Objective To explore the atypical ultrasonic appearances of breast fibroadenoma and analyze the cause of mis diagnosis.Methods A total of 493 lesions in 485 patients of breast fibroadenoma detected by ultrasound examination andconfirmed by pathology were retrospectively analyzed.Atypical appearances were analyzed and misdiagnosis rate were cal-culated.Statistical methods were taken to compare the misdiagnosis rates in lesions with various atypical appearances andthose with none or single atypical appearance.Misdiagnosis rates in lesions with different sizes and pathological types wereanalyzed statically.Then misdiagnosing causes were analyzed.Results A total of 404 lesions were diagnosed correctly,in-cluding 99 lesions with atypical appearances,and the other 89 lesions were misdiagnosed,which showed atypical appear-ances.The misdiagnosis rate of lesions with ≥2 atypical features was higher than that with none or single atypical feature(x2 =256.40,P＜ 0.05).Large lesions (maximum diameter＞ 3 am) showed higher misdiagnosis rates than small ones(maximum diameter ≤3 cm,x2=6.73,P＜0.05),and complex fibroadenoma lesions also showed higher misdiagnosisrate than simple ones (x2 =188.01,P＜0.05).Conclusion The lesions with various atypical appearances,large size andcomplex fibroadenoma in pathology are easy to be misdiagnosed.

Cytokinesis ; Micronucleus Tests

Objective To probe the characteristics of the ultrasonography of the intrahepatic duct cystic tumor(IDCT).Methods The ultrasonography of 12 patients with IDCT was analysed.The results were compared with the operation and pathology.Two of them were intraductal papillary adenomas,six were papillary adenocarcinomas,two were biliary cystadenomas and two were biliary cystadenocarcinomas.Results The ultrasonic diagnostic rate was 75%(9/12).The bile ducts of 10 cases(83%) were cystically dilated.Seven cases(58%) with thick walls of bile ducts were all malignant.Six tumors(50%) with intraluminal papillate echoes could be malignant or benign.The tremellose echoes were detected in 7 cases(58%) and the common bile ducts of six cases were obstructed by the tremellose substance.Conclusions It is the important diagnostic basis of IDCT that the bile ducts in some liver lobal or segment are dilated without reasons,with the thick bile duct wall and the poor ultrasound penetration,especially when the bile ducts are full of tremellose substance and the papillomas are detected in the ducts.It is of significance in the clinic to raise the early diagnostic rate of IDCT by ultrasound.

AIM:To set up a method for determining epimedin C and icariin in Xianling Guobao Capsules(Herba Epimedii,Radix et Rhizoma Salviae miltiorrhizae,Fructus Psoraleae,Radix Rehmanniae,etc.). METHODS:The chromatographic conditions included the column of Spherisorb C 18 (4.6 mm?250 mm,5 ?m),the mobile phase was acetonitrice and water as gradient eluent was at a flow rate of 1.0 mL/min,the detection wavelength was set at 270 nm and the column temperature was at 25 ℃. RESULTS:The linear range of epimedin C was 0.22-2.20 ?g and icariin was 0.04-0.40 ?g,respectively. The average recovery of epimedin C and icariin were 103.2% (RSD=3.1%) and 97.8% (RSD=3.2%),respectively. CONCLUSION:The method is reliable,stable and well reproducible,and can control the quality of Xianling Guobao Capsules.

Objective To probe the clinical diagnosis value of high frequency ultrasonography (HFUS) in thyroglossal duct cyst(TDC). Methods Forty-one TDC were taken HFUS and the location, boundary,shape,interal echo of lesions and the relation to hyoid bone were observed. The periphery and internal blood flow signal were detected by color Doppler flow imaging. The results of HFUS were compared with those of pathology after operation. The cases were divided into groups according to pathological types and were compared with acoustic image shows. Results All cases were diagnosed TDC by pathology after operation. Internal walls of 9 TDC consist of cilium columnar epithelium, 19 consist of stratified pavement epithelium and 13 consist of this two epitheliums. HFUS showed different pathological types had different ultrasonic appearances. In this study, 77.8%(7/9) TDC with columnar epithelium showed echoless,84.2 (16/19) TDC with pavement epithelium showed similar solid echopattern and TDC with two epitheliums mainly showed similar solid echopattern and multi-room cyst. Hyperechogenicity of hyoid bone displayed around the lesion in 80.5%(33/41)TDC. No blood flow signal showed in 41 TDC and a little punctiform blood flow signal showed in the periphery of 5 TDC. The diagnose accordance rate of HFUS in TDC was 95.1%(39/41). Conclusions HFUS can clearly show the location, boundary, shape,interal echo of TDC and its relation to hyoid bone. HFUS is important for diagnosis and differential diagnosis of TDC.

