Objective To compare postoperative pulmonary infection in patients undergoing surgical operation at different surgical opportunities.Methods Patients who underwent surgical operation in a hospital from January to December 2014 were surveyed retrospectively,patients' data were reviewed,patients with postoperative pulmonary infection were compared.Results A total of 20 343 surgical patients were investigated,227(1.12％) had postoperative pulmonary infection.Postoperative pulmonary infection rate in patients undergoing emergency operation was higher than that of selective operation (5.13 ％ vs 0.70 ％,x2 =307.49,P＜0.001).Postoperative pulmonary infection rates in patients undergoing emergency neurosurgical,general surgical,and cardiothoracic surgical operation were all higher than selective operation (all P ＜ 0.001).Among patients with pulmonary infection following emergency operation,the proportion of those who aged ＜60 years,with preoperative irrational antimicrobial use,cardiovascular disease,hypertension,and tracheotomy were all higher than those who received selective operation (all P＜0.05);the proportion of patients with cancer is lower than that of elective surgery patients(P＜0.05).Conclusion Postoperative pulmonary infection rate in patients undergoing emergency operation is higher than selective operation,postoperative pulmonary infection rates in patients undergoing emergency neurosurgical,general surgical,and cardiothoracic surgical operation are high.Patients with cardiovascular disease and hypertension are the focus of protection;for elective surgery,cancer patients are the focus of protection.

Objective To study the correlation between single point pulse wave velocity (PWVβ)of different peripheral arteries and coronary artery stenosis quantity obtained by coronary arteriongraphy so as to explore the diagnostic value of PWVβin coronary heart disease.Methods We made a retrospective analysis of 183 patients receiving coronary arteriongraphy in our hospital from October 2013 to May 2014.Based on stenosis quantity of coronary artery,the patients were divided into one-vessel lesion group,double-vessel lesion group,multi-vessel lesion group,and nonstenosis as control group.Clinical data of all the patients were collected before coronary arteriongraphy.Different peripheral artery PWVβwas measured with vascular echo tracking (ET)technology for statistical analysis.Results As the lesion vessel number increased,PWVβandβvalues in three peripheral arteries presented a rising tendency.Correlation analysis indicated that PWVβvalues in the three peripheral arteries showed a positive correlation with coronary artery involvement degree.The correlation between PWVβvalue of the common carotid artery and coronary artery involvement degree was most obvious,followed by the femoral artery and the popliteal artery.The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of the common carotid artery PWVβvalue to diagnose coronary heart disease were 91.2%,84.5%,92.7%,81.7 and 0.76,respectively.Non-conditional multi-factor Logistic regression analysis was implemented by choosing age, sex,smoking history,hypertension history,diabetes history,hyperlipemia,BMI,HDL-C,LDL-C,TC,TG,GLU,SBP,DBP,UA,Cr,and PWVβ value as independent variables,and the degree of coronary artery disease as dependent variable.The results revealed that age,hypertension history,diabetes history,and PWVβ value were independent risk factors for coronary heart disease.Conclusion PWVβ value can be regarded as one index for observing artherosclerosis lesion degree and predicting early lesion.PWVβvalue of the common carotid artery can be an important index for dynamically observing the occurrence and development of artherosclerosis.

Objective To study the clinic imaging features and the clinic applications of the contrastenhanced ultrasound(CEUS) in the diagnosis of gallbladder carcinoma.Methods The characteristics of CEUS were reviewed in 24 patients with gallbladder carcinoma proven pathologically. Results After injection of SonoVue, all gallbladder carcinoma of 24 cases showed enhancement and these lesions looked clearer than those in conventional ultrasound.The analysis of time-intensity curve indicated the upslope of curve was steep in the lesions,which was flat in normal liver parenchyma around.In 10 cases of thick wall of gallbladder carcinoma, quick and obvious enhancement was seen in 9 cases, 1 case showed poor enhancement during scanning,but thick and tortile blood vessels could be seen in the thickening wall.Quick and uneven enhancement was been seen in both 8 cases of soft-tissue mass and 6 cases of nodules within gallbladder.Five cases of gallbladder carcinoma with liver metastasis revealed more liver metastasis depend on CEUS.Conclusions CEUS plays an important role in diagnosis and improving the diagnostic accuracy for gallbladder carcinoma.

