Objective:To summarize the ultrasound features of renal arteriovenous fistula(RAVF)under various ultrasound imaging modes,so as to avoid missed diagnosis of RAVF on initial ultrasound examination.Methods:The clinical data of 6 patients with RAVF,including the ultrasound evidence,the timing of ultrasound diagnosis,the modes of ultrasound diagnosis, and the agreement between ultrasound diagnosis and selective renal arterial angiography,were retrospectively analyzed.Results: 2D ultrasound had 1 case of correct diagnosis,1 case of misdiagnosis and 4 cases of missed diagnosis.Color Doppler and spectral Doppler both had all the 6 cases correctly diagnosed.Ultrasound angiography in 3 cases demonstrated that the contrast agent reached the renal veins earlier than reached the renal parenchyma;large fistula lumen was associated with ischemia of downstream areas.3D ultrasound vividly reflected the structure of fistula lumen volume,and provided us with the profiles of blood signal in fistula at different planes and angles,improving our knowledge of blood flow on the fistula.Conclusion: Ultrasound is the first line screening method for RAVF.Color Doppler plays a decisive role in the diagnosis of RAVF and pulsed spectral Doppler plays a synergetic role and contributes to differential diagnosis.Contrast-enhanced ultrasound may help to discover the abnormality of venous circulation and the ischemic parenehyma area due to shunting.2D ultrasound has a poor diagnostic value and is liable to lead to misdiagnosis and missed diagnosis.

0.05). There was only 2/109 cases (5.8%) need a second course of antibiotics because of likely infection and 102/109 cases (93.5%)need not any moor antibiotics. The mean period of antibiotic treatment in group Ⅰ, group Ⅱa and group Ⅱb were (1.2?0.5) days,(4.8?0.8) days and (9.3?1.8) days,respectively.There were significant differences(all P

Objective To investigate the distribution of pathogens and positive alarming time of blood culture,and provide basis for laboratory diagnosis and clinical treatment. Methods Blood specimens from clinical departments in a hospital in May-November 2015 were collected,positive alarming time of blood culture was recorded,species of pathogens were identified. Results A total of 157 pathogenic strains were isolated from blood culture specimens, gram-positive cocci,gram-negative bacilli,and fungi accounted for 31 .85% ,57.32% ,and 10.83% respectively. The median positive alarming time were as follows:Enterobacteriaceae 0.50 day,non-fermenting bacteria 0.63 day, Enterococcusspp. 0.60 day,Streptococcusspp. 0.80 day,Staphylococcusspp. 1.01 days,and fungi 1.44 days, respectively. Conclusion Positive alarming time of blood culture specimens from early to late are as follows:Enter-obacteriaceae,Enterococcus,non-fermentative bacteria,Streptococcus spp.,Staphylococcus spp.,and fungus. Positive alarming time of pathogens causing bloodstream infection are all within 4 days,and most of them are within 1 day.

Aged ; Apoptosis ; physiology ; Carcinoma, Squamous Cell ; genetics ; Cell Cycle ; Female ; Gene Expression Profiling ; Humans ; Laryngeal Neoplasms ; genetics ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; Signal Transduction

Objective To evaluate the safety and accuracy of CT-guided cutting needle biopsy for the hepatic lesions near diaphragmatic dome.Methods A total of 25 cases with hepatic lesions near the diaphragmatic dome were undertaken CT-guided cutting needle biopsy using 16 gauge or 18 gauge core biopsy needles.Results Histological examination showed malignancy in 17 cases and benign in 8 with 2 false negative results(8%),and there were no false positive results.The specificities of malignant and benign lesions were 100% and 75%,respectively.Overall accuracy was 92%.Pneumothorax,needle tract hemorrhage,and subcapsular hepatic hemorrhage occurred in 2(8%),1(4%)and 1(4%),respectively.Conclusion CT-guided cutting needle biopsy for the hepatic lesions near diaphragmatic dome is a reliable and relatively safe diagnostic method.(J Intervent Radiol,2007,16:838-840)

Objective To evaluate the functional outcome,predicting response and toxicity of CT- guided permanent implanted ~(125)I seed branchytherapy for metastatic cancers in vertebrae.Methods Forty three vertebrae with metastatic cancer were treated by CT-guided percutaneous permanent implanted ~(125)I seed branchytherapy in 15 patients.There were 8 male and 7 female patients with average age of 54.6 years and 2 to 5 vertebrae involved in this group.According to the size of tumor,the optimal activity and quantity of seeds were calculated by TPS and correlative formula.~(125)I seeds were implanted percutaneous puncture under CT- guidance with coaxial needles to pass the normal osseous tissue for approaching the lesions including 3 routes of pedicnlar lateral and anterior ways.The distance between seeds and posterior border of vertebral body was over 3 nun(3-10mm).Permanent ~(125)I seed implantation brachytherapy for paraspinal metastatic lesions were also taken place.Results Mean follow-up time was 12.3 months(range 3-30 months)and outcome was evaluated clinically and radiographieally in 10 of 15 procedures,with 5 only on clinical data.No new pain occurred at 11 sites with no previous complaint.The pain was completely controlled at 18/32 sites,partial control at 14/32 sites.No complications correlated to the radiotherapy damage of nerve and spinal cord were found.Conclusion The procedure of CT-guided permanent implanted ~(125)I seeds brachytherapy for vertebral metastatic cancers is a safe effective and minimal invasive method with few complications.It is beneficial not only for pretherapeutic metastasis but also for recurrent tumors after radiotherapy;bearing rather high tolerance and safety.(J Intervent Radiol,2007,16:834-837)

