Objective To investigate the clinical significance of serum interleukin (IL)-6,IL-8,tumor necrosis factor (TNF)- α, high-sensitivity C-reactive protein (hs-C RP), total immunoglobulin (Ig) and complement C levels in children with mycoplasma pneumoniae pneumonia (MPP). Methods Sixty-one cases of children with MPP (observation group) and 60 healthy children (control group) were selected. The serum IL-6 and IL-8 levels were tested by enzyme linked immunosorbent assay(ELISA) method; the serum TNF-α level was tested by γ radioimmunoassay (RIA) counter; the serum hs-CRP, total Ig and complement C levels were tested by rate nephelometry method. Results The serum IL-6 concentration was (109.31 ±54.72) ng/L, IL-8 concentration was (128.19 ±65.87) ng/L, hs-CRP concentration was (34.13 ± 19.21) mg/L, total Ig concentration was (12.62 ± 5.51) g/L and complement C concentration was (2.98 ± 0.97) g/L in the observation group, and they were higher than those in the control group [(67.23 ±32.18) ng/L, (31.78 ±8.91) ng/L, (1.62 ±1.34) g/L, (6.71 ±3.65) g/L, (1.46 ±0.45) g/L]. The differences were significant (P ＜ 0.05 or ＜ 0.01). The serum TNF- t level between two groups had no significant difference (P＞ 0.05). Conclusions The serum cytokines IL-6 and IL-8, hs-CRP, total Ig and complement C play an important role in MPP. It has important significance to detect the serum cytokines IL-6 and IL-8, hs-CRP, total Ig and complement C levels in children with MPP.

Objective To investigate left ventricular(LV) systolic dyssynchrony in heart failure of different etiology which caused respectively by ischemic heart disease and dilated cardiomyopathy and analyse the correlation between the systolic dyssynchrony index(SDI) and the LV ejection fraction(LVEF). Methods Forty-three subjects were divided into two groups. Group A consisted of 17 heart failure patients which caused by ischemic heart disease and group B included 26 heart failure patients which caused by dilated cardiomyopathy. Three-dimensional datum of left ventricle were obtained using real-time three-dimensional echocardiography (RT-3DE) in full volume mode. Post-processing software Qlab was used for advanced analysis. The end-diastolic volume (EDV), end-systolic volume (ESV), LVEF and bull eye graph of seventeen segments were obtained. Standard deviation of time-to-minimal-systolic-volume of 16-LV segments corrected by R-R interval was calculated as SDI of LV. Results There was no statistical difference in age, heart rate, LVEF and EDV between the two groups (P >0.05). SDI of group A was lower than that of group B,but there was no statistical difference between them (P>0.05). Bull eye graph of seventeen segments revealed that the distribution of delayed systolic segments were different between the two groups. SDI of two groups appeared negative correlation with LVEF(r = -0.83, r = -0.71, P-< 0.01). Conclusions LV systolic dyssynchrony existed in heart failure which caused by ischemic heart disease and dilated cardiomyopathy,but the distribution of delayed systolic segments were different between them. SDI increased with worsening LV systolic function.

Objective To investigate the application of echocardiography in the diagnosis of neonatal ductus arteriosus aneurysm (DAA).Methods A total of 27 neonates with DAA were detected by echocardiography.Echocardiographic features in these cases were explored and outcome of these neonates were followed up.Results There were four crucial features in DAA detected by echocardiography:① A vessel bump was shown on the left side of the origination of left pulmonary artery(LPA) in the high parasternal short-axis view.②A horizontal shunt jet from the bump to the origination of LPA was shown when interrogate the top of the bump.③The bump joined the descending arota when interrogate it down and back orientately.A ‘V' shaped sign was shown when the aortic arch appeared on the right side and the bump on the left side.④A slow red flow signal was found in bump when the scale of color Doppler was cut down.The follow-up echocardiography showed spontaneous closure of the DAA when 3 months of age except one case lost.There were no abnormality in the figure and function in heart.Conclusions Echocardiography can be a valuable method for the diagnosis of neonatal ductus arteriosus aneurysm.Neonate with DAA have a good outcome.

