Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS), and compare it with contrast-enhanced CT(CECT). Methods Eighty-one focal liver lesions were evaluated with CEUS and CECT, diagnostic value of two modalities were calculated, vaseularity manifestations of two modalities in arterial phase were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CEUS were 96.6 %, 86.9 %, 94.9 %, 90.9 %, 93. 80%, respectively, and the diagnostic value of CECT were 98.3%, 82. 6%, 93.4%, 95.0%, 93.8%, respectively. Among all the metastasis, hypervascular manifestation lesions in arterial phase of CEUS and CECT were 72% (18/25) and 32% (8/25)( P <0.05). Conclusions The diagnostic value of CEUS and CECT in focal liver lesions are comparably satisfying,and there is no significant difference between them, the combination use of two modalities would improve the diagnosis performance. CEUS can show more hypervaseular metastasis than CECT in arterial phase.

Objective To analyze the clinical and radiographic outcomes of staged reduction and fixation in a consecutive series of patients with the old Lisfranc injuries. Methods Fifty patients (16 feet) with Lisfranc injuries were treated with staged reduction. Mean duration between injury and surgery was 4. 8month ( 3 to 8 month) . In first stage an external fixator was applied across the Lisfranc joint and distraction was done at 1 milliliter per day to 2 milliliter per day. In the second staged the ORIF ( open reduction and internal fixation) was doneand we were able to reduce all the fractures and dislocations. Extra-Articular screws and staple fixation were used for fixation. We compared categorical variables using Fisher’ s exact test and continuous variables using paired t-test or Wilcoxon signed-rank test. Results All patients were followed up 1 to 3 years ( mean 2. 2 years) in the clinic. The visual analogue scale score averaged 3. 1 points at the final follow-up, the average AOFAS scores for these patients were 55. 8 points ( range, 43 to 98 points), with a significant increase than before surgery ( P=0. 001). The mean duration between two surgeries was 3. 2 weeks (range 2. 5-4. 5 weeks). Anatomic reduction was obtained in all 15 patients. At the last follow-up, 2 patients had lost reduction. Posttraumatic osteoarthritis was observed in 5 patients, and all of them were scheduled for arthrodesis because of persistent pain. Conclusions The study have displayed that staged reduction and Extra-Articular fixation should be considered for old Lisfranc injuries with a good reduction, the firm stability, low risk of intraoperative fracture. The short-term effectiveness is good, but the long-term effectiveness needs further follow-up.

Objective To understand the progress in schistosomiasis resoareh over the last l0 years through a biblimetrie approaeh.Methods The literature was searched in Web of Science citation database (1998-2008)by using the following terms: schistosomiasis* or schistosoma or schistosome. The searching results were analyzed by the Derwent Analytics software concerning the article numbers and the total citations by countries,institutes and authors, and journal distribution, in an effort to discover schistosomiasis research progress in and outside China. Results The annual number of schistosomiasis articles published in Web of Science had little change from 1998 to 2008.The US phyed a leading role in the schistosomiasis research in the world.China had made a great progress in schistosomiasis research in the past years.but Was still lagging behind developed countries.The vaccine and drug development,the immune mechanisms resulting in morbidity were the focuses of schistosomiasis research in the world.Meanwhile.the transcriptome and proteome of Schistosoma japonicum,schistosomiasis vaccines and drugs,spatial epidemiology Were the focuses of research in China.Conclusion The research of schistosomiasis in China has been progressing rapidly,but is still lagging behind its international peers.

Objective To investigate characteristics and ultrasonic imaging of the nano-scale ultrasound-enhanced contrast in vivo. Methods Nano-scale microbubbles were prepared by machine vibration and low speed centrifugation. The surface morphology and average size distribution of microbuble were measured. The contrast-enhanced effect of the hahn-scale microbubbles in the normal rabbit liver was observed,and compared with micro-scale microbubbles. Results The nano-scale microbubbles had a good shape and uniform distribution by light microscope and transmission electron microscope, with average diameter of 623.4 nm and surface electric potential of 1.3 inV. The contrast imaging study in vivo showed the nano-scale microbubbles could significantly enhance ultrasonic imaging of rabbit livers, which had no obvious difference with micro-scale microbubbles. Conclusions The nano-scale ultrasound contrast agent is stable and effective for the enhancement of ultrasound imaging, which is based on development of miniaturizing targeting ultrasound contrast agent.

