ObjectiveTo evaluate the applicection value of ultrasonically guided percutaneous puncture and drainage of gallbladder (PPDG) in treating elderly patients with acute cholecystitis.MethodsThe clinical data of 59 elderly patients with acute cholecystitis treated by ultrasonically guided PPDG were retrospectively analyzed and compared with 37 patients treated by cholecystectomy or 13 cases by cholecystostomy.ResultsThe rates of complication and fatality and average hospital days were 32.4 ％ (12/37),5.4 ％ (2/37) and (25.4 ± 16.5 ) d in patients by cholecystectomy and 7.7％(1/13),7.7％(1/13) and (32.0± 12.5) d in patients by cholecystostomy,respectively,while the complication and mortality were not found in patients by ultrasonic ally guided PPDG with average hospitalization of(19.5 ±9.8)d. The rates of the complication and average hospital days were significantly higher in patients by cholecystectomy and cholecystostomy than in patients by ultrasonically guided PPDG (P＜0.05).ConclusionsUltrasonically guided PPDG is effective,safe and convenient for the treatment of acute cholecystitis in elderly patients.

Objective To evaluate the values of clinical application of color Doppler ultrasound in the diagnosis and treatment of iatrogenic femoral artery pseudoaneurysm (IFAP) in the elderly following percutaneous transluminal coronary angioplasty(PTCA). Methods A tota.of 35 patients aged(73.8±1.3) years with IFAP after PTCA were examined by color Doppler ultrasound.All cases were treated by compression simply for blocking blood flow with probe guided by ultrasound,and the failed cases were injected Reptilase into the lumen of pesudoaneurysm. Results 35 patients were diagnosed as IFAP by color Doppler ultrasound and the coincidence rate with clinical diagnosis was 100％ (35/35).Among all patients,31 cases were cured by simply compression guided by ultrasound and 3 cases were cured hy the injected reptilase into lumen,the cure rate was 97.15％(34/35).One cases was cured by surgery after failure to treat by the two above methods.34 cases (97.2％)were verified into occlusio by ultrasound after 24-48 h of treatment. Recurrence and other serious complications were not found during follow-up of 3-6 months. Conclusions Color Doppler ultrasound can be used for the preferred method in accurate diagnosis and effective cure of IFAP following PTCA in the elderly.

Objective To study the regularity of occurrence and development in the elderly with AAA. Methods Twenty-seven elderly cases with abdominal aortic aneurysm(AAA) were analyzed and followed up with ultrasound for ten years. Results The AAA diameters were 2.5 ~6.6 cm,with the average in crease of(0.14 ? 0.01) cm/ year. Intraluminal thromi(ILT) were found in 63.0% of all the patients. ILT were found(3.9?2.0 ) years after the AAA diagnosis with the average in crease of(0.21 ? 0.05)cm / year. Conclusions The size of AAA in the elderly is slowly enlarged to varying degree with ageing. ILT are found in more than half of all the patients. A few cases of AAA are found ruptured and a few cases of ILT exfoliated.

Objective: To determine the extract from Radix Astragali. Methods : Astragaloside IV in extract from Radix Astragali was determined by TLC-Scanning. Results : The linear relationship was at the rang of 0.78 ?g～ 4.68 ?g. The average recovery was 99.06% ( RSD=1.17% and n =5). Conclusion : The method is available with a good reproducibility. The pretreatment is simple and easy to operate.

Objective To evaluate the value of color Doppler flow imaging (CDFI) in the diagnosis of elderly femoral arterial pseudo aneurysm and treating with ultrasound-guided compression after percutaneous transluminal coronary angioplasty (PTCA). Methods Twenty-six elderly patients who were found a mass and/or vascular murmur in the puncture region were examined by CDFI, and the results of CDFI were proven by clinic and MRI. All pseudo aneurysms were repaired by CDFI guidance to compress simply and/or injecting directly batroxobin into the pseudo aneurysm lumen combined with compression.Results Pseudo aneurysms were diagnosed definitely by CDFI in 26 cases,and the accuracy rate was 100%. Twenty-two cases were repaired with CDFI guidance to compress simply and percutaneously injection of batroxobin into the pseudo aneurysm lumen combined with compression occurred in 3 cases. One case was cured by surgery after failing to be repaired with CDFI guidance. Conclusions CDFI has an important diagnosis value of pseudo aneurysm after PTCA. The method of CDFI guidance compression and batroxobin injection for repairing pseudo aneurysm is simple, safe and effective.

