Objective To evaluate the value of dual‐Doppler imaging technology (referred to as dual‐Doppler modality for short) in assessing left ventricular diastolic function in patients with atrial fibrillation (AF) and normal left ventricular ejection fraction (LVEF) .Methods A total of 40 patients with AF and normal LVEF were enrolled as the AF group ,and 40 healthy volunteers were composed of the control group .①Peak early diastolic transmitral flow velocity (E) and tissue Doppler lateral (L ) mitral annular early diastolic velocity (e′) were measured simultaneously in the particular cardiac cycle by dual‐Doppler modality .②Peak early diastolic transmitral flow velocity (E) and tissue Doppler septal (S) mitral annular early diastolic velocity (e′) were measured simultaneously in the particular cardiac cycle .③ Peak early diastolic transmitral flow velocity (E) and color M‐mode Doppler flow propagation velocity (Vp) were measured simultaneously in the particular cardiac cycle .Then E/e′(L) ,E/e′(S) and E/Vp were calculated , respectively .Results Compared to the control group ,E/e′(L) ,E/e′(S)and E/Vp were all higher in AF group ( P <0 0.5) .Bland‐Altman showed that E/e′(L) ,E/e′(S)and E/Vp measured by the dual‐Doppler modality had better reproducibility and higher intraclass correlation coefficient (ICC) than the conventional Doppler modality .Conclusions The dual‐Doppler modality is valuable for evaluating left ventricular diastolic function in patients with AF and has better reproducibility and more accurate results than the conventional Doppler modality .

Objective To assess the enhancement characteristic of breast lesions of contrast-enhanced ultrasound (CEUS) in comparison with contrast-enhanced magnetic resonance imaging (MRI).Methods Between August 2011 and March 2013,72 women with 72 lesions were enrolled.All patients underwent ultrasound,CEUS and MRI.The histopathologic results obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard.CEUS section evaluations were made similar with MRI regarding the size and shape of lesions.Different contrast enhancement patterns including homogeneous/heterogeneous,the tumor areas,the perfusion defect areas,and modality of time-intensity curve were evaluated.Pearson's correlation coefficient,Student's t-tests,and the concordance test were used for evaluation.Results Of the 72 lesions,pathologic examination revealed 56 (77.8％) malignant lesions and 16 (22.2％) benign lesions.The tumor areas measured by CEUS and MRI agreed well,with a correlation of r =0.894,P =0.000.The difference between the two measurements was not significant according to a paired t test (P =0.886).The concordance tests gave a value of the coefficient Kappa =-0.153 (P =0.061),indicating a low concordance between the results obtained with CEUS and those obtained with MRI regarding the enhanced uniformity.There were statistically significant differences in the perfusion defect areas as measured by CEUS and MRI (P =0.01).The CEUS estimates [(0.837 ± 0.827)cm2] were consistently higher than the MRI estimates [(0.576 ± 0.524)cm2].The time-intensity curve patterns between the two groups showed no correlation.Conclusions The enhancement patterns evaluated by CEUS and MRI partly agreed well.There was no direct association between the two methods regarding the enhancement patterns because of the different contrast agent.

Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in patients with uremia.Methods Forty patients with uremia and forty healthy volunteers were enrolled.The quantitative parameters,including vorticity,sum total energy loss (sEL),average energy loss(aEL),and the alteration circulation were measured in the VFM imaging mode.Difference was evaluated between two groups at apical,mid and basal segments at different periods.E/e'was derived via dual-Doppler imaging technology.And correlationship was analyzed between vorticity,sEL,aEL,circulation and E/e',separately.Results ①At apex segment of isovolumetric relaxation time and at three segments of atrial systole,there were difference in vorticity,sEL,aEL between two groups (P ＜0.05).Circulation in rapid filling phase of anterior mitral valve and slow filling phase of posterior mitral valve were different[(15.94 ± 8.40) m2/s vs (8.36 ± 7.84) m2/s,(5.34 ± 5.24) m2/s vs (13.37 ± 10.42) m2/s,P ＜0.05].②In control group,vorticity,sEL and aEL were different in different segments of same phase or at different phases of same segment,and also did in the uremia group(P ＜0.01).③In uremia group,vorticity had a good correlation with E/e'at basal segment of rapid filling phase(r =0.34,P =0.046)and atrial systole(r =0.38,P =0.02).And sEL had a good correlation with E/e'at basal segment of rapid filling phase,isovolumetric relaxation time and at mid segment of rapid filling phase(r1 =0.44,P1 =0.008;r2 =0.48,P2 =0.003;r3 =0.50,P3 =0.002),and in time phase mentioned above,there were also the correlationship between aEL and E/e'(r1 =0.39,P1 =0.017;r2 =0.49,P2 =0.002;r3 =0.48,P3 =0.003).Conclusions VFM can be utilized to analyze left ventricular hemodynamics features of uremia patients and it may be a good supplement for assessing cardiac diastolic function.

