Adenocarcinoma ; diagnosis ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; methods ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; False Negative Reactions ; Female ; Granuloma ; diagnosis ; pathology ; Humans ; Lung Diseases ; diagnosis ; pathology ; Lung Neoplasms ; diagnosis ; pathology ; Male ; Middle Aged ; Radiography, Interventional ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; diagnosis ; pathology ; Young Adult

Objective To study the enhancement patterns of hilar bile duct wall of ischemic-type biliary lesion (ITBL) on contrast-enhanced ultrasound (CEUS).Methods Eighteen healthy subjects,18 orthotropic liver transplantation (OLT) recipients without complications,and 36 patients,which were subdivided into 2 groups according to the final diagnosis:patients with (n =24) and without (n =12)ITBL,were enrolled in this study.The patients without ITBL had anastomotic biliary stricture (n =3),cholangitis (n =4),biliary sludge (n =1),and acute rejection (n =4),respectively.The images of baseline sonography and CEUS were retrospectively analyzed in consensus by 2 readers.The enhancement time and level of hilar bile duct wall,hepatic artery and liver parenchyma were recorded.Results Hilar bile duct wall became enhancing earlier than liver parenchyma in all of 4 groups.During arterial phase,hyper-or isoenhancing bile duct walls were present in most cases in the groups of healthy subjects,OLT recipients without complications and patients without ITBL.However,non-or hypo-enhancement of hilar bile duct wall were present in 16 (66.7％) ITBL patients,which is different from the other groups (P ＜0.05).Conclusions The main features of ITBL differing from the other groups were non-or hypo-enhancement of hilar bile duct wall in arterial phase.It may be a diagnostic index to apply in detecting ITBL with CEUS.

Purpose To explore the significance of three-dimensional reconstruction of fetus based on MRI scan data. Materials and Methods Three woman (more than 39 weeks' gestation) with a strong wish to have natural childbirth and voluntary to take the examination in Nanfang Hospital of Southern Medical University were recruited in the study. Mimics 10.01 software was used to do three-dimensional reconstruction. Results The fetal surface tissue showed low signal on the two-dimensional images, and amniotic fluid and lung, bladder, cerebrospinal fluid showed high signal. The placenta and uterine wall showed moderate to low signal. Those contributed to the clear boundary between fetal surface and other tissue surround. The three-dimensional fetus models were reconstructed successfully, which clearly demonstrated the main surface features and spatial position of the fetus. The fetal morphology and fetal position could be viewed in various directions. Conclusion Fetus surface can be reconstructed into three-dimensional model based on MRI data set, which has advantage of large visual field and can be observed at arbitrary angle. It provides a new method for morphological analysis and prenatal evaluation for fetal development and growth.

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in diagnosing ischemic-type biliary lesion (ITBL) and analyze the relation between the enhancement patterns of bile duct wall of ITBL and its outcome.Methods 36 patients confirmed with ITBL (24 cases),anastomotic biliary stricture (3 cases),cholangitis (4 cases),biliarysludge (1 cases),and acute rejection (4 cases),who underwent CEUS examination,were enrolled in this study.The images were retrospectively analyzed in consensus by 2 readers.After reviewing the images,the readers were asked to make a diagnosis of ITBL.The diagnostic standard was hypo-or non-enhancement of hilar bile duct wall in arterial phase on CEUS.Results The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 66.7％,83.3％,72.2％,88.9％,and 55.6％ for reader 1;62.5％,83.3％,69.4％,88.2％,and 52.6 ％ for reader 2,respectively.The interobserver agreement was good (κ =0.83).In 24 ITBL patients,the ratio of mortality or retransplantation with non enhancing hilar bile duct wall in arterial phase was much higher than that with enhancing hilar bile duct wall (non-enhancement 54.5％,hypo-enhancement 20％,hyper-or iso-enhancement 12.5％).Conclusions CEUS had diagnostic value of ITBL.Non-enhancing hilar bile duct wall in arterial phase on CEUS predicated the poor outcome.

Objective To evaluate the usefulness of baseline ultrasound(BUS) and contrast-enhanced ultrasound(CEUS) in diagnosis of portal vein(PV) patency and to explore the indication of CEUS. Methods The diagnostic capability of BUS and CEUS were assessed in 64 cases according to definition of PV on BUS,which was divided into high, moderate and low definition. Results Thirty-five patients with portal vein thrombosis(PVT) and 29 patients with normal portal vein were confirmed. The diagnostic accuracies by using BUS and CEUS were 93.1% and 96.6% with high definition of PV,56.3% and 87.5% with moderate definition,and 68.4% and 89. 5% with low definition, respectively. Conclusions In the case of high definition of PV,the validity of diagnosing of PV patency with BUS may be similar to that with CEUS,thus introduction of CEUS would probably not be necessary. Otherwise CEUS is recommended.

s parameters of CEUS between ITBL group and control groups reflect the characterization of flow perfusion in ITBL, which can provide the objective evidence in the diagnosis of ITBL.

