As a technique which can assess both the micro-vascularization and macro-vascularization of the tumor,contrast-enhanced ultrasound have been developed rapidly,and its researches in thyroid nodules check and differentiation has became more and more widely.Different infusion modes in the diagnostic of thyroid nodules are really meaningful.The development of CEUS and identification of thyroid nodules will be reviewed in this article.

Child ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Rhinitis, Allergic ; therapy

Objective Observes the sparse blood to pass treatmentacute myocardial infarction the curative effect.Meth- ods Will diagnosefor the acute myocardial infarction 62 examples patient stochasticallydivides into the treatment group and the comparison group,thetreatment group gives the sparse blood to pass with the foundationtreatment (including low molecular heparin,aspirin,Betaloc,a ACEI kind of medicine,simvastatin,tallies dissolveshitch to dissolve hitch),the comparison group will give thefoundation treatment,15 days will he a treatment course,through tothe curative effect check analysis,to will count the material tocarry on statistics processing.Results Treatment group totaleffectiveness is 93.5%,obvious is good to the foundation group(60.93%).Conclusion Adds in the traditional convention foundation- treatment with the sparse blood passes treatment acute myocardialinfarction to obtain a better curative effect.

Objective To compare the differences in histological morphology and hemodynamics between benign and malignant tumor, as well as differences between the different perfusional regions in tumors of the same type. Methods Thirty cases with malignant breast carcinoma and 30 cases with fibroadenoma were inspected by contrast enhanced ultrasound with time-intensity quantitive analysis. Perfusion index like peak intensity(PI), area under the curve(AUC), time to peak(TTP) and wash-out time (WOT) were collected both inside and at the margin of focus. The ultrastructures of new microvessesl were observed routinely with microscopy and transmission electron microscopy. Results The curve of malignant tumor group was characterized as ascend rapidly and drop slowly while the benign group presented as ascend slowly and drop rapidly. The AUC and WOT of malignant tumor group were significantly higher than that of benign group,while the PI and TTP had no statistical difference. In malignant tumor group,PI, AUC and WOT of the margin of focus were significantly higher than that of inside region of focus,while TTP was the opposite. However,there was no statistical differences between the perfusion parameter inside and outside of focus in benign group. The ultrastructures of newly built blood vessels in malignant group had strong ability to split,which was different from normal endothelium cells but was similar to other tumor foci. The margin of foci were characterized with dilatating and distorting vessels,and the center of the foci were occupied by narrow,occlusive new vessels and contracted anamorphic endothelium cells and pericytes. Rich microvessel areas located in the margin of foci. Conclusions The perfusion pattern,modality of time-intensity curve, mean perfusion parameter and variance of regional perfusion parameters are valuable diagnostic basis in discriminating benign and malignant breast tumor. The density,modality,distribution,structure and function of new microvessels in tumor focus are also keystone factors when tumors are assessed by means of imaging.

Objective To test the degree of acceptance and understanding of the entries for patient reported outcomes of stagnation of qi and blood;To further optimize and modify the entries. Methods A small sample pre-survey and group interviews were used to get the feedback information abut entries of patients, then the panel discussed to modify entries according to the data information. Results After a small sample pre-survey and group interviews, 11 items for modification were obtained, including the rejection in physical pain, belching and so on. Through further optimization and modification, the entries for patient reported outcomes of stagnation of qi and blood covered 41 entries in physiological domain, 11 entries in psychological domain, 1 entry in independent domain, and 8 entries in social domain. Conclusion The core part of the entries for patient reported outcomes of stagnation of qi and blood was formed, which comprehensively reflects the connotation of stagnation syndrome of qi and blood.

Objective To evaluate the clinical results of arthroscopic reconstruction of posterior cruciate ligament (PCL) via posteromedial,posterolateral and posterior trans-septal portals with the preservation of intact meniscofemoral ligaments and remnant PCL fibers.Methods Nine patients with PCL injuries were treated with autogenous hamstring tendons arthroscopically through routine arthroscopic portal,posteromedial portal,posterolateral portal and posterior trans-septal portal with preservation of intact meniscofemoral ligaments and remnant PCL fibers.Tibial tunnel of 1-1.5 cm was made below the lateral articular surface of PCL tibial attachment via arthroscopic posterolateral approach.Femoral tunnel of 1 cm was made posterior to the articular cartilage of the medial femoral condyle through anterolateral approach.Autogenous tendon graft was positioned in the knee joint through the navigation of tibial and femoral double-folded silk loops that traversed the bone tunnels and was fixed with bioabsorbable interface screws at both ends.Knee function was evaluated with Lysholm scale six months postoperatively.Results All patients were followed up for average 8.6 months (range,7-14 months).None of the patients had knee extension limitation six months postoperatively,but there were two patients with 10°-15° flexion limitation and one withⅠ degree positive result in posterior drawer test.Lysholm knee score was increased from preoperative (47.6 ± 14.9)points to (92.9 ±4.6) points at six months postoperatively (P ＜0.01).Conclusion PCL reconstruction via posteromedial,posterolateral and posterior trans-septal portals can obtain clear vision (with no blind area),safe operation,accurate positioning of tibial attachment and affirmative short term treatment results.

