Objective To determine the relation between enlarged perihepatic lymph node (PLN) and viraemia,and to find out whether there is a difference in PLN size between the healthy individuals and patients with hepatitis C virus (HCV) infection. Methods Seventy-four patients with HCV infection and 283 healthy individuals were examined by two-dimensional ultrasound. The length and thickness of lymph node were measured. The lymph-node area index(LN area index) was calculated. The LN area index was evaluated by the ROC curve and compared with serum HCV core antigen (HCV-Ag) levels by correlation analysis. Results Detection rate, the length and thickness, LN area index of group with HCV infection were significantly different by compared with the normal control group ( P < 0. 001 ). The ROC curve showed that the LN area index as a diagnostic indicator had high sensitivity and specificity. The LN area index showed a significant correlation with HCV-Ag level (r = 0.436, P <0.05), but no significant differences were found between LN area index and HCV-Ag grade. Conclusions Perihepatic lymphadenopathy indicates viraemia,and LN area index of 100 mm2 is a reference index in estimating whether patients have HCV infection.

Objective To investigate the spectrum of mitochondrial DNA (mtDNA) mutations in Chinese patients with Leber′s hereditary optic neuropathy (LHON). Methods The primary mtDNA mutations (G3460A?G11778A and T14484C) of 140 patients with LHON were detected by mutation-specific priming polymerase chain reaction (MSP-PCR), heteroduplex-single strand conformation polymorphism polymerase chain reaction (HA-SSCP), restriction fragment length polymorphisms (RFLP) and measurement of DNA sequence. The transmissibility of the patients′ stirps was analyzed. Results In the 140 patients with LHON, G11778A mtDNA primary mutation was found in 130 (92.9%), including 113 males and 17 females; G3460A mutation was found in 2 (1.4%) including 1 male and 1 female; G14484A mutation was found in 8 (5.7%) including 6 males and 2 females. Conclusion In Chinese patients with LHON, the incidence of G11778A mtDNA mutation is higher than that of G3460A and T14484C.

Objective A retrospective study was conducted to evaluate the clinical significance of Video EEG monitoring in the diagnosis of epilepsy and other paroxysmal events Methods Video EEG monitoring under the state of awaking and sleeping and evoked tests were performed continuously in 216 patients with epilepsy and other paroxysmal events Results The characteristic events were captured in 130(60%) of the 216 patients And out of the 130 patients, 53 had clinical events accompanying epileptiform discharge 73 patients had no epileptiform discharge in both ictal and interictal period Seizure types were defined in 80%of 80 patients with epileptiform discharge, and classification was different from the original 42% of the 64 patients Conclusions Video EEG can record much more epileptiform discharge than routine EEG It should be an effective method in both diagnosis and classification of epilepsy

Objective To explore the effect of enteral nutrition combined with parenteral nutrition support on the prognosis of severe acute pancreatitis(SAP).Methods Sixty-one patients diagnosed with SAP in our hospital from July 2011 to June 2012 were chosen and randomly divided into EN and PN group(30 cases)and PN group(31 cases).At the early stage of treatment,the former group was provided parenteral nutrition(PN)alone while the latter group was given enteral nutrition together with parenter-al nutrition.Then we measured the patients′body mass index on the 1st,2nd,3rd,5th,7th,10th,14th day respectively after admis-sion,and recorded the following indexes:whether complications occurred or not,the time for the first passage of gas by anus and defecation,the total time and cost of hospitalization,the drug proportion and the time the serum and urine amylase returned to nor-mal.Results The two groups of patients′body mass index showed no significant differences in the first 3 days,but there were sig-nificant differences in statistics on the 5th,7th,10th and 14th day(P <0.05).In addition,the two groups of patients formed a sharp contrast in such aspects as the bowel sound recovery time,the anal exhaust time,the total cost of hospitalization and the incidence rate of the complications(P <0.05)whereas there were no remarkable differences in the serum and urine amylase recovery time and the total time of hospitalization(P >0.05).Conclusion Compared with PN,the combined therapy of EN and PN could improve the patients′nutrition,reduce the weight loss caused by consumption,promote intestinal peristalsis,effectively reduce infectious compli-cations caused by floraectopic and ease the patients financial burden.

Objective To study the clinical features of Crohn's disease(CD)at different location,I.e.small intestine.colon and ileocolon,to facilitate the knowledge of the disease.Methods Data of 103 patients,hospitalized to our department from 2000 to January 2008,were retrospectively analyzed,including general status,clinical manifestations,laboratory findings and pathological changes.Results The cohort included 70 males and 33 females,with the age when the diagnosis was confirmed ranging from 12 to 70,with a peak at 20-29 yr.The location of the main lesion was at small bowel(L1)in 39(38%),at colon (L2)in 16(16%)and at ileum-colon(L3)48(46%).There was no significant difference between each group,regarding the age of onset or the when the diagnosis was confirmed.The incidence of intestinal obstruction was higher in L1 patients than that in L3(P＜0.05).In group L1,12(30.8%)were diagnosed by capsule endoscopy,and 17(44%)were confirmed by colonoscopy.Diagnostic rates of L2 and L3 with reference to clinical manifestations.combined with colonoscopy and pathology were 87.5%and 83.3%,respectivelv.In this cohort,there were 23(22.3%)mild cases,58(56.3%)moderate cases and 22 (21.4%)severe cases,according to simplified CD activity index(CDAI).The rate of severe case in L3 was 59.0%(13/48),which was significantly higher than that in L1(P＜0.05).Conclusion In patients with CD,L1 is characterized by delayed diagnosis and need of emergent surgery,while L3 is featured with extensive involvement.severe complications and systemic manifestations.Severe case is common in 13 patient,capsule endoscopy and Colonoscopy are important in early detection of the disease to decrease operation rate and delay the time of first operation.

