Objective To evaluate the application of ultrasound elastography (UE) 5-point scores and ratio of traced area in diagnosis of breast diseases. Methods One hundred and thirty foure patients with 178 lesions were examined with UE. And 5-point scores were applied at first, and then the area ratios were calculated. The receiver operating characteristic (ROC) curve was established to evaluate diagnostic value. The histology results were used as the golden standard. The optimal cut-off point was calculated. Results The sensitivity, speciifcity and accuracy of 5-point scores (score≥4) were 78.8%, 93.8%and 91.0%respectively. The sensitivity, speciifcity and accuracy of ratio of traced area were 75.8%, 95.8%, 92.1%respectively. There was no signiifcant difference between these two diagnostic methods (Ρ>0.05). The cut-off of ratio of traced area was 1.45. When combining these two methods, the sensitivity, speciifcity and accuracy were 90.9%, 98.6%, 97.2%respectively. The accuracy was signiifcantly improved (Ρ<0.05). Conclusions The ratio of traced area and 5-point scores were both valuable diagnostic approaches. The combination of the two methods can improve the accuracy of diagnosis.

Objective To explore the ultrasonographic features of fetal gastrointestinal tract dilatation and associated abnormalities. Methods From July 2009 to June 2013, 118 cases of fetal bowel dilatation of detected by prenatal ultrasound in our hospital were followed up for their ultrasonographic changes and pregnancy outcomes. The features of fetal bowel dilatation with associated abnormalities and their impact on pregnancy outcomes were summarized. Results Among the 118 cases of fetuses, 101 cases had small bowel dilatation, including 4 cases with adverse pregnancy outcomes. One case had cleft lip and palate and was aborted during 25th week of pregnancy. The other 3 cases had continuous excess of amniotic lfuid and progressive widening of bowel, the average inner diameter of which was above 30.0 mm. In the 3 cases, 2 cases ended with intrauterine death during 34th week of pregnancy and 1 case ended with death at one week after birth. Among the 97 cases of pregnant women with good pregnancy outcomes, 66 cases (66/97) were solitary bowel dilatation, while the remaining 31 cases (31/97) were associated with abnormal soft markers, e.g., excess or decrease of amniotic lfuid, fetal echogenic bowel, fetal uronephrosis, short femur, single umbilical artery, fetal widened lateral ventricles and placenta overripe, etc. Among the 17 cases of colonic dilatation, 1 case had exessive amniotic lfuid and“double-leaf sign”clumps in abdomen during the second trimester and was proved to be anal atresia post partum, while the remaining 16 cases had the colonic dilatation which were found after 34th week of pregnancy and the widest inner diameter of colon was less than 30.0 mm associated with abnormal soft markers like excess or decrease of amniotic lfuid and fetal echogenic bowel, etc., and associated with good pregnancy outcomes. Conclusions Most fetuses with mild to moderate bowel dilatation had favorable outcomes. During ultrasonic examination, the degree and dynamic change of bowel dilatation shall be observed. If bowel dilatation or increment of amniotic fluid continues or worsens, greater risk of poor prognosis is indicated. The larger inner diameter of the small bowel, the greater risk of poor prognosis. If the fetus with bowel dilatation had echogenic bowel before, the risk of intestinal obstruction is comparatively lower. For the fetus suspected for colonic obstruction and anal atresia, it is more meaningful to observe the intestinal morphology and its changes.

Marine Glycosphingolipids(GSLs) compounds mainly come from marine ogranisms of marine sponge and starfish. The advances of study on GSLs compounds in recent two decades were reviewed. The relationship between chemical structure and biological functions of GSLs compounds was also described.

