Objective To study the clinical effect of enalapril maleate and folic acid tablets in the treatment of H type hypertension, and to observe the blood homocysteine(Hcy), to provide the basis for clinical diagnosis and treatment.Methods 126 patients with H type hypertension were selected.They were divided into study group and control group according to the random number table method,63 cases in each group.The control group was given enalapril maleate, the study group was given enalapril maleate and folic acid tablets.The clinical efficacy of the two groups was compared.The systolic blood pressure, diastolic blood pressure and Hcy level before and after treatment in two groups were observed.Results The total effective rate of the study group was 90.5%(57/63),which of the control group was 74.6%(47/63),the difference was statistically significant(x2=15.371,P<0.05).There was no significant difference in systolic blood pressure and diastolic blood pressure before treatment between the two groups(P>0.05).The systolic pressure after treatment of the two groups were (129.3±5.7)mmHg and (137.9±4.9)mmHg, the diastolic blood pressure were (81.5±3.6)mmHg and (89.6±5.1)mmHg, the differences were statistically significant compared with before treatment(t=8.969,7.851,7.343,6.987,all P<0.05),the difference between the two groups was statistically significant(P<0.05).There was no significant difference in Hcy before treatment between the two groups(P>0.05), after treatment Hcy levels of the two groups were (8.93±0.63)μmol/L and (15.35±0.57)μmol/L respectively, the differences were statistically significant compared with before treatment(t=8.097,8.031,all P<0.05),the difference between the two groups was statistically significant(t=7.573,P<0.05).Conclusion Enalapril maleate and folic acid tablets in the treatment of H type hypertension has good clinical effect, can significantly lower blood pressure, improve Hcy level.

Objective To explore the value of transvaginal color doppler ultrasound(TVS) in the differential diagnosis of endom-etrial hyperplasia(EH) and endometrial cancer(EC) .Methods The clinical data concerning TVS in 48 patients with EH and 37 pa-tients with EC were reviewed retrospectively ,then we compared the ultrasonic diagnosis with the pathological diagnosis to observe the preoperative diagnostic accuracy of ultrasonic diagnosis .Results In 48 patients with EH ,the inspection results of 44 cases were accordant with the pathological diagnosis .The rest of 4 cases were misdiagnosed by TVS as EC before operation ,and the accurate rate is 91 .67% (44/48);In 37 patients with EC ,the checking results of 34 cases were consistent with the pathological diagnosis . The rest of 3 cases were misdiagnosed by TVS as endometrial atypical hyperplasia ,and the accurate rate is 91 .89% (34/37) .Con-clusion TVS has diagnostic significance in the differential diagnosis of EH and EC .

Objective To explore the clinical value of fetal syetem ultrasound union real-time three-dimensional ultrasound to diagnose the abnormalities of fetal palms and feet in medium-term pregnancy.Methods The results of fetal syetem ultrasound u-nion real-time three-dimensional ultrasound in 23 675 cases during dmedium-term pregnancy in our department from January 2009 to November 2013 were retrospectively analyzed,including 47 350 palms and feet.Results If using the fetal syetem ultrasound u-nion real-time three-dimensional ultrasound to examine fetal palms and feet more than three times,the display rate of palms and feet was 100.0%,while the first-time display rate of finger and toes was 81.2%,second-time display rate was 97.2% and the third-time and more display rate more thatn 99.8%.136 cases hand-foot deformity were diagnosed,including 37 cases of hand gesture abnor-malities,6 cases of finger abnormalities,93 cases of food abnormalities,and the main abnormality was strephexopodia.Of all the 136 cases,there were 2 cases also with Trisomy 18,4 cases with Trisomy 21.Conclusion Malformations of fetal palms and feet can be detected by fetal system ultrasound combined with real-time three-dimensional ultrasonography during the second trimester,which is important indicators of prenatal screening for chromosomal abnormalities.

