Background and purpose:Axillary lymph node metastasis of breast cancer has an important significance in prognosis and treatment of breast cancer. This study was to investigate the correlation between axillary lymph node metastasis and ultrasonographic characteristics of axillary lymph node combined with immunohistochemistry in breast cancer patients.Methods:A total number of 366 breast cancer patients were selected in this study. Seven hundred and twenty-eight axillary lymph nodes were collected. With ultrasonography, the maximum cortex thickness, the ratio of the height to the length, the ratio of the cortex to the medulla and blood lfow of axillary lymph nodes were observed, in order to study the correlation between these indicators and axillary lymph node metastasis combined with the postoperative immunohistochemical results.Results:According to univariate analysis, axillary lymph node maximum cortex thickness, the ratio of the height to the length, characteristics of blood flow and the positive expression rate of p53 were related to axillary lymph node metastasis (P<0.05). Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve showed that axillary lymph node maximum cortex thickness was the best indicator to determine axillary lymph node metastasis. The positive expression rate of p53 in patients with maximum cortex thickness >3 mm (42.78%) of axillary lymph node was signiifcantly higher than that in patients with maximum cortex thickness≤3 mm (25.82%) (P<0.01).Conclusion:Ultrasonographic characteristics of axillary lymph node and immunohistochemistry method are closely correlated with axillary lymph node metastasis in patients with breast cancer, which is important in diagnostic and treatment in clinic.

ObjectiveTo study the feasibility and stability of hepatocellular carcinoma model established in mouse with the guidance of ultrasound, and to explore the value of ultrasonography in hepatocellular carcinoma model.MethodsThe type of H22 cells, whose concentration was 2×107/ml, were injected into the left liver of 30 mice with the guidance of ultrasound. After injection, the mice were examined by ultrasound on the tenth and twentieth day, and implemented laparotomy on the twentieth day. The tumors were examined pathologically. The formation rate and growth of tumors were evaluated, and the ultrasonic features of tumors were observed.ResultsThe formation rate of implanted tumors was 96.7% (29/30), and the peritumoral blood flow could be detected. The diameters measured by ultrasound and explorative laparotomy were (8.4±0.3) mm and (8.6±0.2) mm, respectively (P>0.05). The pathological examination showed that the tumors were hepatocellular carcinoma.ConclusionEstablishing mouse model of hepatocellular carcinoma by ultrasound-guided is simple and minimally invasive, and it provides an ideal model of high formation rate for the study of hepatocellular carcinoma.

Objective: To investigate the mechanism of apoptosis of CD8⁺T lymphocyte in peripheral blood of patients with hepatocellular carcinoma (HCC). Methods: The proportion and apoptosis of peripheral blood CD8⁺T lymphocytes in 30 healthy controls, 30 patients with cirrhosis and 60 HCC patients were detected by Flow cytometry, and the expression of Fas on the surface of CD8⁺T lymphocytes was reported. The differences between groups were compared using independent sample t-test, and data of variance were tested with Mann-Whitney U non-parametric test, P < 0.05 was considered statistically significant. Results: The proportion of CD8⁺T lymphocytes in peripheral blood of patients with HCC was 26.4% ± 9.2%, higher than that of 24.5% ± 7.1% in cirrhosis (t = 0.783, P = 0.489), and and healthy control 19.7% ± 4.7% (t = 2.920, P = 0.004). The proportion of apoptotic CD8⁺T lymphocytes in peripheral blood of HCC patients was 25.3% ± 6.5%, of the total CD8⁺T lymphocytes, which was significantly higher than that of healthy controls 12.1%±6.5% (t = 7.555, P < 0.001) and cirrhotic 13.6% ± 5.8% (t = 5.213, P < 0.001), the differences were statistically significant. The proportion of Fas⁺CD8⁺T lymphocytes in the HCC group was 62.2% ± 18.5%, higher than that in the healthy control group 42.6%±16.5% (t = 4.127, P < 0.001) and 46.1% ± 14.5% (t = 2.561, P < 0.01)of the cirrhosis group, the differences were statistically significant. Fas expression was positively correlated with the apoptosis of CD8⁺T lymphocytes (r ² = 0.113, P < 0.05). Conclusion The proportion of CD8⁺T lymphocytes in peripheral blood of patients with HCC is higher than that of healthy controls, but the proportion of CD8⁺T lymphocyte apoptosis based on Fas/FasL pathway increased, which may be an important mechanism for tumor cell immune escape.

Objective:To evaluate the medical service quality of psychiatric hospitals in Beijing based on diagnostic related group (DRG), analyze the evaluation effect, for refences to constructe a DRG performance evaluation system suitable for psychiatric hospitals.Methods:This study extracted data such as the number of DRG groups, etc. of hospitalized patients in 14 tertiary and secondary psychiatric hospitals in Beijing from 2018 to 2020 from the Beijing inpatient medical performance evaluation platform, and analyzed data on DRG performance evaluation indicators, as well as the average length of hospital stay and average cost of DRG enrolled cases. All data were analyzed using descriptive research methods, and inter group comparisons were conducted using the Mann Whitney U-test. Results:From 2018 to 2020, the average number of DRG groups in tertiary hospitals (28) was higher than that in secondary hospitals (10) ( P<0.05), and the average CMI values of both were the same(1.79); The average cost consumption index (1.15) of tertiary hospitals was higher than that of secondary hospitals (0.65) ( P<0.05), while the average time consumption index (1.11) was slightly lower than that of secondary hospitals (1.30); The mortality rate of the low-risk group in tertiary hospitals (0.01%) was generally lower than that in secondary hospitals (0.88%), and the average percentage of DRG admitted inpatients (82.8%) was significantly higher than that in secondary hospitals (27.3%) ( P>0.05). The average length of stay and cost per case for DRG enrolled inpatients in tertiary and secondary hospitals were lower than the overall hospital discharge cases ( P<0.05). Conclusions:The number of DRG groups, CMI value, and low-risk mortality rate could be used for evaluating the medical service capacity and safety of psychiatric hospitals, but the cost and time consumption index could not objectively reflect the efficiency of hospital medical services. DRG performance evaluation indicators are more suitable for evaluating short-term hospitalization of psychiatric patients. The proportion of DRG enrolled cases might be a potential indicator for evaluating the service quality of psychiatric hospitals.