Purpose To explore the association between ultrasound contrast agent injection volume as well as regurgitation and tubal patency. Methods SonoVue contrast agent was used for 515 cases of infertility transvaginal four-dimensional ultrasound imaging hysterosalpingography, recorded the amount of contrast agent injection, regurgitation, and compared contrast agent injection volume and regurgitation in different patency. Results The ultrasound contrast agent injection volume between bilateral patency with bilateral passable and one side patency one side passable as well as one side patency one side barrier, between one side patency one side passable and one side patency one side barrier had no significant difference (U=1467.0-4843.0, P>0.05);and it had statistical difference between any other two conditions (U=273.5-6160.0, P<0.05). The regurgitation between bilateral passable and bilateral barrier, one side passable one side barrier, between bilateral barrier and one side patency one side barrier, one side passable one side barrier, between one side patency one side passable and one side patency one side barrier had no statistical difference (U=949.5-6378.5, P>0.05), and it had statistical difference between any other two conditions (U=919.5-5126.5, P<0.05). Conclusion Ultrasound contrast agent injection volume and regurgitation in hysterosalpingography are associated with tubal patency, which can be used as objective indexes for assessing tubal patency, and provide basis for tubal patency.

Purpose To explore the clinical value of reducing the incidence of reflux and improving patients' comfort by low pressure contrast injection during transvaginal ultrasound real time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D-HyCoSy).Materials and Methods Data ofTVS RT-3D HyCoSy using low pressure contrast injection of 498 infertile women were analyzed.The peak pressure,the incidence of reflux and adverse reactions were recorded.Compared these parameters between bilateral tubals.Results The peak pressure in patency,partially patency and fully obstructed of bilateral tubals were (22.47±5.96) kPa,(37.24±8.83) kPa and (44.64±7.73) kPa.There was significant difference among the three groups (F=70.35,P＜0.05).Among all 498 patients,the incidence of reflux was 26.31％.The incidence in patency,partially patency and fully obstructed of bilateral tubals were 18.00％,30.21％ and 43.59％.There was significant difference among the three groups (x2=15.59,P＜0.05).Different degrees of adverse reactions were 88.96％,10.64％ and 0.4％.Conclusion By using low pressure contrast injection during HyCoSy,the incidence of reflux can be reduced and examination comfort can be improved.

Objective To investigate the changes of estrogen receptor expression in mast cells of bronchial mucosa from female asthmatic patients.Methods 12 cases of female asthmatic patients and 9 cases of control female patients were enrolled in this study.The bronchial mucosa was obtained from the third grade bronchial by fiexible bronchofiberscope.Mast cells were marked by anti-mast cell tryptase monoclonal antibody,the expression of estrogen receptor(ER)were detected by anti-human estrogen receptor(ER)monoclonal antibodies.Results Mast cells and estrogen receptor positive cells of bronchial mucosa in female asthmatic patients were significantly higher than that in control group(P＜0.01).Coincident with the known features of bronchial asthma,the cells positive for estrogen receptor were morphologically similar to the mast cells.The cells stained for estrogen receptors by dual immunostaining coincided exactly with cells labeled as mast cells.Conclusion The result suggested the estrogen may be involved in the pathogenesis of female asthmatic patient through the changes of estrogen receptor expression in mast cells of bronchial mucosa.

ObjectiveTo investigate the current situation of postoperative fluid therapy in general surgery department of grade Ⅲ-A general hospitals in Beijing and Tianjin. Methods Postoperative patients in general surgery department who were fasting for 3 days were retrospectively investigated, and 600 cases were recruited without considering age, gender, denomination of disease and operation type.The general information of patients, laboratory examination before and after operation, postoperative fluid therapy for 3 days, postoperative complications and infusion reaction were collected.Results In total 588 valid cases, the volume of average fluids supplement was (3030±638)ml per day, With the prescribed glucose (142+67)g per day, potassium chloride (59.9±23.9) mmol per day and sodium chloride (179.5±66.7) mmol per day. 85.2 % of total patients received nutrition support and the ratio of parenteral nutrition/enteral nutrition (PN/EN) was 28/1.There were 549 patients with BMI>18.5 before operation, and among them, 470 cases (85.6%)received parenteral and enteral nutrition treatment. There were 39 patients with BMI < 18.5 and 27 cases (69.2%) received parenteral nutrition support without enteral nutrition treatment. During the 3 days after operation, there were 36 cases with fluid therapy without potassium chloride supplement.ConclusionsThe proportions of receiving nutrition support and parenteral nutrition treatment are relatively high in grade Ⅲ-A general hospitals in Beijing and Tianjin. Ready-to-use preparation canreduce mistake and will be benefit to patients.

