Objective To explore the characteristics of chest multi-slice spiral CT and dynamic changes in adult patients with se-vere adenovirus pneumonia.Methods Clinical and CT data of 6 patients with severe pneumonia in an epidemic of the respiratory ade-novirus infection were retrospectively analyzed.The impact of hormone therapy was also studied.Results The first chest CT exami-nations in 6 patients were performed 2.22 ± 0.75 days after fever.CT showed segmental consolidation with ground-glass opacity (GGO)in one case,patchy consolidation with GGO in 3 cases,patchy interstitial changes in one case and small nodules in one case. The duration reaching the standards of severe pneumonia was 6.1 7 ± 0.37 days from the onset.During severe phase chest CT showed a range of lobar consolidation in one case,lobar in 2 cases,segmental in 2 cases or patchy in one case,consolidation with GGO in 5 cases.In all cases the lesions were commonly seen in the lower lobes of bilateral lungs.Multiple lobes were involved in 2 cases.After methylprednisolone treatment,no new lesion was showed but the early lesion was enlarged.During the first 2 to 4 days GGO absorbed completely in 6 cases,consolidation absorbed completely in one case and mostly in 5 cases.Conclusion Chest CT findings of severe adenovirus pneumonia in adult are single or multiple lobar or segmental consolidations with or without GGO which distribute mainly at lower lobes.

Objective To evaluate the value of three-dimensional power Doppler imaging(3D-PDI) in the discrimination between benign and malignant endometrium in women with postmenopausal bleeding. Methods Eighty-four women with post menopausal bleeding who examined by 3D-PDI were enrolled. All patients scheduled for pathological examination were divided into benign group (30 cases with endometrial polyps and 34 cases with hyperplasia) and malignant group (20 cases with endometrial carcinoma). Endometrial volume, vascularity index ( VI) , flow index ( FI) and vascularity flow index ( VFI) were measured. The diagnostic value of parameters derived from 3D-PDI was evaluated by using the receiver operating characteristic ( ROC) curve. Results Differences of these parameters (VI, FI and VFI) were considered statistically significant between two groups, the parameters of endometrial volume had no significant differences between two groups; the area under ROC curve(AUC) of the meaningful data were 0.976,0.888 and 0.894 respectively. Among these parameters, VI had the highest diagnostic value for discriminating between benign and malignant endometrium, the cut-off value of which was 2. 97 with a sensitivity of 95% and a specificity of 86%. Conclusions 3D-PDI is a good diagnostic tools in the discriminations between benign and malignant endometrium in women with postmenopausal bleeding.

To evaluate the application of intracavitary three-dimensional ultrasonography in the diagnosis of polycystic ovary syndrome ( PCOS). The three-dimensional volumes of ovary were measured by intracavitary ultrasonography in 40 PCOS patients and 40 normal controls. The diagnostic value of parameters derived from three-dimensional ultrasonography was evaluated by using the receiver operating characteristic (ROC) curve. The ovarian volume, stromal volume, and the stromal/total volume ratio in PCOS group were significantly higher than those in control group (both P ＜ 0. 05 ) ; the area under ROC curve ( AUC ) of them were 0. 876, 0. 926, 0. 886 respectively. Among these parameters, stromal volume had the highest diagnostic value for PCOS, the cut-off value of which was 7.52 cm3 with a sensitivity of 88% and a specificity of 90%. Volume parameters of ovary measured by intracavitary three-dimensional ultrasonography can offer quantitative information for the diagnosis of PCOS.

Objective To discuss the aetiological agent,prevention and treatment of the ureteroscopy lithotripsy concurrence urosepsis.Methods Retrospective analysis of 180 cases with ureteroscopy lithotripsy postoperative clinical data of 8 cases in urosepis patients.Results Eight patients with early active anti-infection,anti-shock treatment,eight patients were recovered and discharged,curative effect is satisfied.Conclusion Ureteroscopy lithotripsy postoperative patients concurrent urosepsis is dangerous,early detection,early diagnosis,early treatment is the key.