Objective To summarize the echocardiographic characteristics and clinical signiifcance of prenatal diagnosis of coronary artery ifstula (CAF). Methods Images and follow-up results of ifve fetuses with CAF diagnosed by fetal echocardiography between January, 2011 and December, 2012 in our department were reviewed. Results Echocardiographic characteristics of CAF were a dilated coronary artery in the four chamber view and the left ventricular outlfow tract view. Track the course of the dilated coronary artery can conifrm the oriifce of the ifstula. Among the ifve cases, the oriifce of the ifstula included the aortic root of left ventricular outlfow tract, right atrium side of interatrial septum, the entrance of superior vena cava to right atrium, right ventricular apex and right ventricle cone. The colour Doppler lfow imaging showed turbulence in the dilated coronary artery. The spectral Doppler with the sampling gate in coronary artery showed the characteristic bidirectional lfow pattern. One case was associated with other complex intracardiac abnormalities and one case with persistent left superior vena cava. Among the ifve cases of CAF diagnosed by fetal echocardiography, one case was missed and four cases were conifrmed by postnatal echocardiography. Conclusion Coronary artery ifstula has special fetal echocardiographic characteristics. The fetal echocardiography plays an important role in early detection, diagnosis and treatment of CAF.

Objective To evaluate the fallopian tube patency with transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) in diagnosis of infertility.Methods Taking laparoscopy and dye test as the reference standard,a total of 126 infertile women underwent both transvaginal real-time 3D-HyCoSy with SonoVue and laparoscopy.Bilateral fallopian tubes were dynamic observed.Results Transvaginal real-time 3D-HyCoSy showed that in clinical suspected infertility patients,125 fallopian tubes were patent,81 fallopian tubes were narrow and circuitous,and 37 fallopian tubes were obstructed.Among all the patients,60 cases (115 fallopian tubes) underwent laparoscopy with chromopertubation.The results showed that 10 fallopian tubes were patent,73 fallopian tubes were narrow and circuitous,and 32 fallopian tubes were obstructed.Taking laparoscopy and dye test as the reference standard,107 fallopian tubes of the 60 cases were diagnosed correctly,and the coincidence rate of 3D-HyCoSy and laparoscopy and dye test was 93.0％ (107/115).Taking laparoscopy and dye test as the gold standard,the accuracyof transvaginal real-time 3D-HyCoSy in diagnosis of fallopian tubes patency or obstruction was 93.0％(107/115),the sensitivity was 94.3％ (99/105),the specificity was 80.0％ (8/10).Conclusions Tansvaginalreal-time 3D-HyCoSy can provide dynamic,real-time and three-dimensional display of the fallopian tubes.Itcan get more accurate diagnostic information,so it's an important method.3D-HyCoSy is a safe and non-invasivemethod,so it plays an important clinical role in the screening,diagnosis and treatment of gynecological diseases.

Objective To evaluate the role of fetal brainstem-vermis (BV) and brainstem-tentorium (BT) angles in differential diagnosis of fetal cereballar vermis anomalies by three-dimensional ultrasonography. Methods A total of 335 normally developed fetuses at 18-34 gestational weeks were examined prospectively in Prenatal Ultrasound Center of Suzhou Municipal Hospital from July 2013 to July 2014 by three-dimensional ultrasonography scanning. The BV angles and BT angles were measured at the mid-sagittal sections of fetal heads which were obtained by three-dimensional ultrasonography. Sixteen fetuses with abnormal cerebellar vermis were selected. The BV angles and BT angles were measured and compared with the measurements of normal group. Results In normal fetuses, the mean of BV angles was (3.3±1.7)° , ranging from1.0 to 10.0°;the mean BT angle was (31.5±6.9)° , and ranging from 16.6 to 57.8° . In 16 cases of abnormal cerebellar vermis, 4 cases of Dandy-Walker Malformation (DWM) showed significantly upward rotated cerebellar vermises, the BV angles increased significantly (88.9±18.1)° , the cerebellar tentoriums were superior displaced, the BT angles increased remarkably (89.0±12.8) ° ;6 cases of Dandy-Walker variant (DWV) showed upward rotated cerebellar vermises, with increased BV angles (23.7±5.2) ° , and slightly increased BT angles (54.5±12.0)°;6 cases of Blake′s pouch cyst (BPC) showed upward rotated cerebellar vermises were, mildly increased BV angles (16.7±1.8)° , and slightly increased BT angles (50.3±8.2)° . The comparison results showed:BV angles increased with increasing severity of the condition in BPC, DWV and DWM;BT angles increased significantly in DWM. Conclusions The measurements of BV angles and BT angles are valuable in the differential diagnosis of fetal cereballar vermis anomalies. From 19 gestational weeks, a BV angle>60° is strongly suggestive of a Dandy-Walker malformation, while a measurement>10.0° and<20° favors the diagnosis of Blake′s pouch cyst.

