Objective To explore the correlations between measurements of Doppler velocity waveform parameters of fetal main pulmonary artery and gestation age (GA) in normal fetus. Methods This is a cross-sectional study, in which totally 252 normal singleton fetuses between 23 and 40 weeks of gestation were divided into 10 groups. The following velocity waveform parameters were measured in the main trunk of fetal pulmonary artery by Doppler ultrasound: acceleration time(AT), ejection time(ET), acceleration time/ejection time(AT/ET), peak systolic velocity(PSV), end diastolic velocity(EDV), mean velocity(MV), pulsatility index(PI) and resistance index(RI). The normal reference values of Doppler velocity waveform parameters at various GA were established. A scatter diagram of each parameter against GA was plotted out. The optimal formula was selected out according to the correlation and regression analysis. Results Among 252 normal fetuses, satisfactory Doppler velocity waveform of fetal main pulmonary were achieved in 249 (98.8%, 249/252). Among these parameters, AT, AT/ET, PSV, EDV and MV increased with increasing GA(F=343.23, 96.012, 8.649, 2.158, 10.169, all P<0.05), while PI decreased slightly(F=2.346, P<0.05) and ET, RI had no signiifcant changing(F=0.883, 1.534, both P>0.05). Signiifcant and positive linear correlations were found between parameters of AT, AT/ET, PSV, EDV, MV and GA(r= 0.898, 0.868, 0.446, 0.203, 0.507, all P<0.01);while PI was inversely linear correlated with GA(r=-0.184, P<0.01) and ET, RI had no correlation with GA(r=-0.103, 0.011, both P>0.05). Conclusions The fetal main pulmonary artery could be a reliable sampling point to obtain pulmonary velocity waveform by Doppler ultrasound. Doppler velocity waveform parameters have correlations with GA in normal fetus;among which AT and AT/ET were the best.

ObjectiveToevaluatethefeasibilityandresultsof transorallaparoscopic thyroidectomy. MethodThyroidectomy was attempted in 5 cases,including 4 females and 1 male with the average age of 42 years( range 35 -60 years).All patients was diagnosed as single nodule of the thyroid gland confirmed by B-mode ultrasound examination before the operation.The average diameter of nodule was 2.5 cm (range 2 - 3.4 cm). ResultTransoral laparoscopic thyroidectomy was perfoormed successfully in all 5 patients.The operation time was 120 - 210 min,averaging 170 min,blood loss during the operation was 15-60 ml,the postoperative hospitalization was 4 days. There was no conversion to open surgery,no recurrent laryngeal nerve injury,nor parathyroid glands dysfunction. ConclusionsTransoral laparoscopic thyroidectomy is feasible and safe,giving excellent cosmetic results.

Objective To evaluate the feasibility and results of laparoscopic thyroidectomy by oral and breast approach for the treatment of papillary throid carcinoma.Methods Thyoidectomy was performed in 26 cases,including 24 females and 2 males with the average age of 34 years (range 20-53 years).All patients were diagnosed throid carcinoma confirmed by FNA or B-mode ultrasound examination,a thyroid lobe or total thyroidectomy and central compartment dissection was performed by breast approach,then additional dissection of central compartment was completed through oral approach.Results Laparoscopic thyroidectomy via oral in combination with brest approach was performed successfully in all 26 cases.The mean operative time was (164 ± 13) min,including average time of oral approach of (40 ± 7) min.The mean number of lymph node dissection in central compartment was 7.42 ± 4.88,oral approach achieved additional 1.23 ± 2.21,with metastatic lymph nodes diseccted by oral approach in 3 cases.Conclusions Laparoscopic thyroidectomy via oral in combination with breast approach for the treament of papillary throid carcinoma is better than breast approach alone in central compartment dissection.

Doppler ultrasound has become an indispensable technique for fetal prenatal diagnosis,clinical monitoring,intrauterine treatment and assessment the timing of delivery nowadays.This study briefly described the principle of Doppler ultrasound and the structure of the fetus and placenta.Based on these,we discussed the application of Doppler ultrasound technique in diagnosing of fetal structural malformation,monitoring of significant blood vessels and screening of fetal chromosomal abnormality.

Objective:To evaluate the diagnosis and treatment of abdominal cocoon.Methods:The clinical data of 8 patients with abdominal cocoon in our hospital from Jan 2015 to Dec 2021 were retrospectively reviewed including clinical and imaging manifestations, treatment and follow-up.Results:One case was asymptomatic, and the other 7 cases suffered from recurrent abdominal pain with complete or incomplete intestinal obstruction. The median course of disease was 6 months (15 days to 40 years). Six cases underwent laparcoscopic cocoon membrane resection and intestinal adhesion lysis, of which 2 cases underwent laparotomy, one case was converted to open surgery, 4 cases underwent concomitant appendectomy. Follow-up ranged from 3 to 69 months, there were 2 cases complicating early inflammatory intestinal obstruction, 1 case suffred wound fat liquefaction and infection, 1 case with a colic 5 months after operation, and the others were doing well.Conclusions:The clinical characteristics of abdominal cocoon disease are not typical. Surgery is the main treatment. The prognosis of the disease is generally fair.

Objective:To investigate the safety and feasibility of endoscopic level V lymph node dissection for thyroid cancer.Methods:Two cases undergoing level V lymph node dissection via breast combined with oral approach for papillary thyroid cancer in May. 2021 and Sep.2021 were retrospectively analyzed. The primary thyroid lesions and metastatic lymph nodes were diagnosed pathologically by fine needle aspiration before operation. The routine examination such as ultrasound, CT and laryngoscopy were completed before operation.Results:Both operations were successfully completed under endoscopy. In case 1, one lymph node was found in neck V region, and no metastatic lymph node was found. In case 2, 7 lymph nodes were found in cervical V region. No "shoulder syndrome" encompassing shoulder dysfunction and pain was found in either case.Conclusions:The study on the two cases reveals that level V dissection after the routine operation of endoscopic central and lateral neck dissection via breast combined with oral approach for papillary thyroid cancer is feasible and safe. More cases in further study were needed for to verify the finding.