Objective To assess the diagnostic value of ultrasonographic elastography for identifying suspected malignant thyroid nodules. Methods Fifty-one patients with small single solid thyroid nodule underwent two-dimensional and color power Doppler ultrasonography. The size, shape, boundary, internal echo and halo, calcification of thyroid nodule were observed with two-dimensional ultrasound. Then color Doppler ultrasonography was used to detect blood signal and distribution in the nodules. Longitudinal scanning of elastography was performed, and the findings on elastography were classified into Ⅰ-Ⅴ grades. The ultrasonographic results were compared with pathologic findings. Results Six patients were found with grade Ⅰ and Ⅱ benign lesions;9 with grade Ⅲ ( 6 benign and 3 malignant), 36 with Ⅳ and Ⅴ (2 benign and 34 malignant) lesions on ultrasonographic elastography. Taking the elasticity grade Ⅳ or Ⅴ as malignant standard, the diagnostic sensitivity was 91.89%, specificity was 85.71%, accuracy was 90.20%, while the positive and negative predictive value was 94.44% and 80.00%, respectively. Conclusion Real-time ultrasound elastography is a promising imaging technique that can assist in the differential diagnosis of malignant thyroid small single solid nodule.

Objective To explore the changes of plasma level of adrenomedullin(ADM)in congenital heart disease patients with heart failure,analyze the relationship between ADM and the severity of heart failure, assess the value of plasma ADM in the diagnosis of CHF and evaluate the cardiac function in pediatric patients with congenital heart disease. Methods 46 patients with CHD were enrolled according to the modified Ross Score. They were divided into three groups:mild CHF group(n = 16)and moderate CHF group(n = 18)and severe CHF group(n = 12). 25 matched normal children were enrolled as controls. Plasma ADM was measured with radioimmunoassay(RIA)and the contents of NT-proBNP were determined among all the patients. LVEF and E/A in all of them were also detected. The relationship between plasma ADM level and modified Ross Score and echocardiographic cardiac functional indexes was analyzed. Results Plasma ADM was positively correlated with modified Ross Score(r = 0.65,P < 0.01). Plasma ADM concentration in the severe CHF group was significantly higher than that of mild and moderate CHF group(P < 0.01),and plasma ADM concentration in the mild CHF group was higher than that in the control group(P<0.05).Plasma ADM was negatively correlated with LVEF and E/A(r =-1.05,P < 0.01). Conclusion Plasma ADM level could be used to assess cardiac function and diag-nose CHF with CHD.