AIM: To investigate the effects of angiotensinⅡ receptor type Ⅰ antagonist irbesartan and angiotensin-converting enzyme inhibitor perindopril on the myocardial expression of connexin 43 (CX43), desmin and cardiac troponin T (cTnT) in the pressure overload-induced rat cardiac hypertrophy. METHODS: 40 male adult Sprague-Dawley rats were divided into 5 groups (8 animals for each): sham operation group and other four groups with ventricular hypertrophy caused by banding aortic artery. Drugs were given one week after operation as follows: sham operation group, normal saline (2 mL?kg~-1?d~-1 ig) was given; Operative groups: animals with ventricular hypertrophy were treated with normal saline 2 mL?kg~-1?d~-1 ig; Treatment groups: animals with ventricular hypertrophy were treated with perindopril 2 mg?kg~-1?d~-1 ig, irbesartan 20 mg?kg~-1?d~-1 ig or irbesartan 20 mg?kg~-1?d~-1 ig plus perindopril 2 mg?kg~-1?d~-1 ig, respectively. Left ventricular mass index (LVMI), transverse diameter of myocardial cell (TDM), and myocardial expression of CX43, desmin and cTnT by immunohistochemistry were performed at the end of 8 weeks of drug intervention. RESULTS: LVMI, TDM were remarkably decreased after drug intervention, compared to animals of operative group (P

Objective To analyze the clinical application of detecting anti Mullerian hormone (AMH) in the patients with polycystic ovary syndrome (PCOS).Methods A total of 480 cases with PCOS and 500 cases of healthy females were selected in the study.The levels of AMH in the patients with PCOS were compared between the two groups.Results The levels of AMH,luteinizing hormone (LH),testosterone (T) in patients with PCOS were significantly higher than those in the healthy control group (P＜0.05).Differences of the levels of estradiol (E2) and follicle-stimulating hormone (FSH) in patients with PCOS and thosein healthy control group had no statistical significance(P＞0.05).As the age increased,the level of AM H obviously declined.Conclusion The level of AMH in patients with PCOS is obviously higher than that in the healthy ones,it declines with the age increasing.

Objective To evaluate the diagnostic value of thyroid microcarcinoma using contrastenhanced ultrasound(CEUS).Methods The CEUS characteristics of 31 lesions in patients with thyroid microcarcinoma which were confirmed by surgery and pathology were retrospectively analyzed.[Results]The enhancement features of 31 lesions were hypoenhancement,morphological irregularity,and lack of a complete envelope.The time intensity curve showed late washed in and late washed out.The start-time of the lesions was later than that of normal thyroid tissue.The enhancement intensities of the lesions were lower than that of normal thyroid tissue.Conclusions The contrast enhancement patternshypoenhancement,suggested that the CEUS might provide a useful,quantitative analysis method for the diagnosis of thyroid microcarcinoma,which can improve diagnostic confidence in thyroid microcarcinoma.

Objective To explore the sensitivity of contrast-enhanced ultrasound (CEUS) and ultrasonic elastography(UE) in detecting different sizes of thyroid papillary carcinoma.Methods 64 cases of thyroid papillary carcinoma were divided into two groups according to the diameter size(group 1,≤1 cm;group 2,＞ 1 cm) and examined by the contrast-enhanced ultrasound and elastography,then the features were analyzed and the sensitivity for detecting of the two methods in different groups were compared.Results The sensitivity for detecting in CEUS was higher than in UE,which had significant difference between two methods.CEUS and UE were valuable for detecting and they had no difference in sensitivity for detecting in group 1.There was a significant difference in sensitivity for detecting between two methods in group 2.Conclusions Both CEUS and UE were valuable in diagnosis of thyroid papillary carcinoma and the sensitivity for detecting in CEUS is higher than in UE in group 2.