Objective To probe the differential diagnostic value of color Doppler ultrasonography(CDU)in cystitis glandularis.Methods Thirty-nine cystitis glandularis and 192 bladder cancer were examined with CDU.The location,shape,boundary,internal echo and relationship with wall of urinary bladder of lesion were observed.Internal blood flow disposition of lesion were detection.The results of CDU were compared with those of cistoscope biopsy and pathologic diagnosis after operation.Results 59.0%(23/39)cystitis glandularis and 52.9%(74/140)bladder cancer lesions located in trigone of bladder and surrounded the orifice of ureter.53.8%(21/39)cystitis glandularis showed part wall thickening and 72.9%(140/192)bladder cancer showed single nodus or bolus.Sacculiform anechoic area were observed in 69.2%(27/39)cystitis glandularis and were not observed in bladder cancer.Punctiform hyperechogenicity appeared in periphery of 48.4%(93/192)bladder cancer and 7.7%(3/39)cystitis glandularis.The detection rate of interior blood flow signal of bladder cancer was 84.9%(163/1 92),which was obviously higher than that of cystitis glandularis.The diagnostic accurate rates of CDU in cystitis glandularis and bladder cancer were 84.6%(33/39)and 95.3%(183/192),respectively.Conclusions CDU can clear display the location,shape,boundary,internal echo and relationship with wall of urinary bladder of cystitis glandularis and is of important value in diagnosis,differential diagnosis and clinical fllow-up of cystitis glandularis.

Objective To establish normal range of components of cord blood cells in healthy fetuses from 19 to 37 weeks' gestation and to provide proof for diagnosis of hematological disorders in prenatal fetuses and premature infants.Methods Twelve hematological parameters were determined in 182 fetuses using Coulter GENS system 2 full automated blood cell counter,and the blood cells were classified by microscope.Results The number of white blood cell(WBC) was increased gradually from 3.58?10~9/L to 5.76?10~9/L with the gestational weeks increasing from 19 to 37 weeks.The differential counts indicated that the lymphocytes represented the main population.The number of lymphocytes and normoblast was decreased gradually and that of neutrophils was increased gradually.The numbers of monocytes,eosinophils and basophils remained stable as the increasing of gestational weeks.The red blood cell(RBC),hemoglobin(HGB) and hematocrit(HCT) were increased gradually but mean corpuscular volume(MCV) was decreased.The differences between mean corpuscular hemoglobin(MCH),platelet volume distribution width(PDW),mean platelet volume(MPV),plateletcrit(PCT) and mean corpuscular hemoglobin concentration(MCHC) were not significant among different fetuses' ages.Conclusion The components of cord blood cells in healthy fetuses are dynamic and the establishment normal range of components of cord blood cells in healthy fetuses is helpful to diagnose the disorders in prenatal fetuses and premature infants.

ObjectiveTo probe the value of transrectum ultrasound (TRUS) in evaluating the effect of new adjuvant therapy (NAT) in treating middle-low level rectal cancer (MLLRC).MethodsTRUS was used to examine 82 cases of MLLRC before and after NAT.All cases were pathologically confirmed.The results of TRUS before and after NAT were compared.ResultsThe diagnostic rate of TRUS in MLLRC was 97.6％(80/82).The up to down range and thickness of foci of 80 cases which were detected by TRUS before NAT showed different degree diminution after NAT( P ＜0.05).The number of lymph node around rectum decreased obviously ( P ＜0.05).Only the lymph nodes of 5 cases of all lymph nodes detected by TRUS before and after NAT showed dot flow signal.ConclusionsTRUS can clearly showed the MLLRC foci,internal flow signal and lymph nodes around rectum.This is of important value in evaluating the effect of NAT,choosing the therapeutic schedule and avoiding over therapy.

