Objective To study the influence of anesthetic effect,maternal and infant outcomes and safety of subarachnoid block used sulfentanyl combined with ropivacaine for patients with gestational hypertension in the cesarean section.Methods 180 cases of gestational hypertension ready to cesarean section were selected as study subjects,and they were randomly divided into A group,B group and C group by digital table method,60 cases in each group.A group used 10mg ropivacaine,B group used 13mg ropivacaine,C group used 5μg sulfentanyl combined with 10mg ropivacaine.The anesthetic effect,circulation function,duration of pain,operation time,neonatal Apgar score at 1 and 5 min after birth,neonatal weight,motor block evaluation after operation,adverse reaction and complication were compared in three groups.Results The anesthetic effect between B group and C group had no statistical difference (x2 =1.233,1.465,all P ＞ 0.05).The anesthetic effect of B group and C group was better than that of A group(F =5.633,7.299,all P ＜0.05).The HR and MAP of every time points between A group and C group had no statisticaldifferences (F =1.313,1.265,all P ＞ 0.05).Compared with T0,the HR and MAP of B group at T1,T2,T3,T4 had statistical differences compared with A group and C group(F =5.633,7.299,all P ＜0.05).The operation time of the three groups had no statistical difference(F =0.933,P ＞ 0.05).The duration of pain between B group and C group had no statistical difference(t =0.822,P ＞ 0.05).The duration of pain of A group was longer than that of B group and C group(F =8.316,P ＜0.05).The neonatal Apgar scores at 1 and 5 min after birth and neonatal weight of the three group had no statistical differences(F =0.822,0.929,all P ＞ 0.05).The improved Bromage score between A group and C group had no statistical difference (t =2.627,1.991,all P ＞ 0.05).The improved Bromage score between B group and A,C group had statistical differences(F =6.371,5.693,all P ＜ 0.05).The complete recovery time of motor nerve of B group was much longer than that of A group and C group (F =8.924,P ＜ 0.05).The incidence rates of vomit and nausea of A group and B group were much higher than that of C group(F =3.561,12.581,all P ＜ 0.05).The incidence rate of bradycardia and hypotension of B group was much higher than that of A group and C group (F =8.273,10.833,all P ＜ 0.05).Conclusion During subarachnoid block anaethesia using 5 μg sulfentanyl combined with l0mg ropivacaine can be applied to mild and moderate gestational hypertension,it has advantages such as less adverse reaction,good analgesic effect,less hemodynamic effect,and it is worthy of clinical promotion.

Objective To evaluate the diagnostic and differential diagnostic effects of ultrasound in testicular tumors and tumor-like lesions.Methods Ultrasound features of 33 cases of testicular masses were reviewed and the results were compared with pathological findings.Results For the 33 cases of testicular masses,12 cases were diagnosed as seminoma,6 cases as lymphoma,6 cases as epidermoid cyst,2 cases as mixed germ cell tumor,2 cases as teratoma,1 case as embryonal carcinoma,1 case as endodermal sinus tumor and 3 cases of the other tumor.Conclusions Ultrasound has important value in the diagnosis and differential diagnosis of testicular tumor and tumor-like lesions,and it can be considered first choice of clinical imaging examination.

Objective To evaluate the value of transrectal contrast enhanced ultrasound(TR-CEUS) in diagnosis of benign and malignant prostatic neoplasms.Methods Sixty patients with elevated level of serum prostate specific antigen and suspected prostate diseases were examined with transrectal uhrasound(TRUS), and TR-CEUS.The pattern and intensity of CEUS in these patients were observed;and the patients with nodules were examined with CEUS guided biopsy and sextant system biopsy after ultrasound imaging.Time-intensity curves (TIC) were drawn to calculate the parameters, and the difference between benign and malignant nodes was compared.Results All sixty prostate patients were confirmed by pathological examination.Thirty-seven patients belong to benign lesions, among them 15 patients with nodule lesion had total 20 nodules, while 22 cases had benign prostatic hyperplasia.In 23 cases of malignant lesions, 18 cases had centralized nodules and 5 cases showed diffuse pathologic changes.Benign nodes of inner gland showed a main pattern of homogenous enhancement and a clear node zone, whereas, malignant nodes displayed significant enhancement in peripheral tissue.The time to peak and accelerating time (ACT) of malignant nodes were shorter than those of benign nodes (P <0.05).There was no significance in arrival time (AT) between the two groups (P>0.05).The accordance rate of TR-CEUS in the differential diagnosis of benign and malignant prostatic lesions was higher than that of TRUS (P<0.05).In addition, the sensitivity, specificity and accurate rate of TR-CEUS were higher than those of TRUS, whereas, both misdiagnosis and missed diagnosis rate of TR-CEUS were lower than those of TRUS.Conclusions TR-CEUS has clinical value for early discovery of prostatic cancer and has higher application value to differentiate malignant from benign diseases.

Objective To evaluate diagnostic value of transrectal gray scale contrast enhanced ultrasound (CEUS) in distinguishing benign from malignant nodes of prostate. Methods Thirty-three patients with 38 prostate nodes underwent real-time transrectal gray scale CEUS with SonoVue and contrast pulsed sequence (CPS). Contrast enhancement pattern of the prostate nodes were recorded and time-intensity curves (TIC) were drawn to calculate the parameters and difference between benign and malignant nodes. Results Twenty benign nodes (17 in inner gland) and 18 malignant ones (14 in external gland) were confirmed by pathology. Compared with normal peripheral zone, malignant lesions showed significantly earlier time to enhancement. The time to peak (TTP), accelerating time (ACT) and peak intensity (PI) of malignant lesions were lower than those of benign lesions (P<0.05).There was no significance in arrival time (AT) between the two groups (P>0.05). Conclusion Of all parameters in CEUS, TTP, ACT and PI are different between prostate benign and malignant lesions, and thus contribute to discriminate prostate cancer from benign diseases.

Purpose To investigate the relationship between ultrasonic manifestations in prostate cancer (PCa) and Gleason score,and improve the clinical value of transrectal ultrasound (TRUS) examination of PCa.Materials and Methods 362 patients with PCa treated in the First Affiliated Hospital of Soochow University from September 2009 to January 2015 were analyzed retrospectively,according to TRUS examination,the ultrasonic manifestations of PCa were divided into the localized type,diffuse type and negative type.Gleason score of pathological tissue divided the risk factor of PCa into low risk (＜7 points),medium risk (=7 points),and high risk (＞7 points).The relationship between ultrasonic manifestations of PCa and risk factor was analyzed.Results Ultrasonic results showed that,for the 362 patients with PCa,patients with ultrasonic negative manifestations accounted for 32.9％ (119/362) and those with ultrasonic positive manifestations accounted for 67.1％ (243/362),including 38.7％ (140/362) localized type and 28.4％ (103/362) diffuse type.In localized and diffuse PCa,the number of patients in high risk group was significantly more than the low risk group,and the difference among the high risk,medium risk and low risk groups was statistically significant (P＜0.05);in the low risk group,the ultrasonic negative manifestations were more than the positive manifestations,and the difference was statistically significant (P＜0.05);in high risk group,the localized and diffuse manifestations were more than the negative manifestations and the difference was statistically significant (P＜0.05).Conclusion TRUS shows more clinical values in the diagnosis and treatment of PCa,and the ultrasonic positive manifestations can preliminarily evaluate the risk factor of PCa.