ObjectiveTo evaluate the significance of ankler-brachial index (ABI) to predict the extent of intracranial artery stenosis in ischemic stroke patients. Methods243 ischemic stroke patients were enrolled, brain angiography were examined and all of the ABI and basic data were collected. ResultsABI≤0.9 was associated with a specificity of 84.6% and a sensitivity of 16.8% for predicting the presence of severe stenosis in intracranial artery. The area under receiver operating characteristic curve was (0.591±0.046) (P<0.05). ConclusionABI≤0.9 has a relative specificity and sensitivity for predicting the presence of severe stenosis of intracranial artery.

AIM: To observe the effect of (IFN-?1b) on morphology and the expression of connective tissue growth factor (CTGF) in hepatic stellate cells (HSC). METHODS: HSC were cultured in vitro, and were treated with (IFN-?1b) and TGF-?_1. The changes of HSC on morphology were observed, and the expression of CTGF in HSC was assessed using reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Phenomenon of apoptosis were observed in HSC treated with IFN-?1b. The expression of CTGF in HSC was decreased after treatment with (IFN-?1b) in control and TGF-?1-triggered groups. CONCLUSION: (IFN-?1b) is able to induce the apoptosis and suppress the expression of CTGF in HSC.

Objective:To summarize the ultrasound features of medullary thyroid cancer (MTC) and analyze its diagnosis value for MTC.Methods:91 patients with medullary thyroid carcinoma (103 nodules) in Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from Apr. 2013 to Nov. 2018 were retrospectively analyzed, including 36 males and 55 females. Preoperative ultrasound features and serum calcitonin levels were recorded. SPSS 22.0 was used and the measurement data of normal distribution was expressed as ± s, and the enumeration data was described by ratio or rate. The comparison between groups was performed by single factor ANOVA and rank sum test. Results:83.5% (86/103) of the MTC nodules were located in the middle and upper thyroid gland. Hypoechoic accounted for 78.6% (80/103) . 81.6% (84/103) of them had calcification and 74.8% (77/103) of these nodules had abundant blood flow signals (color Doppler flow imaging, CDFI Ⅱ-Ⅲ) . 91.3% (94/103) of them had aspect ratio less than 1, 87.4% (90/103) were solid and 35.0% (36/103) had comet tail sign. The positive rate of preoperative serum calcitonin was 86.8% (79/91) . There were significant differences in shape ( P=0.001) , margin ( P=0.012) , cystic ( P=0.004) , comet-tail ( P<0.001) , lymph node ( P<0.001) and color Doppler flow imaging ( P=0.001) through comparing MTC nodules in different TI-RADS grades. Conclusions:MTC can behave as single, solid, hypoechoic, large round nodule located in the middle or upper thyroid gland, with thick calcification and abundant blood flow signals in ultrasound. The surrounding area may be accompanied with comet tail sign, and the probability of lymph node metastasis is high. The suspicious nodules screened by ultrasound can be further diagnosed by serum calcitonin.

Objective To investigate the CT manifestations of Meckel's diverticulum and its complications in children. Methods Retrospective analysis of Clinical and CT findings in 25 cases with pathologically proved Meckel's diverticulum. The unenhanced and contrast-enhanced CT were obtained in all patients. Results (1)The direct signs: the diverticulum cannot be shown in 5 cases; the diverticulums were found around the navel or in lower right abdomen in 20 cases. The blind-ending fluid-filled or gas-filled structures were found in 9 cases, with heterogeneous ring-enhancement. The tubercle-like structures were detected in 11 cases, which showed no enhancement in 4 cases, and homogeneous enhancement in 3 cases,and heterogeneous enhancement in 4 cases. (2) The indirect signs included intestine obstruction in 8 cases,swelling fat layer surrounding the diverticulum in 9 cases, free gas around the diverticulum in 3 cases,thickened mesentery in 8 cases, ascites in 4 cases, and intussusception due to inverted Meckel's diverticulum with "target sign" in 1 case. (3) CT classification: with diverticulitis or diverticular bleeding in 20 eases; with intestine obstruction or intussusception in 8 cases; bands-caused obstruction in 7 cases;intussusception in 1 case; with perforation in 3 cases. Conclusion Meckel's diverticulum and its complications have typical CT findings, and CT can clearly demonstrate diverticulum's shape, margin,internal components and surroundiug tissues.