Objective To evaluate the predictive value of Wells score combined with D-dimer in the diagnosis of acute pulmonary embolism.Methods A total of 540 patients with suspected pulmonary embolism admitted from 2008 to 2011 were enrolled for study.The diagnosis of pulmonary embolism (PE) was confirmed by using computed tomography pulmonary angiography (CTPA).These patients were divided into two groups:PE group and non-PE group.Comparative analysis was carried out in demographics,underlying diseases,chief complaints,physical signs,venous thrombosis risk factors,laboratory findings and Wells scores between the two groups.Results Of 502 patients selected into this study,there were 246 in PE group and 256 in Non-PE group.The incidence rates of history of recent surgery or bed-ridden,recent fracture of pelvis or lower limb,symptoms of hemoptysis,transient disturbance of consciousness,signs of unilateral lower limb swelling,hypoxia and hypocapnia of arterial blood gas analysis,elevated levels of D dimer,high Wells score in PE group were significantly higher than those in non-PE group (P ＜ 0.05).And there were no statistical difference in other variables found between the two groups.The areas under the ROC curve of Wells score,D-dimer and the combination of the two were 0.775 (95％ CI:0.719-0.831),0.802 (95 ％ CI:0.751-0.853) and 0.899 (95 ％ CI:0.834-0.964),respectively.And the area under the ROC curve of the combination of the two was greater than that of separated application (P ＜ 0.05).When the cut-off value of Wells score was 5 and D-dimer was 1 724 μg/L,the weighted maximum sensitivity and specificity were reached,and these cut-off values were higher than above determined values,the reliability of the diagnosis of PE was obviously increased,and those were lower than these cut-off values,the reliability of excluding PE was also increased.Conclusions Wells score combined with D-dimer showed a higher value in predicting acute pulmonary embolismthan than their separated application.

OBJECTIVE To investigate the clinical distribution and resistance of Alcaligenes xylosoxidans,discussing risk factors of nosocomial infection and measures of prevention and treatment.METHODS We retrospectively analyzed 1323 isolated strains of Al.xylosoxidans in our hospital from Sep 2004 to Aug 2006.RESULTS For specimen from which Al.xylosoxidans was examined,sputum accounted for 99.85%,being the highest percentage.Al.xylosoxidans was especially distributed at respiratory ward(46.94%) and intensive care unit(ICU) ward(12.77%).Then was cardiovascular ward,endocrinology ward and hematology ward.The antibiotic drugs which had the high drug-resistance rate(i.e.more than 98%) were aminoglycoside(amikacin and gentamicin),quinolone(ciprofloxacin) and cefepime.But the drug-resistance rate to carbapenems,?-lactam/?-lactamase inhibitor combinations and the third generation cepholosporins(cefoperazone and ceftazidime) was less than 5%.CONCLUSIONS It is important for clinic to strengthen the disinfection for hospital environment and to use antibiotic drugs reasonably in order to control colonization and spread of Al.xylosoxidans in hospital.

For promoting the quality evaluation of Gardenia resource,a UPLC method for the determination of 4 compounds (geniposidic acid,geniposide,crocin-1 and crocin-2) in Gardeniae Fructus was established.The UPLC separation was performed on an Waters Acquity UPLC BEH-C18 (2.1 mm× 100 mm,1.7 μm) column eluted with the mobile phases of acetonitrile-0.1％ formic acid solution in a gradient mode at a flow rate of 0.3 mL· min-1.The detection wavelengths were 240 nm and 440 nm,respectively.Under the optimum conditions,the calibration curves of four analysis were linear in the range of 0.0065-0.0096 μg· mL-1,with correlation coefficients more than 0.9995.The limits of detection (LODs) of four analysis were in the range of 0.0386-0.1875 μg· mL-1.As the results of determination of 4 compounds of 12 batches of Gardeniae Fructus showed,there was great differences between the contents of the 4 compounds,the contents of geniposide were 2.44％-6.96％,while the contents of crocin-1 were 1.26％-3.04％.In addition,fingerprints of 12 batches of Gardenia resources were built using ChemPattern software,and analysis and exploration over the detection results of several samples were carried out using multivariate statistical method (similarity analysis,principal component analysis and cluster analysis).The present study provided a reference to value the importance of this method in the quality evaluation and quality control of Gardeniae resources and slices.

Objective To investigate the imaging and clinical features of Percheron artery infarction.Methods The clinical manifestations,imaging data,treatment,and prognosis of 10 patients with Percheron artery infarction were analyzed.Results All 10 patients had acute onset and had different degrees of consciousness disorders,including vertical gaze palsy (n =3),language disorder (n =3),limb weakness (n =6),and memory impairment (n =4).MRI showed bilateral thalamus infarction.Midbrain V-sign in one patient was observed.Cerebral angiography revealed that one patient had Percheron artery infarction.All 10 patients were improved and discharged,but left with varying degrees of sequelae.Conclusions Percheron artery infarction is rare in clinical practice.The diagnosis is mainly based on clinical manifestations and imaging examinations.Cerebral angiography can diagnose the disease.