Objective To investigate the clinical diagnostic value of transperineal ultrasound in women in late pregnancy with stress urinary inconti?nence. Method Totally 66 cases of women in late pregnancy were selected,who did not suffer from SUI(groupⅠ),and 54 cases of women in late pregnancy who suffered from SUI(groupⅡ). Another 63 cases of healthy childless women were used as normal control(groupⅢ). Transperineal ultrasound was used to dynamically observe their pelvic floor structure,and the ultrasonic parameters were recorded and analyzed,including the posi?tion of bladder neck in X axis and Y axis((Djx,Dzx,Djy,Dzy)during resting period and tension period,the vesicourethral angle(αj,αz),the Bladder angle(βj,βz). The moving of the bladder neck in X axis(ΔDx=Dzx-Djx)and Y axis(ΔDy=Dzy-Djy),as well as the bladder rotation an?gle(Δβ=βz-βj)were calculated and the movement of the bladder neck(ΔD)was measured,followed by comparative analysis. The threshold val?ues of all ultrasonic parameters were determined by the ROC curve analysis. Results The bladder neck of all three groups were backward during tension period. Compared with groupⅢ,ΔDy,Djx,Dzx obviously decreased in groupⅠand groupⅡ,whileβj,βz,αj increased significantly.ΔDx of groupⅡwas significantly larger than that of groupⅢ(P<0.05);There was significant difference in Djy,Dzy,ΔD,Δβandαz among the three groups(P<0.05);In ROC curve analysis,when the critical value of Djy,Dzy,ΔDy,ΔD,αz andΔβwas-1.75 cm,-1.71 cm,0.25 cm,0.29 cm,131.5° and 3.5° ,their sensitivity was 88.9%,88.9%,72.2%,83.3%,88.9%and 72.2%,and the specificity was 72.2%,81.8%,72.7%, 95.5%,86.3%and 68.2%,respectively. Conclusions The transperineal ultrasound could clearly show the pelvic floor of the women in late preg?nancy,the bladder urethral support structure damage or defect was more serious in the women in late pregnancy who were suffering from SUI,and the determination of the critical values of all ultrasonic parameters helped the screening of SUI in women in late pregnancy.

Objective To study the clinical value of bedside ultrasound in predicting the fluid responsiveness in pa?tients with septic shock in intensive care unit (ICU). Methods Forty-two mechanically ventilated patients with septic shock who admitted to ICU of the Affiliated Hospital of North China University of Science and Technology from January 2015 to April 2015 were included in this study. All patients were treated with volume expansion (VE) text. Hemodynamics in?dexes were obtained by ultrasound before and after each test, including stroke volume (SV), aortic peak blood flow velocity variation rate of breathing (△VpeakAO), inferior vena cava expansion index (△IVC) and brachial artery maximum speed vari?ation rate (△VpeakBA). Clinical data and central venous pressure (CVP) were recorded. Based on the responsiveness of SV, patients were divided into responsive group (R) and non-responsive group (NR), respectively. The differences of the above in?dexes were compared between two groups. The correlation of△IVC,△VpeakAO,△VpeakBA and△SV was determined. The role of the hemodynamic index for predicting volume responsiveness was evaluated by receiver operating characteristic ROC curves. Results A total of 47 VE tests were performed in 42 patients, 25 in R group and 22 in NR group. Before VE test, the hemodynamics indicators of△IVC,△VpeakAO and△VpeakBA were significantly higher in R group compared with those of NR group (P<0.05). The values of△IVC,△VpeakAO and△VpeakBA were positively correlated with△SV in two groups. The areas under the ROC curve of the hemodynamics indicators were 0.825, 0.853 and 0.866 for △IVC, △VpeakAO and△VpeakBA, and they all showed high sensitivity and specificity. Conclusion The hemodynamic index measured by bedside ultrasound can predict the volume responsiveness in mechanically ventilated patients with septic shock fluid therapy, and which can be used to fluid therapy with a high degree of specific and sensitivity in clinical practice.