Five compounds were isolated from the ethyl acetate extract of the marine sponge Cin-achyrella australiansis collected from the South China Sea. Their structures were identified by IR,1 H-NMR,13C-NMR,MS as the follows : 24-ethyl-cholest-4-en-3-one(Ⅰ), cholesterol (Ⅱ), benzene- ac-etamide(Ⅲ), p-hydroxyphenylacetamide(Ⅳ), indole-3-acetamide(Ⅴ).

Objective To investigate the echocardiographic features and clinical significance of prenatal diagnosis of fetal double aortic arch (DAA). Methods Totally 21 596 fetuses underwent fetal echocardiography in Nanjing Medical University Afifliated Suzhou Hospital and ifve cases were diagnosed as DAA by echocardiography. Echocardiographic characteristics, types and outcomes of these ifve cases were summarized retrospectively. Results Five fetal cases were diagnosed as DAA by fetal echocardiography. 1. Prenatal echocardiographic features:In three-vessel and trachea view, the normal“V”-shaped conlfuence formed by the aortic arch and ductal arch was absent. However, the ascending aorta bifurcated into the left and right aortic arch and these two arches encircled the trachea. Annular lfow signal around trachea was seen on color Doppler imaging. 2. Types:Among these ifve fetuses, three cases were called right arch predominant type, whose diameters of right arches were larger than those of left arches. The other two were balanced type, whose diameters of right arches were almost equal to those of left arches. 3. Accompanied malformations:Case 2 was accompanied with membranous ventricular septal defect and permanent left superior vena cava. Case 4 was associated by hemivertebrae. The other three cases had no other abnormalities. 4. Follow-up:These five cases were all arranged for MRI subsequently and all were confirmed by follow-up till to the induction of labor or three months after birth. Conclusions Double aortic arch is a kind of severe congenital heart disease. Echocardiography is the ifrst choice to diagnose DAA prenatally and three-vessel and trachea view are the effective cross sections in the diagnosis of double aortic arch.

Objective To explore the relationship between fetal heart size and gestational weeks (GW). Methods The size of left atrium (LA), right atrium (RA), left ventricle (LV), right ventricle (RV), aorta (AO), pulmonary artery (PA), foramen ovale (FO), heart area (HA), thoracic area (TA), heart circumference (HC) and thoracic circumference (TC) were measured for 512 fetal hearts at 14-39 GW. The relationship between GW and the measurement was evaluated. Results The size of fetal heart chambers, AO, PA and ventricular septum (IVS) increased with the development of GW. The PA/AO, LA/RA, LV/RV, HC/TC and HA/TA were stable compared with different GW. Conclusion Fetal heart chambers increase with the development of GW. HA is correlated well with GW.

Objective To explore the diagnostic value of ultrasonography of fetal congenital cystic adenomatoid malformation of the lung (CCAM), and to predict the prognosis according to ultrasonographic findings. Methods The chest of 19 fetus with CCAM was multi-sectionally scanned with two-dimensional ultrasonography. The position, appearance and size of mass were observed, and complications were continuously followed. Results CCAM was pathologically confirmed in 13 fetus after induced abortion. One neonatal died, while CCAM in other 5 fetus disappeared before 36 weeks. The mass of typeⅠCCAM became smaller and smaller, and eventually disappeared. The echo-free spaces in typeⅡbecame smaller and fewer, and the strong echo weakened to the same level as normal lung. For type Ⅲ, the echo of solid mass weakened to the same level as normal lung, or transformed to typeⅡ gradually, and finally recovered to normal echo of lung as the gestational age increased. During follow up, there were 10 fetus (10/19, 52.63%) that lung adenoma cyst increased with the gestational age increased, and the heart, mediastinal shifted, pleural effusion, and (or) fetal edema were observed. Conclusion Ultrasound examination is a reliable method for the diagnosis of CCAM, and enable to predict the prognosis of the affected fetuses. If heart and mediustinum displacement, pleural effusion, hydrops fetal or other abnormalities exist, it's necessary to terminate the pregnancy.