Objective To study the change of early carotid elasticity in perimenopausal women treated by hormone replacement therapy using e-tracking technique. Methods A total of 82 perimenopausal women with lower level of estradiol were randomly divided into two groups:41 cases in the treatment group and 41cases in the control group. Postmenopausal women in the treatment group were treated with Climnen. Before and 6 months after estrogen therapy,e-tracking technique was used to evaluate the carotid elastic modulus,such as the stiffness parameters (β), pressure-strain elastic modulus ( Ep), arterial compliances (AC), pulse wave conducting velocity (PWVβ) and augment index(AI). Results Compared with the normal group,datas of Ep,β,PWVβ and AI were significantly lower in treated group, while AC was obviously higher ( P ＜0.01). Conclusions E-tracking technique is a quick, simple and high accurate evaluating method for the change of carotid elasticity in perimenopausal women.

Objective To assess the value of approximal side angle of carotid atherosclerotic plaques in patients with cerebral infarction by ultrasonography.Methods One hundred and seventy six patients with carotid atherosclerotic plaques were examined with uItrasonography and divided into two groups:cerebral infarction group (n=67)and none cerebral infarction group(n=109).Vessel area and residual lumen area of carotid artery were measured in axial view using linear probe.Area stenosis rate was calculated.The approximal side angle and thickness of plaque were measured respectively.The results of two groups were compared.Results The approximal side angle of plaque of cerebral group was significantly higher than that of none cerebral infarction groups(P<0.05).The sensitivity and specificity for approximal side angle of plaque(cutoff value:13.0°)were 79.1%,71.6%,respectively.There were no significant difference of area stenosis rate and plaque thickness between two groups(P>0.05).Conclusions The approximal side angle of plaque can be regarded as a novel index to assess the stability of plaque.

Objective To assess the effects of QRS duration on left ventricular systolic synchronicity in patients with heart failure by real-time three-dimensional echocardiography(RT-3DE).Methods Thirty-four patients with heart failure(LVEF≤35%)were selected and divided into two groups.Group A consisted of 20 patients with normal QRS duration,and group B included 14 patients with long ORS duration.All the patients underwent two-dimensional echocardiography(2DE)and RT-3DE respectively.Parameters including left ventricular inlernal diameter(LVIDd),left ventricular ejection fraction(LVEF)of 2DE,and left ventricular endsystolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),LVEF,the time to minimal systolic volume of 16-segmental standard deviation as a ratio of R-R interval(Tmsv16-sd/RR)of RT-3DE were obtained and analyzed between the two groups.Results There were no significant differences of LVIDd,LVEF acquired by 2DE between the two groups(P＞0.05);LVESV,LVEDV,Tmsv16-sd/RR of RT-3DE were slightly higher in group B than those in group A,but didn't reach the significant difference between the two groups(P＞0.05).The mechanical dyssynchrony maybe related to the severity of heart failure.Conclusions RT-3DE can quantify global left ventricular systolic synchronicity.QRS duration has no significant effect on left ventricular systolic synchronicity in patients with heart failure.

Objective To report the experiertce of management of complicated renal stones by percu taneous nephrolithotripsy (PCNL) with pneumatic and ultrasonic power by ultrasound guidance. MethodsThree hundred and eighty two cases(218 males,164 females,4 74 years) who underwent PCNL by u sing the third generation Swiss LithoClast Master for kidney stones from 2004 to 2007 were retrospectivelyreviewed. Clinical data including operation time,stone free rate and complications were analyzed. ResultsPhaseⅠlithotripsy was performed in 397 sides and delayed phaseⅡlithotripsy in 8 sides. Twenty three casesunderwent simultaneous bilateral PCNL. The operation time ranged from 70 to 190 min,average time was(93±11)min. Nine cases needed blood transfusion. Severe complications did not occur during operations.Stone free rate was 91.8% (372/405). Residual stone fragment was found in 33 cases after delayed phase Ⅱlithotripsy and 14 cases received adjuvant extracorporeal shock wave lithotripsy. One hundred and forty sixcases were followed up for 3 to 24 months and showed no recurrence. Conclusion PCNL with pneumaticand ultrasonic power could be an efficient treatment for complicated kidney stones.

