Objective To investigate the clinical efficacy of transthoracic echocardiography (TTE) in catheter interventional treatment of congenital heart disease. Methods 57 patients with congenital heart disease were selected by preoperative TTE screening and then received Amplatzer occluder interventional treatment under X-ray monitoring. 23 of them were atrial septal defect (ASD), 29 were ventricular septal defect (VSD), 4 were patent ductus arteriosus (PDA), and one was VSD complicated with ASD. Results All the patients were treated successfully. The occlusion effect was observed by follow-up immediately after the procedure, and one week, one month, three months, six months, and one year after the procedure. The position of the occluder did not change, the surrounding of the occluder has no residual shunt. 3 cases of ASD and 2 of VSD were failed to plugged. Conclusions TTE has important clinical values in selection of the patients with indication , intraoperative detection of the release of Amplatzer, and postoperatve assessment of the efficacy.

Objective: To study the effect of color Doppler ultrasound (CDUS) combined with serum glucoside antigen 125 (CA125) on the diagnostic efficacy of patients with ovarian cancer. Methods: A total of 78 patients with ovarian tumors admitted to our hospital from February 2012 to June 2018 were enrolled. Among them, 38 patients with malignant tumors and 40 patients with benign tumors were tested for CDUS and serum CA125. The characteristics of CDUS images and serum CA125 levels in patients with malignant tumors were analyzed by pathological examination as the gold standard. The diagnostic efficacy of CDUS combined with serum CA125 level detection and separate examination was analyzed. Results: ⑴ Characteristics of CDUS images: the size, location, texture, blood flow signal, resistance index, ascites, peritoneal implant nodule or enlarged lymph node of patients with malignant tumors were significantly different from those of benign tumors (P<0.05). ⑵ Serum CA125 level: the serum CA125 level of patients with malignant tumors was higher than that of patients with benign tumors (P<0.05). ⑶ Diagnostic results: among 78 patients with ovarian tumors, 33 cases of malignant tumors were detected by serum CA125, 45 cases of benign tumors, of which 5 cases were misdiagnosed, and 10 cases were missed. For example, CDUS detected 35 malignant tumors and 43 benign tumors, of which 6 were misdiagnosed and 9 were missed. A total of 43 malignant tumors and 35 benign tumors were detected, of which 6 were misdiagnosed and 1 was missed. ⑷ Diagnostic efficacy: the accuracy of CDUS combined with serum CA125 level detection (91.03%) was higher than that of the two groups (80.77% and 80.77%), but the difference was not statistically significant (P>0.05); the sensitivity of CDUS combined with serum CA125 level detection was 97.37%. The two were independently examined by 76.32% and 73.68% (P<0.05). The specificity of CDUS combined with serum CA125 was 85.00%, with no significant difference between the two groups (80.05%, 87.50%) (P>0.05). Conclusions The serum CA125 level of patients with ovarian cancer is abnormally elevated. The characteristics of CDUS images are different from those of benign tumors, which can effectively identify benign and malignant tumors. CDUS combined with serum CA125 level detection can significantly improve the diagnostic efficacy, and they can be used to judge the disease and symptom , and provide guidance for treatment and prognosis assessment.

Background: and Purpose Collateral circulation is considered an important factor affecting the risk of stroke, but the factors that affect collateral circulation remain unclear. This study was performed to identify the factors associated with collateral circulation, especially blood lipids. Methods: The study involved patients who had undergone digital subtraction angiography and were confirmed as having severe unilateral stenosis or occlusion of the internal carotid artery (ICA). We classified the collateral circulation status of each patient as good (Grade 3 or 4) or poor (Grade 0, 1, or 2) according to the grading system of the American Society of Interventional and Therapeutic Neuroradiology/American Society of Interventional Radiology. We collected data on patients’ characteristics and identified the factors that affect collateral circulation. Results: This study included 212 patients. The multivariate logistic regression analysis showed that the high-density lipoprotein cholesterol (HDL-C) concentration and a complete anterior half of the circle of Willis were independent protective factors for good collateral circulation, whereas elevated lipoprotein(a) [Lp(a)] and serum creatinine concentrations were independent risk factors for good collateral circulation. The area under the receiver operating characteristics curve (AUC) was 0.68 (95% confidence interval [CI], 0.61–0.76) for HDL-C and 0.69 (95% CI, 0.62–0.76) for Lp(a). A binary logistic regression model analysis of the joint factor of HDL-C and Lp(a) yielded an AUC of 0.77 (95% CI, 0.71–0.84). Conclusions In patients with severe unilateral ICA stenosis or occlusion, the combination of HDL-C and Lp(a) is a useful predictor of collateral circulation.

