Objective To explore the instruction value of the color Doppler ultrasonography for the diagnosis and treatment of the pediatric intussusceptions .Methods Retrospective study the color Doppler ultrasonographic performance of 114 patients with diagnosis of pediatric intussusception in the affiliated hospital of Zunyi medical college ,from October 2009 to June 2012 ,reviewed the case ,groups were compared according to the ways of therapeutic methods .Results All the 114 cases of children of the intus-susception are subject to air enema reset or surgery cured confirmed .Age younger than 12 months intussusception children ,air ene-ma reset were more likely to success ;the diameter of concentric circles levy,the length of sleeve for and the thickness of bowel wall were smaller ,the more suitable for outsiders air enema reset .The blood supply of scabbard of bowel wall and the mesenteric was rich ,the air enema reset had a higher success rate ,blood supply was poor and the success rate was lower .The success rate of air enema reset was influenced by the part of intussusception .Conclusion Combined use of conventional color ultrasonic and high fre-quency probe checking ,can raise the diagnosis rate of pediatric intussusception ,the primary lesion confirmed and the detection rate in the position of the disease ,provide guidance for clinical choice reduction treatment .

Objective:To understand the correlation of different ultrasound characteristics with thyroid cancer, and evaluate the effect and safety of different surgical strategies in pathological suspected cancer and highly suspected cancer by pure ultrasound.Methods:The clinical data of 679 patients (787 thyroid nodules) underwent thyroid surgery from August 2016 to December 2019 in Beijing Daxing District People′s Hospital were retrospectively analyzed, including ultrasound characteristics (echo, margin, form, ratio of tall to wide, calcification), surgery data (operation time, surgical strategies, whether the second surgery), recovery process (whether combined with secondary injury, including hoarse voice and choking on drinking water; drainage tube retention time and postoperative drainage), pathological examination results (pathological types, whether included parathyroid gland in the submitted specimen and whether lymph node metastasis). The effect and safety were compared between dissection and non-dissection of central group lymph nodes in pathological suspected cancer patients and highly suspected cancer by pure ultrasound patients.Results:Among the 787 thyroid nodules, 316 nodules (40.2%) were malignant nodules, including 308 papillary carcinomas; 471 nodules (59.8%) were benign nodules. The rates of low echo, unclear margin, form irregularity, ratio of tall to wide >1 and microcalcification in malignant nodules were significantly higher than those in benign nodules: 90.5% (286/316) vs. 38.9% (183/471), 52.5% (166/316) vs. 11.5% (54/471), 53.8% (170/316) vs. 11.5% (54/471), 30.4% (96/316) vs. 5.5%(26/471) and 65.5% (207/316) vs. 8.7% (41/471), and there were statistical differences ( P<0.01). Among 26 patients with pathological suspected cancer, there were no statistical difference in operation time, drainage tube retention time, postoperative drainage, surgical complications and paraffin pathology result between patients with dissection of central group lymph nodes (17 cases) and patients without dissection of central group lymph nodes (9 cases) ( P>0.05); the patients with dissection of the central group lymph nodes were all proved to be cancer by paraffin pathology examination. The highly suspected cancer by pure ultrasound was in 57 cases, there were no statistical difference in operation time, drainage tube retention time, postoperative drainage, choking on drinking water or hoarse voice between patients with dissection of central group lymph nodes (23 cases) and patients without that dissection (34 cases) ( P>0.05); the incidence of parathyroid gland in the submitted specimen and malignant rate of paraffin pathology result in patients with dissection of central group lymph nodes were significantly higher than those without that dissection: 39.1% (9/23) vs. 2.9% (1/34) and 30.4% (7/23) vs. 8.8% (3/34), and there were statistical differences ( P<0.01 or <0.05). Conclusions:Thyroid ultrasound characteristics have important predictive value. It is recommended to clean central group lymph node in most cases of pathological suspected cancer; while when highly suspected cancer by pure ultrasound happens, it is recommended to clean lymph node only when lymph node metastasis is highly suspected.

The present case report described a patient with paroxysmal atrial fibrillation who received pulsed-filed ablation guided by intracardiac echocardiography and 3-dimentional mapping system.All four pulmonary veins were isolated in the procedure,good clinical results and acute safety profile were achieved.The present case reveals the safety and feasibility of the technique for the treatment of paroxysmal atrial fibrillation.