Objective To estimate the value of neck circumference in diagnosis of metabolic syndrome. Methods We analyzed the neck circumference of 523 volunteers and the occurrence of metabolic syndrome among them. Then we updated and revalued their data after follow-up for 1.5 years, meanwhile, we evaulated the value of Body Mass Index (BMI) and neck circumference in predicting metabolic syndrome. Results The increase of neck circumference was closely related to the occurrence of metabolic syndrome , and this tendency continued in the follow-up. Compared with BMI , neck circumference was sensitive in identifying the patients of metabolic syndrome. Conclusion Neck circumference has great value in diagnosis and treatment of metabolic syndrome.

Objective To explore the clinical value of wave intensity(WI) curve of the carotid artery in patients with thyroid diseases and its value in evaluating cardiovascular function. Methods All 85 patients with thyroid diseases,including 45 hyperthyroidism and 40 hypothyroidism, were enrolled as case groups,while 270 healthy volunteers were considered as control. All the case groups and control were taken WI test under quiescent condition,and six continuous curves of the carotid artery diameter changes were recorded.Then the parameters of accelerating wave intensity (W1), decelerating wave intensity ( W2), negative area (NA) ,corrected R-W1 and W1-W2,elasticity modulus(Eρ) ,stiffness index(β) ,arterial compliance(AC) and pluse wave velocity(PWV) were calculated. Relationship between those indices and FT3 ,FT4 and TSH were analyzed by Pearson correlative analysis. Results The WI curve appeared differently among different groups,but the vessel elasticity indices did not have statistical significance. Correlation only existed between FT3 and part of the WI parameters. FT3 positively correlated with W1 ( r = 0. 951, P ＜0.01 ), NA( r =0.813, P ＜0.01) and W1-W2' ( r = 0. 887, P ＜0.01 ). And R-W1 ' negatively correlated with FT3( r =-0.878, P ＜0.01 ). Conclusions The WI curve could represent different function status of thyroid,and could be considered as a noninvasive examination for further clinical research,which may help explain the corresponding cardiovascular changes.

Objective To investigate the efficacy of standardized protocol,including prenatal diagnosis,perinatal management and treatment,on babies with meconium peritonitis.Methods A standardized protocol with prenatal diagnosis,perinatal management,treatment and follow-up on congenital anomaly was founded by Capital Institute of Pediatrics and several other obstetric hospitals.Thirty neonates diagnosed as meconium peritonitis prenatally from March 15,2006 to August 27,2012 were intervened according to this protoccl.The data of diagnosis,treatment after birth and prognosis were analyzed.Results (1) Prenatal diagnosis:Abnormal meconium peritonitis relative signs were found by ultrasound in all of these 30 cases.Among them,23 cases presented with intestine dilation,15 with polyhydromnios,nine with ascites,four with abdominal cystic mass and four calcification.(2)Diagnosis after birth (n=27):The most common imaging findings in abdominal X-ray were distention (27 cases),dilated intestine with air-fluid levels (22 cases) and calcification (11 cases).The most common imaging findings in ultrasound were obvious intestinal dilation (19 cases),cystic mass (7 cases) and calcification (7 cases).(3) Operation:Except for three cases without symptoms,the other 27 infants received operation at averagely 42 hours after birth (12 h-5 d).Besides the basic treatment as removal of the fuci and dissection of adhesion,peritoneal drainage was performed in one infant,two-stoma enterostomy in seven infants,inverted T-shape enterostomy in eight infants and primary intestinal anastomosis in 11 infants.Among these 27 cases,24 cases were cured,2 cases refused following treatment after surgery and one case was lost to follow up.Conclusions Standardized protocol with prenatal diagnosis,perinatal management and earlier intervention might improve the prognosis of meconium peritonitis.