Objective To explore the clinical application of blood perfusion quantitatively by contrastenhanced ultrasonography(CEUS) to grade cerebral gliomas during operation. Methods Thirty-one patients with cerebral gliomas were examined by CEUS with Sonoliver software during operation. Maximum intensity (IMAX), time to peak (TTP), rising time (RT) and mean transit time(mTT) of the regions of interest (ROIs) of normal brain tissue and high- and low-grade gliomas were respectively determined and comparatively analyzed. Results Fifteen high-grade gliomas and sixteen low-grade gliomas were postoperatively confirmed by pathologic results. The administration of contrast agent led to higher echo enhancement in cerebral gliomas than normal brain tissues in all cases. The TTP of high- and low-grade gliomas were significantly shorter than that of normal cerebral tissues ( P ＜0.05) ,and the mTT was longer than that of normal brain tissue( P ＜0. 05). There was significant differences of IMAX and TTP between high- and low-grade gliomas(P ＜0.05), but there was no significant difference of RT and mTT between the two groups ( P ＞0.05). Conclusions CEUS with quantitative analysis software on blood perfusion of the tumors can provide valuable information to grade cerebral gliomas.

Objective To investigate the utilization of contrast-enhanced ultrasound (CEUS) for the detection of splenic artery steal syndrome (SASS) after orthotropic liver transplantation (OLT).Methods Color Doppler flow imaging (CDFI) were performed at various time points post-operatively.CEUS and celiac angiography were conducted in patients suspected of SASS.Results 9 patients were suspected of SASS by slim or undetectable hepatic arterial Doppler blood signals by CDFI at various time points postoperatively.CEUS in 9 patients showed a delayed and weak contrast-enhanced blood signal in the hepatic artery associated with a rapid and intense enhancement of portal venous blood.No narrowing of a hyperintense signal was observed in the hepatic artery by CEUS.The 9 diagnoses of SASS were proven by celiac angiography.Conclusions SASS is identified as a sluggish and weak hyperintense blood signal in the hepatic artery without the narrowing and interruption of hypeintense signal in CEUS.CEUS is an effective imaging modality for detection of SASS following OLT.

ObjectiveTo summarize the early clinical experience of the extracorporeal membrane oxygenation (ECMO) for protecting the liver donation after cardiac death (DCD).Methods Review and analysis the clinical data of 17 cases of liver transplantation with the donors from Chinese citizen after cardiac death from July 2009 to May 2011 in our liver transplantation center,and comprehend the primary diseases and the relevant index of the donors,the flow-sheet of donation and obtain of the organs from the donation after cardiac death,and the apply methods of extracorporeal membrane oxygenation during those processes.ResultsAll 17 cases had been diagnosed as brain death before,and waited for cardiac death,so all were clearly the donation of brain death plus cardiac death(DBCD).During the processes waiting for cardiac death,extracorporeal membrane oxygenation were introducted in every case,and the using time were 51-380 (mean 187)min.The donation after brain death plus cardiac death (DBCD) were all harvested liver donors and were transplanted to 17 receivers respectively.In our center,there was no operational death in liver transplantation in this series.The post-operation liver function recovered satisfactory,without transplant liver non-function or recovering delay.One case died of the pulmonary infection one month later after operation,and the other 16 cases all survived and were followed up to now.The longest survival time was 29 months.ConclusionThe donation after brain death plus cardiac death (DBCD) was the special donation type for citizen in China.The extracorporeal membrane oxygenation (ECMO) could well control the warm ischemia for protecting the liver donor just without ethics dispute.So,the using of the extracorporeal membrane oxygenation (ECMO) for the liver donation after cardiac death(DCD)of citizen in our China have very important contribution.

