Objective To evaluate the value of virtual touch tissue imaging quantification (VTIQ),which was combined with ultrasound Breast Imaging Reporting and Data System (BI-RADS),for differentiating benign from malignant breast lesions.Methods Totally 190 patients with 214 breast lesions were enrolled in this study.All lesions were classified according to the BI-RADS for sonography.The maximum,minimum and mean shear wave velocity (SWV) values on VTIQ in the lesions were obtained.The SWV between benign and malignant lesions were analyzed.Receiver operating characteristic(ROC) curves were plotted to determine the cut off value of VTIQ for differential diagnosis of breast lesions. Results Pathology confirmed 166 benign lesions and 48 malignant lesions.The SWVmax,SWVmin,SWVmean of malignant lesions were significantly higher than those of benign lesions (all P<0.001).The SWVmean 3.67 m/s as the best value in the diagnosis of benign and malignant lesions.The sensitivity,specificity,positive predictive value and negative predictive value of the combination of the SWVmean and BI-RADS classification standard in the diagnosis of benign and malignant breast lesions were 77.6%,97.5%,92.7%,91.3%,respectively.Conclusions The combination of VTIQ and ultrasonic BI-RADS can improve the ability of differential diagnosis of benign and malignant breast lesions.

Objective To study the expression of mitochondrial tumor suppressor gene 1 (MTUS1) mR-NA in papillary thyroid carcinoma(PTC).Methods Reverse transcription polymerase chain reaction(RT-PCR) was used to detect MTUS1 mRNA level in 68 cases of human PTC and the adjacent non-cancerous epithelium (NCE) specimens.Results The relative expression value of MTUS1 mRNA in PTC was 0.31 ± 0.09,while it was 0.65 ±0.12 in NCE.The difference had statistical significance between the 2 groups(t =2.39,P ＜0.05).In PTC,mRNA expression of MTUS1 gene was related to the pathological grade,and lymph node metastasis(P ＜ 0.05)while it was not related to patients' age,sex,differentiation degree,tumor size or TNM stage(P ＞ 0.05).Conclusion mRNA expression of MTUS1 gene is lower in PTC than in NCE,which may play an important role in carcinogenesis and progression of PTC.

Objective To study the relationship between the level of serum epithelial fatty acid binding protein (E-FABP) and cardiovascular disease in obese children. Methods Thirty children with metabolic syndrome (MS), 32 obesity children with no MS and 50 healthy children were recruited. Serum E-FABP and glucose/lipid metabolic indices were measured. Results Com-pared with the healthy children, levels of serum E-FABP in MS children were signiifcantly elevated (P=0.001). Compared with obesity children, levels of serum E-FABP of MS children were elevated, but the difference was not signiifcant (P>0.05). The cor-relations of E-FABP with waist to hip ratio, waist-to-height ratio, atherogenic index, fasting insulin, insulin resistance index were positive (P<0.05). According to the multivariate stepwise regression analysis, E-FABP was the independent risk of atherogenic index (P=0.018). Conclusions E-FABP plays a role in the development of atherosclerosis in obesity and MS.

Aim To investigate the effect of MAPK signal transduction pathway on the expression of TNF-? in AM(alveolar macrophage) of CB(chronic bronchitis) rats,meanwhile,to initially discuss the possible regulated target of TAL(triterpene acids of loquat.leaf),to explain the mechanism about anti-inflammatory action of TAL on CB rats.Methods The depurated AM was incubated with the special inhibitors of MAPK signal transduction pathway respectively(ERK,p38 or JNK) and the expression of TNF-? was observed by RT-PCR and Western blot.Using factorial design,TNF-? level in AM culture supernatant was detected by ELISA.Results The special inhibitors of ERK(PD98059) and p38(SB203580) could change the expression of TNF-? in AM of CB rats apparently.Factorial analysis shows there is statistical significance between TAL,PD98059/SB203580 and mixture of them.Conclusions TAL reducing the expression of TNF-? may be related with the inhibition of ERK and p38 signal transduction pathway.It may be one of the mechanisms by which TAL has the preventive and therapeutic effects on chronic bronchitis.