Objective: To investigate the ultrasound evaluation on lfuid responsiveness in patients with septic shock. Methods: There 42 septic shock patients treated by mechanical ventilation in our hospital from 2015-01 to 2015-04 were studied. All patients received volume expansion (VE) text, ultrasound examination was conducted to measure hemodynamic parameters of inferior vena cava variation rate of breathing (ΔIVC), aortic peak blood lfow velocity variation rate of breathing (ΔVpeakAO), brachial artery maximum speed variation rate (ΔVpeakBA) and stroke volume (ΔSV) at before and after text. Based on the response to VE text, the patients were divided into 2 groups as Responsive group and Non-responsive group, the above indexes and their correlations to ΔSV were analyzed. The clinical values of those parameters for predicting volume responsiveness were evaluated by ROC curves. Results: A total of 47 VE tests were conducted in 42 patients including 25 cases in Responsive group and 22 cases in Non-responsive group. Before VE test, the parameters of ΔIVC, ΔVpeakAO and ΔVpeakBA were higher in Responsive group than Non-responsive group; ΔIVC, ΔVpeakAO and ΔVpeakBA were obviously related to ΔSV (r=0.631, 0.668 and 0.619). The area of ΔIVC, ΔVpeakAO and ΔVpeakBA under ROC curves were 0.817, 0.853 and 0.866 respectively, they were all with the high sensitivity and speciifcity. Conclusion: Ultrasound monitored hemodynamic parameters may predict the volume responsiveness in septic shock patients with mechanical ventilation, it could be used for guiding liquid treatment in relevant patients.

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Objective To compare and analyze the phylogenetic tree and sequence variant characteristics of Klebsiella species between 16S rDNA and rpoB. Methods Eighteen isolates identified as genus Klebsiella (with 15 of K. Pneumoniae and 3 of K. Oxytoca) by automated biochemical tests were selected. DNA were extracted, 16S rDNA and rpoB genes were amplified and sequenced with Klebsiella 16S rDNA and rpoB primers. Together with already published 8 species of Klebsiella and 9 species of Enterobacteriaceae 16S rDNA and rpoB sequences from GenBank, totally 35 sequences of 16S rDNA and rpoB respectively, phylogenetic trees were constructed with MEGA 4.0 to the analysis of groups. DNAStar/MegAlign was used for comparison of variable regions of 16S rDNA and rpoB, with analysis of degree of divergent at the same time. Results As for all 35 sequences, both 16S rDNA and rpoB phylogenetic trees divided Klebsiella species into three groups, 15 of K. Pneumoniae in this study and 6 of K. Pneumoniae from GenBank (except for K. Oxytoca and K. Mobilis) cluster to group Ⅰ, K. Oxytoca and K. Mobilis were cluster to group Ⅱ and Ⅲ, respectively. In rpoB phylogenetic tree, no matter group Ⅰ and group Ⅱ, or subgroup within group Ⅰ, the bootstrap values in each node of rpoB phylogenetic tree is obviously higher than that of 16S rDNA. Moreover, as for cluster to K. Oxytoca, rpoB is better than 16S rDNA. Analysis nucleic acid sequences of Klebsiella species, with 41 variable regions and 4 most significant regions were found within the Klebsiella 16S rDNA, while rpoB with 63 variable regions, and 1 most significant region. The similarity of 16S rDNA and rpoB within Klebsiella were 95.9%-100% and 90.2%-100% respectively. Further analysis divergent degree of 16S rDNA and rpoB within Klebsiella, the divergent value of rpoB (0-10.6) is higher than that of the 16S rDNA(0-4.0). Conclusion As for molecular classification and identification within KlebsieUa species, rpoB has more advantages than 16S rDNA.

