSV) treated with ultrasound guided foam sclerotherapy. Methods Forty limbs with moderate to severe symptomatic varicose veins with incompetent GSV in 38 patients were injected with foam sclerosing agent (Fibro-Vein) under ultrasound guidance. There were 36 patients with unilateral varicose veins and 2 with bilateral varicose veins. No of them suffered from deep vein incompetence or perforating vein incompetence. Second injection was performed one month after the initial injection in 7 limbs. Thirty-eight of 40 limbs were followed up with clinical examination and duplex ultrasound scan 30-47 months (mean 40 months) after the treatment. Results Among 38 limbs with follow-up mild debilitation was found in two limbs(5. 3%). There were no other symptoms or complications. Duplex ultrasound demonstrated four type of results: type I, sclerosed GSV trunk with no detectable venous flow in 32 of 38 limbs (84. 2%) ;type II,patent GSV trunk in 3 limbs (7. 9%) ,two of them had mild reflux in the GSV trunk;type III,sclerosed GSV trunk and mild reflux in the GSV tributaries, 1/38(2. 6%) ; type IV,sclerosed proximal GSV trunk,patent distal GSV communicated with a superficial vein and mild reflux in the veins, 2/38 (5. 3% ). Conclusions Clinical examination and duplex ultrasound scan demonstrated excellent results of varicose veins with incompetent GSV treated with ultrasound guided foam sclerotherapy 40 months after the treatment. Sclerotherapy is less invasive treatment option for varicose veins with incompetent GSV with satisfactory clinical and cosmetic outcome.