Objective To evaluate the value of ultrasound-guided mammotome in the diagnosis and therapy of breast tumor.Methods From May 2006 to February 2009,a total of 205 cases diagnosed with breast tumor by physical examination or ultrasonography underwent ultrasound-guided mammotome in our department.In the patients,142 cases had single tumor and 63 cases showed multiple tumors.Among the 205 cases,impalpable lesions were detected by ultrasonography in 58 patients.Mammotome biopsy system with 11 G/8 G needles were used in the operation.After the surgery,pathological examination was carried out,and short-and medium-term follow-up results of the patients were analyzed.Results In the 205 cases,totally 356 tumors were detected.The size of the tumors ranged from 0.3 to 3.5 cm in diameter.The operation time of the patients was 10.2 min in average(1-50 min).After the surgery,22 patients showed bruise in the surgical area,and 19 patients developed hematoma(three of them received puncture of the hematoma).Post-operative pathological examination showed fibroadenoma in 98 cases,breast hyperplasia in 246 cases(154 of them were complicated with fibroadenoma),7 had intraductal papilloma,4 were diagnosed with breast cyst,and 1 showed tubular adenoma.Follow-up was achieved in 132 patients for 2 to 36 months,during the period,residual tumor was detected in 4 patients(3.0%).All the patients were satisfied with the cosmetic results of the surgery.Conclusions Ultrasound-guided mammotome is a minimally invasive procedure that can safely and reliably diagnose and remove breast tumor,particularly multiple tumors and impalpable lesions.The cosmetic results of the operation are satisfying.

Objective To assess the value of high-frequency ultrasound guided venipuncture of forearm superficial veins. Methods Forty patients with failure of direct venipuncture were given high-frequency ultrasound guided venipuncture. After the direction and depth of superficial veins were identified by high-frequency ultrasonography, a re-puncture was performed. Real-time ultrasonic guidance was employed in case of necessity. Results High-frequency ultrasound identification was used in 11 patients, and real-time ultrasonic guidance was used in 29 patients. All the procedures were successfully completed on one session. Conclusions High-frequency ultrasound guided venipuncture of superficial veins is a simple method without complications, being worthy of wide clinical application.

The contrast-enhanced ultrasound(CEUS) been equipped in most commercial ultrasound system, is a newer technology which could evaluate the blood flow of soft tissue. It could not only make qualitative and semi-quantitative analysis, but also the quantitative analysis could be acquired. At present, it has been applied on cardiovascular imaging and tumor perfusion assessment in clinical. The clinical usage of CEUS in rheumatoid arthritis(RA) was summarized in the paper which included its common clinical type, dose of ultrasound contrast agent and various method of usage described. Besides, the paper not only introduced the evaluation of the synovitis in RA with the parameters resulted from CEUS, but also illuminated the progress of the researches. Through compared these parameters, indexes and methods, this summary revealed the limitation and application value of CEUS to RA, and more exploration need be done in future.

Objective To evaluate the value of ultrasound in diagnosing shoulder lesions.Methods Ultrasound images were obtained by two museuloskeletal sonologists in 111 patients suspected of having rotator cuff and non-rotator cuff lesions which were confirmed by following arthroscopic surgery.Results The arthroscopic findings demonstrated that there were two or more lesions in one patient in majority of patients,included 67 supraspinous tendon tears,5 infraspinous or subscapular tendon injuries,10 calcific tendonosis,2suprascapular notch cysts,34 subaeromial bursitis,1 intrabursa loose body,13 biceps longus tendon dislocation or disruption,and 21 lahrum injury.The accuracy of ultrasonogrpahy was 92% in diagnosis of supraspinous tendons tear,97% in subscapular tendon inj uries,96% in calcific tendonitis,1 00% in suprascapular notch cysts,88% in subacromial bursitis,100% in biceps longus tendon dislocation or disruption,and 81% in labrum injury.Conclusions Ultrasound can evaluate shoulder lesions effectively.

Objective To observe the efficacy of duloxetine combined with Bodhi Tree relaxation tech?nique in the treatment of generalized anxiety disorder ( GAD ) and the influence of heart rate variability ( HRV ) . Methods According to the standard of ICD?10,124 GADs were selected as study objects from March 2013 to March 2014. They were randomly divided into intervention group and control group. The intervention group fixedly received duloxetine ( 20 mg/day) and Bodhi Tree relaxation therapy,2 times / week,for 8 weeks;and the control group received only Duloxetine (20 mg/day) treatment. All patients were assessed with SAS,HAMA and Treat?ment Emergent Symptom Scale( TESS) at the baseline and at the end of the 2nd ,4th ,6th ,8th week of the treatment to evaluate the efficacy and side effects. The LF/HF of HRV were observed. Results 1.In both groups,SAS score and HAMA score remarkably decreased after intervention than before treatment( before intervention:control group (63.52±14.25,30.26±11.25) intervention group (64.35±14.33,29.83±10.85);after 8 weeks:control group (30.23±6.68,9.28±3.20) intervention group (25.14±5.59,7.70±2.87), P<0.05). There was statistical signifi?cant between the two groups in the therapeutic effects (χ2=4.09, P<0.05) ,and no significant difference between the two groups on the TESS (P>0.05). 2. The ratio of LF/HF showed significantly decrease in the intervention group than those in the control groupt 13?16=-2.806,-2.725,-3.572,-2.272;P13?16=0.006,0.007,0.001,0.025).The value of anxiety se?verity index and LF/HF was positively correlated ( r=0.342, P<0.05).Conclusion Duloxetine combined with Bodhi Tree relaxation technique can effectively improve the heart rate variability in patients,curative effect is better.

