Objective To explore the Diagnostic value of real-time three-dimensional ultrasound for urethral vaginal fistulas.Methods 5 patients with urethral vaginal fistulas were checked using real-time three-dimensional ul-trasound ,respectively by the abdomen and the sonographic appearance of pudendal observation of female urethral vagi -nal interval sagittal and transverse ,sagittal and transverse section by measuring the size of the fistula ,and voiding trial or colored liquid test injection from urethral to confirm .Results 5 cases of urethra,vagina ultrasonography can dis-play and urethral vaginal interval throughout the sagittal plane and different levels of cross section ,urethral vaginal in-terval by low echo-band-low echo constitute the sandwichsign in the fistula showed partial loss ,local band echo in-terruption,urethral and vaginal local fusion ,voiding trial or from the urethra into the colored liquid test further con-firmed the fistula,fistula and verify the existence of fistula after the operation the size .Conclusion Real time three-dimensional echocardiography by urethral vaginal interval in the axial and sagittal plane ultrasound at different levels , combining with the history and voiding trial or injected with colored liquid test from the urethra ,can provide a new i-dea for diagnosis of urethral vaginal fistula .

Objective To measure the angle and distance between superior mesenteric artery (SMA) and abdominal aorta (AA) at the level of left renal vein and duodenum in Chinese.Methods The angle and distance between SMA and AA were measured in 41 patients with normal CT findings in the supine position using 16 slices multislice spiral CT(MSCT)scanner.Results The average angle of 41 normal cases was 47.4??18.3? (mean?SD), and 3 of 41 (7.3%)≤15?,10 of 41 (24.4%)≥70?. At the level of left renal vein and duodenum, the average distance between SMA and AA were (1.3?0.4) cm and (1.4?0.4) cm respectively.Conclusion MSCT allows accurately measure the angle and distance between SMA and AA, it shows significance in the diagnosis of SMA syndrome and nutcracker phenomenon.

Objective To evaluate the value of 16-slice spiral computed tomography(SCT)in diagnosing acute aortic syndrome.Methods Thirty-four cases with acute aortic syndrome underwent 16-slice SCT,performed with unenhanced,contrast-enhanced scanning of bolus tracking and three-dimensional reconstruction.The CT findings of these cases were analysed.Results Twenty-three of them were confirmed Aortic Dessection(AD),the true and false lumen,intimal flap,extent involved and complications of which were all revealed.Six cases were confirmed intramural aortic hematoma(IMH),with features of ring or crescent-shaped non-enhanced thickening wall around the aorta.Five cases were confirmed penetrating atherosclerotic ulcer(PAU),with features of niche sign outstanding the lumen of the aorta.Conclusion Acute aortic syndrome can he diagnosed exactly and completely by 16-slice SCT,which can provide valuable information to select therapeutic methods.

Objective The rate of post -operative complications has been increased with the changes in patients' age,prolonged duration, more severe and diffused lesions, and more patients with complications in recent years. We try to identify the risk factors associated with prolonged stay in the intensive care unit ( ICU ) after coronary artery bypass graft surgery (CABG). Methods 1623 patients who received CABG surgery in Beijing Anzhen Hospital Between June 1, 2006 and December 31,2007 were divided into two groups based on their stay duration in the ICU. Prolonged stay in ICU was defined as 5days or more. Univariate and multivariate analysis ( logistic regression) were used to identify the risk factors. The discrimination and calibration of the result were tested after the risk factors were determined. Results Fifty one patients had prolonged ICU stay, accounting for 3.14% of total cases. Multivariate logistic analysis showed that the age of patients, peripheral vascular diseases, critical status before operation, LVEF, operative status, mitral regurgitation, postoperative respiratory failure,postoperative renal failure, secondary thoracotomy for postoperative bleeding were associated risk factors. Conclusion Prolonged ICU stay after CABG surgery can be predicted based on the above factors. For patients with these risk factors, more pre-and postoperative care strategies are needed.