Objective To evaluate the efficiency,safety and complication of transcatheter closure of large atrial septal defect (ASD) with Amplatzer occlusion device under the guidance of transthoracic echocardiography (TTE) Methods The study group consisted of 12 males and 9 females, age ranged from 17-45 years old, underwent transcatheter closure of ASD with Amplatzer occlusion device The diameter of ASD (balloon stretched diameter) was 30-36mm The Amplatzer occluder size was chosen to be 2-4 mm more than the balloon stretched diameter of ASD All cases were guided by TTE Results All cases were successfully treated under the guidance of TTE, the procedure successful rate was 100% No severe complication was observed except 1 patient with frequent atrial premature beats after procedure and disappeared 1 months later by drug Conclusion Transcatheter closure of ASD can be performed safty and effectively with Amplatzer occlusion device under the guidance of transthoracic echocardiography But it is necessary to perform TEE to examine the peri structure of ASD before procedure

Objective To study the value of high frequency ultrasound in predicting spontaneous closure of patent duct arteriosus (PDA) in premature neonates. Methods One hundred and seventy premature neonates aged less than 37 weeks of gestation were enrolled. They were all admitted in the neonatal intensive care unit of Jinhua People′ s Hospital within 24 hours after birth. Echocardiographic examinations was conducted using GE′s Vivid I Portable color Doppler ultrasonography with routine cardiac probe (frequency 1.7-3.4 MHz) and high-frequency transducer (frequency 7.5 MHz). Up to the 7th day, the echocardiography was carried out every day after birth until the closure of PDA .They were divided to two groups according to whether spontaneous closure of PDA took place with in 7 days after birth (the control group) or not (the PDA group). There were 16 premature neonates in PDA group, including 6 male and 10 female. The mean gestational week at birth was (35.3±1.4) weeks. The mean birth weight was (2 330.9±325.5) g. Thirty-two premature neonates were included incontrol group, including 13 male and 19 female. The mean gestational week at birth was (35.0±1.3) weeks. The mean birth weight was (2 337.5±287.8) g. The clinical characteristics and echocardiographic parameters were compared between the two groups. Results The detection rates of high-frequency ultrasound and routine echocardiography were all 100%. The spontaneous closure rate of PDA in preterm infants at 24 hours, 48 hours, 72 hours were 18.8%(32/170), 61.2%(104/170), 78.8%(134/170) respectively. Within 7 days after birth, the closure rate was 90.6%(154/170), therefore the incidence of PDA in premature neonates was about 9.4%(16/170) in our study. The display rate of entire duct arteriosus using high frequency ultrasound was signiifcantly higher than that using routine ultrasound [82%(39/48) vs 46%(22/48), P<0.001, 100%(48/48) vs 77.1%(37/48), P<0.01]. The diameters of duct arteriosus in PDA group were signiifcantly larger than that in control group [(2.08±0.4) mm vs (1.09±0.22) mm, P<0.001]. However, the remaining echocardiographic parameters showed no signiifcant difference between the two groups (P>0.05). To predict the spontaneous closure of PDA in preterm neonates within 7 days after birth by high frequency ultrasound, the sensitivity, specificity and accuracy were 87.5%, 90.6% and 66.5% respectively using the cutoff point of 1.55 mm. While the sensitivity, speciifcity and accuracy were 75%, 93.7%, 44.15%by routine echocardiography with the cutoff point of 2.36 mm. Conclusions High-frequency ultrasound can conifrm the diagnosis of PDA in preterm infants and it is better than routine echocardiography in depicting the structure of arterial duct. The larger PDA diameter was suggestive of the lower possibility of spontaneous close.

Objective To investigate the correlation between matrix metalloproteinase-3 (MMP-3)serum level and polymorphism(5A/6A) and the stability of carotid plaque in Chinese Han population.Methods Two hundred and eighty acute cerebral infarction patients from the department of neurology of Taizhou Hospital were divided into carotid vulnerable plaque group and carotid stable plaque group according to the results of carotid B-mode uhrasonngraphy.Serum MMP-3 level waa measured by means of enzyme-linked immunosorbent assay (ELISA).At the same time, genotype was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for the common 5A/6A functional promoter polymorphism of the MMP-3 gene.The serum MMP-3 level and genotype frequencies of the MMP-3 gene between the two groups were analyzed.Results The genotype frequencies of the MMP-3 gene 5A/6A polymorphism of the two groups were in Hardy-Weinberg equilibrium The genotype distribution of the MMP-3 promoter 5A/6A polymorphism between the carotid vulnerable plaque group and the carotid stable plaque group was significantly different(χ2 =6.13, P =0.01, OR = 1.90, 95% CI 1.14-3.15).The frequencies of 5A allele were 20.6% and 12.8% in the carotid vulnerable plaque group and the carotid stable plaque group respectively (χ2=6.09, P=0.01, OR =1.76, 95%CI 1.12-2.77).Serum level of MMP-3 in the carotid vulnerable plaque group was higher than that in the carotid stable plaque group (t = 3.39, P =0.00).Conclusion The present findings suggest that serum level of MMP-3 and genetic polymorphism of 5A/6A in MMP-3 promoter are related with carotid vulnerable plaque in Chinese Han population and 5A allele may be a susceptible predictor of carotid vulnerable plaque.

Objective:To investigate the effect ofLeech Capsule on stability ofcarotid plaque and expression ofplatelet membrane glycoprotein in patients with cerebral arteriosclerosis.Methods:203 patients with cerebral arteriosclerosis which with unstable carotid plaque were divided into two groups.There were 101 patients in observation group which were treated by conventional therapy and Leech Capsule, and 102 patients in control group which were treated only by conventional therapy.Then comparison analysis ofIMT, plaque area, unstable plaque number and positive rates ofPAC-1 and CD62P were made before and after treatment with two groups.Results:After treatment, the IMT, plaque area, unstable plaque number and positive rates ofPAC-1 and CD62P in observation group were significantly lesser than those in control group.In observation group, all parameters after treatment were significantly lesser than those before treatment, but in control group there were no significant difference in IMT and positive rates ofCD62P between after treatment and before treatment.In addition, there were no obvious adverse reactions after treatment by leech capsule.Conclusion:Leech Capsule was an effective drug for stabilizing carotid plaque and depressing the level ofplatelet activation, and it had few adverse reaction.It was worth further spreading.

Fetal cystic lymphangioma is a developmental anomaly of the lymphatic system, which can occur in any part of the body, but most commonly in the neck and armpit. A case of fetal cystic lymphangioma located at the chest wall under the right armpit with a size of 21 mm×18 mm×16 mm is reported here. The mass was initially diagnosed by routine ultrasound examination at 21 gestational weeks. After the diagnosis, ultrasound was repeated every 4 weeks till 37 +4 gestational weeks. Over this period, the mass increased progressively to 101 mm×110 mm×95 mm. Ultrasound-guided intrauterine fetal cystic mass puncture and aspiration was performed 38 +4 weekss, and Bleomycin was injected into the cyst after operation and on day 42 after birth. During a follow-up to 10 months after birth, no obvious cystic mass was found at the right axillary chest wall of the child.