Objective To investigate the incidence,sonographic appearance of the anatomic variation of carpal tunnel median nerve and its accompanying structures in healthy volunteers and explore the value of this variation in carpal tunnel syndrome.Methods A total of 360 hands of 180 healthy volunteers were included in the study.The full course of the median nerve in the forearm and carpal tunnel was examined with high-frequency ultrasound.The median nerve was first located in cross section at wrist and then with continuous cross-sectional scanning to observe the the full course of the median nerve in the forearm and carpal tunnel with high-frequency ultrasound.Results Anatomic variation of carpal tunnel median nerve and its accompanying structures were observed:① High division median nerve were found in 2 wrists (0.56 ％) ;②Bifid median nerve were found in 17 wrists (4.72％) ;③Persistent median artery were found in 22 wrists (6.11％),and 2 wrists (0.56％) were also found accompanied vein.Aanatomic variation of carpal tunnel median nerve accompanied with persistent median artery were observed in 16 wrists (4.44 ％).Conclusions High-frequency ultrasound was sensitive to diagnose the anatomic variation of carpal tunnel median nerve and its accompanying structures.Recognition of these variations can help us to make correct diagnosis of carpal tunnel syndrome.

Objective:To investigate the normal sonographic anatomic characteristics of the pectoralis major and the clinical value of ultrasound in diagnosing the extent and location of the pectoralis major tears.Methods:High frequency transducer was used in scanning the pectoralis major.The ultrasono-graphic images of 40 normal pectoralis major were obtained from 20 healthy volunteers with both sides. Longitudinal and transversal views were performed and stored.The distal tendon was identified in the transverse plane coursing superficially to the long head of the biceps brachii tendon inferior to the level of the subscapularis tendon.Eighteen cases of pectoralis major tears were analyzed retrospectively,with MRI,surgical and ultrasound follow-up results correlation respectively.Results:High-frequency ultra-sound could clearly show the anatomic orientation of the normal pectoralis major.The fibers converge was like a fan into three laminae that twisted upon each other at 90°before coalescing into a single tendon of insertion.In the study,1 8 patients of pectoralis major muscle tears [average age:(37.2 ±1 5.6)years] sustained injuries during weightlifting,basketball and impact.Three of the eighteen patients had MRI re-sults;nine had surgical correlation;six were followed by ultrasound.Eleven were injured on the left side,and 7 on the right side.Seven were involved in the distal tendon (1 in sternal head,2 in clavicular head,4 in both sternal and clavicular head),five were involved the musculotendinous junction,6 were involved muscle belly.Twelve cases were partial-thickness petoralis major tears(4 in the distal tendon, four in the muscle tendon junction,4 in the muscle belly),with the partial fiber intact,echogenicity de-creased and the internal structure disordered;6 cases (3 in the distal tendon,1 in the muscle tendon junction,2 in pectoralis major muscle belly)were completely disrupted,with fiber fracture and retrac-tion,accompanied with or without hematoma formation.Conclusion:High-frequency ultrasound can clearly show the anatomic structure of the pectoralis major.Ultrasonography can diagnose the pectoralis major tears with the extent and location of injuries,and can be used to help the clinical treatment.

Objective To discuss the effect of “practice teaching methods ” in musculoskeletal ultrasound diagnosis training process .Methods Thirty refresher doctors for a month with the method training .The effect training is evaluated by objective exam and questionnaire survey .Results Thirty refresher doctors received tests before and after the training .Test results showed that the accuracy after the training was significantly higher than that of before ( P<0.05 ) .Refresher doctors survey about satisfaction of the training method showed that whole satisfaction is 100%, in which 70%were very satisfied , 30%were satisfied .The self-assessment results for the improvement of the level of diagnosis musculoskeletal ultrasound showed that 45%doctors are very satisfied ,40%doctors are satis-fied, and 15%is not satisfied .Conclusions With the implementation of “teaching by practice” method, refresher doctors could master the knowledge of musculoskeletal anatomy as soon as possible , and have the ability to diagnose common musculoskeletal diseases independently .