Objective To evaluate the echocardiographic findings and clinical application in the rupture of sinus of Valsalva aneurysm(SVA).Methods Typical transthoracic echocardiographic appearance of 62 patients with SVA and accompanied abnormality were reviewed and compared with operative results.Results Fifty-eight (93.5%) cases SVA were preoperatively discovered by echocardiography, while 2 (3.2%) misdiagnosed as tetralogy of Fallot and tricuspid regurgitation and 2 (3.2%) missed diagnosis.Accompanying teratisms included frequently ventricular septal defect (VSD) (33 cases, 53.2 %) and aortic valve dysplasia(11 cases, 17.7%).The rupture site and the drainage chamber were essentially consisted with surgery,while the size of VSD measured by echocardiography was significantly smaller than that measured in operation.Conclusions Transthoracic echoeardiography is valuable in diagnosing of the site, drainage chamber and the accompanied abnormality of SVA.

Objective To evaluate the lung protection of remote limb ischemic preconditioning during one-lung ventilation (OLV) in the patients undergoing esophageal cancer resection.Methods Seventyone patients of both sexes,aged 30-64 yr,with body mass index of 15-28 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective esophageal cancer resection,were randomly divided into control group (group C,n =34) and remote limb ischemic preconditioning group (group RLIP,n =37) using a random number table.Patients in group RLIP received three cycles of 5-min ischemia/5-min reperfusion induced by a blood pressure cuff placed on one upper arm before OLV.Before OLV (T0),at 1 and 2 h of OLV (T1,2),at 20 min after re-expansion of the collapsed lung (T3),and at 2 h after operation (T4),blood samples were drawn from the radial artery for blood gas analysis,oxygenation index (PaO2/FiO2) and alveolar-arterial oxygen gradient (A-aDO2) were calculated.At T0,T2,T3 and T4,blood samples were collected from the radial artery for determination of plasma tumor necrosis factor-alpha (TNF-α),interleukin-6 (IL-6),and IL-10 concentrations.Results Compared with group C,PaO2/FiO2 was significantly increased,and A-aDO2was decreased at T1,2,the plasma TNF-α concentrations were decreased at T2-4 (P＜0.05),and no significant change was found in the plasma IL-6 and IL-10 concentrations and rate of abnormal pulmonary function at T1-4 in group RLIP (P＞O.05).Conclusion Although remote limb ischemic preconditioning can produce lung protection during OLV in the patients undergoing esophageal cancer resection,it provides no clinical significance.

Objective To observe the enhancement pattern and time-intensity curve of endometrial carcinomas by using contrast-enhanced ultrasound(CEUS). Methods Altogether 30 endometrial carcinomas were evaluated with real-time gray-scale CEUS, using pulse inversion harmonies technique. The enhancement patterns were observed. Twenty tumors were compared for the size between traditional ultrasound and CEUS. In 21 cases, the parameters of time-intenaity curve were compared between the endometrial lesion and un-involved myometrium. Results The contrast agent arrived at the feeding vessels firstly and then branched into the endometrial tumors. All of the endometrial tumors were enhanced completely except for the necrosis area. In 73.3 % (22/30) of cases, the tumors washed out earlier than the un-involved myometrium. By using CEUS 76. 7% (23/30) of cases showed the feeding vessels of tumor. 43.3% (13/30) of cases showed more clearly than traditional ultrasound in tumor base, position and boundary. The mean enhancement sizes of tumor were bigger than the size showed by traditional ultrasound in 85% of cases by (0. 62±0.50)cm. More than 90% cases showed the tumors start to enhance and wash-out earlier than or at the same time as myometrium. The arrival time and peak time of cancer group were significantly earlier than myometrium group. The peak intensity, enhancement intensity and the rising rate of the tumor group were significantly higher than those of the myometrium group. Conclusions There are some characteristic points in CEUS of endometrial carcinomas. CEUS can provide richer information in tumor imaging than traditional ultrasound and has certain clinical value.

