Objective To investigate the value of contrast enhanced ultrasound (CEUS) in diagnosing poor differentiated cholangiocarcinoma. Methods Sonograms of 11 patients with pathologically confirmed poor differentiated cholangiocarcinoma were retrospectively analyzed. The size, boundary, shape, echo, blood distribution and characteristics of the enhancement duration were observed. Results All lesions presented irregular shape (100%), most (9/11, 81.82%) with indefinite boundary, some (6/11, 54.55%) with low echo. No blood flow signal was found in the interior of masses, while grade 1 blood flow signal was detected in periphery of the lesions. Resistance index (RI) was ≥0.6 in spectral Doppler in 7 (63.64%) lesions. Marginal rim-like hyperechoic enhancement in the arterial phase was found without centripetal filling in all 11 patients, marginal rim-like hypoechoic enhancement was observed, but being hyperecho compared with interior part without medium in delayed phase. Conclusion The contrast-enhancement modality of poor differentiated cholangiocarcinoma is characteristic. Combined with two-dimensional ultrasonography and color Doppler ultrasound, the diagnostic rate will be improved.

Objective To explore the ultrasonic diagnosis of fetal cleft palate.Methods By applying coronal,sagittal and transverse planes to scan the fetal facial anatomy routinely, 2125 pregnant women with 20 odd weeks′ gestation were examined.Results Complete cleft palate was diagnosed in 4 cases by ultrasonography, all of which were accompanied with complete cleft lip and alveolar process.Incomplete cleft palate were missed in 2 cases.Conclusions Complete cleft palate is accompanied mostly with cleft alveolar process and complete cleft lip, and cleft palate can be found out through cleft alveolar process.To those fetuses without cleft lip or with incomplete cleft lip,their palate cannot be explored by ultrasound,and their cleft palate cannot be displayed.

Objective To investigate the evaluation of virtual touch tissue quantification(VTQ)in differential diagnosis of thyroid benign and malignant nodules and its influence factors.Methods 127 patients with thyroid lesions and its adjacent normal thyroid tissue at the same depth were examined with VTQ.Test results were performed by shear wave velocity value (SWV) on the long axis dimension of the nodules.The maximum(Vmax),minimum(Vmin) value of SWV of thyroid lesions and the SWV(Vn) value of surrounding normal tissue were recorded.The mean value of SWV (Vm) and the ratio of Vm and Vn (Vm/n) were calculated.SWV value of benign and malignant nodules and different pathological types of nodules were analyzed.Receiver-operating characteristic curve(ROC) was drawn to assess the diagnostic efficiency.Results The Vmax,Vmin,Vm,Vm/n of malignant lesions [(4.61 ± 2.65) m/s,(2.74 ± 2.23) m/s,(2.99 ± 0.82)m/s,(1.69 ± 1.07)m/s,respectively] were obviously higher than that of benign nodules [(2.78 ± 0.96)m/s,(1.75 ± 0.60)m/s,(2.31 ± 0.38)m/s,(0.94 ± 0.23)m/s,respectively,P ＜0.01].The SWV value of thyroid papillary carcinoma was higher than that of nodular goiter,thyroid adenoma and Hashimoto's thyroiditis(P ＜0.05).The SWV value of Hashimoto's thyroiditis was higher than that of thyroid adenoma and nodular goiter (P ＜ 0.05).No significant differences of SWV value were found between thyroid adenoma and nodular goiter (P ＞ 0.05).Contrast the area under the receiver-operating curves above four groups of different SWV values,the results showed that Vm had the highest diagnostic value in diagnosis of benign and malignant thyroid nodules.When the best cut-off point of Vm was 2.48 m/s,the diagnostic value was highest and the sensitivity and specificity were 97％ and 81 ％.Conclusions VTQ could be used to quantify and evaluate the hardness of thyroid nodules and provided important value for the differential diagnosis of benign and malignant thyroid nodules.