Objective: To discuss the significance of neoadjuvant chemotherapy followed by surgery in the treatment of local advanced esophageal cancer. Methods:A total of 272 cases of local advanced esophageal cancer were studied in retrospect. Out of the 272 cases, 112 were treated with neoadjuvant chemotherapy followed by surgery (CT-S), whereas the remaining 160 cases underwent surgical treatment (S) only. Complications and survival state after surgery were compared. Results: The rate of complications after surgery was as follows: CT-S: 34.8% (39/112); S: 29.4% (47/160), P=0.50. The five-year survival rate was 35.7% and 29.4%, respectively, P<0.05. The CT-S patients were divided into partial remission (PR) and stable disease (SD)/progressive disease (PD) groups according to the effect of the chemotherapy. The five-year survival rate was 38.5% and 30.1%, respectively, P<0.01. Conclusion: Neoadjuvant chemotherapy is available for local advanced esophageal cancer. Postoperative complications are not increased by chemotherapy, and the survival rate for local advanced esophageal cancer is improved by neoadjuvant chemotherapy. PR has better prognosis compared with SD/PD.

Objective To access the diagnostic accuracy and clinical value of transvaginal real time three-dimensional hysterosalpingo-contrast sonography (RT-3D-HyCoSy) in evaluating the fallopian tube patency.Methods 428 infertile women were under went transvaginal RT-3D-HyCoSy and 32 of them were underwent laparoscopically salpingoraphy to evaluate the fallopian tube patency.Results 846 fallopian tubeswere studied by RT-3D-HyCoSy,271 of them were unobstructed,202 of them were obstructed,373 of them were partially passable.Compared with laparoscopically salpingography,sensitivity,specificity,positive predictive value and negative predictive value of transvaginal RT-3D HyCoSy were 84.0％,100％,87.5％ and 90.9％,respectively.The transvagianl RT-3D HyCoSy and the laparoscopy with a Cohen's Kappa was 0.788.Conclusions Transvagianl RT-3D HyCoSy could dynamic show the visualization of the course from uterus to distal tubal and the both ovary consecutively.It has more advantage in assessing the patency of tubal and distal tubal function.

Objective To summarize the experience of diagnosis and treatment for pancreatic neuroendocrine neoplasms (pNENs).Methods Forty-seven patients with pNENs who were treated at Anhui Province Hospital during January 2002 to December 2013 were retrospectively analyzed.They were followed by telephone or clinic interview,and the deadline date was January 31st,2014.Survival was analyzed with the Kaplan-Meier method,and the prognostic factors for survival were identified.Results Among the47 patients,there were 13 males and 34 females,aged from 16 to 74 years old,with a median age of 45 years,There were 17 cases of non-functioning pNENs,30 cases of functioning pNENs.The detection rate of B ultrasound,CT,MRI was 71.8％ (28/39),92.7％ (38/41),75.6％ (6/8).Forty-six patients underwent radical surgery,and 1 patient underwent palliative surgery.The pathologic type included 41 cases of pancreatic neuroendocrine neoplasms,6 cases of neuroendocrine cancer.There were 22,19,6 cases of grade G1,G2,G3 lesions,respectively.There were 32,11,4 cases of TNM staging Ⅰ,Ⅱ,Ⅲ,respectively.Vascular structure was invaded in 15 cases,and nerve was invaded in 18 cases.Lymph node was examined in 15 cases,and 5 were found to have metastatic lesion.After surgery,pancreatic fistula occurred in 9 patients,ascites in 4 patients,wound infection in 4.The follow-up period ranged from 2 to 144 months.The overall 1,3,5-year survival rates were 94.9％,88.4％,and 84.4％.The 5-year survival rates of patients with grade G1,G2,G3 were 100％,73.3％,60％;and the 5-year survival rates of patients with TNM staging Ⅰ,Ⅱ,Ⅲ were 100％,70.0％,33.3％.It was showed that TNM staging system,WHO classification,lymph node metastasis,vascular and neural invasion were associated with the prognosis.Conclusions CT is the imaging test of choice for pNENs,while surgery is the first choice for treatment.Surgical resection of pNENs results in long-term survival.TNM staging,WHO classification,lymphatic metastasis,vascular and neural invasion are closely related to the prognosis of pNENs.