Objective To explore the application values of acoustic radiation force impulse imaging (ARFI) in predicting the staging of chronic kidney disease (CKD) and the degree of renal tissue fibrosis. Methods 48 CKD patients of different stages undergoing the examination of ARFI from March to December of 2016 were selected in the study and the pathological types of all the patients were confirmed as nephropathy by the pathological results. Those patients were divided into five stages from Stage 1 to Stage 5 according to the CKD clinical staging. In accordance with the standard of Estimated Glomerular Filtration Rate (eGFR)=60 mL·min-1·1.73m-2, those patients were also divided into the group with eGFR<60 mL·min-1·1.73m-2 and the group with eGFR≥60 mL·min-1·1.73m-2. The shear wave velocity (SWV) of renal cortex in each group was detected by ARFI and compared among different stages and groups. The Spearman correlation analysis was adopted to analyze the correlation of renal cortical elasticity of CKD patients with the indicators such as clinical stage, pathological fibrosis degree, serum creatinine, urea nitrogen, and kidney size respectively. The SWV differences of each group were analyzed by One-way ANOVA. Results The SWV value increased with the aggravation of CKD, and the SWV values of CKD Stage 4 and 5 were the highest and they were(2.51±0.50)m/s and(2.51±0.00)m/s respectively. The SWV value of the group with eGFR<60 mL·min-1·1.73m-2 was (2.29±0.40)m/s, while that of the group with eGFR≥60 mL·min-1·1.73m-2(2.30±0.40)m/s. The results of Spearman correlation analysis showed that the SWV values of renal cortex of CDK patients were not correlated with the indicators including the clinical stage of CKD, pathological fibrosis degree, serum creatinine, urea nitrogen, and kidney size (P>0.05). The results of One-way ANOVA showed that there were no significant differences in the SWV value among all the stages of CKD (P>0.05). Conclusion The SWV value increases with the aggravation of CKD, but it cannot be taken as the method to predict the clinical stage of CKD and the renal tissue fibrosis.

目的 探讨青年缺血性脑卒中的发病率、危险因素.方法 回顾性研究成都军区总医院神经内科2007～2016年225例首次发生的青年缺血性脑卒中患者资料.结果 缺血性脑血管病的发生趋于年轻化;青年缺血性脑卒中的危险因素在性别和不同年龄组上存在差异.结论 "三高"发病率的逐年升高和年轻化严重侵蚀着人们的健康.加强健康宣传,改变烟酒等不良嗜好有利于预防青年缺血性脑卒中的发生.

Objective To explore the cerebral vasoreactivity (CVR) changes before and after middle cerebral artery stenting (MCAS) and the relationship between thrombolysis in yocardial infarction(TIMI)flow grade and CVR. Methods Thirty-nine patients with middle artery stenosis received MCAS treatment were selected as operated group and 48 non-stroke hospitalized patients at the same period as control group. Transcranial Doppler (TCD) combined with CO2 inhalation test was performed to assess the changes of CVR before and after MCAS. Digital subtraction angiography (DSA) was employed to assess the TIMI flow grade. These data were statistically analyzed. Results As compared with that of the control group, preoperative CVR of the operated group was significantly reduced (P<0.05); the postoperative CVR significantly increased as compared with the preoperative one in the operated group (P<0.05); preoperative CVR was positively correlated with the TIMI grade (R=0.594, P<0.05). Preoperative CVR had a significant difference between TIMI grade 1 and TIMI grade 2 (P<0.05), but not between TIMI grade 2 and TIMI grade 3 (P>0.05). The degree of CVR improvement was negatively correlated with the TIMI grade (R=-0.620, P<0.05) and preoperative CVR (R=-0.760,P<0.05). Conclusion MCAS can effectively improve the CVR.

Objective To assess the differential diagnosis and characteristics of renal benign and malignant tumors with three-dimensional contrast-enhanced ultrasound (3D-CEUS). Methods Totally 68 patients with renal tumors were examined by conventional ultrasound and two-dimensional contrastenhanced ultrasound(2D-CEUS). 3D imaging was reconstructed from 2D imaging, the differential diagnosis of renal tumors with 3D-CEUS was analyzed by comparing with 2D-CEUS. All patients with renal tumors were proved by operational pathology. Results Eighteen patients with renal benign tumors mostly displayed equal or low enhancement, showed "slowly in and slowly out" with 2D-CEUS, while displayed regular peripheral and internal vessels with 3D-CEUS. Fifty patients with renal malignant tumors mostly displayed high enhancement, showed "rapidly in and rapidly out" with 2D-CEUS,displayed winding peripheral vessels and disordered internal vessels with 3D-CEUS. 3D-CEUS may display the vascular characteristics of tumors and showed superior imaging quality to 2D-CEUS ( P ＜ 0.05). Conclusions 3D-CEUS can display the vascular characteristics of tumors and their spatial positions, it plays an important role in differential diagnosis between renal benign and malignant tumors.

Objective: To search for a new method of color Doppler ultrasonography-guided percutaneous drainage and sclerotherapy with absolute ethanol for renal cyst.Methods: In a retrospective study,we analyzed the clinical data of 137 patients treated for kidney cysts by color Doppler ultrasonography-guided percutaneous aspiration and absolute ethanol injection into the cysts.Results: One hundred and forty two renal cysts from 137 patients were treated by this method,with a recovery rate of 99.3% and an excellence rate of 100%.Inflammatory reaction was serious in the 1st week after punctuation;hydatid fluid was absorbed obviously in a month;and the capsule space vanished in six months.Conclusion: Percutaneous alcoholization,safe,simple,with definite effect and fewer complications,is the first-choice method for simple renal cyst.Careful selection of the puncture path and flushing the capsule space with absolute ethanol until the drained hydatid fluid turned clear are critical for sclerotherapy.

Objective: To investigate the diagnose nutcracker syndrome with color Doppler flow imaging.Methods:Doppler sonographic findings in 47 children with orthostatic proteinuria or idiopathic hematuria and in 23 healthy control subjects were compared.The peak velocity,anteroposterior diameter and anteroposterior diameter ratio(hilar segment/aortomesenteric segment) were measured in the left renal vein.Results: The anteroposterior diameter ratio of the 2 segments were 4.13±2.34 in the patient group and 2.16±0.56 in the control.The anteroposterior diameter and the peak velocity in the aortomesenteric segment were(0.16±0.07)cm/s and(83.3±37.2)cm/s in the patient group and(0.24±0.09)cm/s and(43.1±10.8)cm/s in the control,with significant difference in between(P0.05).The value of the anteroposterior diameter ratio for diagnosing nutcracker syndrome was greater than 4.0.Conclusion: Color Doppler flow imaging of the left renal vein may be a useful imaging tool in the diagnosis of patients with nutcracker syndrome.