OBJECTIVE To evaluate the drug resistance of Candida isolated from patients' specimen in clinic.METHODS The minimal inhibitory concentration(MIC) test to 243 Candida strains was performed using ATB-Fungus drug susceptibity plate provided by Bio-Merieux.RESULTS The most popular species of Candida in clinic was Candida albicans(64.6%),C.glabrata(14.4%),C.tropicalis(11.1%),C.parapsilosis(5.8%)and C.krusei(4.1%).There was a certain resistance to the 4 kinds of common antifungals including flucytosine,amphotericin B,fluconazole and itraconazole.The resistance status of C.krusei was the most serious,Its resistance rate to 4 kinds of antifungals was 20.0%,50.0%,30.0% and 40.0%,respectively.The drug resistance rate of 5 species of Candida to itraconazole was higher than that to fluconazole.CONCLUSIONS The commonly encountered Candida produce particular resistance to common antifungals,and it is very necessary to detect and control them.

Objective To investigate the contrast enhanced ultrasound (CEUS) characteristics of thickened wall type of gallbladder carcinoma and to evaluate their diagnostic value. Methods The CEUS images, clinical information and pathological results of 26 patients with thickened wall type of gallbladder carcinoma and 37 patients having benign gallbladder disease with thickened wall were retrospectively analyzed. CEUS characteristics of thickened wall type of gallbladder carcinoma were investigated and their diagnostic value was evaluated. The age, length of gallbladder, width and thickness of gallbladder wall were analyzed by t test. The CEUS characteristics of gallbladder wall (intensity of gallbladder wall, mucosal morphology and submucosal hypo-enhancement area)were analyzed by χ2 test.The diagnostic test used ROC (receiver operating characteristic) curve to calculate sensitivity, specificity, positive predictive value, negative predictive value and accuracy. Results The gallbladder wall thickness and patient age in malignant group were all larger than those in benign group[(1.63±0.68)cm vs(0.96±0.55)cm,(63.7±10.1)years old vs (53.2±11.8) years old], with statistically significant difference (t=3.70, 4.32, all P<0.001). In the malignant group, CEUS showed irregular mucosal, hyper-enhancement and sub-mucosal hypo-enhancement area, with statistically significant difference(χ2=48.7,42.9,23.8,OR=9.25,6.17,2.47,all P < 0.001).The sensitivity of irregular mucosa, hyper-enhancement and sub-mucosal hypo-enhancement area were all 100.0%, and their accuracy were 93.7%, 90.5% and 76.2% respectively. If lesions with both irregular mucosa and hyper-enhancement were diagnosed as thickened wall type of gallbladder carcinoma, the diagnostic accuracy could be further improved to 98.4%. Conclusion CEUS can facilitate the differential diagnosis of benign and malignant gallbladder diseases with thickened wall in a high diagnostic value.

OBJECTIVETo assess the accuracy of ultrasound-guided 16G and 18G core needle biopsy for detecting ultrasound visible breast lesions with different sonographic features.

METHODSA total of 955 sonographically detected breast lesions examined with ultrasound-guided core needle biopsy (US-CNB) and subsequently surgically excised from July 2005 to July 2012 were retrospectively reviewed. Histological findings of US-CNB and the surgical specimens were analyzed for agreements, sensitivities, false negative rates, and underestimate rates according to different sonographic features.

RESULTSThe pathological results of the US-CNB showed malignant lesions in 84.1%, high-risk lesions in 8.4%, and benign lesions in 7.5% of the samples. The overall agreement rates were 92.4% for 16G CNB and 92.8% for 18G CNB; their complete sensitivities and false negative rates were both 98.6% and 1.4%, respectively; the high-risk underestimate rates and DCIS underestimate rates were 48.0% and 46.2% for 16G CNB vs 53.3% and 41.2% for 18G CNB, showing no significant difference between the two groups (P>0.01). For both 16G and 18G CNB, the agreements were better for mass lesions than for non-mass lesions (P<0.01). For the mass lesions with a diameter no greater than 10 mm, the agreement rates were lower than the overall data (P<0.01). Calcification in the lesions did not affect the agreement rates (P>0.01).

