Objective To explore the value of real time contrast-enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant adrenal lesions.Methods Totally,57 adrenal lesions (26malignant and 31 benign) underwent conventional ultrasound and real-time CEUS.The enhancement patterns including types of time-intensity curve,centripetal fill-in,homogeneity and intensity of enhancement were analyzed.Results The enhancement pattern of normal adrenal gland was homogeneous,centrifugal and rapid perfusion from the medulla to the cortex.Four enhancement patterns were significantly different between benign and malignant adrenal lesions (P ＜0.05).If enhancement in the early arterial phase and rapid washout was suggestive of malignancy,the sensitivity and specificity of CEUS were 96.2％ and 77.4％,respectively.If peripheral to central filling was suggestive of malignancy,the sensitivity and specificity of CEUS were 76.9 ％ and 80.7 ％,respectively.Conclusions The patterns of real-time CEUS are helpful in differential diagnosis of malignant and benign adrenal lesions.

Objkctive To determine the potential ability of the area of each peak for the proton magnetic resonance spectroscopy(1 H-MRS) in the diagnosis of DNS(Delayed neuropsychological sequelae after carbon monoxide poisoning).Methods MRI and STEAM(stimulated-echo-acquisition mode)were performed in 38 DNS patients and 18 healthy volunteers.The area of the peak of each organic compound were obtained in each volume of interest.Results The data spectra abtained from patients shows NAA(881±76),Cho(2 352 ±86),β、γGlx(3 024 ± 187).Compared with the control group,theβ、γGlx ratio and Cho area increased,but the NAA ratio decreased.The area of NAA,Cho,β、γGlx between DNS and control group were compared,the results showed significant differences (P ＜0.05).In spectroscopy,the Lip evaluated peak in 0.9～1.40 ppm were detected.Conclusion 1H-MRS may do some contribution to the diagnosis of DNS.

Objective To evaluate the color Doppler ultrasonography and contrast enhanced ultrasound (CEUS) findings of congenital intrahepatic portosystemic venous shunts (IPSVS).Methods Nineteen patients of congenital IPSVS were examined with color Doppler ultrasonography and CEUS.All patients were confirmed by CT angiography.The hepatic artery arrival time (HAAT),portal vein arrival time (PVAT),and hepatic vein arrival time (HVAT) on CEUS were recorded.The interval time between hepatic artery arrival time and hepatic vein arrival time (HA-HVTT) and the interval time between portal vein arrival time and hepatic vein arrival time (PV-HVTT) were calculated.Results The types of IPSVS between portal and systemic veins were based on Park's classification.Color Doppler ultrasonography showed abnormal communication between the portal vein branch and the hepatic veins,duplex Doppler ultrasonography showed abnormal spectral pattern from the portal vein such as undulating,triphasic waveform mimicked that of the hepatic vein.CEUS demonstrated abnormal communication between portal vein branch and hepatic vein.HVAT,HA-HVTT,and PV-HVTT were shorter statistically in congenital IPSVS group than those in cirrhosis and normal groups.Conclusions Congenital IPSVS is a rare vascular abnormality that is usually asymptomatic.Color Doppler ultrasonography is a useful tool for diagnosis of congenital IPSVS.CEUS provides helpful data for the diagnosis and differential diagnosis of congenital IPSVS.

Objective To investigate the effects of modafinil,a new wake-promoting agent, on vestibular function during 24 h sleep deprivation(SD). Method Eight male healthy young volunteers were exposed to two 24 h periods of continuous wakefulness during the crossover experiment. In one period, 200 mg doses of modafinil were given and in the other, separated by one week, matching placebos were administered. The SD time started from 8:00 of the first day to 8:00 of the second day. Drugs was given at 0:00 of the second day. Vestibular function was tested at 21:00 of the first day and 1 ,3,5,7 h after drug administration. Result The accuracy of saccade tracking and the gains of VVOR(visual-vestibular optokinetic reflex)and OKN(optokinetic nystagmus)in the placebo group decreased during 24 h SD, especially at 1: 00～5:00 of the second day, while OKN gains in the modafinil group was increased significantly. There were no significant differences of other vestibular function between modafinil group and placebo group. Conclusion Twenty four SD can influence vestibular function in certain degree,but optokinetic nystagmus can be improved by modafinil.