Objective To observe the clinical effect of combination of Tongxiening granule and Mesalazine on treating mild and moderate ulcerative colitis(UC) .Methods Totally 380 patients with mild‐to‐moderate UC diagnosed through endoscopy were allocated to the control group (n=190) and observation group(n=190) .For the observation group ,patients were remedied with the combination of Tongxiening Granules and the Mesalazine by oral administration for eight weeks ,meanwhile the control group only received the Mesalazine for eight weeks .The total effective rate of the two groups were statistically analyzed ,and the levels of ser‐um MMP‐2 and MMP‐9 before and after treatment in the two groups were measured .The expression of S100A12 and RAGE were detected by immunohistochemistry SP method .Results The total effective rate of the observation group and the control group was 94 .74% and 89 .47% respectively ,and the difference was statistically significant(P<0 .01) .After treatment ,the expression levels of MMP‐2 and MMP‐9 in the two groups were decreased ,additionally the expression levels in the observation group was lower than those in the control group ,and the difference was statistically significant (P< 0 .01) .After treatment ,the expression levels of RAGE and S100A12 in the observation group were decreased ,and there was a significant difference when compared with the control group(P<0 .01) .Conclusion Combined application of Tongxiening Granules and Mesalazine in treating patients with mild‐to‐mod‐erate UC could better improve clinical symptoms and bring better therapeutic effect than single use of Mesalazine .

Objective To evaluate the clinical value of three-dimensional contrast-enhanced ultrasonography(3D-CEUS) of hepatic arteries in liver transplant candidates.Methods Twenty-six liver transplantation donors and recipients were examined using two-dimensional contrast-enhanced ultrasound (2D-CEUS) and 3D-CEUS.The 3D image's qualities, reconstruction successful rates, and the diagnostic level of hepatic artery complications were estimated. Results Twenty-one hepatic arteries were reconstructed successfully (80.8%).The 3D images showed artery trees continuous, spatial relationship definite, fine and circuitous branches distinct, and the segmental hepatic arteries' origin could be recognized.In 4 of 5 hepatic artery complications,both 2D-CEUS and 3D-CEUS made the correct diagnoses.However,2D-CEUS made a false positive diagnosis and 3D-CEUS retrieved it.Conclusions The 3D-CEUS images of the hepatic arteries are direct and distinct.In evaluating hepatic artery complications, when artery spatial relationship is complicated, the 3D-CEUS could provide more information, and confirm or correct some diagnosis of 2D-CEUS.

Objective To assess the difference between two-dimensional contrast-enhanced ultrasonography ( 2D-CEUS ) and three-dimensional contrast-enhanced ultrasonography ( 3D-CEUS ) in evaluating hepatic arteries in the liver transplantation. Methods Both 2D-CEUS and 3D-CEUS were used to examine 26 liver transplantation donors and recipients. Fifteen patients who were confirmed by CTA or DSA or MRA were analyzed. The image' s quality and diagnostic levels of 2D-CEUS and 3D-CEUS were compared, and the diagnostic information about anatomic features of hepatic arteries provided by the two methods was evaluated. Results 1) The image' s quality of 2D-CEUS and 3D-CEUS were 3. 62 ± 0. 41, 2. 52 ± 0. 93, respectively. The difference between them was statistically significant ( P <0. 05). 2)When evaluating anatomic features ,2D-CEUS and 3D-CEUS had no significant difference in common hepatic artery (CHA) and proper hepatic artery (PHA). But 3D-CEUS was prior to 2D-CEUS in left hepatic artery (LHA) ,right hepatic artery(RHA) and segmental hepatic artery(SHA) ( P <0. 05). 3)Five hepatic artery complications were discovered by CTA or DSA or MRA in 15 patients. In 4 patients (80%) ,both 2D-CEUS and 3D-CEUS made the affirmative diagnoses in accordance with the results. However, 2D-CEUS made a false positive diagnosis and 3D-CEUS corrected it. Conclusions The 3D-CEUS could provide more diagnostic information,could confirm or correct some diagnosis of 2D-CEUS,but,its image's quality is not as good as 2D-CEUS. Therefore,combining the 3D-CEUS with 2D-CEUS has practical clinical value in liver transplantation.

Objective Construct the reasonably effective performance assessment mode of clinical departments,which is suitable for the continuous development of modern hospital.Method Use of balanced scorecard (BSC) principle,using the analytic hierarchy process (AHP) and Rank sum ratio method (RSR)to establish a performance assessment system. Results Constructed the performance assessment mode of clinical departments,which can be dynamically adjusted based on management objectives strategy.The mode takes the BSC as the baseline,the strategy of hospital development as the guide,performance assessment index system as the key element. Conclusion The performance assessment mode of clinical departments,base on BSC,achieve the strategic performance management,and is conducive to the hospital for continuous improvement of medical care quality,in line with the long-term strategic needs of the hospital.