Objective:To evaluate the effects of wearing N95 mask on the quality of chest compression and fatigue.Methods:A total of 80 participants from Zhongnan Hospital with basic life support (BLS) certification conferred by American Heart Association (AHA) within two years were enrolled. After reviewing the key points of cardiopulmonary resuscitation (CPR) and grasping the operation on the manikin, they were randomized (random number) into two groups: wearing surgical masks (SM group, n=40) and wearing N95 masks (N95 group, n=40) during CPR. Each participant performed a 2-minute chest compression-only CPR on the manikin. Participants' height, body weight, Borg scores and physiological parameters before and after CPR were recorded. The quality of chest compression (including compression depth, compression rate, adequate depth proportions, adequate rate proportions, hand position and complete chest recoil) were recorded by Laerdal QCPR ? software. Student's t test and Mann-Whitney test were used to compare the differences of chest compression quality indexes between the two groups. Results:Compared with the SM group, participants in the N95 group had significantly increased median of Borg scores after CPR (16 vs 14, P=0.027), and decreased quality of chest compression, including the decline in compression depth (mean 47 mm vs 52 mm, P=0.020), compression rate (107 times/min vs 118 times/min, P=0.004), complete chest recoil rate (89.8% vs 98.1%, P=0.046), adequate depth proportions (67.4% vs 89.6%, P<0.01) and adequate rate proportions (60.6% vs 74.8%, P<0.01). Conclusions:Wearing N95 masks during CPR decreases the quality of chest compression and aggravates rescuers’ fatigue. Therefore, it is necessary to exchange rescuers more frequently to ensure the quality of chest compression when wearing N95 masks.

Objective To analyze the misdiagnosed cases of the nodular goiter (NG)in real-time contrast-enhanced ultrasound(CEUS),in order to improve the diagnostic accuracy of NG.Methods Two-hundred and sixty-five cases of NG CEUS images,especially the 48 nodules in 44 misdiagnosis cases,were retrospectively analyzed to find out the main reasons of the misdiagnosis.In addition,the factors which effected the results of CEUS such as size,number and calcification of NG nodules were summarized.Results There were 42 nodules misdiagnosed as thyroid cancer,5 nodules misdiagnosed as thyroid adenoma and 1 nodular goiter misdiagnosed as subacute thyroiditis in 874 nodular goiter cases.The misdiagnosis rate of nodular goiter was 5.49% (48/874)by the diagnostic criterion of homogeneous enhancement in CEUS.The differences size and calcification of nodules had a significant impact on CEUS.The misdiagnosis rate of the NG nodules with major diameter less than 10 mm was much higher than that of more than 10 mm,the misdiagnosis rate of NG nodules with coarse calcification was much higher than the situation of microcalcification(P <0.05).Conclusions Major diameter less than 10mm and coarse calcifications of NG nodular are the main factors which influence the results of CEUS.

Objective To investigate the different roles of two-dimensional,color Doppler ultrasound and real-time ultrasound elastography in the diagnosis of Hashimoto's thyroiditis(HT).Methods One hundred and forty-one patients clinically diagnosed as HT underwent traditional ultrasound and elastography.The patients were classified into three groups,the hyperthyroidism group,the hypothyroidism group and the euthyroidism group.One hundred and eight volunteers with normal thyroid functions were enrolled as control group.Ultrasonic characteristics (size,echo,accompanied nodules,blood flow distribution of thyroid) and thyroid elastic parameters were recorded and analyzed.Results ①Focal hypoechoic pattern was mainly seen in the group of HT hyperthyroidim,diffuse hypoechoic pattern was mainly seen in the groups of HT euthyroidism,diffuse hypoechoic pattern with heterogeneous linear hyperechoic and nodular changes were mainly seen in the HT hypothyroidism group.②Blood flow reduced according to the order by the hyperthyroidim group,euthyroidism group and hypothyroidism group.③Patients with HT hyperthyroidism had elastic image pattern Ⅰ.Patients with HT euthyroidism had pattern Ⅰ and pattern Ⅱ.Patients with HT hypothyroidism had pattern Ⅱ and pattern Ⅲ.④There were significant differences (P＜0.05) between the mean elastic strain and the ratio of the blue area in each group.Conclusions Real-time ultrasound elastography is helpful for the diagnosis of HT.