CONCLUSIONUltrasound-guided 16G and 18G CNB are both accurate methods for evaluating ultrasound visible breast mass lesions with a diameter larger than 10 mm.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; instrumentation ; methods ; Biopsy, Needle ; instrumentation ; methods ; Breast ; pathology ; Female ; Humans ; Middle Aged ; Sensitivity and Specificity ; Ultrasonography, Mammary ; Young Adult

Objective To investigate the differential diagnostic value for thyroid rich blood supply lesions by contrast-enhanced ultrasound (CEUS).Methods From February 2016 to January 2015,patients who suffered with thyroid nodules underwent conventional ultrasound and CEUS before biopsy.Sixty-two lesions with high-enhancement features were included in the final data.The enhancement patterns within and around lesions of CEUS were analyzed,and the high-enhancement ranges were compared with lesions sizes displayed on conventional ultrasound imaging.When pathology was regarded as the golden standard,39 nodules of 62 were benign,and 23 were malignant.The difference of CEUS characteristics between benign and malignant lesion was compared using x2 test.Results The homogeneity or not had significant difference between benign and malignant lesions with high-enhancement features (x2=9.78,P=0.002).The features of high-enhancement with cystic area and uneven distribution of high-enhancement area had significant difference between benign and malignant lesions (x2=10.77,P=0.001),and the former were frequently seen in benign lesions.Peripheral regular and irregular rings had significant difference between the benign and malignant lesions (x2=24.33,P ＜ 0.001).All lesions showed large high-enhancement area were malignant (x2=6.52,P=0.01).The diagnostic sensitivity,specificity and accuracy of CEUS were 95.83％,78.95％ and 85.48％ for thyroid rich blood supply lesions,which were better than those of conventional ultrasound (87.5％,68.42％,75.81％).Conclusions There are different features in CEUS between the benign and malignant thyroid lesions with rich blood supply.Heterogeneous high-enhancement,peripheral irregular rings and extensive high-enhancement area were malignant features.

Objective To study the correlation between ultrasonographic features of thyroid nodule and BRAFV600Emutation. Methods A total of 179 patients with 194 suspicious throid nodules were included in this study. They underwent ultrasound, biopsy, pathology and BRAFV600Emutation examination between October 2015 and February 2016 at Chinese PLA General Hospital. The size of nodules were (1.1±0.8) cm. The size, echo, boundary, shape aspect ratio, calcification and capsular invasion of nodules were investigated. The correlation between ultrasonographic features of thyroid nodule and BRAFV600Emutation analyzed by chis-square test and Logistic Regression analysis using statistical data as independent variable, BRAFV600Emutation as dependent variable. Results There were significant different in nodule′s ratio, boundary, capsular invasion characteristic between the BRAFV600Epositive group and the BRAFV600Enegative group(χ2=11.174,45.517,11.046,all P < 0.05),and these signs are possibly associated with BRAFV600Emutation by logistic regression model analysis(OR=2.276,95%CI:1.117-4.638, P < 0.05; OR=8.412, 95%CI: 3.836-18.448,P < 0.001; OR=2.582, 95%CI: 1.138-5.860,P < 0.05). Conclusions The ratio, boundary, capsular invasion characteristic of thyroid nodules are possibly associated with BRAFV600Emutation. These signs can be used to predict BRAFV600Emutation and facilitate subsequent treatment for such nodules.

