Diagnostic value of 2-dimentional ultrasonography and color Doppler flow imaging in primary bone tumor / 中南大学学报(医学版)

OBJECTIVE@#To explore the diagnostic value of 2-dimentional ultrasonography and color Doppler flow imaging (CDFI) in primary bone tumor.@*METHODS@#The hemodynamic parameters such as systolic maximum velocity (Vmax), diastolic minimum velocity (Vmin), resistance index (RI), and pulsatility index (PI) of intratumoral folw in 93 patients with primary bone tumors proved by histopathology were studied using 2-dimentional ultrasonography and CDFI techniques.@*RESULTS@#The bone destruction periosteum response and soft tissue mass were essentially revealed with 2-dimentional ultrasonography techniques. The intratumoral flow features were clearly shown by CDFI. The Vmax and Vmin in malignant bone tumor were significantly higher than those in benign one (P < 0.01). RI and PI in malignant bone tumor were lower than those in benign one (P < 0.01).@*CONCLUSION@#Observing the features of bone tumor and hemodynamic parameters by 2-dimentional ultrasonography and CDFI has a great clinical value in diagnosing primary bone tumor and distinguishing the malignant and benign bone tumors.

Application of ultrasound-guided percutaneous biopsy in the preoperative diagnosis and treatment of bone tumors / 中南大学学报(医学版)

OBJECTIVE@#To investigate the value of color Doppler ultrasonography (CDUS)-guided percutaneous biopsy in the diagnosis and treatment of bone tumors.@*METHODS@#Ultrasound-guided percutaneous biopsy was performed in 64 patients who was diagnosed by CDUS. Puncture instruments included automatic core biopsy device and 14 to approximately 18G crude needle. All cases were identified by the operation and pathological examination.@*RESULTS@#Tissue-obtained rate was 97% (62/64). Comparing preoperative pathological diagnosis with postoperative pathological diagnosis, we found the diagnostic correct rate was 97%. No complications resulted from this procedure. According to their pathological results, 33 patients were treated with preoperative chemotherapy. The tumor sizes decreased, and 26 patients saved their limbs and had normal functions.@*CONCLUSION@#CDUS-guided percutaneous biopsy is safe and quick for the preoperative diagnosis and selecting appropriate surgical procedure for bone tumor treatment.

Risk factors for the progress of subclinical atherosclerosis in newly diagnosed type 2 diabetics with multifactorial intervention / 中华全科医师杂志

Objective To investigate risk factors for the progress of subclinical atherosclerosis (AS)in newly diagnosed type 2 diabetics with muhifactorial intervention.Methods One hundred and fifty- six patients of type 2 diabetes,aged 35～70 years,with course of less than one year and without subclinical AS,were observed prospectively.After two-year intervention based on anti-platelet therapy integrated with intensive control of blood glucose,blood lipid,blood pressure and body weight,dynamic changes in all metabolic indicators and subclinical AS in the patients and differences between those with subclinical AS and without it were analyzed to study the risk factors for its progress by logistic regression analysis.Results There were no significant differences in intima-medial thickness(IMT)of common carotid artery(CCA) and femoral artery(FA)in the patients between baseline and two years after intervention,but those in them were significantly increased two years after intervention than those one year after intervention(P＜0.O1). Two years after intervention,increased IMT or atherosclerotic plaques could be found in 45 of 156 patients (28.8%),significantly higher than those one year after intervention(11.5%,P＜0.01).Levels of glycosylated hemoglobin Alc(HbAlc),total cholersterol(TC),high-density lipoprotein-cholesterol (HDL-C)and HOMA-insulin resistance(IR)showed an increased trend two years after intervention,as compared with those one year after intervention(P＜0.01).Proportions of those with normal level of HbAlc two years after intervention was significantly lower than that one year after intervention(P＜0.01). Proportions of those with normal level of HbAlc and low-density lipoprotein-cholesterol(LDL-C)were significantly lower in patients with subclinical AS than those without it two years after intervention(P＜0.01).Logistic regression analysis showed that relative risk(RR)for subclinical AS could reduce by 83% with normal level of LDL-C and 59% by normal HbAlc,respectively,but there was an 82% increase in RR for it with an increase of age by ten years.Conclusions Subclinical AS could not be absolutely prevented in patients with newly diagnosed type 2 diabetics after two-year intensive multifactorial intervention.Subclinical AS could present a progressive trend with time,as well as levels of blood glucose and blood lipid.Levels of LDL-C and HbAlc,as well as age,were major risk factors for occurrence of subclinical AS in patients with newly-diagnosed type 2 diabetes.

Utilising ductus venosus Doppler waveform and four-chamber view to screen for foetal cardiac malformation in early second trimester of pregnancy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Foetal echocardiography has become a diagnostic method to detect foetal congenital heart disease with high probability. However, it is not only time consuming and but also difficult to visualize outflow tract of foetus early in the second trimester of pregnancy, even for an experienced obstetric ultrasonographer. Recently, many methods for screening foetal cardiac anomalies were explored, but much more work is needed to develop an effective and suitable screening method. The aim of this study was to investigate the clinical significance of utilising the ductus venosus (DV) Doppler examination and the four-chamber view of heart to screen for foetal cardiac malformation in early second trimester of pregnancy.</p><p><b>METHODS</b>Heart and DV of 401 consecutive foetuses in early second trimester (12(+1) - 17(+6) weeks) in high risk pregnancies were examined with Acuson 128 xp/10 or Sequoia 512 ultrasound diagnostic systems. Absent or reversed flow during atrial contraction (A-wave) in the DV was defined as sufficiently abnormal to screen for foetal cardiac malformations. The foetal echocardiographic diagnosis was confirmed by postnatal echocardiography (or postmortem). The sensitivities of screening tests were compared among the three methods: DV Doppler examination, four-chamber view alone, and the combination of both techniques.</p><p><b>RESULTS</b>Satisfactory examinations were obtained in 383/401 foetuses (95%). Thirty foetuses with cardiac abnormalities were confirmed by neonatal echocardiography (or postmortem). The sensitivity of DV Doppler examination or four-chamber view alone is 63% (19/30) and 60% (18/30), respectively. The sensitivity of combining information, DV Doppler flow waveform and four-chamber view, to screen for foetal cardiac malformation is 83% (25/30) and significantly better than that of either DV Doppler flow waveform or four chamber view alone (P < 0.05).</p><p><b>CONCLUSION</b>Doppler flow waveform of DV can be used to screen for foetal cardiac malformation early in the second trimester. Combining information from Doppler flow waveform of DV and four-chamber view will improve the overall sensitivity of the screening.</p>