ObjectiveTo discover potential serum biomarkers of osteosarcoma by an integrated analysis of datasets from gene chip and surface enhanced laser desorption-ionization time-off-light mass spectrometry(SELDI-TOF-MS).Methods Gene chip was used to screen potentialbiomarkers of osteosarcoma from osteosarcoma cell lines (MG-63,Saos-2 and U-2OS),and SELDI-TOF-MS was used to screen protein peaks with statistically significant difference from serum samples (27 osteosarcoma cases and 47 healthy cases).The association between these two types of markers was constructed by link-test to get cross-validated serum biomarkers of osteosarcoma.Immunoblot analysis was performed to detect the expression of one candidate osteosarcoma protein maker in serums from osteosarcoma patients and members of the control group.ResultsSix hundred and fifty three candidate osteosarcoma gene markers were found by gene chip and 6 protein peaks were found by SELDI-TOF-MS.Thirteen differentially expressed serum markers of osteosarcoma including CYC-1 were screened by link-test analysis (12 of them were up-regulated in serum samples of the osteosarcoma patients while 1 was down-regulated ).By immunoblot,we found that CYC-1 protein was significantly up-regulated in serums from osteosarcoma patients compared to the control group.ConclusionAn integrated analysis of datasets from gene chip and SELDI-TOF-MS could accelerate the discovery,screening and identification of tumor biomarkers.A total of 13 potential serum protein markers of osteosarcoma were discovered in this study.

Objective To evaluate the clinical training outcomes from two clinical practice modes for undergraduate students. Methods Total two grades 2009 and 2010,150 undergraduate students were randomly divided into two groups: 69 students in group A and 81 students in group B. The synthetic teaching mode was applied in group A,and group B received the traditional teaching mode. The Objective Structure Clinical Examination (OSCE)and a written comprehensive examination were used to evaluate the training outcomes by T test analyzed by SPSS 17.0(α= 0.05). Results The theoretical level of 2009 grade students was better than that of 2010 grade (P < 0.05). The clinical practice skills of the two groups had no significant difference(P > 0.05). There were no significant differences between two groups in theoretical and clinical training(P > 0.05). Comparing with the 2010 grade,the theoretical level of the 2009 was better,but the clinical skill level was weaker. Conclusion Synthetic teaching mode and traditional teaching mode both achieved good outcomes. In order to obtain better comprehensive progresses,the two teaching modes need to be combined. The orientation by following the requirements of oral practicing qualification examination may enhance the clinical skills of the students.

ObjectiveTo determine the correlation of real-time contrast-enhanced ultrasonography (CEUS) patterns and quantitative parameters with microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression of breast tumors.Methods One hundred and five patients with 128 breast lesions(62 benign,66 malignant) underwent CEUS examination.CEUS patterns were analyzed and parameters were obtained by time-intensity curve analysis software.Immunohistochemical staining using anti-factor CD34 was performed to evaluated the MVD and VEGF expression was detected.Results All CEUS patternsweresignificantlyassociatedwithMVDandVEGFexpressionexceptboundary characteristics( P ＜ 0.05).The enhancement parameters showed that the time to peak was significantly faster in malignant tumors than that in benign lesions,and the peak intensity and area under the curve were significantly higher in malignant tumors than those in benign lesions( P ＜0.05).The time to peak,the peak intensity,area under the time-intensity curve were statistically correlated with MVD (P ＜0.05),the highest correlation was between the area and MVD( r =0.81,P ＜0.001).Only the area under the timeintensity curve was significantly associated with VEGF expression (P ＜ 0.05).Conclusions CEUS patterns and parameters of breast lesions are closely correlated with MVD,which can be used to evaluated the angiogenesis in breast tumors.

Objective: To assess the clinical application of transabdominal ultrasonography for the diagnosis of achalasia. Methods: The subjects were divided into 3 groups, with 8 patients suffered from achalasia as patient group, 10 normal individuals and 8 patients with cardiac carcinoma as controls. All subjects received water provocative test to study the lower esophagus and cardia. Sonographic findings were compared between the 3 groups. After treatment by administration of drugs, pneumatic balloon dilation, or intrasphincteric injection of botulinum toxin, the 8 patients were re-examined by TAUS for longitudinal comparison. Results: (1)The normal subjects had no dilation of cardia and lower esophagus before drinking water, but their cardias opened rapidly with the drinking action. (2)All the patients of achalasia were found to have dilation of lower esophagus before taking water. During 10 min continuous TAUS scanning, 5 of 8 demonstrated absence of relaxation of cardias and absence of water from the esophagus into the stomach. The other 3 showed slight and intermittent relaxation of cardias with water flow into the stomach. Thirty minutes after water provocative test, all the 8 patients had water retardation within the lower esophagus. (3)The patients of cardiac carcinoma had an ultrasound feature of cardiac ring enlargement and thickening of cardiac wall without dilation of lower esophagus before water provocative test. Water passed the cardia more slowly. Conclusion: TAUS is a readily accepted examination. It can quickly give reliable diagnostic clues to achalasia. TAUS can also be used for making assessment of therapeutic effect on achalasia.