ObjectiveTo evaluate the applicection value of ultrasonically guided percutaneous puncture and drainage of gallbladder (PPDG) in treating elderly patients with acute cholecystitis.MethodsThe clinical data of 59 elderly patients with acute cholecystitis treated by ultrasonically guided PPDG were retrospectively analyzed and compared with 37 patients treated by cholecystectomy or 13 cases by cholecystostomy.ResultsThe rates of complication and fatality and average hospital days were 32.4 ％ (12/37),5.4 ％ (2/37) and (25.4 ± 16.5 ) d in patients by cholecystectomy and 7.7％(1/13),7.7％(1/13) and (32.0± 12.5) d in patients by cholecystostomy,respectively,while the complication and mortality were not found in patients by ultrasonic ally guided PPDG with average hospitalization of(19.5 ±9.8)d. The rates of the complication and average hospital days were significantly higher in patients by cholecystectomy and cholecystostomy than in patients by ultrasonically guided PPDG (P＜0.05).ConclusionsUltrasonically guided PPDG is effective,safe and convenient for the treatment of acute cholecystitis in elderly patients.

Objective To evaluate the values of clinical application of color Doppler ultrasound in the diagnosis and treatment of iatrogenic femoral artery pseudoaneurysm (IFAP) in the elderly following percutaneous transluminal coronary angioplasty(PTCA). Methods A tota.of 35 patients aged(73.8±1.3) years with IFAP after PTCA were examined by color Doppler ultrasound.All cases were treated by compression simply for blocking blood flow with probe guided by ultrasound,and the failed cases were injected Reptilase into the lumen of pesudoaneurysm. Results 35 patients were diagnosed as IFAP by color Doppler ultrasound and the coincidence rate with clinical diagnosis was 100％ (35/35).Among all patients,31 cases were cured by simply compression guided by ultrasound and 3 cases were cured hy the injected reptilase into lumen,the cure rate was 97.15％(34/35).One cases was cured by surgery after failure to treat by the two above methods.34 cases (97.2％)were verified into occlusio by ultrasound after 24-48 h of treatment. Recurrence and other serious complications were not found during follow-up of 3-6 months. Conclusions Color Doppler ultrasound can be used for the preferred method in accurate diagnosis and effective cure of IFAP following PTCA in the elderly.

Objective To evaluate the value of color Doppler flow imaging (CDFI) in the diagnosis of elderly femoral arterial pseudo aneurysm and treating with ultrasound-guided compression after percutaneous transluminal coronary angioplasty (PTCA). Methods Twenty-six elderly patients who were found a mass and/or vascular murmur in the puncture region were examined by CDFI, and the results of CDFI were proven by clinic and MRI. All pseudo aneurysms were repaired by CDFI guidance to compress simply and/or injecting directly batroxobin into the pseudo aneurysm lumen combined with compression.Results Pseudo aneurysms were diagnosed definitely by CDFI in 26 cases,and the accuracy rate was 100%. Twenty-two cases were repaired with CDFI guidance to compress simply and percutaneously injection of batroxobin into the pseudo aneurysm lumen combined with compression occurred in 3 cases. One case was cured by surgery after failing to be repaired with CDFI guidance. Conclusions CDFI has an important diagnosis value of pseudo aneurysm after PTCA. The method of CDFI guidance compression and batroxobin injection for repairing pseudo aneurysm is simple, safe and effective.