Objective To observe the changes of artery elasticity in patients with High-Normal Blood Pressure(HNBP) by ET, and search bound values in diagnosis by ROC. Methods Comparative analysis of artery IMT and β, Ep, AC, PWVβ with HNBP and normal group, which were analyzed by ROC. Results Compared with the normal group, β, Ep, PWVβ were increased in HNBP group, AC was lower significantly. Conclusion The peripheral artery elasticity have reduced before the artery IMT didn′t appear morphological change.

Objective: To explore the structural and functional changes of femoral and popliteal arteries in hypertension patients before and after drug therapy. Methods: A total of 201 hypertension patients treated in our hospital from 2010-03 to 2016-01 were studied. Based on blood pressure levels, the patients were divided into 3 groups: Grade-1 group,n=72, Grade-2 Group,n=68 and Grade-3 group,n=61. The patients were treated for 3 months and blood pressure was reduced below 140/90 mmHg. The intima-media thickness (IMT) of femoral and popliteal arteries was measured by two-dimensional ultrasound, blood vessel elasticity parameters of β, Ep, AC and PWV were determined by ET technology. The differences were compared between pre- and post-medication. Results: Compared with pre-medication, post-medication IMT in femoral artery was decreased in 3 groups, allP<0.05 and IMT in popliteal artery was similar,P>0.05; blood vessel elasticity parameters of β, Ep, PWV were decreased in 3 groups and AC was increased, allP<0.05. Conclusion: Drug therapy could effectively improve the elasticity of femoral and popliteal arteries in hypertension patients; two-dimensional ultrasound combining ET technology may dynamically monitor vascular elasticity of lower extremity which provides an objective basis for evaluating medication efifcacy in clinical practice.

Objective To evaluae the meaning and value of ultrasonography in the diagnosis of cubital tunnel syndrome(CuTS).Methods Forty patients(unilateral) of cubital tunnel syndrome(contralateral control group)were used to measure the ulnar nerve entrapment and the most extensive cross-sectional area and circumference.All cases underwent cubital incision preoperative,intraoperative direct vision under surgical line wrapped around the ulnar nerve compression and the most rough after a lap cut,and then we measured with a ruler,the two measurement methods comparison.The diagnostic threshold and the sensitivity and specificity of the most extensive cross -sectional area of the ulnar nerve and perimeter was analysed by using the receiver operating characteristic (ROC) curve.Results The most extensive cross-sectional area and circumference of the ulnar nerve in the CuTS group were significantly higher than those in the control group,and the difference was statistically significant.Forthe ultrasound measurement and intraoperative measurement of CuTS group at the pressure and the most rough circumference,the difference was not statistically significant,indicating that ultrasound can accurately measure the ulnar nerve circumference.The optimal cut-off point of the most rough cross-sectional area of the ulnar nerve and the circumference of the CuTS group were respectively 14.2mm2 and 14.8mm,and sensitivity were respectively 92.5％ and 90％,the specificity were respectively 97.5％ and 87.5％.Conclusion Ultrasonography is a new and valuable method for the diagnosis of cubital tuunel syndrome by measuring cross-sectional area and circumference of elbow.The optimal cut-off point of the most rough cross-sectional area of the ulnar nerve and the circumference of the CuTS group were respectively 14.2mm2 and 14.8mm.

Objective To analyze the clinical characteristics of respiratory involvement in relapsing polychondritis(RPC). Methods The clinical data of 38 patients with respiratory (larynx, trachea and bronchus) involvement in RPC were retrospectively analyzed. Results The incidence of respiratory involvement in patients with RPC was 51.35%(38/74), and the most common symptoms were cough, wheezing, chest tightness and dyspnea. The incidences of erythrocyte sedimentation rate (ESR) increasing, C- reactive protein (CRP) increasing, fibrinogen increasing, D- dimer increased and rheumatoid factor (RF) positive in patients with respiratory involvement were significantly higher than those in patients without respiratory involvement: 47.37% (18/38) vs. 30.56% (11/36), 52.63% (20/38) vs. 33.33% (12/36), 31.58% (12/38) vs. 25.00% (9/36), 21.05% (8/38) vs. 13.89% (5/36) and 36.84%(14/38) vs. 5.56% (2/36), and there were statistical differences (P<0.05). CT was the main method to discover the respiratory involvement, and MRI could detect early cartilage inflammation lesions. Laryngoscope and bronchoscope could early detect mucosa and cartilage damage. Pathology was given priority to lymphocytes and neutrophils infiltration. Some patients had epithelium metaplasia and even canceration. Primary treatment methods were glucocorticoids combined with immunosuppressant. Airway stenosis and infection was the main factors influencing the prognosis of patients. Conclusions The respiratory involvement is not uncommon in RPC, and early CT, MRI, laryngoscope and bronchoscope examination is an important means of early diagnosis.Early glucocorticoid combined immunosuppressive therapy is the key to achieve good prognosis.