The onset of hepatocelluar carcinoma, one of the serious complications of primary Budd-Chiari syndrome, is associated with poor prognosis.Although so, the diagnosis and treatment of such disease has still not been standardized at recent.In this paper, we overviewed the recent advances on Budd-Chiari syndrome associated with hepatocelluar carcinoma.

Objective To investigate the pattern of antihypertensive medication prescribing in outpatients from the Second Hospital of Tianjin Medical University, and analyze the shortcoming and deficiency compared with 2010 Chinese guidelines for the management of hypertension. Methods A total of 154 262 electronic prescribing for outpatients with hy-pertension, from January-December 2012 in a Grade 3A hospital in Tianjin, were enrolled in this retrospective survey. Data of commonly used antihypertensive medication and combination therapy in patients were analyzed. The patient data collected were divided into different groups according to age, gender, high blood pressure level and the onset of the season. Results (1)The list of the drugs commonly used for treating hypertension in outpatients were calcium antagonist (52.3%), angiotensin receptor blockers (34.0%),βblockers (25.9%), angiotensin-converting enzyme inhibitors (12.1%), fixed-dose combination (11.0%) and diuretics (1.4%).(2)The fewer combination therapy was found in outpatients than that of monotherapy (43.9%vs 56.1%). Some prescriptions were not routinely recommended by the Guideline (4.6%).(3)The combination therapy used in patients with stage 3 hypertension was higher than that of patients with stage 1or stage 2 hypertension (44.5%vs 37.7%vs 37.7%, P<0.01). The rate of combination therapy was significantly higher in cardiology department than that of other clini-cal departments (P<0.01). The combination therapy tended to be used in the elderly patients than that of non-elderly pa-tients (P<0.01). The number of prescriptions was lower in summer than that of other seasons,but the rate of combination therapy was higher in summer than that of spring, autumn and winter (P<0.01). Conclusion The prescriptions of combina-tion therapy and diuretic were inadequate in outpatients with hypertension. These findings indicate the difference between clinical prescription and the guideline for the management of hypertension.

Objective:To explore the safety and efficacy of Castor branched stent-graft exclusion in the treatment of aortic dissection and aneurysm involving left subclavian artery.Methods:The clinical and imaging data of 88 patients with aortic dissection or aneurysm involving left subclavian artery diagnosed by CTA or DSA in our hospital from December 2017 to December 2019 were collected retrospectively, including 67 aorta dissections, 7 thoracic aortic aneurysms and 14 aorta penetrating ulcer. All patients were treated with branched stent-graft under the guidance of DSA. The postoperative curative effect and complications were observed. The paired t test was used to compare the maximum aortic diameter of the lesion before and 6 months after the operation. Results:Eighty-eight patients were successfully treated with integrated stent, the success rate of operation was 100%, and the disease-related symptoms of all patients were basically or completely relieved. The mortality rate within 1 month after the operation was 2.7% (2/88). The two deaths were complicated with other serious diseases before the operation, and the cause of death was not related the operation. All patients were followed up except 4 patients who lost contact after discharge. During the follow-up, there were 1 case of retrograde type A dissection, 1 case of new aneurysm of aortic arch, 2 cases of in-stent stenosis of left subclavian artery branch, 3 cases of mild stroke, no persistent endoleak and no death or other serious complications. The mean maximum aortic diameter at 6 months after operation [(34±4)mm] was significantly lower than that before operation [(38±6 mm)] ( t=6.63, P<0.05). Conclusion:Castor branched stent-graft is simple, mini-invasive and effective in the treatment of aortic dissection and aneurysms involving the left subclavian artery.