Objective To explore the diagnosis value of 3D-power Doppler ultrasound in differentiating benign and malignant breast masses in elderly patients.Methods A retrospective study of 53 lesions in 45 patients was performed,and breast masses were divided into benign and malignant group by pathological diagnosis after operation.Display of cross,vertical and coronal plane of total 53 masses were automatically acquired by 3D-power Doppler examination before operation,and 3D imaging of masses were reconstructed by virtual organ computer-aided analysis.The vascular morphology inside and beside the breast neoplasm was observed by tomographic ultrasound imagine layer by layer in different sections.Vascular distribution characteristics were divided into penetrating,central,surrounding and few vessel type.Quantitative analysis of vascularization-flow index inside the breast neoplasm was measured by 3D-power Doppler histogram.Results The difference in vascular distribution characteristics by 3D-power Doppler ultrasound was statistically significant between 15 (28.3％) benign and 38 (71.7％) malignant lesions(x2=19.52,P＜0.01).The case number of presence of penetrating vessels was 26(68.4％)in the malignantuniors.The sensitivity and specificity of penetrating vessel diagnosed malignant breast tumor were 68.4％ and 86.7％.Vascular distribution characteristics of benign masses was mainly of surrounding vessel type(53.3％).Vascularization-flow index was higher in malignant group than in benign group [(1.32 ± 1.58) vs.(0.63 ± 0.53),t=2.187,P＜0.05].Conclusions 3D-power Doppler ultrasound completely presents the vessel stereoscopical distribution and shows quantificationally blood perfusion of breast neoplasm.The 3D-power Doppler ultrasound is superior to conventional ultrasound for enhancing differential diagnosis ability between benign and malignant breast tumors.

Objective To study the ultrasonographic characteristics and significance of color Doppler ultrasound in the diagnose of soft tissue haematoma in the elderly.Methods Totally 45 elderly patients with soft tissue hematoma were retrospectively analyzed.Hematoma were divided into 3 types:traumatic hematoma,iatrogenic hematoma and spontaneous hematoma.The ultrasonographic features of hematoma including location,size,shape,internal echo,boundary and relationship with around muscles were detected by color Doppler ultrasound.Results The ultrasonographic diagnostic rate of soft tissue haematoma was 98.0％ (44/45) in this study.The haematomas in patients were found in the soft tissues of many body parts and the types were mainly iatrogenic and spontaneous haematomas (42.0％ and 40.0％ respectviely).The traumatic hematomas and iatrogenic hematomas could be found in the early stage by ultrasound due to the trauma history,and the sonograms were mainly equal and low echo (75.0％ and 80.0％ respectively).Traumatic hematoma was found between the disorder muscles,and partial ruptured muscle fibers could be detected within or around the hematoma.Iatrogenic hematoma was mainly located around the vessels,which were compressed to the deep part as compared with the vessel in contralateral.Spontaneous haematoma was not almost found in the early stage and could be easily ignored and misdiagnosed.Spontaneous hematoma was mainly located within muscle fibers or fatty layers,presented anechoic area with irregular hypoechoic between the muscles and had well-defined hyperechoic boundary with compressed muscles around it.Conclusions Color Doppler ultrasound has a reliable diagnosis of soft tissue haematoma with quick,noninvasive,convenient for follow-up advantages in the elderly.

Objective To explore the applicative value of contrast enhanced ultrasound (CEUS) through rectumin the T-staging of rectal cancer.Methods 24 cases with rectal cancer were examined preoperatively by endorectal ultrasound (ERUS) and CEUS during May 2012 to November 2013 in our hospital.The characteristics of contrast enhanced ultrasound imaging in early and late phase of the rectal cancers were studied,and the imaging distribution and enhancement mode were observed.The preoperative staging diagnosis was conducted by consulting T staging criteria.The diagnostic results were compared with the postoperative pathologic diagnosis.Results The contrast enhanced time in rectal cancer began at 14-35s.The early tumor showed uneven nodular,ribbon or ring in high enhancement.At the advanced late,angiographic tumor showed homogeneous enhancement and continued to be observed during the whole time.Normal rectal wall ultrasonography showed spotty low enhancement or no enhancement.The overall accuracy of ERUS in T-staging was 66.7％ (16/24) and the overall accuracy of CEUS was 83.3％ (20/24) respectively.There was a significant difference in the overall accuracy between ERUS and CEUS (P＝0.018).The sensitivity,accuracy and positive predictive value of CEUS were 100.0％ (2/2),100.0％ (2/2),100.0％ (2/2) inT1 stage,83.3％ (10/12),83.3％ (10/12),100.0％ (10/10) in T2 stage,100.0％ (8/8),88.9％ (8/9),88.9％(8/9) in T3 stage,and 100.0％ (2/2),100.0％(2/2),100.0％ (2/2) in T4 stage,respectively.Conclusions As compared toroutine transrectal ultrasound,transrectal contrast enhanced ultrasound imaging on rectal cancer shows the typical sonographic characteristic imaging on microvascular focus size and borders,on characteristic infiltration zone.Therefore,contrast enhanced ultrasound improves the diagnostic accuracy of preoperative T-staging in rectal cancer surgery.