AIM and METHODS: To investigate the cardioprotective effect of adenosine infusion before ischemic preconditioning on immature myocardial reperfusion injury in rabbit heart. Isolated perfused working heart model were performed, all hearts were subjected to 2-hour global hypothermic ischemia and received intermittent cold cardioplegia perfusion. RESULTS:During reperfusion, the recovery of left ventricular systolic pressure, left ventricular end-diastolic pressure, +d p /d t max, and -d p /d t max of hearts received adenosine infusion before ischemic preconditioning were significantly improved, myocardial adenosine triphosphate and adenosine diphosphate content and superoxide dismutase activity were higher, the leakage of myocardial creatine kinase and the malondialdehyde content were lower, and myocardial water content was obviously less. CONCLUSION: These results suggest adenosine infusion before ischemic preconditioning enhances cardioprotection of ischemic preconditioning against immature myocardial reperfusion injury in the rabbit heart.

Objective To study the effect of intracoronary adenovirus vector-mediated transforming growth factor ?_1 (Ad.TGF-?_1) gene transfer on discordant cardiac xenograft in the setting of acute vascular rejection. Methods In a cervical heterotopic cardiac transplantation model by cuff technique, after harvest, guinea pig donor hearts’coronary arteries were perfused ex vivo with Stanford University solution containing 5?1010 plaque-forming units/g of donor heart of Ad.TGF-?_1, then implanted in the necks of complement depleted and immunosuppressed rat recipients. As controls, other hearts were perfused with Stanford University solution containing 5?1010 plaque-forming units/g of donor heart adenoviral blank-vector or with virus-free Stanford University solution by the same method.Results The exogenous TGF-?_1 gene transcripts and expression in the Ad.TGF-?_1 infected grafts were confirmed. The number of inflammatory cells and macrophages and nature killer cell infiltration in the cardiac xenografts of Ad.TGF-?_1 infected grafts was less than that of other groups (P

Objective To study the regularity of blood type and Doppler parameters at the interior and surrounding of the hepatic carcinoma.Methods Seventy-five masses with blood flow signals were selected.The size,mean color density (MCD),flood flow type and Doppler parameters including velocity of peak systolic (PS) and resistance index (RI) were studied.Results ①In the interior of masses,the PS of branch and insert types was the highest,and the RI of branch and net types was the highest (P 0.05 ).Conclusions The parameter is associated with the blood type and grade closely in hepatic carcinoma.

Objective To study the effects of intracoronary transfer of adenovirus vector-mediated transforming growth factor ?_1 gene on acute rejection of cardiac allograft in rats. Methods In a cervical heterotopic cardiac transplantation model, donor hearts coronary arteries were perfused ex vivo after harvest with Stanford University solution containing 5?10~ 10 plaque-forming units/gram of donor heart of donor heart of Ad. TGF-?_1, then implanted in the necks of recipients. As controls, other hearts were perfused with Stanford University solution containing 5?10~ 10 plaque-forming units/gram of donor heart adenoviral bland-vector or with virus-free Stanford University solution by the same method. Results The exogenous TGF-?_1 gene transcripts and expression in the Ad.TGF-?_1 infected grafts were confirmed. The expression of CD_ 68 and the apoptosis index in the cardiac allografts of Ad. TGF-?_1 group were less than that of other two groups (P

