Objective To evaluate the feasibility and clinical value of color Doppler flow imaging(CDFI) guided inferior vena caval filter insertion(IVCFI). Methods Thirty-one consecutive patients with unilateral lower extremity deep venous thrombosis were selected for IVCFI. Screening CDFI was performed in all the patients. Locations of renal veins (RV),maximum diameter of the inferior vena cava (IVC),and presence or absence of thrombus were documented. If visualization was adequate,IVCFI was performed under guidance of CDFI. CDFI and abdominal plain film of radiograph were used to document proper deployment,and circumferential engagement of the filter struts in the IVC wall. Also,CDFI was repeated each one month to assess IVC filter migration,thrombus adherent to the filter,and IVC patency. Results CDFI visualization was adequate in thirty-one patients(100%) and the average diameter of IVC was 19.7 mm. Thirty-one VenaTech IVC filters were placed without technical difficulty. No technical complication occurred in all the patients. Follow-up examination showed that no filter uncompleted opening and migration and no IVC thrombus were observed. Seven cases (29%) with embolus trapped by IVC filter were found. There had been no report of pulmonary emboli after IVCFI. Conclusions Placement IVC filter is feasible and safe with CDFI. CDFI-guided IVCFI substantially reduces the procedural cost and avoids the need for radiation exposure and intravenous contrast.

Objective To evaluate the basilar artery hemodynamical changes in cervical rotation and ventral flexion by color Doppler flow imaging(CDFI). Methods Basilar artery blood flow were detected during cervical With cervical right lateral,left lateral rotation and ventral flexion, the detection ratio of basilar artery by ultrasound were 89% ,84% ,81% respectively. There were no difference in statistics between the detction ratio of three kinds during cervical flexion,peak systolic velocity(PSV) and end-diastolic velocity(EDV) decreased apparently during left lateral rotation,which did not change during right lateral rotation. No changing was found with resistant index between the three kinds of cervical position. Conclusions The hemodynamic changing of basilar artery during cervical rotation and flexion could be detected by CDFI accurately,which might be useful in clinical study.

Objective To investigate the effect of vascular inner diameter and artery flow velocity on the flow of internal arteriovenous fistula. Methods Sixty-two patients received the operation of internal fistula were enrolled. According to the inner diameter (Group A: d ≤ 1.5 mm, Group B: 1.5 mm < d ≤ 2.0 mm, Group C: 2.0 mm < d ≤ 3.0 mm, Group D: d > 3.0 mm), the patients were divided into four groups in terms of artery flow velocity (Group a: v ≤ 20 cm/s, Group b:20 cm/s < v≤50 cm/s, Group c:50 cm/s < v ≤ 100 cm/s, Group d:v > 100 cm/s), the differences of fistula and dialysis flow for two months were analyzed among various groups. Results Compared with Group B/b, patients in Group A/a had higher risk of operation failure, with lowered inner fistula flow and dialysis flow. In terms of inner venous diameter , there were significant differences between Group B and C. Conclusions It is not recommended to carry out the inner vascular fistula operation. Followed with the thickening and increasing of inner artery diameter and artery flow , the inner fistula flow and the dialysis flow increase. The inner venous diameter has no significant impact on the inner fistula flow.

ObjectiveTo evaluate inferior vena cava (IVC) filter placement guided by color ultrasonography for the prevention of pulmonary embolism(PE) in cases of deep veous thrombosis(DVT) of the lower extremity. Methods From May 2002 to July 2003, 30 DVT cases were admitted and treated by IVC filter placement under the guide of color ultrasound. Fifteen cases received open thrombectomy immediately after filter placement, others were treated conservatively.Results Filters were successfully placed in all patients without complications except for one case in which occlusion was found during follow up of 1～14 months. Four patients surviving previous PE attacks before the placement of a filter had no more PE attacks thereafter. Conclusions IVC filter placement guided by color ultrasonography can prevent PE due to DVT effectively.

Objective To assess the effectiveness of cerebral hemodynamical changes after carotid endarterectomy (CEA).Methods Eleven patients with symptomatic internal carotid arterial stenosis were selected.Before and after CEA,the peak systolic velocity,blood flow volume in ipsilateral internal carotid artery and the peak systolic velocity in bilateral cerebral middle artery were measured by color Doppler flow imaging (CDFI) and transcranial Doppler (TCD).Also collateral circulations via the circle of Willis and the ophthalmic artery were detected.Results After operation,the systolic peak velocity in the ispilateal internal carotid arteries decreased [( 291.70 ? 65.2 5)cm/s vs ( 100.85 ? 35.68 ) cm/s,P

Objective To discuss the surgical method of resection of petroclival tumors used temporal base transtentorial approach.Methods Analyzed 26 cases of petroclival tumors.All of them were surgically treated under intraoperative neurophysiological monitoring by temporal base transtentorial approach.Firstly the supratentorial part of tumors were resected by pieces,and then the tentorium was cut open,in order to resect residue of the subtentorial part of tumors.This surgical maneuver was applied to reduce the retraction to surrounding vessels,nerves and brain stem,as well to protect important structures and to finally achieve radical removal of the tumors.The efficacy and complications were observed.Results Among 26 cases,19 cases (73.1％,19/26) achieved total removal,5 cases (19.2 ％,5/26) achieved subtotal removal and 2 cases (7.7％,2/26) achieved great partial removal.There was no surgery-related death.Eleven cases suffered from partial neurological deficit.All cases were followed up for 3 months to 4 years,3 cases underwent complete recovery,4 cases underwent partial recovery,and 4 cases underwent permanent deficit.Conclusions Using temporal base transtentorial approach to resect petroclival tumors is convenient,applicable,safe and with minimal injury and with high proportionality of total resection.Under intraoperative neurophysiological monitoring,this approach may be an ideal choice for surgical treatment of these tumors.