Objective To evaluate the changes of morphology, hemodynamics and endothelial function of the dorsal artery of foot in patients with early-stage type 2 diabetic mellitus (T2DM) by high-resolution ultrasound. Methods The changes of morphology, homodynamics and endothelial function of the dorsal artery of foot were measured in 25 elderly and 35 non-elderly T2DM patients and 35 elderly and 30 non-elderly healthy persons. Results (1) The change percentage of inside diameter of foot dorsal artery under reactive hyperemia situation was obviously reduced in elderly T2DM patients compared with elderly healthy controls [(10.52±2.79)% vs. (15.43±4.69)%, P<0.01] and there was significant difference between non-elderly T2DM versus healthy persons [(12.89±4.68)% vs. (17.97±4.61)%, P<0.01],and it was lower in elderly versus non-elderly T2DM ones (P<0.05). The change percentage of inside diameter of foot dorsal artery wassignificantly lower in elderly T2DM versus healthy subjects after taning nitroglycerin [(12.40± 3.23)% vs. (16.11±5.74)% , P<0.01]. (2) Compared with control groups, the intima-medial thickness (IMT) of dorsal artery of foot was thickened significantly, and the peak reverse velocity (PRV) in early diastole, the velocity in end diastole (EDV) and pulsatility index(PI) were reduced significantly in T2DM groups (P<0.05). The peak systolic velocity (PSV) had no significant differences among all the groups (P>0. 05). (3) In T2DM groups, the PI was correlated positively with the change percentage of inside diameter of dorsal artery of foot under reactive hyperemia situation (r=0.79, P<0.01) and after having taken nitroglycerin (r=0.71, P<0.01), respectively. Conclusions The changes of morphology, hemodynamics and the injuries of endothelial function of the dorsal artery of foot can be detected in patients with early-stage T2DM byhigh-resolution ultrasound, which has clinical significance and applicable value.

Objective To compare the diagnosis value of three-dimensional power Doppler imaging(3D-PDI)and color Doppler flow imaging(CDFI)on carotid artery stenosis.Methods Forty-nine patients with carotid artery atherosclerosis plaque or stenosis diagnosed by CDFl were enrolled in the study.The degree and ratio of carotid artery stenosis were measured by 3D-PDI in free-hand mode,and measured by DSA in one week,the results were compared with CDFI.Results 3D-PDI of normal carotid artery with atheromatous plaque showed the stereo image,quantity character and exact position of plaque,volume of vessel lumen and spatial distribution of blood flow directly.There was no statistical difference in diameter stenosis rate between 3D-PDI and CDFI[(52.0±0.9)% vs(51.7±0.8)%,P＞0.05],and the area stenosis rate measured by CDFI was significantly lower than that by 3D-PDI[(58.0±0.2)% vs(52.0±0.5)%,P＜0.01].In the diagnosis of stenosis classification,the rates of light,mild and severe stenosis were significantly different between CDFI and 3D-PDI(P＜0.05)and not significantly between 3D-PDI and DSA methods(X2=0.0538,P＞0.05).The detection rates of atherosclerotic plaques numbers in carotid crotch were significantly different between 313-PDI and CDFI(P＜0.05).Conclusions 3D-PDI can offer more valuable information for the diagnosis and trentment of carotid artery stenosis,it is more accurate than CDFI and similar to DSA.