Objective To investigate two-dimensional color Doppler commissure real-time shear wave elastrography (SWE) examination and its application value in the diagnosis of breast diseases.Methods One hundred and thirty patients (158 breast lesions) confirmed with breast disease were chosen from September 2013 to September 2014,and all patients underwent two-dimensional color Doppler ultrasound and SWE examination.The receiver operating characteristic (ROC) curve was examined to obtain maximum elasticity modulus value,average elastic modulus value and the corresponding critical value for the diagnosis of benign and malignant breast lesions.According to the results of pathological examination,sensitivity,specificity and accuracy of two-dimensional ultrasound and SWE for the diagnosis of breast lesions were evaluated and compared.Results Of all 158 breast lesions in 130 patients,90 were malignant lesions and 68 were benign lesions.The sensitivities of two-dimensional ultrasound and SWE in diagnosis of breast cancer were 89.7％ and 89.5％,the specificities were 85.6％ and 95.3％ and the accuracy were 87.3％ and 91.4％,respectively.The sensitivity,specificity and accuracy in the diagnosis of breast cancer by combination of two-dimensional ultrasound and SWE were 98.5％,93.3％,95.6％,respectively.Conclusions Although two-dimensional color Doppler ultrasound is a commonly used method in the diagnosis of breast lesions,it has certain limitation.The specificity of diagnosis can be improved by SWE,which is a useful complement to traditional two-dimensional ultrasound technology.Combination of the two methods can significantly increase the sensitivity and accuracy of the diagnosis and provide a reliable basis for the differential diagnosis,reduce the rate of misdiagnosis,missed diagnosis and unnecessary biopsy,which has important clinical application value.

Objective To verify and valuate the performance of small dense low-density lipoprotein cholesterol (sdLDL-C) detection by the direct clearance method and evaluate its preliminary clinical application in acute coronary syndrome (ACS).Methods Case control study:The performance (accuracy,precision,linearity) of sdLDL-C was assessed by direct clearance method.In 143 cases of ACS patients selected from Cardiology Department and Emergency Department of Shangdong Provincial Hospital from April to October in 2016,with 100 cases male,female 43 cases,including acute myocardial infarction (AMI)group of 59 cases,unstable angina pectoris (UAP) group of 84 cases;83 cases of healthy volunteers as a control group selected from health physical examination center of Shandong Provincial Hospital,with 59cases male,female 24 cases.Levels of sdLDL-C,total cholesterol (TCH),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),apolipoprotein A (ApoA I),apolipoprotein B (ApoB),lipoprotein (a) (Lpa) and high sensitive C-reactive protein (Hs-CRP) were detected separately by automatic biochemical analyzer.Non high density lipoprotein cholesterol (non-HDL-C) equals TCH minus HDL-C.x2 test,t test,one-way ANOVA,Pearson correlation and multiple linear regression analysis were used as statistical methods.Results The within-lot or between-lot variation was 2.85％ and 3.36％.Methodological comparison:regression equation Y =0.984X + 0.018,r2 =0.966,t =-0.191,P =0.850.There was a good linear correlation (Y =1.026X + 0.007,r2 =0.999) between theoretical values and actual detection results in range of 0.15-2.65 mmol/L.SdLDL-C concentrations were positive correlated with TCH,non-HDL,LDL-C,TG,ApoB (r =0.758,0.848,0.839,0.514,0.885,respectively,P ＜0.01),and negative correlated with HDL-C (r =-0.224,P =0.001),but no correlation with APOA I,Lpa and Hs-CRP(r =-0.021,0.050,0.003,respectively,P ＞ 0.05).Multiple linear regression analysis showed that the factors influencing sdLDL-C level were HDL-C,ApoB,LDL-C and TG.The levels of sdLDL-C,TG in the ACS group were significantly higher than those in the control group (t =3.415,4.660,respectively,P ＜ 0.01),but no difference between the two groups in the levels of TCH,non-HDL-C and LDL-C (t=-1.831,-0.452,-1.398,respectively,P ＞0.05).Comparing AMI group with control group,sdLDL-C,TG and Hs-CRP were significantly higher than the control group (P =0.000,0.000,0.000,respectively),but TCH,LDL-C and non-HDL were similar between the two groups (P =0.800,0.320,0.120,respectively);Comparing UAP group with control group,TG and Hs-CRP were higher than control group (P =0.001,0.047,respectively),TCH and LDL-C were significantly lower than the control group (P =0.003,0.008,respectively),but sdLDL-C had no difference (P =0.305);Comparing AMI group with UAP group,sdLDL-C,TCH,LDL-C and Hs-CRP were significantly higher than UAP group (P =0.000,0.003,0.001,0.000,respectively),and TG were no statistical significance (P =0.473).Conclusions Direct clearance method can meet the requirement of sdLDL-C detection.sdLDL-C level can assess the metabolism of blood lipids and be used as an independent risk factor and predictive index of ACS,superior to LDL-C.