Objective To investigate clinical value of right ventricular morphology in children with congenital heart disease associated pulmonary hypertension. Methods From October 2014 to October 2017, 37 children with congenital heart disease without associated pulmonary hypertension ( resting pulmonary systolic pressure ≤30 mmHg,1 mmHg＝0. 133 kPa) were selected as group A. Thirty-seven children with congenital heart disease and associated pulmonary hypertension (resting pulmonary systolic pressure＞30 m) . were in group B,and 37 healthy children were in control group. Echocardiography was performed to compare the results of right ventricular morphology and systolic function in three groups. Results ( 1 ) Right ventricular morphology indexes:right atrium upper and lower diameter((56. 8±4. 0) mm),right atrium left and right diameter((49. 2± 3. 3) mm),right ventricle basal segment inner diameter(( 43. 7± 2. 5) mm), right ventricle medial diameter((41. 7±3. 9) mm),right ventricle long axis distance((73. 4±6. 2) mm), sternum sidelines right ventricular outflow tract proximal end diameter((37. 8± 2. 4) mm),short axis view right ventricular outflow tract distal internal diameter (( 33. 6 ± 2. 1) mm),main pulmonary artery internal diameter((30. 5± 2. 5) mm), right ventricle end diastolic area (( 31. 6 ± 1. 8) cm2 ), right ventricle end systolic area((19. 0± 2. 7) cm2 ) in group B were higher than those in group A((46. 2± 3. 1) mm,( 40. 4 ±2. 8) mm,(34. 6±2. 2) mm,(32. 5±2. 6) mm,(65. 1±4. 7) mm,(30. 2±2. 0) mm,( 29. 4±1. 8) mm, (23. 0±1. 6) mm,(22. 5±1. 1) cm2,(11. 6±1. 2) cm2)and control group((45. 3±2. 6) mm,(39. 5±1. 7) mm,(34. 0±1. 9) mm,(31. 8± 2. 0) mm,(63. 2± 3. 8) mm,( 29. 6± 1. 7) mm,(28. 9± 1. 5) mm,(22. 4 ±1. 4) mm,(22. 1±1. 0) cm2,(11. 3±0. 9) cm2),( F＝140. 26,147. 47,223. 08,130. 46,43. 56,183. 33, 74. 71,209. 94,587. 99,221. 34, all P＜0. 01 ) . ( 2) Right ventricle contractile function indexes : right ventricular area change rate((40. 1±1. 6)%),three tricuspid ring systolic displacement((2. 2±0. 2) cm), tricuspid valve peak systolic flow velocity((13. 8±0. 9) cm／s)in group B were lower than those in group A ((46. 3±1. 7)%,(2. 5±0. 3) cm,(16. 7±1. 2) cm／s)and control group((46. 8±1. 5)%,(2. 6±0. 3) cm, (17. 2±1. 4) cm／s),the difference was statistically significant(F＝200. 81,21. 86,88. 85,all P＜0. 01 ) . Conclusion Children with congenital heart disease associated pulmonary hypertension have right ventricle morphological changes and right ventricular systolic function decreasing. Right ventricular morphological examination has important clinical value.