ObjectiveTo present 4 cases of primary c ar cinoid tumor of urinary bladder and to discuss the characteristics,diagnosis,tre atment and prognosis.MethodsA retrospective study of p athological and clinical data of 4 cases of primary bladder carcinoid tumor was made.Three were male patients and 1 female with an average age of 58.Two cases w ere considered as benign carcinoid tumor whereas the other 2 carcinoid of high malignancy.All of them presented macroscopic or microscopic hematuria but with no carcinoid syndrome noted.ResultsOne case of maligna nt carcinoid tumor with deep muscle invasion underwent radical cystoprostatectom y and adjurvent chemotherapy,but the prognosis was poor (died 5 months after the operation).Transurethral resection were performed for 2 cases of benign carcino id tumor and 1 case of focal malignant carcinoid with good prognosis.ConclusionsThe primary carcinoid tumor of urinary bladder has no specific symptoms,and should be diagnosised on histopathologic studies.Surgical intervention is the mainstay to treat the disease but the prognosis is hard to b e predicted.

A total of 104 patients with polycystic ovarian changes on ultrasound were divided into polycystic ovary syndrome (PCOS) and polycystic ovaries (PCO) groups according to their clinical symptoms and endocrine examinations.And 40 women with normal ovulation served as the controls.Ovarian volume (OV),ovarian stroma area (SA),ovarian total area (TA) and SA/TA ratio were measured by transvaginal uhrasonography.Their endocrine hormone levels were determined.Patients with PCOS showed significantly higher OV,SA,TA and SA/TA than those of PCO and control groups.SA/TA was positively correlated with testosterone.The median serum levels of anti-Mullerian hormone (AMH) and inhibit B in the PCO group were intermediate between those in control and PCOS groups.AMH and inhibin B of PCOS were higher than the PCO and control groups.It indicated that the levels of AMH and inhibit B were associated with the degree of polycystic ovaries and they could be used to differentiate PCOS and PCO.SA/TA is associated with the elevated serum testosterone of PCO.And SA/TA is an important ultrasonic parameter for diagnosing PCOS.

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) by using dynamic 3-Dimensional (3-D) CT imaging. A total of 41 male patients who presented with 2 of the following symptoms, i.e., daytime sleepiness and fatigue, frequent snoring, and apnea with witness, were diagnosed as having OSAHS. They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller's maneuver. The soft palate length (SPL), the minimal cross-sectional area of the retropalatal region (mXSA-RP), and the vertical distance from the hard palate to the upper posterior part of the hyoid (hhL) were compared between the two breathing states. These parameters, together with hard palate length (HPL), were also compared between mild/moderate and severe OSAHS groups. Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index (AHI) and the lowest saturation of blood oxygen (LSaO(2))] was examined. The results showed that 31 patients had severe OSAHS, and 10 mild/moderate OSAHS. All the patients had airway obstruction at soft palate level. mXSA-RP was significantly decreased and SPL remarkably increased during Muller's maneuver as compared with the quiet breathing state. There were no significant differences in these airway parameters (except the position of the hyoid bone) between severe and mild/moderate OSAHS groups. And no significant correlation between these airway parameters and the severity of OSAHS was found. The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group. The patients in group with body mass index (BMI)≥26 had higher collapse ratio of mXSA-RP, greater neck circumference and smaller mXSA-RP in the Muller's maneuver than those in group with BMI<26 (P<0.05 for all). It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients. All the OSAHS patients had airway obstruction of various degrees at soft palate level. But no correlation was observed between the airway change at soft palate level and the severity of OSAHS. The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI<26.

