Objective To describe the sonographic features of abdominal wall endometriosis(AWE).Methods 105 consecutive women with proven pathological endometriosis of the abdominal wall were retrospectively recruited.The clinical data and the result of the sonographic examinations were reviewed and described.The AWE lesions were divided into ＜3 cm and ≥3 cm groups according to their maximum diameter.Results The sonographic feature of AWE includes irregular hypoechoic nodules with ill-defined margins,anechoic and hyperechoic ring maybe exist.In color Doppler,most of them showed few internal vascularity.Compared with≥3 cm group,＜3 cm group nodules manifested as shorter latent period,with more superficial location,round or oval shape,peripheral hyperechoic ring and none or few vascularity were more common.As for ≥3 cm group nodules manifested as longer latent period,with deeper location,irregular shape,abundant of vascularity were more common.Conclusions Specific diagnosis of AWE can be made by using high frequency sonography combined with clinical features.More accurate information can be provided by judging the size,range and infiltrative depth.

BACKGROUND:Rehabilitation brace can significantly improve the motor function of patients with post-stroke hemiplegia. OBJECTIVE:To investigate the types and biocompatibility of brace materials for post-stroke hemiplegia. METHODS: A computer-based search of Wanfang, CNKI, PubMed databases was performed for articles related to post-stroke hemiplegia and biocompatibility of brace materials published from 1999 to 2015 using the keywords of cerebral apoplexy, hemiplegia, support, material in Chinese and English, respectively. In the same field, the articles published recently or in authoritative journals were preferred. Finaly, 15 articles were enroled in result analysis. RESULTS AND CONCLUSION: Thermoplastic orthoses are mainly made of polypropylene materials, which are used for foot drop caused by post-stroke hemiplegia. Polypropylene has high strength and good toughness, and it is also safe and non-toxic. Semi-rigid planta pedis can help the lift of the toe in swing phase. Orthoses made of polymer fiber materials are characterized by ease of use, good toughness, high strength, and good air permeability, which cannot impact X-ray examination. Carbon fiber materials have light mass, high specific strength and modulus, good anti-fatigue performance, good safety performance and good designability. Clinical trials have shown that patients wearing ankle foot orthoses made of polypropylene and carbon fiber materials have improvement in walking distance and speed of climbing stairs, and these patients also feel more balanced and secure. Experimental studies on different orthotics materials can get more patient preferences, which have a great help for the design and development of orthotics materials.

Objective To measure total hemoglobin concentration (THC) of breast lesion using US-guided diffused optical tomography(DOT) and to investigate the THC optimal threshold value in different size breast lesions.Methods DOT was performed on 500 breast lesions and surgical pathology was as the gold standard.The optimal diagnostic threshold and the efficacy were figured out.Results There were 265 benign and 235 malignant lesions.In malignant lesions,THC of ≥2 cm lesion group was higher than that of ＜2 cm lesion group(P =0.000).In benign lesions,there was no statistical difference between ≥2 cm group and ＜2 cm group (P =0.13).As for ＜2 cm breast lesions,when a THC threshold value of 146.9 μmol/L and 102.2 μmol/L were used,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 74.2％,70.0％,71.7％,62.9％,79.9％ and 86.7％,44.4％,61.6％,51.6％,83％,respectively.As for ≥2 cm breast lesions,when a THC threshold value of 210.4 μmol/L were used,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 74.0％,86.7％,79.1％,89.2％,69.2％.Conclusions THC of breast cancer increased with the increasing size of lesions.The different diagnostic threshold value should be used according to different size lesions so as to enhance sensitivity,specificity and accuracy.

Objective To evaluate the inter-observer variability of static breast sonogram final assessment among observers with different breast imaging experience, using the first edition of the Breast Imaging Reporting and Data System(BI-RADS) for ultrasound. Methods Thirty patients with 30 breast lesions were included who underwent beast lesions resection operation. A pathological diagnosis was available for all 30 lesions:16 (53%) malignant and 14 (47%) benign. Twelve radiologists independently reviewed two sonograms of each lesion, and assigned a final BI-RADS assessment category. Inter-observer variability was measured using kappa statistic. Positive predictive value(PPV) and negative predictive value (NPV) for final assessment were also calculated. Results As for the experienced observers,kappa values of categories 3,4 and 5 were 0.72,0.28 and 0.60,NPV of category 3 was 93% ,PPV of category 5 was 97% ,all of which decreased as the breast imaging experience reduced. PPVs of categories 4a,4b and 4c were 56 % ,88% and 69%, respectively. Conclusions Using BI-RADS final assessment, radiologists with sufficient breast imaging experience can provide accurate and consistent assessment for breast ultrasonography,but the agreement of diagnosis decreased as the breast imaging experience reduced. The clinical feasibility of 4a,4b and 4c subcategories is uncertain.