The combination of preoperative chemoradi-otherapy and surgery has become the standard treatment for locally advanced rectal cancer. Up to 30% of patients received pathologic complete response(pCR) after neoadjuvant therapy, for whom low rates of local recurrence and improved outcome after surgery were achieved. Given that, some authors have recommended local resection for clinical extensive response or non operative "wait and see" policy for clinical complete response(cCR) respectively, in which radical surgery-associated complication and dysfunction can be avoided. Current imaging can provide excellent accuracy in primary staging of rectal cancer, however, when used for restaging, the ability is less satisfactory, especially for pCR prediction, as a result of modification on tumor and surrounding tissue induced by neoadjuvant therapy. The question on how to identify patients with pCR before surgery has received more attention recently. On the basis of pathological findings after surgery, in this article, we review the reliability and predictive ability of current imaging for restaging and pCR after preoperative chemoradiotherapy in rectal cancer.
Chemoradiotherapy ; Humans ; Neoadjuvant Therapy ; Rectal Neoplasms ; pathology ; therapy ; Treatment Outcome

Objective To observe the epidemiology characterization of Borna disease virus (BDV) in animal brain in Ili, Xinjiang, and to find out the potential infection of the Borna disease virus to prevent its outbreak. Methods The BDV p24 gene of animal brain tissues in Ili including 200 horses, 75 donkeys and 100 shepherd dogs was detected by fluorescence quantitative nest reverse transcriptase polymer-ase chain reaction(FQ-nRT-PCR). GFP-p24,pMD-19 plasmid contamination was excluded from positive products. Clone sequencing was used to analyze the homology of gene and amino acid sequence. Results BDV p24 gent was found in 3 Ili horses, 4 Ili donkeys and 9 shepherd dogs, and the positive ratio is 1.5%, 5.3% and 9.0%, respectively. The GFP-p24,pMD-19 were not found in BDV p40 gene and plasmid stand-ard. The sequence of BDV p24 amplification production was totally the same as He/80 virus strain. Conclu-sion Natural infection of BDV may exist in the animals(horses, donkeys and dogs)in Ili, and the epidem-ic strain of BDV in this area was homological as He/80 virus strain.

Objective To investigate the effect of IGF1R β subunit mutants sb-IGF1R and ma-IGF1R on the biological behavior of osteosarcoma 143B cells. Methods We designed and constructed sb-IGF1R and ma-IGF1R fragments. They were cloned into adenovirus AdEasy shuttle plasmid, to obtain Ad-sbIGF1R and Ad-maIGF1R. We observed the proliferation, migration and apoptosis of the osteosarcoma cells transfected with Ad-sbIGF1R, Ad-maIGF1R and Ad-IGF1R. The Ad-sbIGF1R, Ad-maIGF1R and Ad-GFP nude mouse models were constructed to evaluate the tumor growth in vitro. Results By plasmid PCR, IGF-1R β subunit mutant was overexpressed in osteosarcoma cells. Ad-sbIGF1R and Ad-maIGF1R significantly inhibited the proliferation and migration of osteosarcoma cells, and promoted cell apoptosis, and inhibited tumor growth in subcutaneous tumor-bearing nude mouse models. Conclusion IGF1R β subunit mutants inhibit the proliferation and migration of osteosarcoma cells and induce cell apoptosis.

