Objective To investigate and compare the clinical efficacy of mifepristone alone and combined with Gongliuxiao capsule in the treatment of uterine fibroids.Methods 106 patients with uterine fibroids in Harrison International Peace Hospital from December 2012 to December 2013 were selected.The patients were randomly divided into control group and experimental group(n=53).The former were treated with mifepristone alone while the later were treated with the combination of mifepristone and Gongliuxiao capsule.All the patients were given 2 courses of treatment with 12 weeks for a course.The menstrual phase,volume of menstruation,uterus and the volorne of uterine fibroids before and after the treatment,and the clinical efficacy of both groups were evaluated.All the results were recorded and compared. Results The menstrual phase,volume of menstruation,uterus and uterine fibroids of both groups after the treatment were significantly less than those before treatment (P <0.05 ).And the total effective rate of experimental group was 92.45%,which was significantly higher than 73.58% of control group.Both groups had some mild adverse reactions,which didn’t affect the treatment.Conclusion The combination of mifepristone and Gongliuxiao capsule has a great efficacy in the treatment of uterine fibroids.Compared with the use of mifepristone alone,the combination treatment is much more effective.

Objective To explore the occurence,clinical characteristics and treatment of Mycoplasma pneumonia complicated with embolism in children.Methods Twenty-three cases with Mycoplasma pneumonia complicated with embolization were retrospectively analyzed from January 1990 to December 2012.Results The ages of cases were from 4 years old to 13 years old,and fifteen cases were male,eight cases were female.Nineteen cases with single-shot embolism included four cases of lower limb venous thrombosis,one case of internal carotid artery thrombosis,nine cases of cerebral infarction,two cases of cardiac infarction,two cases of splenic infarction,one case of pulmonary infarction; and the other four cases were multiple embolism,two cases combined pulmonary embolism and lower limb deep vein thrombosis,one case combined cardiac embolism and pulmonary embolism,one case combined internal carotid artery and the brain embolism.In addition,eight cases had temporary anti-cardiolipin antibody IgM,two cases combined protein C decrease,one case merge protein S decrease,and one case was lack of AT-Ⅲ.At last,two children died,the rest all recovered well after thrombolysis and anticoagulation therapy.Conclusion Mycoplasma pneumoniae has hypercoagulative state and potentialized to thrombosis,especially for children with high risk factors of thrombosis.Early diagnosis and anticoagulation and thrombolysis treatment actively is the key to better prognosis.

PurposeThe restriction of strain ratio (SR) in the diagnosis of thyroid malignant tumor are caused mainly because of disadvantages including low sensitivity, in this research the authors used different calculation methods of strain ratio based on the size of tumors, to explore the clinical application value of them on the differentiation of benign and malignant thyroid nodules.Materials and Methods Data of 336 patients with thyroid nodule (340 nodules) who underwent elasticity imaging and ultrasound-guided fine-needle aspiration were retrospective analyzed, with the pathology combined follow up acted as golden standards, fixed surface area assay and true surface area assay of strain ratio were compared on the differential diagnosis of benign and malignant thyroid nodules with various size.Results Among 340 thyroid nodules, there were 91 small nodules and 249 big nodules. Pathological results showed that 36 of 91 small nodules and 104 of 249 big nodules were malignant, while the others were benign. The true surface area assay was significantly better for the diagnosis of smaller thyroid nodules with longitudinal diameter and transverse diameter<8 mm with higher consistency with pathology (χ2=20.89,P<0.01), and fixed surface area assay is more suitable of thyroid nodules with longitudinal diameter and transverse diameter>8mm (χ2=57.08,P<0.01). The sensitivity, specificity and consistency for the diagnosis of malignant nodules of true surface area assay were 57.10%, 83.00% and 72.30% (Kappa=0.413), which were 73.60%, 85.00% and 72.30% (Kappa=0.590) in the fixed surface area assay, and 85.00%, 85.50% and 85.30% (Kappa=0.699) in the selective usage of two methods according to the tumor size, respectively.Conclusion The sensitivity is highest when using the two methods selectively according to the nodule size, with a better consistence rate with pathological results as well.

Objective To explore the factors what may influence the formation of tophi by high frequency ultrasound.Methods The gouty patients who were experiencing an acute attack and were clinically diagnosed with gouty arthritis were divided into two groups:the tophi group (44 cases) and the no tophi group (101 cases) group,clinical data and ultrasound features of joints were collected.The differences of ultrasound features and clinical characteristics between the two groups were analyzed.Results ① Ultrasound features showed that synovitis (x2=8.479,P=0.004) and effusion (x2=9.740,P=0.002) of the first metatarsophalangeal joint (MTP1) were most frequently observed in the no tophi group;bone erosion of MTP1 (x2=9.593,P=0.003),double contour (DC) sign (x2=14.069,P=0.000) and bone erosion (x2=5.870,P=0.020) of ankle joint,DC sign of knee joint (x2=8.224,P=0.006) were most frequently observed in the tophi group.Hyperechoic aggregates of MTP1 (x2=9.649,P=0.003) were most frequently observed in no tophi group.(②) Logistic regression analysis showed that MTP1 was the first attacked joint [OR=9.725,95％CI(2.765,34.209),P=0.000],the multiple joints involved [OR=1.908,95％CI (1.190,3.057),P=0.007] and bone erosion of MTP1 [OR=4.339,95％CI(1.300,14.490),P=0.017] were the main risks of the formation of tophi.Synovitis of MTP1 often presented in no tophi patients [OR=0.108,95％CI(0.026,0.441),P=0.002].Conclusion High frequency ultrasound combine with clinical data is of great value for evaluating the development and treatment of gout.

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in detection of synovial hyperplasia in wrist joint of patients with rheumatoid arthritis (RA) and to explore the correlation with disease activity . Methods Thirty-nine RA patients with their wrist involved were examined by CEUS . The imaging features of synovitis were observed and the analysis of time intensity curve ( TIC ) was performed by contrast dynamic software . Some quantitative parameters were obtained from these fitting curves including basic intensity ( a0 ) ,increased intensity ( a1 ) ,descending slope ( a2 ) ,ascending slope ( a3 ) , timetopeak(TTP),peakintensity(PI),actualpeakintensity(PI-a0),arrivaltime(AT),andareaunder the curve ( AUC) . And the correlation between these parameters with clinical activity index was analyzed . Results 35 .9％ (14/39) synovitis showed a centripetal enhancement pattern supplied by ring-like or arc-shaped arterials peripherally while 64 .1％ (25/39) showed diffusely entire enhancement . All the lesions were heterogeneous enhanced ,87 .2％ (34/39) of which exhibited hyperenhancement . The detection rate of perfusion defects was 41 .0％ (16/39) . The disease activity in the diffuse enhancement group was higher than that in the centripetal enhancement group ( 4 .64 ± 1 .09 vs 3 .69 ± 0 .67 , P = 0 .005 ) . CEUS quantitative parameters a3 and ( PI-a0 ) were positively correlated with erythrocyte sedimentation rate ( ESR) ( r =0 .465 , P =0 .006 ;r =0 .325 , P =0 .043) ,however TTP had a negative relationship ( r = -0 .352 , P =0 .041) . Conclusions Active synovitis usually represents as a diffuse enhancement pattern . A higher a3 and PI ,and a shorter TTP indicate a higher disease activity . CEUS plays a great role in monitoring RA disease activity both from qualitative and quantitative aspect .