Objective To explore the curative effect and influencing factors of percutaneous radiofrequency ablation(PRFA)for benign thyroid nodules in order to improve the effect of thyroid benign nodule ablation treatment.Methods The study included 482 benign thyroid nodules.The largest diameter of benign thyroid nodules ranges from 0.7 to 9.2 cm.Two hundred and fifty-eight nodules were solid nodules,224 nodules were cystic-solid nodules,and 96 thyroid nodules combined with the background of Hashimoto's thyroiditis.The patients of this study included 356 females and 126 males,the ages of the study population ranged from 14 to 82 years old.In order to observe the local pain,swelling,skin infection,hoarseness and other complications of the thyroid nodules with PRFA,we conducted conventional ultrasound and contrast-enhanced ultrasound immediately and followed up in 1,3,6,12,18 and 24 months after the treatment.Besides,the nodule volume reduction ratio was calculated,and the effects of gender,age,nodule size,cystic proportion,and the background of Hashimoto's thyroiditis on the treatment were analyzed.Results The volume of benign thyroid nodules after the PRFA treatment was significantly reduced after 1,3,6,12,18,24 months,and their nodule volume reduction ratio(VRR)was(51.2±5.7)%(1 months),(69.7±4.3)%(3 months),(84.6±3.7)%(6 months),(89.3±2.9)%(12 months),(93.7±1.6)%(18 months)and(94.9±1.4)%(24 months),respectively.The thyroid nodules were divided into 3 groups according to the cystic portion,significant differences were found in the volume reduction rate at 1,3,6,12,18 and 24 months after PRFA(F=66.858,69.101,19.410,49.559,146.653 and 309.950 respectively,all P＜0.001),the more cystic portion was,the faster the lesion shrinked.The nodules with the cystic portion ＜ 20%were grouped according to the maximum diameter(≤3 cm/＞3 cm),and the background of Hashimoto's disease; and significant differences were found in the volume reduction rate at 1,3,6,12,18 and 24 months after PRFA(the t values for different size groups were 9.710,8.925,9.899,12.734,17.226 and 42.580,respectively,the t values for whether there is a background of Hashimoto's disease were 66.858,69.101,19.410,49.559,146.653,309.950,respectively,all P ＜ 0.001).The VRR of nodules of which the maximum diameter ≤ 3 cm,or without Hashimoto's thyroiditis was larger after radiofrequency ablation.The nodules of which the maximum diameter≤3 cm and with the cystic portion ＜20%were grouped according to different genders(male or female)and different ages(≤40 or＞40 years old),and the mean VRR of the nodules between different gender and age groups are not significantly different(P＞0.05).Conclusions Ultrasound guided PRFA is a safe and effective minimally invasive therapy for benign thyroid nodules.

Objective To investigate the application of CT image and cone beam computed tomography (CBCT) image registration based on 3D Slicer software in image-guided radiotherapy for uterine cervical neoplasms. Methods Based on 3D Slicer software and Slicer RT toolkit, 10 positioning CT images and 50 CBCT images of 10 patients with uterine cervical neoplasms in Henan Provincial People's Hospital between January 2018 and October 2018 had rigid registration and b-spline deformation registration respectively. The dice similarity coefficient (DSC) and Hausdorff distance (HD) of the bladder, rectum, femoral head, spinal cord, and body of CT-CBCT images were compared by using paired t-test before and after the registration. Results Pre-registration, rigid registration and after b-spline deformation registration of CT images and CBCT images, the DSC in the bladder (0.459±0.177, 0.528±0.184, 0.542±0.187, respectively), the rectum (0.564±0.141, 0.632±0.091, 0.684±0.097, respectively), the femoral head (0.695±0.088, 0.833± 0.030, 0.865±0.027, respectively), the spinal cord (0.587±0.119, 0.746±0.085, 0.834±0.032, respectively) and the body surface (0.922±0.013, 0.948±0.011, 0.959±0.009, respectively) showed an increased trend; HD in the bladder (12.8±7.2, 12.2±7.1, 11.7±7.3, respectively), the rectum (5.0±1.8, 4.4±1.2, 3.4±1.2, respectively), the femoral head (3.6±1.2, 1.8±0.5, 1.5 ±0.5, respectively), the spinal cord (4.0 ±1.0, 2.7 ±1.3, 1.8 ±0.5, respectively) and the body surface (6.3±2.1, 5.2±2.0, 4.3±2.0, respectively) showed a decreased trend. The differences of pairwise comparison in the same parts were statistically significant (all P < 0.05). Conclusions Both rigid registration and b-spline deformation registration of CT-CBCT images based on 3D Slicer softwarecan improve the radiotherapy accuracy of uterine cervical neoplasms, and b-spline deformation registration has more significant advantages.