Objective To assess the association between Metformin use and the risk of dementia in patients with type 2 diabetes mellitus(T2DM).Methods The research data came from the big medical data platform of Yinzhou District,and we constructed a cohort of T2DM patients who had initiated treatment of Metformin or sulfonylurea since January 1,2009.The inverse probability of treatment weighting(IPTW)was used to control the baseline confounding factors,and the Cox regression model was used to estimate the HR(95%CI)of the association between Metformin use and dementia risk.Results The incidence rate of dementia in new users of Metformin(41181 persons)and sulfonylureas(38092 persons)was 128.4 per 100000 person years and 142.3 per 100000 person years respectively.Compared with sulfonylureas,the crude analysis with no adjustment for confounding factors showed that there was a negative association between the use of Metformin and the incidence of dementia,with an HR(95%CI)0.930(0.800～1.090).After adjusting for potential confounders with IPTW,Metformin was not significantly associated with the risk of dementia HR(95%CI)1.040(0.890～1.220).The subgroup analysis results for different baseline characteristics were consistent with the primary analysis results,and there were no statistically significant associations between Metformin and dementia incidence risk in all subgroups.Conclusions There is no significant association between the use of Metformin and the risk of dementia in T2DM patients in the Yinzhou District.

OBJECTIVE: To explore strategies of prenatal genetic testing for fetuses featuring abnormal skeletal development. METHODS: Clinical data of 17 fetuses with skeletal dysplasia was collected. The results of genetic testing and outcome of pregnancy were analyzed. RESULTS: For 12 fetuses, the femur-to-foot length ratio was less than 0.9. Thirteen fetuses had a positive finding by genetic testing. One fetus was diagnosed with chromosomal aneuploidy, three were diagnosed with microdeletion/microduplications, and nine were diagnosed with hereditary bone diseases due to pathological variants of FGFR3, COL1A2, GPX4 or ALPL genes. CONCLUSION For fetuses with skeletal dysplasia characterized by short femur, in addition to chromosomal karyotyping and microarray analysis, sequencing of FGFR3 and other bone disease-related genes can improve the diagnostic rate.
Bone Diseases, Developmental/genetics* ; Female ; Fetus/diagnostic imaging* ; Genetic Testing ; Humans ; Karyotyping ; Pregnancy ; Prenatal Diagnosis ; Receptor, Fibroblast Growth Factor, Type 3/genetics* ; Ultrasonography, Prenatal

Objective:To establish a multi-state Markov model of type 2 diabetes mellitus (T2DM) patients and explore the transition rule between the cumulative number of different chronic complications, estimate the transition probability and intensity between status, and explore the possible factors affecting the transition between status.Methods:A retrospective cohort study of 33 575 patients with T2DM was conducted. According to the baseline and the cumulative number of chronic complications during the follow-up period, the patients were classified based on five status: T2DM, one complication, two complications, three complications, four and above complication, indicated by S0, S1, S2, S3 and S4, respectively. A time-continuous and state-discrete multi-state irreversible Markov model was used for statistical analysis.Results:The study included 33 575 T2DM patients, and their average age was 60 years old, the median of follow-up length was 8 years. In these patients, 32 653 had no baseline complications. At the end of follow-up, the transition probabilities of S0→S1, S1→S2, S2→S3 and S3→S4 were 16.4%, 32.4%, 45.6% and 25.9%, respectively. The results of multivariate analysis showed that being female ( HR=0.919), less than 60 years old ( HR=0.929), higher fasting plasma glucose ( HR=1.601), lower high-density lipoprotein ( HR=1.087), higher total cholesterol ( HR=1.090),weekly exercise ( HR=0.897), vegetarian diet ( HR=0.852) and heavy diet ( HR=1.887) were the risk factors for S0 to S1. And being female ( HR=0.768), less than 60 years old ( HR=0.859) and lower high-density lipoprotein ( HR=1.160) were the risk factors for S1 to S2. Conclusions:The probability of multiple complications in T2DM patients increased over time, the transition intensity of S2→S3 was largest, followed by S1→S2. Therefore, we need to conduct both early and long-term indicators monitoring and disease prevention, strengthen the health education to improve patients' daily living habits at early stage of the illness, encourage patients to have moderate exercise and balanced diet, strengthen the monitoring of fasting blood- glucose, cholesterol and high-density lipoprotein levels to prevent the deterioration of the illness.