Objective To investigate the effect of intratracheal instillation of curosurf on neonatal respiratory distress syndrome ( NRDS ) in children with right ventricular function.Methods 52 patients with NRDS were retrospectively selected and divided into two groups according to different treatment.The patients in the conventional group were treated with nasal airway ventilation.Based on the conventional group, the curosurf group was taken with curosurf.26 cases were in each group.The blood gas index (PaCO2, PaO2, pH), inflammatory reaction (TNF-α, IL-10), SF of the two groups were compared, the complications and curative effect of the two groups before and after treatment were taken for statistics.Results There was no significant difference in pH value between the two groups at each time point.The PaO2 expression levels in the curosurf group at different time points after treatment were significantly lower than the conventional group (P<0.05).The levels of TNF-αand IL-10 in the curosurf group were more stable than those in the control group at different time points after treatment (P<0.05), and the degree of SF increasing at different time points were higher (P<0.05).The total effective rate 80.77% of the curosurf group was significantly higher than that of the conventional group 61.54%(P<0.05).The total complication rate 19.24% had no significant differences with the conventional group 23.08%.Conclusion Intratracheal instillation of CsA in the treatment of NRDS has the advantages of simple operation, little side effect, rapid recovery of blood gas index and inflammatory factors, so it is a feasible method for clinical treatment of NRDS.

Objective To explore the efficacy and safety of percutaneous transhepatic portal vein or transjugular intrahepatic portosystemie shunt (TIPS)to implant the portal vein metallic stent in treatment of cavernous transformation of portal vein (CTPV).Methods Clinical and imaging data of 8 patients with CTPV were retrospectively analyzed who were treated in our hospital.All patients were treated with metallic stent implantation in portal vein including 3 patients by TIPS and 5 by percutaneous transhepatic portal vein.Results All patients were successful in the stent implantation without any occurrence of serious complications such as intra-abdominal hemorrhage and so on.Intraoperative angiography showed blood circulated freely in these stents.1 day-2 weeks later,the patients symptoms of abdominal pain and gastrointestinal bleeding were obviously relieved or disappeared.Follow up 1 month-3 years,1 patient with stent occlusion after one year of operation,the blood flow recovery after stent reimplantation,and the remaining patients,color doppler ultrasound reflected patency of blood flows in their stents.No one suffered from gastrointestinal bleeding or abdominal pain again.Conclusion Implantation of portal vein metallic stent via percutaneous transhepatic portal vein or via TIPS in treatment of cavernous transformation of portal vein is safe and effective.

Objective:To compare the diagnostic values of C-TIRADS, ACR-TIRADS and EU-TIRADS.Methods:According to the classification methods of the 3 guidelines, the ultrasonographic features of 283 thyroid nodules from 266 patients in Sir Run Run Shaw Hospital from January 2019 to June 2020 were analyzed retrospectively. The pathological results were taken as the gold standard, the malignant percentage of different classification was calculated, the ROC curve was plotted, the area under the ROC curve (AUC) and the best diagnostic cut-off value were calculated, and the diagnostic values of the three guidelines were compared. According to the FNA recommendations of the guidelines, the recommended number of thyroid nodules and the detection rate of malignant nodules in different guidelines were analyzed.Results:The AUCs of C-TIRADS, ACR-TIRADS and EU-TIRADS were 0.80, 0.66, 0.61, respectively. The AUC of C-TIRADS was higher than those of ACR-TIRADS and EU-TIRADS ( P<0.001, P<0.001). The best diagnostic cutoff values of C-TIRADS, ACR-TIRADS and EU-TIRADS were 4C, 5 and 5, respectively. Under the critical points, the sensitivities of the 3 guidelines were 95.27%, 98.10%, 99.53%, the specificities were 54.17%, 33.33%, 20.83%, respectively. There was no significant difference in the number of FNA recommendations among the 3 guidelines(all P>0.05), their FNA recommendations were highly consistent (Kappa>0.9). Conclusions:The diagnostic value of C-TIRADS in the classification of benign and malignant thyroid nodules is higher than those of ACR-TIRADS and EU-TIRADS. The best critical value for diagnosis of thyroid nodules is C-TIRADS 4C. The three guidelines are similar in the number of FNA recommendations and the detection rate of malignancy.