Objective To investigate the causes and prevention of postpartum hemorrhage. Methods 84 cases with postpartum hemorrhage were analyzed. Results The main cause of postpartum hemorrhage was involved in poor contraction of uterus; The second cause was concerned with placenta; There was higher rate of postpartum hemorrhage after caesarean section than vaginal delivery. Conclusion It was necessary for preventing postpartum hemorrhage to strengthen antenatalcare, improve labor observe, decrease caesarean section.

Objective To explore the application of contrast-enhanced scoring system in the diagnosis of breast tumor.Methods 249 patients with 260 lesions were examined by elastography and contrastenhanced ultrasound before surgery.All the lesions were scored according to the two different methods.Pathological results were made the golden criteria.The diagnosis accuracy of the two methods were compared.Results There were 145 benign and 115 malignant tumors.The diagnosis accuracy,specificity and sensibility of elastography were 85.0％,88.3％,80.1 ％ respectively.The critical value of contrastenhanced ultrasound was between 3 and 4.The diagnosis accuracy,specificity and sensibility of contrastenhanced ultrasound were 88.9％,87.6％,90.4％ respectively.Area under ROC curve of the two methods were 0.901 and 0.910,the difference was not statistically significant.Conclusions Contrast-enhanced ultrasound 5-point scoring system was an initial quantitative criterion for breast tumor diagnosis.The diagnosis accuracy was parallel to that of elastography.

Objective　To determine the sensitivity and specificity of using the computer-photoscreener and non-cycloplegic retinoscopy in the detection of amblyopiogenic factors in nine to fifty months old infants.Methods　Three hundred children whose ages range from nine to fifty months were screened with the computer-photoscreener and non-cycloplegic retinoscopy. With a masked standardized clinical assessment as the standard, an overall comparison of the results obtained with the two techniques revealed a sensitivity and specificity. Photoscreen images on the computer monitor screen were reviewed and analyzed immediately by two independent observers for indicators of amblyopiogenic risk factors. Simultaneously, the results were compared to the findings of a full ophthalmologic examination.Results　The computer-photoscreener revealed a sensitivity of 94.2% and specificity of 90.1%, and the non-cycloplegic retinocopy revealed a sensitivity of 85.7% and specificity of 81.1% for the detection of amblyopiogenic risk factors, including hyperopia (+2.75 D or more), myopia (-1.50 D or more), astigmatism (2.00 D or more),anisometropia (2.00 D or more), ocular misalignment (5 degrees or more), and media opacity (1.5mm or more). Conclusion　The computer-photoscreener offers an opportunity to identify problems that limit vision, and could provide a feasible and sufficiently reliable screening technique in infants and preschool children who can be screened successfully for amblyopiogenic risk factors.

Objective To evaluate the diagnostic value of conventional ultrasound and ultrasonic elastography (UE) in differentiating benign and malignant hepatic lesions.Methods One hundred and forty-five patients with 159 hepatic tumors were included in the study.Conventional ultrasound scan and UE were performed on each patient.Pathological results were as the golden standard.The diagnostic performance of the 2 methods were evaluated with receiver operating characteristic (ROC) curves and the interobserver agreements were analysed.Results A better interobserver agreement was achieved in UE (κ =0.325 at conventional ultrasound versus κ =0.782 at UE).The area under ROC curve of conventional ultrasound,ultrasonic elastography and the combination of both methods were 0.76,0.77 and 0.87,respectively.After the combination of the 2 methods,the sensitivity and accuracy could be enhanced significantly ( P ＜0.05).Conclusions Conventional ultrasound combined with UE may be more helpful in differentiating malignant from benign hepatic tumors.

Objective To explore the value of improved elasticity scores in differentiating malignant and benign breast lesions. Methods A prospective study was done in 394 patients with 508 breast lesions confirmed by pathology and the elastographic images of the lesions were evaluated by using old and improved elasticity scores respectively. Results The elastographic images of the lesions could be evaluated and classified in all patients by improved elasticity scores but could not be evaluated and classified in 82 lesions by old elasticity scores. The accuracy of ultrasonic elastography for diagnosing benign and malignant breast lesions was 88.8% and 78.1%, respectively by old elasticity scores and improved elasticity scores. Conclusions The elastographic images of breast lesions were accurately evaluated by using improved elasticity scores, and the use of improved elasticity scores is helpful to reduce the biopsy which is not necessary.