Objective To investigate the sonographic features of follicular variant of papillary thyroid carcinoma (FV-PTC) and to decrease misdiagnosis rate. Methods Thirty-one patients with 35 FV-PTCs and 66 patients with 75 conventional PTCs (C-PTCs) were enrolled in this study. The sonographic features were reviewed retrospectively between the two groups with universally accepted standards. Results The sonographic features of 35 FV-PTCs included irregular shapes (6/35), anteroposterior to transverse diameter ratio A/T > 1 (7/35), spiculated margins (25/35), marked hypoechogenicity (0/35), hypoechogenicity (18/35), isoechogenicity (16/35), no calcification (15/35), microcalcifications (11/35), macrocalcification (9/35), color Doppler lfow patternⅠ(20/35), color Doppler lfow patternⅡ(10/35), color Doppler lfow patternⅢ(5/35). Irregular shapes, A/T>1, spiculated margins, marked hypoechogenicity, microcalciifcations, and color type Ⅱ were rarer in FV-PTCs than in C-PTCs, while isoechogenicity, no calciifcation, macrocalciifcation, and color type Ⅲwere more frequent in FV-PTCs than in C-PTCs. The differences of the above features were statistically significant [χ2=4.276, P=0.039; χ2=8.125, P=0.004; P=0.009 (Fisher′ s exact test); χ2=8.548, P=0.003;χ2=4.898, P=0.027,χ2=7.796, P=0.005;χ2=5.462, P=0.019;P=0.001 (Fisher′s exact test)] . During the preoperative ultrasonography, 20 of 35 FV-PTCs were diagnosed as malignancy, and others were misdiagnosed as benign nodules (misdiagnosis rate was 43%). The lymphatic metastasis rate of FV-PTCs was 29%(9/31), significantly lower than C-PTCs [62%(41/66),χ2=9.246, P=0.002]. In terms of the sonographic features of metastatic lymph nodes, there was no marked difference between FV-PTCs and C-PTCs. Conclusions Some FV-PTCs are lack of malignant features, and tend to be misdiagnosed frequently when coexisting with benign thyroid nodules. Observing the echogenicity, color lfow characteristics and other features of each thyroid nodule and cervical lymph node with multiple views may decrease the misdiagnosis rate.

Objective To explore the diagnostic sensitivity and specificity of echocardiography parameters ,and the diagnostic value of multiple parameters score . Methods Forty‐nine cases of the fetus checked by fetal echocardiography and were indicated aortic coarctation . According to the results of follow‐up ,the cases were divided into the positive and negative groups . Comprehensive analysis were performed in fetal echocardiography parameters ,such as diameter ratio and velocity ratio of ventricle ,aorta ,pulmonary artery ,ductus artery ,middle cerebral artery and umbilical artery . Results Diameter ratio of left ventricle/right ventricle ( LV/RV ) ,pulmonary artery/aorta ( PA/AO ) ,aortic isthmus/ductus artery ( AI/DA ) ,and velocity ratioof middle cerebral artery/inner umbilical artery ( MCA/inUA ) were calculated ,ROC curve showed their area under ROC were>0 .5 with a significant statistical significance ( P < 0 .05) . The Chi‐square test showed that the consistency of any single ratio was relatively low . When the number of the ratiois increased to 3-4 ,the Kappa value was 0 .687( P = 0 .000) and 0 .649( P = 0 .000) ,respectively , which had relatively high diagnostic value . Conclusions Ultrasonic diagnosis of fetal coarctation of aorta has certain difficulty ,and the value of single hemodynamic parameter of fetal echocardiography in diagnosis of fetal aortic coarctation is lower ,so that the comprehensive evaluation and combined multiple ultrasonic parameters can improve the sensitivity and specificity of ultrasound diagnosis .