Objective To observe the clinical effect of Sangpa Zhike decoction in the treatment of acute exacerbations of chronic bronchitis. Methods 180 patients with acute exacerbation of chronic bronchitis admitted to Autonomous Prefecture Hospital of traditional Chinese medicine(TCM)in Changji,Xinjiang,from August 2012 to August 2013 were enrolled. They were divided into Sangpa Zhike decoction treatment group and western medicine treatment control group by random number table,90 cases in each group. General treatments were given to the two groups. In the Sangpa Zhike decoction treatment group,additionally only oral Sangpa Zhike decoction was given(composition:Morus alba 10 g,loquat leaf 10 g,Houttuynia 10 g,honey aster 15 g,honey coltsfoot flower 6 g,Zhejiang Fritillaria 12 g,perilla 10 g,white mustard seed 6 g,Platycodon grandiflorum 10 g,Rhizoma Cynanchi Stauntonii 12 g,tangerine peel 6 g,Stemona 6 g). The ingredients were mixed in water and boiled to form a decoction,one dose daily,divided into two parts to be taken twice a day. In the western medicine treatment group,the infection was controlled by western medicine and the drugs to eliminate cough and phlegm,etc were used. The therapeutic course in both groups was 7 days. The therapeutic effect for treatment of TCM syndromes and the cough quantized integration score in the two groups were observed after treatment. Results The cure rate of Sangpa Zhike decoction treatment group was significantly higher than that of western medicine treatment control group〔70.00%(63/90)vs. 33.33%(30/90),P<0.01〕. Before treatment,the cough symptom quantization integral scores in the two groups had no statistically significance, but after treatment,the scores in the two groups were significantly lower than those before treatment. And the score in Sangpa Zhike decoction treatment group was decreased more significantly (1.66±1.12 vs. 4.36±2.32, P<0.01). Conclusion Sangpa Zhike Decoction has obvious curative effect in the treatment of acute attack of chronic bronchitis.

Recent studies have demonstrated that coagulation function and liver microcirculation disturbance are important in the development and progression of liver diseases. ADAMTS13, also known as von Willebrand factor-cleaving protease, is a metalloproteinase produced by hepatic stellate cells, with major functions to cleave the von Willebrand factor multimers produced by vascular endothelial cells, regulate the adhesive capacity of platelets, and influence the body′s coagulation function and microcirculation. The important role of ADAMTS13 in the pathophysiological processes of various severe liver diseases such as liver cirrhosis, severe alcoholic hepatitis, hepatic veno-occlusive disease after stem cell transplantation, and liver graft dysfunction is reviewed in this paper, and its association with the severity of liver diseases is clarified. Plasma ADAMTS13 is involved in the development and progression of various liver diseases, and measurement of its level and activity can help the diagnosis and differential diagnosis of liver diseases.

Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with severe dysmenorrhea in a prospective cohort study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, carrying status of LNG-IUS, menstruation patterns and adverse effects. Changes of scores and patterns of pain during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 640 cases (58.18%, 640/1 100) had severe dysmeorrhea, with median follow-up period of 35 months (range 1-60 months), and accumulative carrying rate of 65% at 60 months follow-up. After placement of LNG-IUS, scores of pain and ratio of severe dysmenorrhea had decreased significantly compared with baselines (all P<0.01), the scroes of visual analog scale (VAS) were 8.1 ± 0.9, 5.5 ± 2.4, 4.6 ± 2.4, 3.3 ± 2.2, 2.2 ± 2.1, 2.2 ± 1.8, 1.4 ± 1.6 and 1.3 ± 1.3 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 36 months after placement of LNG-IUS, scores of pain had improved significantly compared with preceding period (all P<0.01). We found no universal dependent factors predicting improvement of pain, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusion LNG-IUS is effective for adenomyosis of severe dysmenorrhea. Improvement of pain is independent on patients characters, menstruation patterns or adverse effects.

Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with menorrhea in a prospective study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including scores of menstruation blood loss, carrying status of IUS, symptoms and scores of dysmenorrhea, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Changes of pictorial chart scores of menstruation and distribution of anemia during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 618 cases (56.18%, 618/1 100) had severe menorrhea, with median follow-up period of 28 months (range 1-60 months), and accumulative carrying rate of 66% at 60 months follow-up. After placement of LNG-IUS, compared with baselines, pictorial chart scores and ratio of menorrhea had decreased significantly (all P<0.01), the scroes of menstruation were 157±34, 94±35, 70±33,67 ± 18, 67 ± 20, 65 ± 19, 66 ± 19, 65 ± 21 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 24 months after placement of LNG-IUS, pictorial chart scores and distribution of anemia had improved significantly compared with preceding period (all P<0.01). We found no dependent factors predicting improvement of pictorial chart scores of menorrhea, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusions LNG-IUS is effective for adenomyosis of menorrhea. Improvement of menstruation blood loss is independent on patients characters, menstruation patterns or adverse effects.

Objective To observe the ultrasonographic features of primary squamous cell carcinoma of the breast and its clinical and histopathological characteristics. Methods The ultrasonographic features, clinical and histopathological characteristics of 7 middle-aged women (median age 61 years old) with primary squamous cell carcinoma of the breast confirmed histopathologically from January 1995 to December 2014 in Peking Union Medical College Hospital were retrospectively reviewed. Results There were 8 lesions in seven cases. Six cases were single lesion and 1 case with multiple lesions, the diameters of the lesions were 7.0-60.0 mm [mean (34.0±19.6) mm]. On grayscale ultrasound, 6 lesions with solid compoments were hypoechoic, 2 lesions with solid and cystic compoments were complex echogenic, the lesions all had irregular shape and indistinct margin, 2 lesions had calcifications. On color Doppler flow imaging, 7 lesions had rich blood flow signals (Ⅱor Ⅲ) and 1 lesion had no blood flow signal. On gross histopathological examination, 6 masses were solid, pale-white colored, medium texture and the boundary was not clear. Two masses had cystic cavity. One old patient who was 70 years old had several times chest wall recurrence after mastectomy. On ultrasonography, the lesion showed an anechoic cyst with thick wall. Two chest wall recurrence lesions were cystic with thick wall. Microscopic examination showed squamous cell carcinoma infiltrating into the fiber adipose and skeletal muscle tissue. Conclusions Primary squamous cell carcinoma of the breast is more common in large tumor size. Ultrasound can show the more cysticcomponents of the tumor and abundant vascularity, which is helpful for diagnosis.

Objective To investigate the changes of mestruation patterns and adverse effects during the treatment of levonorgestrel-releasing intrauterine system (LNG-IUS) for symptomatic adenomyosis in a prospective cohort study. Methods From December, 2006 to December, 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in Peking Union Medical College Hospital were given LNG-IUS. Before and after placement of IUS, all patients′ parameters were recorded, including carrying status of IUS, symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Risk factors for changes of menstruation patterns and adverse effects, and their impact on treatment effects were analyzed. Results Totally 1 100 cases met inclusion criteria, with median age 36 years (range 20-44 years), median follow-up 35 months (range 1-108 months). During follow-up changes of menstruation patterns increased significantly with amenorrhea and shortened-menstruation being the most common manifestations. On 3, 6, 12, 24, 36, 48 and 60 months after the placement of LNG-IUS, 0, 5.8%(43/744), 6.9%(47/682), 10.1%(60/595), 17.3%(87/502), 27.2%(104/383) and 29.6%(82/277) patients achieved amenorrhea respectively (P<0.01). Total and subclassification of adverse effects decreased significantly (P<0.01). Within 12 months and >12 months after placement, abdominal pain and body weight increasing ≥5 kg/year were the most common adverse effects. Changes of menstruation patterns, total and subclassifications of adverse effects were neither dependent on patient parameters, treatment modes and treatment effects, nor could predict future LNG-IUS carrying status (all P>0.05). After taking out of LNG-IUS, most changes of menstruation and adverse effects disappeared. Conclusions During the treatment of LNG-IUS for symptomatic adenomyosis, changes of menstruation patterns increase gradually with amenorrhea and shortened-menstruation being the most common manifestations, while adverse effects decrease significantly. Changes of menstruation patterns or adverse effects neither have any risk factor nor have impact on treatment effects.