Objective To explore the value of color doppler ultrasound in infants with hypothyroidism between 0 to 3 years old before and after treatment .Methods The normal infants ,whose thyroids were examined by two‐dimensional ultrasound and were used by color doppler ultrasound ,were used as control group .The clinically diagnosed infants with transient hyperthyroidism or permanent hyperthyroidism were used as experimental group .The thyroids were examined by multiple ultrasonography before and after the treatment respectively in different periods .The measured values of thyroids were compared each other .Results In in‐fants with transient hyperthyroidism ,the major ultrasonographic findings were atrophy of thyroids before the treatment .Most of these thyroids enlarged ,and a small part of them recovered after the treatment .In infants with permanent hyperthyroidism ,the pri‐mary finding was thyroid agenesis ,and followed by atrophied before the treatment .The thyroid agenesis exist in most cases and few cases recover with normal values after the treatment .Conclusion Color doppler ultrasound can indirectly reflect the thyroid devel‐opment situation in infants .Combined with the advantages of non traumatic and high repeatability ,it can be used as an important auxiliary examination method for clinical diagnosis of hypothyroidism in infants .

Objective To investigate the values of echocardiographic parameters for predicting the spontaneous closure of the ductus arteriosus in preterm infants .Methods A retrospective study of 110 preterm infants from October 2013 to October 2014 in our hospital was done .Examination was done at 1 ,3 ,7 d with echocardiography for those infants .Diameter of left atrium(LA) ,aotic root(AO) and arterial canal‐related parameters (the smallest width of ductal color Doppler flow jet and the maximum velocity at the ductus) at first .Preterm infants in this study were divided into two groups .The early patent ductus arterisus group included ones whoes ductus didn′t closed spontaneous in 7 d ,and the control group included ones whoes ductus closed spontaneous in 7 d ,and then the echocardiographic parameters between the two groups were compared .Results (1)The rates of ductus arteriosus sponta‐neous closure in preterm infants at 3 ,7 d were 70 .9% (78/110) ,78 .2% (86/110) ,respectivly .(2)When compared with the control group ,The rate of LA/AO in patent ductus arterisus group were higher than that of the control group(P<0 .01);The smallest width of ductal color Doppler flow jet in patent ductus arterisus group were bigger than that of the control group(P<0 .01);The maximum velocity at the ductus in patent ductus arterisus group were lower than that of the control group(P<0 .05) .(3)The best critical points of the LA/AO ,the smallest width of ductal color Doppler flow jet and the maximum velocity at the ductus of the spontaneous ductus arteriosus closure in preterm infants were 1 .32 mm ,2 .56 mm and 185 .5 cm/s ,respectivly .Conclusion Echo‐cardiography plays a significant role in prediction of the spontaneous closure of the ductus arteriosus in preterm infants .

Objective To analyze the diagnostic value of transvaginal three-dimensional ultrasound in intrauterine adhesion.Methods The data in 75 patients with intrauterine adhesion confirmed by hysteroscopy surgery and conducting transvaginal twodimensional and three-dimensional ultrasound examination in this hospital from November 2014 to November 2016 were retrospectively analyzed.Results The diagnostic accuracy rate of the three-dimensional transvaginal ultrasound for diagnosing intrauterine adhesion reached 87.7 ％,which of two-dimensional ultrasound reached 69.2 ％;the accuracy rates of transvaginal two-dimensional ultrasound for detecting mild,middle and severe intrauterine adhesion were 56.7％,76.9％ and 88.9％ respectively,while which of transvaginal three-dimensional ultrasound were 76.7 ％,96.2 ％ and 100.0 ％ respectively;the accuracy rates of transvaginal two-dimensional ultrasound for detecting peripheral,central and mixed intrauterine adhesion were 66.7％,76.7％ and 54.5％ respectively,while which of transvaginal three-dimensional ultrasound were 83.3％,88.7％ and 100.0％ respectively;the accuracy rate of three-dimensional transvaginal ultrasound was significantly superior to that of transvaginal two-dimensional ultrasound,the difference was statistically significant (P＜0.05).Conclusion Compared with transvaginal two-dimensional ultrasound,transvaginal three-dimensional ultrasound is more accuracy in diagnosing intrauterine adhesion and can provide more information for clinical doctors.