Objective: To determine the extract from Radix Astragali. Methods : Astragaloside IV in extract from Radix Astragali was determined by TLC-Scanning. Results : The linear relationship was at the rang of 0.78 ?g～ 4.68 ?g. The average recovery was 99.06% ( RSD=1.17% and n =5). Conclusion : The method is available with a good reproducibility. The pretreatment is simple and easy to operate.

Objective To study the regularity of occurrence and development in the elderly with AAA. Methods Twenty-seven elderly cases with abdominal aortic aneurysm(AAA) were analyzed and followed up with ultrasound for ten years. Results The AAA diameters were 2.5 ~6.6 cm,with the average in crease of(0.14 ? 0.01) cm/ year. Intraluminal thromi(ILT) were found in 63.0% of all the patients. ILT were found(3.9?2.0 ) years after the AAA diagnosis with the average in crease of(0.21 ? 0.05)cm / year. Conclusions The size of AAA in the elderly is slowly enlarged to varying degree with ageing. ILT are found in more than half of all the patients. A few cases of AAA are found ruptured and a few cases of ILT exfoliated.

Objective To evaluate the endothelial function in diabetic patients by high resolution sonography. Methods The intima-media thicknesses (IMT) of the bilateral carotid artery, femoral artery and the iliac artery of 22 elderly patients and 142 non-elderly patients with diabetes mellitus (DM) and 20 elderly and 20 non-elderly healthy persons were measured. The changes of the diameter of brachial artery were determined by measuring the diameter of brachial artery during reactive hyperemia and after sublingual nitroglycerin. Results The increased percentage of the brachial artery diameter under reactive hyperemia was significantly lower in elderly patients with DM (10. 03?6. 39)% than that in the elderly healthy control (15. 87?4. 79)% (P 0. 05). The IMT in elderly patients with early-stage DM incrassated significantly(P

Objective To evaluate the changes of morphology, hemodynamics and endothelial function of the dorsal artery of foot in patients with early-stage type 2 diabetic mellitus (T2DM) by high-resolution ultrasound. Methods The changes of morphology, homodynamics and endothelial function of the dorsal artery of foot were measured in 25 elderly and 35 non-elderly T2DM patients and 35 elderly and 30 non-elderly healthy persons. Results (1) The change percentage of inside diameter of foot dorsal artery under reactive hyperemia situation was obviously reduced in elderly T2DM patients compared with elderly healthy controls [(10.52±2.79)% vs. (15.43±4.69)%, P<0.01] and there was significant difference between non-elderly T2DM versus healthy persons [(12.89±4.68)% vs. (17.97±4.61)%, P<0.01],and it was lower in elderly versus non-elderly T2DM ones (P<0.05). The change percentage of inside diameter of foot dorsal artery wassignificantly lower in elderly T2DM versus healthy subjects after taning nitroglycerin [(12.40± 3.23)% vs. (16.11±5.74)% , P<0.01]. (2) Compared with control groups, the intima-medial thickness (IMT) of dorsal artery of foot was thickened significantly, and the peak reverse velocity (PRV) in early diastole, the velocity in end diastole (EDV) and pulsatility index(PI) were reduced significantly in T2DM groups (P<0.05). The peak systolic velocity (PSV) had no significant differences among all the groups (P>0. 05). (3) In T2DM groups, the PI was correlated positively with the change percentage of inside diameter of dorsal artery of foot under reactive hyperemia situation (r=0.79, P<0.01) and after having taken nitroglycerin (r=0.71, P<0.01), respectively. Conclusions The changes of morphology, hemodynamics and the injuries of endothelial function of the dorsal artery of foot can be detected in patients with early-stage T2DM byhigh-resolution ultrasound, which has clinical significance and applicable value.