Purpose To explore the differences of the accuracy of detection and recognition of thyroid nodules and the diagnostic efficacy of benign and malignant thyroid nodules via artificial intelligence(AI)ultrasound assisted systems based on different ultrasound parameters.Materials and Methods A total of 147 patients with 289 nodules who underwent thyroid surgery in the First Medical Center of Chinese PLA General Hospital from March 30,2023 to May 1,2023 were prospectively selected.Different ultrasound parameters were adjusted and the AI system was used to detect and diagnose benign and malignant thyroid nodules via each parameter.Taken pathological results as the gold standard,the accuracy of thyroid nodule detection and the accuracy of benign and malignant diagnosis under different ultrasound parameters were compared,respectively.Results Under the standard ultrasound parameters,the accuracy of AI system in detecting thyroid nodules was 94.1%,the sensitivity for benign and malignant diagnosis was 90.9%,the specificity was 79.6%,and the accuracy was 86.6%,respectively.In terms of detection accuracy,accuracy under low gain(χ2=4.453,P=0.035)and high gain(χ2=6.215,P=0.013)parameters of AI system were significantly lower than those of standard ultrasound parameters.In terms of diagnostic efficacy,specificity(χ2=4.620,P=0.032),accuracy(χ2=7.521,P=0.006),area under the curve(Z=3.102,P=0.001),high gain sensitivity(χ2=6.170,P=0.013),accuracy(χ2=4.127,P=0.042),area under the curve(Z=2.152,P=0.031)and high depth accuracy(χ2=5.011,P=0.025),area under the curve(Z=2.420,P=0.015)of low gain were all significantly reduced compared to standard ultrasound parameters,with statistical differences.Conclusion When using the AI system to assist in the examination of thyroid nodules,attention should be paid to the adjustment of ultrasound instrument parameters.Improper parameter adjustment may reduce the AI system's ability to detect thyroid nodules and the accuracy of benign and malignant diagnosis.

Objective To compare the ultrasound features of papillary thyroid carcinoma with or without cervical lymph node metastasis (LNM). Methods Patients suspected of thyroid cancer underwent the conventional ultrasound and contrast-enhanced ultrasound (CEUS) examinations. Patients' age,sex,and ultrasound characteristics of lesions were recorded. With the surgical pathology as the golden standard,the ultrasound features were compared between the cervical LNM group and non-LNM group. Results Of 144 patients,51 had cervical LNM and 93 did not. Patients' ages,sex and number of lesions had no significant difference between two groups (all P>0.05). Tumor with LNM had maximum size greater than 0.85 cm,ill-defined margin (P=0.000),irregular shape (P=0.007),internal heterogeneous echogenicity (P=0.007),microcalcification (P=0.020),internal heterogeneous low-enhancement (P=0.002),peripheral non-enhancement ring (P=0.030),and extracapsular extension (P=0.000). Conclusion Conventional ultrasound and CEUS are helpful for predicting the cervical LNM of PTC. CEUS can obtain more accurate diagnostic results for the extracapsular extension,which contributes to the prediction of cervical LNM.

Objective: The aim of the study is to compare the diagnostic value of multiparametric transrectal ultrasound(TRUS) and multiparametric magnetic resonance imaging (MRI) in prostate cancer. Methods: The clinical data of 102 patients who received multiparametric TRUS (including conventional transrectal ultrasound, shear wave sonoelastography and contrast enhanced ultrasound), multiparametric MRI(including T2 weighted diffusion weighted, and dynamic contrast enhanced MRI) and laboratory tests from April 2016 to May 2018 were retrospectively analyzed. The average age was 66.1 years old, ranging 38.0-85.0 years old. The average PSA was 30.1 ng/ml, ranging 0.4-227.0 ng/ml. The average PSAD was 0.67 ng/ml^2, ranging 0.02-4.27 ng/ml². The pathology results from TRUS guided biopsy or surgical operation were chosen as gold standard. Diagnostic performance including sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), accuracy and area under the receiver operating characteristic curve(AUROC)of multiparametric TRUS and multiparametric MRI in prostate cancer were analyzed. Results: There were 62 prostate cancer and 40 BPH patients in our study. Parallel multiparametric TRUS diagnosed 63 prostate cancer and 39 BPH, and multiparametric MRI diagnosed 75 prostate cancer and 27 BPH. The sensitivity, specificity and accuracy of parallel multiparametric TRUS were 98.4%, 70.0% and 87.3%, respectively. And those of multiparametric MRI were 95.2%, 60.0% and 81.4%, respectively. The AUROC of parallel multiparametric TRUS and multiparametric MRI were 0.842 and 0.776, with no significant differences(P=0.208). Conclusion The diagnostic value of multiparametric TRUS was not inferior to multiparametric MRI in prostate cancer.