Objective To evaluate the clinical effects of combined therapy of Fuyuan Huoxue decoction and transcatheter hepatic arterial chemoembolization in the treatment of primary hepatic carcinoma. Methods 80 patients with primary hepatic carcinoma were randomly divided into a control group, treated by transcatheter hepatic arterial chemoembolization, and a treatment group, additionally treated by Fuyuan Huoxue decoction on the basis of the control group. By observing the change of gross tumor volume、tumor markers、clinical symptoms、Karnofsky Performance Status(KPS) score、quality of life and so on,compare the clinical effects and quality of life between the two groups. Results The effective rate of solid tumor was 47.50%and 35%in the treatment and the control group respectively, with no significant difference(χ2=-1.229, P>0.05);The total effect rate was 87.50%and 32.50%in the treatment and the control group respectively, with significant difference(χ2=-5.633, P<0.05);The rate of patients merged with portal vein tumor thrombus whose cancer embolus narrowed more than 1/2 after the treatment was 78.95%and 33.33%in the treatment and the control group respectively, with significant difference(χ2=7.836, P<0.05);The rate of alpha fetoprotein(AFP) decreasing or turning negative was 78.95%and 37.83%after the treatment in the treatment and the control group respectively, with significant difference(χ2=-3.857, P<0.05);Both groups have improvement in Karnofsky Performance Status(KPS) score after the treatment, the ratios was 80% and 72.50% in the treatment and the control group respectively, with no significant difference(χ2=-1.203, P>0.05);The accumulated scores change of quality of life(QOL) has asignificant difference(χ2=-3.025, P<0.05) between the two groups after the treatment. Conclusion The combined therapy of Fuyuan Huoxue decoction and transcatheter hepatic arterial chemoembolization can alleviate the clinical symptoms, improve treatment effects and quality of life of patients with primary hepatic carcinoma.

Objective:This study aims to evaluate the sonographic features of phyllodes tumors of the breast (PTBs) and the cor-relation between sonographic and pathologic findings to improve the understanding of the disease. Methods:Sonographic findings of 85 PTBs from 83 patients were reviewed. The sonographic findings included the results of two-dimensional ultrasound and color Dop-pler flow imaging, elastographic features, and pathologic data. Results:Of the 85 lesions, 33 were the benign tumors, 28 were border-line, and 24 were malignant according to the pathologic diagnosis. Tumor morphology revealed that most masses were lobulated, with a clear-cut boundary, smooth verge, and inhomogeneous internal echo. Clear boundary was more common in the benign phyllodes tumors (χ2=12.721, P=0.002), and a cystic echo-free area was more commonly observed in these malignant tumors (χ2=9.677, P=0.046). LevelⅡandⅢsignals of the blood flow were observed in 75.3%of PTB cases. Of all lesions, only 26 were subjected to elasticity imaging, and the elastographic scores ranged from 2 to 3 in 88.5%of the cases (23/26). Conclusion:Conventional ultrasound and elastographic findings on PTBs exhibited definite characteristics. The border and cystic areas in the tumors can be used to differentiate between be-nign and malignant PTBs.