Objective To study the value of time intensity curve of contrast enhanced ultrasound in the discrimination of benign and malignant soft tissue tumors. Methods Thirty-seven cases of soft tissue tumors were carried out contrast-enhanced ultrasound examination. The region of interest in the dynamic images were chosen to carry out Gamma-Variate curve fitting through Q-LAB software and made a quantitative analysis. Then they were compared with pathological diagnosis to analyze the ultrasound imaging performance of benign and malignant tumors and their characteristics of micro-irrigation. Results Thirty-seven cases of soft tissue tumors were pathologically diagnosed 21 cases of benign and malignant in 16 cases. The perfusion of benign tumors were mainly uniformity (19/21) or potentialization (2/21). The perfusion of malignant tumors were mainly uniformity (10/16) or nonuniformity (6/16). There were no significant differences in time to peak(TTP) and arrival time of contrast agent(AT) between benign and malignant tumors( P ＞0.05). The upslope rate(A) and the derived peak intensity(DPI) in benign group were significantly less than malignant group ( P ＜0.05). Conclusions Time-intensity curve analysis of contrast-enhanced ultrasound showed that benign and malignant soft tissue tumors were different in perfusion,and it will be of a certain value for the clinical differential diagnosis.

Objective To detect the expression of chemokine receptors CXCR3 mRNA in the peripheral blood mononuclear cells (PBNCs) of patients with Rheumatoid Arthritis (RA) and to analyze the relationship between the expression and the disease activity. Methods mRNA was extracted from PBNCs and the expression of CXCR3 mRNA was detected by real-time fluorescence quantitative PCR (RFQ-PCR) in 51 RA patients and 32 controls. T-test, x2-test, ANOVA were used for statistial analysis. Results Comparison between the two groups had shown that the expression levels of CXCR3 mRNA in clinical active RA group were higher than those of the RA patients in remission and healthy controls (P<0.05). The expression levels of CXCR3 mRNA were positively correlated with serum levels of ESR and CRP in clinical active RA group (r=0.824, r=0.765, P<0.05). In addition, RF titer, APF, AKA, and anti-CCP had no significant correlation with the expression levels of CXCR3 mRNA in RA patients (P>0.05). Conclusion RFQ-PCR is a sensitive,reproducible and practical test. The mRNA expressions of CXCR3 are significantly elevated in RA patients,which suggest that CXCR3 may be involved in the pathogenesis of RA. The mRNA expressions of CXCR3 in active RA patients are higher than those of RA patients in remission. These results indicate that CXCR3 may play an important role in the pathogenesis and progression of RA, and CXCR3 may be considered as an indicator for disease activity, therapeutic efficacy and prognosis of RA.

Objective To explore the clinical features of hemophagocytic syndrome in children and the signifi﹣cance of gene detection. Methods TWenty－tWo pediatric patients diagnosed as hemophagocytic syndrome since 2004 clinical and laboratory criteria Were enrolled in Children＇s Hospital Affiliated to Zhengzhou University from January 2014 to January 2016. The clinical data of patients Were analyzed,and the genes associated With hemophagocytic syn﹣drome Were detected. The clinical biochemical indicators Were compared betWeen mutation group and non －mutation group. Results TWenty－tWo cases of patients(3 months to 12 years)Were enrolled,including 10 males and 12 fe﹣males,and the proportion of children over 5 years old accounted for the highest proportion,accounting for 50%,and all of them had fever,liver,spleen and lymph node enlargement. The main test results Were as folloWs:peripheral blood cells decreased in 6 cases( 27. 27%),hemophagocytic phenomena presented in bone marroW smears in 12 cases (54. 55%),abnormal liver function in 18 cases(81. 82%),and loW serum albumin in 22 cases(100. 00%). High serum ferritin levels Were detected in 20 cases(90. 91%);the detection of natural killer(NK)cell activity shoWed nor﹣mal activity( active ＞ 15%) in 7 cases( 31. 82%),and decreased activity( activity ≤ 15%) in 15 cases (68. 18%). The genes associated With hemophagocytic syndrome Were detected in 22 cases of patients,and 12 of them Were associated With mutations related to hemophagocytic syndrome,accounting for 54. 55%. LYST,ITK and UNC13D gene Were common. There Was no statistical difference in Which ages of onset,symptoms of the nervous system,and labo﹣ratory data of leukocyte count,red blood cell count,hemoglobin,platelet count,NK cell activities,prognosis,hemophago﹣cytic phenomena shoWed in bone marroW smears,alanine aminotransferase,albumin,triglyceride,ferritin and fibrinogen betWeen mutation group and non－mutation group(all P＞0. 05). Conclusions Pediatric hemophagocytic syndrome is mostly accompanied by fever,liver,spleen and lymph node enlargement,and most of them are accompanied by gene mu﹣tations. LYST,ITK and UNC13D gene are commonly seen. But there is no significant correlation betWeen gene mutation and general condition,biochemical index and severity of the disease.