Objective To study the synchronization of carotid artery wall motion with atheroscleroticsoft eccentric plaque using velocity vector imaging(ⅤⅥ). Methods Seventy-two patients with carotid artery atherosclerotic soft eccentric plaque were enrolled in this study. Their carotid arteries were examined using Acuson Sequoia 512 instrument respectively.Combined with ECG,two dimensional imaging of short axis view of carotid artery atherosclerotic soft eccentric plaque were recorded and analyzed on-line using ⅤⅥ software. The carotid artery wall of short axis was automatically divided into 6 segments. Time to peak index (TTPI)was calculated respectively. Results The TTPI was significantly higher than that of control group (P＜0.001). A cut-off value＜0.595 of TTPI for assessing the synchronization of carotid artery wall motion had a sensitivity of 93.9%,a specificity of 91.7%,respectively. Conclusions ⅤⅥ provides a new tool to assess the synchronization of arterial wall motion.

Objective To assess the relationship between the enhanced intensity of carotid plaque and risk of cerebral infarction using contrast-enhanced ultrasonography(CEUS). Methods Eighty one patients with cerebral infarction and 95 patients without cerebral infarction were enrolled in this study. All the patients were performed using CEUS. The characteristics of plaque enhancement was categorized: grade Ⅰ , non-enhancement;grade Ⅱ , the arterial wall vasa vasorum enhancement; grade Ⅲ. the arterial wall vasa vasorum and plaque shoulder enhancement; grade Ⅳ , extensive and internal plaque enhancement. The data between the two groups was compared and analysed. Results Plaque enhancement presented with grade Ⅰ in 7 cases of 81 patients and 26 cases of 95 controls,grade Ⅱ in 14 and 37,grade Ⅲ in 26 and 17,grade Ⅳ in 34 and 15. The percentage of stroke in grade Ⅰ was 21.2% (7/33),grade Ⅱ was 27.5%(14/51), grade Ⅲ was 60.5% (26/43) and gradeⅣ　was 69.4% (34/49). The percentage of stroke in grade Ⅲ was significantly higher than that in grade Ⅰ and Ⅱ ( P = 0. 001, P = 0. 001 ), and there was no significant difference between grade Ⅲ and Ⅳ ( P = 0.370). The sensitivity and specificity for grade of plaque enhancement (AUC = 0. 721, cutoff value > grade Ⅱ ) were 74. 1 % and 66. 3% respectively. Conclusions The grade of enhancement of carotid plaques in CEUS is a valid indicator to anticipate cerebral infarction. The higher the grade of enhancement of carotid plaques,the higher the risk of cerebral infarction.

Objective To explore the safety of the elderly donors in living related donor kidney transplantation. Methods Forty-five elderly donors (51 - 78 years,study group) who underwent ne-phrectomy for living related donor kidney transplantation from April 1993 to December 2007 were retrospectively investigated. Clinical data including serum creatinine (SCr), glomerular filtration rate (GFR) in pre-and post-operation, operation complications and hospital stay time were analyzed and compared with the control group(62 cases, the donors age were younger than 50 years). Results The operations of all living donors were successful. The SCr and GFR in pre-operation were (82.16 ± 10.86)μmol/L, (85. 82±6.26)ml/min(study group)and (78. 66±10. 41)μmol/L, (88. 74±9. 44) ml/min (control group) respectively. There were no significant differences in SCr and GFR between the groups at different time points (P>0. 05). The average hospitalization time was 9 days in study group and 8 days in control group. There were no severe perioperative complications and no renal function failure was found in long-term following-up in study group. Conclusions Age is not the absolute contraindication of donor for living related donor kidney transplantation. The preoperative evaluation and careful operation can ensure the safety of elderly donors.