Objective To evaluate the correlation between hyperlipidemia and lower limb arterial disease in eldedy diabetic patients with color Doppler uhrasonography.Methods Two hundred and sixty elderly diabetic patients and 206 normal subjects were enrolled in the study.Doppler uhrasonographic manifestations of lower limb arterial disease,blood pressure and blood biochemistry parameters including fasting plasma glucose(FPG),postprandial plasma glucose(PPG),TC,TG,HLD-C,LDL-C,apoprotein B (apoB),very low density lipoprotein cholesterol(VLDL-C),apoprotein Al(apoA1)and fibrinogen(Fb)were compared between the 2 groups.Results (1)The blood biochemistry parameters,including the levels of FPG,PPG,TC,TG,VLDL-C,LDL-C,apoB and Fb were higher in diabetic patients t11an in normal subiects.while HDL-C was lower(all P＜0.05).(2)The thickness of intima-media(IMT)in the lower limb arterial disease group was significantly increased and the presence of arterial stenosis and wall plaques more in diabetic patients[IMT in 205 cases(78.85%),atherosclerotic plaque in 241 cases(92.69%),muhivessel disease(more than 2 vessels)in 60 cases(23.08%)and arterial stenosis in 89 cases (34.23%)]than in normal subjects[IMT in 37 cases(17.96%),atherosclerotic plaque in 51 cases (24.76%),muhivessel disease in 27 cases(13.11%)and arterial stenosis in 3 cases(0.01%)],all P＜0.01.(3)Regression analysis showed that lower limb arterial disease was correlated with high level of LDLC and low level of HDL-C.Conclusions Arteriosclerotic plaque is one of the early manifestations in elderly diabetic patients and hyperlipidemia may provide the basis of its formation.Doppler uhrasonographic examination of lower limbarterial discloses the early arteriosclerotic changes of lower limb arterial disease in elderly patients and offers the basic data of indication for clinical treatment.

Objective To evaluate the color Doppler flow imaging (CDFI) findings in predicting possible difficulties of laparoscopic cholecystectomy (LC). Methods A total of 99 patients with acute cholecystitis received CDFI examination, and were divided into easy LC group (n=67) and difficult LC group (n=32) according to the indexes including the volume of gallbladder, the thickness of gallbladder wall, the condition of arterial flow in the gallbladder wall, the condition of gallbladder cavity and fossa, and of the intra-and extra-hepatic bile duct. After LC, all the patients were redivided into easy LC group and difficult LC group according to a difficulty scoring system of LC. The relationship among imaging results, operation difficulties and operation findings was investigated. Results According to the final score of difficulty scoring system of LC, the number of patients in easy LC group and difficult group was 61 and 38, respectively. Compared with easy LC group, patients in difficult LC group had bigger gallbladder volume [(39.5±13.2)am3 vs(32.6±10.4)cm3], thicker gallbladder wall [(10.1±4.0)mm vs(3.8±0.9)mm], more stone incarceration in the neck of gallbladder, abundant color blood flow signal of the gallbladder wall and more severe adhesion of gallbladder to the adjacent tissues, with statistical difference between the 2 groups (t=-2.820,-12.318,-3.952,x2=33.548,19.461,P<0.05). Using gallbladder volume, the thickness of gallbladder wall, infarction of stones in the neck of gallbladder and adhesion of gallbladder to the adjacent tissues as prediction indexes, the accuracy of CDFI in predicting the possible difficulties of LC was 94% (93/99). Conclusion Preoperative CDFI is helpful in predicting difficulties of LC for acute cholecystitis.

Objective To explore the diagnosis value of 3D-power Doppler ultrasound in differentiating benign and malignant breast masses in elderly patients.Methods A retrospective study of 53 lesions in 45 patients was performed,and breast masses were divided into benign and malignant group by pathological diagnosis after operation.Display of cross,vertical and coronal plane of total 53 masses were automatically acquired by 3D-power Doppler examination before operation,and 3D imaging of masses were reconstructed by virtual organ computer-aided analysis.The vascular morphology inside and beside the breast neoplasm was observed by tomographic ultrasound imagine layer by layer in different sections.Vascular distribution characteristics were divided into penetrating,central,surrounding and few vessel type.Quantitative analysis of vascularization-flow index inside the breast neoplasm was measured by 3D-power Doppler histogram.Results The difference in vascular distribution characteristics by 3D-power Doppler ultrasound was statistically significant between 15 (28.3％) benign and 38 (71.7％) malignant lesions(x2=19.52,P＜0.01).The case number of presence of penetrating vessels was 26(68.4％)in the malignantuniors.The sensitivity and specificity of penetrating vessel diagnosed malignant breast tumor were 68.4％ and 86.7％.Vascular distribution characteristics of benign masses was mainly of surrounding vessel type(53.3％).Vascularization-flow index was higher in malignant group than in benign group [(1.32 ± 1.58) vs.(0.63 ± 0.53),t=2.187,P＜0.05].Conclusions 3D-power Doppler ultrasound completely presents the vessel stereoscopical distribution and shows quantificationally blood perfusion of breast neoplasm.The 3D-power Doppler ultrasound is superior to conventional ultrasound for enhancing differential diagnosis ability between benign and malignant breast tumors.