Objective:To investigate the diagnostic performance of different thyroid imaging reporting and data systems (TI-RADS) in the diagnosis of medullary thyroid carcinoma (MTC) .Methods:A total of 160 thyroid nodules diagnosed as MTC by postoperative pathology from Aug. 2011 to Aug. 2022 at the First Affiliated Hospital of Zhengzhou University were included. Additionally, 160 papillary thyroid carcinomas (PTC) and 160 benign nodules were randomly selected as controls during the same period. Differences in gender, age, nodule diameter and various ultrasound features were observed. The nodules were classified according to American College of Radiology (ACR) TI-RADS, artificial intelligence (AI) TI-RADS and Chinese (C TI-RADS). Then, receiver operating characteristic curve (ROC) were plotted to calculate the diagnostic value. The Kendall concordance coefficient was used to evaluate the interobserver consistency of each TI-RADS system.Results:There was no statistically significant difference in gender among the three groups ( χ2=1.17, P=0.558). However, significant differences were observed in age and nodule diameter ( F=12.08,40.12, P<0.001 for both). The area under ROC (AUC) for diagnosing MTC and benign nodules using ACR, AI, and C-TIRADS were 0.762, 0.773, and 0.761, respectively, with no statistically significant differences ( Z=1.33, 0.01, 0.87, P=0.183, 0.994, 0.386). However, the sensitivity of C TI-RADS (87.5%) was lower than that of ACR and AI TI-RADS (both 95.0%) ( P=0.018). After combining the biopsy threshold, the false negative rate of C-TIRADS was lower than that of ACR (30.6% vs. 41.3%) ( P=0.048) and AI TIRADS (30.6% vs. 43.1%) ( P=0.020). The inter-observer diagnostic consistency of C-TIRADS was superior to ACR (0.884 vs. 0.819, P<0.001) and AI TIRADS (0.884 vs. 0.839) ( P<0.001) . Conclusions:AI and ACR TI-RADS have higher sensitivity in diagnosing MTC, while C TI-RADS has a lower puncture missed diagnosis rate. AI has similar diagnostic performance to ACR TI-RADS and can replace ACR TI-RADS.

Objective To observe the effect of ultrasound-guided iliopsoas plane block(IPB)on the quality of postoperative recovery in patients undergoing hip arthroplasty.Methods Sixty patients who underwent hip arthroplasty were selected,37 males and 23 females,aged 40-79 years,BMI 18-30 kg/m2,ASA physical status Ⅰ-Ⅲ.The patients were divided into two groups by random number table method:the iliopsoas plane block group(group IPB)and the femoral nerve block(FNB)group(group FNB),30 pa-tients in each group.Before anesthesia induction,IPB was performed with 0.5%ropivacaine 10 ml and lat-eral femoral cutaneous nerve block was performed with 0.5%ropivacaine 5 ml in group IPB.And FNB was performed with 0.5%ropivacaine 10 ml and lateral femoral cutaneous nerve block was performed with 0.5%ropivacaine 5 ml in group FNB.The dosages of propofol,remifentanil,and cis-atracurium during operation were recorded.The quality of recovery-15(QoR-15)scale was evaluated preoperatively and postoperatively 1 day,2 and 3 days.The max VAS(VASmax)pain score and manual muscle test(MMT)score of quadri-ceps muscle were recorded 12,24,and 48 hours after surgery.The time of getting out of bed for the first time,opioid dosage,and patient satisfaction were recorded.The incidence of nerve injury,vascular injury,puncture site infection,and local anesthetic poisoning were recorded.The postoperative complications of diz-ziness,nausea and vomiting,deep vein thromboses,and elirium were also recorded.Results There was no significant difference in the dosage of propofol,remifentanil,and cis-atracurium between the two groups.Compared with group FNB,the QoR-15 scale score in group IPB was significantly higher 1 day,2 and 3 days after operation(P＜0.05).Compared with group FNB,the MMT scores of quadriceps muscle was sig-nificantly higher in group IPB 12 and 24 hours after surgery(P＜0.05),and the first time of getting out of bed was shortened in group IPB(P＜0.05).However,there were no significant differences in the VASmax pain score,MMT score of quadriceps muscle 48 hours after surgery,opioid dosage,and patient satisfaction between the two groups.No nerve block related complications were found in both groups.There were no sig-nificant differences in postoperative complications between the two groups.Conclusion The iliopsoas plane block can improve the quality of postoperative recovery and accelerate the recovery of patients with hip re-placement,and the effect is better than that of femoral nerve block.