Objective To investigate the differential diagnostic signiifcance of different calciifcation types in thyroid benign and malignant nodules with high-frequency ultrasound. Methods Totally 195 patients with thyroid lesions were examined on conventional high-frequency ultrasound pre-operatively. The evaluation was foucsed on the number and echo of thyroid nodules and the size, shape and distribution of calciifcation inside. Different calciifcation patterns were divided into 3 types:type 1 micro-calciifcation, type 2 coarse calciifcation, type 3 peripheral calciifcation. Results The calciifcation rate of thyroid malignant nodules 68.6%(81/118) was signiifcantly higher than that of benign nodules 40.0%(56/140) (χ2=21.096, P<0.01). The ratio of type 1 calciifcation in malignant nodules 72.8%(59/81) was obviously higher than that of benign nodules 41.1%(23/56) (χ2=13.906, P<0.01). There was no signiifcant difference of type 2 calciifcation between malignant and benign nodules (χ2=3.159, P>0.05). The incidence of type 3 calcification in malignant lesions 3.7%(3/81) was lower than that of benign nodules 21.4%(12/56) (χ2=10.669, P<0.05). The malignancy incidence of solitary thyroid nodule 85.3%(58/68) and extremely low echo nodules with calciifcation 76.2%(48/63) was higher than that of multiple thyroid nodules 33.3%(23/69) and other echo nodules 44.6%(33/74) (χ2=38.261, 14.057, both P<0.01). Conclusions There was potential risk of malignancy in each calciifcation of thyroid nodules. Different calciifcation types had important value for differential diagnosis of benign and malignant thyroid nodules.

Objective To investigate living quality of patients after orthotopic cardiac transplantation and to provide scientific evidence for specific strategy of therapy and improvement of living quality of patients with cardiac transplantation. Methods SF-36 and the social support questionnaire were used to analyze living quality of 79 patients who received orthotopic cardiac transplantation in the Department of Cardiovascular surgery of Affiliated Union Hospital of Fujian Medical University. The mode of SF-36 was from the investigative numerical value of residents in Sichuan province. Description, t-test and Spearman correlation analysis were used to study the related factors. Results Compared with a reference general population, the heart transplant recipients showed a significantly worse living quality score on all domains of the SF-36 scales (P＜0. 05), except the domain of somatic pain. Among the patients after cardiac transplantation, living quality was more significantly improved in ＞2-year survival group than that in ＜one-year survival group (P＜0. 05),except the domain of somatic pain. The relationships between the social support and living quality were analyzed,and it was found that as compared with a reference general population, the heart transplant recipients showed significantly lower scores on all domains of the social support questionnaire (P＜0. 01 ). The total social support scores were positively related to mental health related living quality (P＜0.05, r = 0.223 - 0.710), except the domain of somatic pain. Conclusion Compared with a general population, heart transplant recipients demonstrated a significantly worsened living quality. But evidence showed the living quality can be improved gradually with the prolongation of the survival time after heart transplantation. Social support was related to the living quality of heart transplantation patients. Improvement of availability on social support will probably improve living quality.

Objective To retrospectively analyze the clinical management and follow-up of 13 recipients with survival of over ten years after cardiac transplantation. Methods Thirteen male recipients underwent orthotopic heart transplantation between August 1995 and June 2001 in our center and received standard immunosuppressive therapy protocols (8 cases) or induction therapy protocols (5 cases). Cyclosporine, azathioprine or mycophenolate mofetil, and prednisolone were applied as maintenance immunosuppressive regimens. Six recipients switched from azathioprine to mycophenolate mofetil when mycophenolate mofetil was available. Perioperative complications were prevented and treated. After operation, the recipients were followed up regularly to set up personnel long-term follow-up files. The incidence of acute rejection (AR) and (cardiac allograft vasculopathy (CAV) was monitored. Results The 13 survived recipients accounted for 48. 1 % of the total number in the corresponding period (13/27). All survivals recovered well and had a good quality of life. The recent (1 year) complications included acute allograft rejection (3 cases), infection (4 cases), renal insufficiency (3 cases), allograft right ventricular dysfunction (5 cases), post-transplant diabetes (2 cases) and liver dysfunction (5 cases). The long-term (1 year later) complications included acute allograft rejection (2 cases), CAV (2 cases), hypercholesterolemia (5 cases), hypertension (4 cases), hyperuricemia (10 cases) and chronic renal impairment (3 cases). One hepatitis B virus carrier died of liver cancer 13 years after transplantation. Conclusion The long-term survival of cardiac allograft recipients is closely associated with psychological state, financial condition, compliance and follow-up medical system, while the sociological and environmental factors may play important roles.