Against the deficiencies of the current preventive medicine education curriculum,training programs and curriculum were reformed according to the training objectives of the modem preventive medicine, while new ideas of preventive medical personnel training were explored in order to cultivate practical professionals with a certain ability to innovate and to adapt the development of modern public health and preventive medicine preferably.

Children with pediatric tumors have better prognosis and longer survival than adults, suggesting that attention should be paid to the long-term complications induced by radiotherapy. In this article, the data from more than 40 clinical studies of pediatric tumor radiotherapy published in the recent decade were retrospectively analyzed. Long-term complications of nervous system, cardio-cerebrovascular system, respiratory system, endocrine system, urinary system, reproductive system, skeletal development, long-term secondary tumors were considered and the corresponding radiation dose-volume parameters were summarized, aiming to guide radiation oncology physicians and physicists to optimize radiotherapy plans for children with pediatric tumors.

Objective To evaluate the clinical outcome of NB09 (China Pediatric Neuroblastoma cooperative group 09) protocol on children with high-risk and ultra-high risk neuroblastoma. Methods The clinical and follow-up data of pa?tients who suffered from high-risk (n=7) and ultra-high risk (n=31) neuroblastomas and admitted in Tumor hospital of Tian?jin Medical University between January 2009 to January 2013 were retrospectively reviewed (27 boys and 11 girls). The age at diagnosis was 19-160 months (median age was 36.5 months). In the high risk group, patients were evaluated and operated after 4 to 6 circles of neoadjuvant chemotherapy. In ultra-high risk group, patient received chemotherapy before and after op?eration, then autologous stem cell transplantation and tumor bed radiotherapy. After chemotherapy, retinoic acid treatment was given to patients in ultra high risk group as in high risk group. Results At the end of treatment, 25 patients achieved complete remission; 5 patients achieved partial remission; 3 patients were in stable disease;5 patients were deteriorating in their conditions which lead to 2 deaths. In total, the response rate reaches upto 86.8%. By the end of follow up, 15 patients had a disease-free-survival, 9 patients survived with tumor, 7 died from recurrence and 7 died from deteriorating conditions. Survival time ranged from 6 to 52 months (median survival 25.5 months). The 1-, 2- and 3-year overall survival were 91.7%, 64.5%and 57.3%respectively. Kaplan-Meier curve and Log-rank test showed no statistical significance between high risk and ultra-high risk neuroblastomas. Conclusion The outcome of NB09 protocol for high risk and ultra-high risk neuroblastoma was preliminary affirmed. It is worthy of further clinical verification.

Background The incidence and progression of glaucomatous optic neuropathy is related to a disturbance of the retrobulbar hemodynamics.Compound anisodine is clinically applied for the treatment of ischemic ocular diseases.Objective To evaluate the effects of compound anisodine injection on the ocular blood flow of glaucoma patients.Methods Twenty-one patients with primary glaucoma were divided into the treatment group and the control group.The eyes of each patient in the treatment group were selected further into the treatment eye group (11 eyes with greater mean deviation [MD]) or the opposite eye group(11 eyes with lesser MD).One of the eyes of each patient in the control group with MD value were selected as control eyes (10 eyes).The treatment eye group received compound anisodine on the para-superficial temporal artery via subcutaneous injection once a day for 2 treatment periods (each period equals 14 days,with 7 days intermittent between periods,totally 35 days) in addition to routine treatment.The retrobulbar blood flow,optic disc data,refraction error,visual field and intraocular pressure were measured in 3 time points:Before treatment period (baseline test),one day after treatment period (the 1st postreatment test) and 35 days after treatment period (the 2nd posttreatment test).Results Compared with the control group,the peak systolic velocity (PSV) and end diastolic velocity (EDV) of short posterior ciliary artery (SPCA) of the treatment eye group were relatively increased significantly in the 1st posttreatment test (P =0.017,0.028),the PSV of SPCA of the opposite eye group was relatively increased significantly in the 1 st posttreatment test (P =0.049),the EDV of central retinal artery (CRA) of the opposite eye group was relatively increased significantly in the 2nd posttreatment test (P =0.035).In contrast to the treatment eye group,the inferior quadrant RNFL thickness of the optic disc decreased significantly in the 2nd posttreatment test in the control group (P =0.009),the 6 o'clock RNFL thicknesses of the optic disc decreased significantly in the 1 st posttreatment test in the control group (P =0.014),and the 6 o'clock and 7 o'clock RNFL thicknesses of the optic disc decreased significantly in the 2nd posttreatment test in the control group (P =0.029,0.011).Conclusions The application of compound anisodine for the treatment of primary glaucoma relatively increases the PSV and EDV of SPCA.