Objective: To study risk factors for non-alcoholic fatty liver disease (NAFLD) and vascular erectile dysfunction (ED) in patients with metabolic syndrome (MS). Methods: A total of 18 096 subjects were selected from people undergoing physical examination from 2008 to 2009 in northern cities of China by random cluster sampling method, and analyzed the risk factors for NAFLD and ED. Results: The 18 096 cases with age 18~76 (46.8±10.1) years old，containing 10 096 (55.79%) males and 8 000 (44.21%) females. Awareness rate of MS was 8.33% and prevalence rate of MS in healthy adults was 21.18%. Most common components of MS were hyperuricemia (27%, 4838/18096), obesity and overweight (21%), hypertension (20%,) and dyslipidemia (17%) in turn. Body mass index (BMI, kg/m2) and waist/hip ratio (WHR) of all MS subgroups from high to low were ED group [(28.9±1.1), (1.26±0.03)], overweight or obesity group [(27.5±2.3), (1.31±0.03)], prediabetes group [(26.8±2.6), (1.03±0.03)] and hypertension group [(26.1±1.3), (0.90±0.04)] in turn. A total of 3 721 MS patients （20.56%）complicated with NAFLD; By means of NAFLD complicated by MS as dependent variable, Logistic regression analysis indicated that increased ALT, waist circumference（WC）, age, DM family history, LDL-C and BMI (β=1.004~0.479, P=0.000~0.016 in turn) were risk factors for NAFLD, and physical exercise and occupational physical work were protective factors for NAFLD. There were 106 ED males and its prevalence rate was 1.04%; Logistic regression analysis indicated that age, WC, LDL-C, DM family history and BMI (β=0.681~0.238, P=0.000~0.018 in turn) were risk factors for ED, and educational degree, physical exercise and occupational physical work were protective factors for ED. Conclusion: Risk factors for NAFLD and ED in MS were closely correlated with MS. It’s a new path to prevent and treat NAFLD and ED through correcting risk factors of MS.

Objective To evaluate the feasibility and clinical outcomes of interventional treatment of Budd-Chiari syndrome (BCS) associated with simultaneous upper gastrointestinal hemorrhage.Methods The clinical data of 32 patients of BCS with upper gastrointestinal hemorrhage from October 2015 to April 2008 in First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.Variceal embolization and inferior vena cave (IVC) and/or hepatic veins (HV) angioplasty were performed simultaneously.Perioperative complications were observed.Portal vein pressures were measured through catheterization preand post-operation.Restenosis of IVC and HV,upper gastrointestinal hemorrhage were observed on followup.Results Percutaneous transluminal balloon angioplasty were successfully carried out in all patients:16 patients with IVC and 17 patients with HV stenosis underwent angioplasty without stent placement.Portography indicated one esophageal and gastric varices in 17 patients and two in 15 patients.All the varices were embolized successfully.The portal vein pressure reduced from (35.7±2.9) cmH2O to (31.2±2.5) cmH2O (P ＜ 0.05,1 cmH2O =0.098 kPa).Portal vein pressure reduced from (35.8± 3.0) cmH2O to (30.7±2.3) cmH2O in HV type BCS post-operation,and reduce from (35.6±3.0) cmH2O to (31.8±2.6) cmH2O in HV and IVC involved type,which indicated that portal vein pressure decreased more obviously after HV recanalization.On follow-up for 3 to 32 months (mean 11.7 ±7.8 months),7 patients with IVC and 5 patients with HV stenosis developed restenosis.Transluminal balloon angioplasty was performed.No upper gastrointestinal hemorrhage occurred during the follow-up period.Conclusion One-stage interventional treatment of BCS with upper gastrointestinal hemorrhage was safe and effective,and had satisfactory mediumlong term outcomes.

A survey on the quality of life of diabetic patients was conducted in Shanghai Changqiao community in August 2017.Total 1 002 patients with type 2 diabetes mellitus (T2DM)aged ≥60 years were randomly selected to participant in this face-to-face questionnaire survey,967 participants completed the survey with a effective rate of 96.5％.The Anxiety Self-Rating Scale and Diabetes-Specific Quality of Life Scale (A-DQOL) were applied for evaluation.The results showed that up to 48.9％(473/967) participants had an anxiety state.Multivariate stepwise regression analysis showed that the educational level was the main influencing factor of A-DQOL (P＜0.05).The educational level and fasting blood glucose were the influencing factors of satisfaction degree and impacting degree score;educational level,treatment mode and BMI were the influencing factors of grade Ⅰ anxiety;age and educational level were the influencing factors of grade Ⅱ anxiety (all P＜0.05).The survey demonstrates that age,educational level,treatment,fasting blood glucose and BMI would affect the quality of life of elderly T2DM patients.