Objective To elucidate the prevalence and risk factors of cardiovascular disease (CVD) in end-stage renal disease (ESRD) patients on peritoneal dialysis (PD), and to investigate the associated problems in treatment. Methods A total of 254 PD patients in our division were enrolled in this study. CVD history, laboratory measurements, examinations of carotid atherosclerosis and left ventricular hypertrophy by ultrasonography were collected and associated factors were analyzed. The median follow-up time was 49 months. Results The overall prevalence of CVD was 37% (93/254). Diabetes, longer dialysis duration, hypertfiglyceridemia, hypoalbuminemia, hypoprealbuminemia were commonly found in the patients with new CVD event. The patients without pre-existing CVD had the higher Ccr, Kt/V, D/Pr, nPCR, serum albumin level. In those with pre-existing CVD, the hypertriglyceridemia and the duration of dialysis were independent predictors of progression of CVD. Differences of LAD, LVST, LVMI and IMT were significant between with and without pre-existing CVD groups. Kaplan-Meier curves showed that the presence of CVD was the independent risk factor of survival. Alb<330 g/L, LAD>39.6 mm and peritonitis were risk factors of CVD. Conclusion The prevalence of CVD in PD patients is quite high. CVD history should be realized, dialysis adequacy should be maintained, and peritonitis should be prevented.

Objective To investigate the Laparoscopic management for Nutcraker Syndrome(NCS) with resection of fibrous ring and placing extravascular stent.Methods This was a retrospective analysis of clinical data and treatment process of cases from March 2010 to February 2015 in urology department,affiliated hospital of Guizhou medical university.Five cases with NCS,4 males and 1 female;age were 28-40 years,mean age was 35 years,all cases were afflicted with gross hematuria and flank pain,the history of gross hematuria were 6-72 months.3 cases were afflicted with proteinuria.Duplex ultrasound scanning before surgery revealed the compressed left renal vein (LRV) between the aorta and the superior mesenteric artery(SMA),with peak velocity 110-132 cm/s,an average of 121 cm/s.The flow velocity of LRV in the renal hilum were 18-25 cm/s,an average of 21 cm/s.CT scanning showed that the stricture segment diameter of LRV were 1.2-2.5 mm,an average of 1.8 mm;and the max diameter of proximal dilatation of the LRV in renal hilum were 8.3-15.2 mm,an average of 10.1 mm.The ratio between the dilated segment inner diameter and the stricture segment were 3.4-9.5.Bleeding from the left ureteral orifice was detected by cystoscopy in 3 cases.5 cases were treated by resection of fibrous ring and placing extravascular stent with Laparoscopic management,and the average length of extravascular stent was 4.0 cm.Results The operation was successful in the 5 cases.The average operation time was 83 min.The average blood loss was 65 ml.Hematuria gradually reduce 5-6 days and resolved 7-20 days after surgery in 5 patients.Proteinuria was disappeared successful 2 weeks after surgery in 3 patients.There was no recurrence at 8-24 months' follow-up.3 days after surgery Doppler ultrasound showed the stricture segment diameter of LRV were 3.8-5.6 mm,an average of 4.9 mm;the ratio between the dilated segment inner diameter and the stricture segment decreased were 1.1-2.0,an average of 1.6;the peak velocity of compressed LRV were 25-45 cm/s,an average of 34 cm/s.6 months after surgery,CTA result showed no LRV compression in the aortomesenteric region;the max diameter of LRV in renal hilum were 7.9-9.8 mm and 6.0-8.8 mm in the aortomesenteric region of LRV.Conclusion Etiology of NCS exist a fibrous ring around the left renal vein outflow of the inferior vena cava besides the commonly anatomic extrinsic compression on the LRV as it crosses between the superior mesenteric artery and the aorta.The Laparoscopic management for NCS with resection of fibrous ring and placing extravascular stent is an effective minimally invasive treatment.

To explore the diagnostic values of real-time elastosonography quantitative parameters in uterine fibroids and adenomyoma.The clinical data of 175 cases were analyzed retrospectively.Strain ratios (B/A) of lesion and normal adjacent myometrium were measured and mean B/A was calculated.The average B/A of uterine fibroids and adenomyoma was 3.81 ±0.52 and 1.39 ±0.46 respectively.And there was significant statistic difference (t =2.563,P ＜ 0.05).the accuracy rates of real-time elastosonography in the diagnosis of uterine fibroids and adenomyoma were high at 97.4％ (148/152) and 95.3％ (122/128) respectively.Real-time elastosonography has high diagnostic values for uterine fibroids and adenomyoma.