ObjectiveTo explore the effect of blocking the JAK/STAT signal pathway on the activity of Caspase-3 in the synovial tissue of rheumatoid arthritis rats.MethodsFifty rat models of collageninduced arthritis,which had arthritis index more than 2 were divided into the model group,the low dosage of AG490 group,the medium dosage of AG490 group and high dosage of AG490 group.Inaddition,6 rats were treated as normal control group.Normal saline,AG490 1,5,10 mg·kg-1 ·d-1 were given by intraperitoneal injection.Then the volume claws and pathologic scores of the rat models were recorded and the activity of Caspase-3 in the synovial tissue were compared.The results were analyzed by one-way ANOVA and LSD-t or Tamhane's T2 test.ResultsThe arthritis of the CIA models progressed fast,the volume of the claws and the pathological score of them were significantly higher than those of the control group.At the same time,no Caspase-3 positive express could be detected in the control group,whilethe model group had slightly increased expression.After different dosages of AG490 were applied,the swollen of joints was significantly improved compared with the model group.The histopathological score of the medium AG490 dosage of group and high dosage group(2.7±0.8,1.8+0.9) were remarkably decreased than those of the model group(4.3+1.2),the differences were statistically significant (P＜0.01).In addition,the Caspase-3 expression in the low,medium and high AG490 dosage group ( 1.90±0.15,3.13±0.33,3.56+0.34) was significantly higher than that of the model group(1.48±0.18)(P＜0.05 or P＜0.01 ).ConclusionBlocking JAK/STAT signal pathway can increase the activity of Caspase-3,reduce the excessive proliferation of synovial tissue,and improve arthritis symptoms.

Objective To investigate the relationships between axillary lymph node metastasis and clinicopathologic features in the patients with cT1-2 N0 breast cancer and clarify the law of axillary lymph node metastasis,and to find the risk factor,and provide the theoretical basis for individuation therapy.Methods 687 patients with cT1-2 N0 breast cancer were divided into negative group and positive group according to the pathological results of axillary lymph node,and the clinicopathologic features were layered.The risk factors of axillary lymph node metastasis were screened out by Chi-square test and Logistic regression analysis.Results In 687 cases of cT1-2 N0 breast cancer,156 (22.7%)cases were observed with axillary lymph node metastasis. The age,cT stage,pT stage, pathological type,vascular invasion,perineural invasion estrogen receptor (ER),progesterone receptor (PR), and molecular subtyping were the factors that influenced axillary lymph node metastasis in univariate analyses.The age < 35 years, cT2 , invasive ductal carcinoma, vascular invasion positive and Luminal subtyping were the independent risk factors of axillary lymph nodes metastasis in multivariate analyses (r = 3.440,P = 0.010;r =1.770,P =0.007;r = 3.397,P = 0.001;r = 7.434,P = 0.000;r = 2.212,P = 0.015).Conclusion In the patients with cT1-2 N0 breast cancer,the age,cT,pathological type,vascular invasion and molecular subtyping are important predictors of axillary lymph node metastasis and vascular invasion was the most important predictor.The preoperative comprehensive analysis and evaluation of clinical data and preoperative pathological results obtained will help to select the right surgical operation.

Objective To evaluate and screen out the specific characters of thyroid nodules on grayscale and color Doppler ultrasonography. Methods One hundred and four thyroid nodules in 95 patients were studied with gray-scale and color Doppler ultrasound before surgery.According to the probability of malignancy,the main independent characters were screened out by Logistic regression analysis and then got the formula which could calculate the probability of malignancy.Results Fifty three nodules,included 44 hyperplasia,7 adenomas,1 switch granuloma and 1 Hashimoto's disease,were benign.Fifty one nodules,included 47 papillary carcinomas,3 medullary carcinomas,1 metastatic carcinomas,were malignant pathologically.The significant characters to differentiate malignant from benign were the shape,margin,border,halo,echostucture,echogenecity,echo uniformity,calcicum,bolood vessel shape and partial abnormal rich blood of thyroid nodules.After two variables logistic regression analysis,a fomula were worked out.Probability of malignancy=1/1+e-z,which z=-7.44+1.30×halo+1.05×calcicum+1.5×vessel shape.If a thyroid nodule with no halo,microcalcicum and irregular vessel shape,the probability of malignancy was 0.99,while with complete halo,no calcicum and regular vessele shape,the probability of malignancy of the nodule was 0.02.Conclusions The halo,calcium and blood vessel shape of thyroid nodules were three independent characters of thyroid nodules to predict malignant thyroid nodules on gray scale and color Doppler ultrasound.