Objective To discuss the diagnostic value of HIT-antibodies in suspected HIT patients with heart diseases.Methods A single center study.We collected 242 blood samples of suspected HIT patients whose platelet count decreased after heparin application during July 1 st ,2012 to June 30th ,2016 in Wuhan Asia Heart Hospital and detected the concentration of HIT antibodies , meanwhile the 4T′s score were calculated.Among the study objects , there are 206 patients received cardiac surgery , 28 received cardiac interventional therapy and 8 received drug therapy.And we divided them into HIT group (44, median age 57.5, 23 females ) and non-HIT group ( 198, median age 63.5, 87 females ) according to clinical diagnosis.Quantitative data was analyzed by independent t-test or Mann-Whitney U test.Qualitative data was analyzed by Fisher′s exact test.We drew ROC curve according to the statistical analysis to determine the optimal threshold value of antibodies in diagnosis of HIT andsensitivity , specificity, negative likelihood ratio, positive likelihood ratio of the HIT antibody detection .Therefore, we can assess the value of HIT antibody detection in HIT clinical diagnosis and treatment .Moreover, we used the optimal threshold value of antibodies to testify the suspected HIT patients .Results The HIT antibody concentration of HIT group (44) and non-HIT group ( 198 ) are 3.2 ( 95% CI:1.8 -5.5 ) U/ml and 0.4 ( 95% CI:0.3 -0.4 ) U/ml, respectively.The concentration of HIT group is much higher than the non-HIT group(P<0.000).When the cut-off value of HIT-Ab is set at 0.9 U/ml, sensitivity and specificity are 93.2%and 91.9%, respectively. And negative likelihood ratio and positive likelihood ratio are 0.07 and 11.53, respectively.When the cut-off value of HIT-Ab is set at 0.6 U/ml, sensitivity and specificity are 100.0%and 73.7%.HIT-Ab and 4T′s score of ROC-AUC are 0.971 and 0.745, respectively.The diagnosis value of HIT-Ab in HIT is significantly higher than the 4T′s score ( P<0.000).Conclusions HIT antibody detection is a simple and effective auxiliary diagnostic method in HIT exclusion .And HIT antibody detection is more optimal than the 4T′s score in HIT diagnosis and treatment .

Objective To set up a living mice colonoscopy platform to establish an orthotopic model of colorectal cancer in mice under direct vision,and to observe its biological behavior such as metastasis.Methods Eighteen-week-old male C57/BL mice were anesthetized,and the intestinal lumen of the mice was examined by a self-developed living mice colonoscopy and Olympus URF-P5 ureteroscopy,respectively.The imaging effects of the two methods were compared.Human colon cancer HT-29 cells were injected into the colonic mucosa of BALB/c-nu mice under direct vision.The colonoscopy was performed on the 3rd,7th and 15th day after the injection to observe the tumor formation in the intestinal lumen.The mice were sacrificed when the body weight decreased significantly or cachexia appeared,and then the abdominal cavity was examined including the tumor formation and metastasis.Results The self-developed living mice colonoscopy platform can provide clear vision of enteric cavity,and no mice died in the colonoscopy examination.In vivo subcutaneous injection of HT-29 cells in mice was performed with a perforation rate of 15％,a mortality rate of 33.3％,a tumor formation rate of 62.5％,an abdominal metastasis rate of 60％,a liver metastasis rate of 25％,and an abdominal wall transfer rate of 25％.Conclusion The self-developed mice colonoscopy platform can be used for the study of colorectum in living mice.The imaging effect is no less than that of Olympus URF-P5 ureteroscopy.In addition,an orthotopic colorectal cancer model can be established by this platform combing with submucosal injection technology.

Objective To investigate the application value of ultrasound elastography and contrast enhanced magnetic resonance imaging (CEMRI) in assessing the effect of neoadjuvant chemotherapy (NAC) for T1-2 N1-2 M0 breast cancer.Methods Twenty-three cases of breast cancer operation and receiving preoperative NAC in Chongqing Municipal Tumor Institute from January 2015 to December 2016 were collected.They all underwent ultrasound elastography and CEMRI before the first time NAC and operation respectively.Results Based on the postoperative pathological response grading,the sensitivity and specificity of CEMRI for evaluating the NAC effect were 94.1 ％ and 83.3％ respectively,which of ultrasound elastography were 88.2％ and 83.3％ respectively.The two kinds of examination method showed medium consistency(Kappa values were 0.77 and 0.68 respectively).Conclusion Ultrasound elastography extends the ultrasound diagnostic basis,can more comprehensively display the lesion character and more effectively reflect the NAC effect.