Objective To investigate the role of endometrial thickness,uterine artery and spiral artery blood flow parameters,endometrial and subendometrial blood flow on pregnancy outcome in vitro fertilization-embryo transfer (IVF-ET) cycle,compare the difference of the endometrial and subendometrial blood flow typing between the superb micro-vascular imaging (SMI) and power doppler ultrasound (PDUS). Methods Forty-one patients undergoing IVF-ET cycles in our hospital were recruited in this study. Transvaginal color Doppler ultrasound was performed to determine and record endometrial thickness,peak systolic velocity(PSV),end diastolic velocity(EDV),pulse index(PI),resistance index(RI), systolic diastolic ratio(S/D) of uterine artery and spiral artery,and degree endometrial and subendometrial blood flow signals were showed under the two blood flow modes of PDUS and SMI respectively on the day of human chorionic gonadotropin(HCG) injection.The degree of the endometrial and subendometrial blood flow was scored using Applehau classification method.According to the pregnancy outcome,patients were divided into pregnancy group and nonpregnancy group,the difference of the above indicators between the two groups were compared,and the degree of endometrial and subendometrial blood flow under two kinds of blood flow mode were observed.Results ①On the day of HCG injection,patients in pregnancy group had lower RI,PI,S/D of spiral artery than those in the nonpregnancy group (P< 0.05). There were no significant difference between the pregnant group and nonpregnant group in endometrial thickness and the blood flow parameters of uterine artery ( P >0.05). ②On the day of HCG injection,there was significant difference between the pregnant group and nonpregnant group in endometrial and subendometrial blood flow degree with SMI mode ( P =0.005).The patients with type Ⅲ in pregnancy group were most (50% ). ③The endometrial and subendometrial blood flow typing (β= 1.085,OR= 1.085,95% CI=1.040 -8.421, P=0.042) of pregnancy group under SMI mode have an independent predictive value.With increased blood flow typing under endometrial and subendometrial blood flow,the higher the possibility of pregnancy in patients.The ROC curve analysis showed that the area under ROC endometrial and subendometrial blood flow typing SMI mode on the HCG day was 0.746( P =0.008).Conclusions SMI is a new and effective type of Doppler ultrasound technique to evaluate the endometrial and subendometrial blood flow in IVF-ET cycle.On the day of HCG injection,the endometrial and subendometrial blood flow typing in SMI mode may predict pregnancy outcomes in IVF-ET cycles,and guide to choose the best embryo transfer time.

Objective To evaluate the clinical value of 3D reconstruction in the single utility-port thoracoscopic segmentectomy of early stage NSCLC by propensity score matching (PSM). Methods We retrospectively analyzed clinical data of 150 early stage NSCLC patients undergoing single utility-port thoracoscopic segmentectomy. The patients were divided into reconstruction group (n=58) and non-reconstruction group (n=92) according to 3D reconstruction. PSM was performed on two groups to compare perioperative outcomes. Results Procedures were successfully completed on all patients, without perioperative death. In each group, 43 patients were successfully matched after PSM on the basis of 8 confounding factors, age, gender, smoking status, BMI, maximum tumor diameter on CT, tumor location, % FEV1 and type of planned segmentectomy. After PSM, in complex segmentectomy, the patients in the reconstruction group had shorter operation time (155.77±30.17 vs. 212.94±66.49min, P < 0.001) and less blood loss (46.00±25.94 vs. 88.79±68.36ml, P=0.002), compared with the non- reconstruction group. Conclusion Preoperative 3D reconstruction could help improve the efficiency of single utility-port thoracoscopic surgery for complex segmentectomy and reduce intraoperative bleeding.