Objective:To explore the diagnostic value of contrast-enhanced ultrasound combined with fine-needle aspiration biopsy and BRAF gene detection for TI-RADS category 4 nodules.Methods:The clinical datas of 80 patients who underwent surgery in the First Affiliated Hospital, Zhejiang University School of Medicine and Lishui People′s Hospital and diagnosed with TI-RADS 4 thyroid nodules from January 2019 to January 2020 were retrospectively analyzed. All patients received contrast-enhanced ultrasound combined fine-needle aspiration biopsy and BRAF gene detection, the ROC curves were plotted, the area under the ROC curve(AUC) and the best diagnostic cut-off values were calculated, and the application value of ultrasound-enhanced contrast, fine-needle aspiration biopsy and BRAF gene detection were compared.Results:Based on the results of pathological diagnosis, in diagnosing TI-RADS 4 thyroid nodules, the sensitivity, specificity and accuracy were 77.61%, 70.97% and 75.51% for contrast-enhanced ultrasound, respectively; 80.60%, 74.19%, and 78.57% for ultrasound-guided fine-needle aspiration biopsy, respectively; 79.10%, 96.77%, and 84.69% for the BRAF gene test, respectively; and 98.51%, 70.97% and 89.80% for the combined diagnosis, respectively. The AUC was 0.790 for contrast-enhanced ultrasound, and 0.774 for ultrasound-guided fine-needle aspiration biopsy, 0.799 for BRAF genetic testing, and 0.847 for combined testing. The diagnostic value of combined diagnosis was significantly higher than other diagnostic methods ( P<0.05). Conclusions:Contrast-enhanced ultrasound combined with fine-needle aspiration biopsy and BRAF gene detection is valuable for the diagnosis of TI-RADS 4 class thyroid nodules and improves the preperative diagnosis.

ObjectiveTo observe the clinical efficacy of Qiju Dihuangtang combined with Chinese medicine fumigation in the treatment of dry eye and its effect on the levels of interleukin-6 （IL-6） and matrix metalloproteinase-9 （MMP-9） in tears. MethodA total of 120 patients with dry eye of liver-kidney Yin deficiency syndrome who were treated in the Department of Ophthalmology， The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine（TCM） from october 2019 to october 2021 were randomized into the observation group and control group. The control group was given sodium hyaluronate eye drops， and the observation group was treated with sodium hyaluronate eye drops， Qiju Dihuangtang， and Chinese medicine fumigation. The treatment lasted 30 days for both groups. The changes of ocular surface disease index （OSDI）， TCM syndrome score， tear secretion （SIT）， tear film breaking up time （BUT）， corneal fluorescein staining （FL）， and tear interleukin-6 （IL-6） and matrix metalloproteinase-9 （MMP-9） were observed. ResultAfter the treatment， the total effective rate was 90.0% （54/60） in the observation group and 75.0% （45/60） in the control group （χ²=4.675， P<0.05）. After treatment， the OSDI score and TCM syndrome score were lower than those before treatment in both groups （P<0.05）， and lower in the observation group than in the control group （P<0.05）. After treatment， the SIT and BUT were higher （P<0.05） and FL score was lower （P<0.05） than those before treatment in both groups. After treatment， the improvement of the above indicators in the observation group was better than that in the control group （P<0.05）. After treatment， the levels of IL-6 and MMP-9 were lower than those before treatment in both groups （P<0.05）， and lower in the observation group than in the control group （P<0.05）. ConclusionQiju Dihuangtang combined with Chinese medicine fumigation can effectively improve subjective symptoms， promote tear secretion， prolong BUT， enhance corneal epithelial repair， and reduce the levels of tear IL-6 and MMP-9 in the treatment of dry eye.

DNA/metabolism* ; Gene Editing ; HEK293 Cells ; Humans