Objective To assess the value of ultrasound elastography (UE) in the differential diagnosis of benign and ma‐lignant breast masses.Methods Clinical data of 180 female patients with breast masses were collected. A total of 180 masses in these patients were detected by ultrasound (US) and UE to primarily identify the benign or malignant masses before surgery. The diagnostic coincidence rate and values of ROC curve were compared based on the postoperative pathologic results between the two diagnosis methods.Results Forty‐eight benign masses and 127 malignant masses were correctly diagnosed by UE ,and 38 benign masses and 112 malignant masses by US. The sensitivity ,specificity ,accuracy ,positive predictive value and negative predictive value were higher in UE group than in US group ,and there were significant statistical differences (P<0.05 for all). Furthermore ,the value of area under the ROC curve (AUC) in UE group was 0.926 ,significantly higher than that in US group (0.899) (Z=2.8 ,P<0.05).Conclusion UE has the advantages of high sensitivity ,specificity and accuracy in differential di‐agnosis of the nature of breast masses. In terms of some disadvantages of UE ,UE should be combined with US in the diagnosis of benign and malignant breast diseases.

Objective To study the efficacy and safety of high intensity focused ultrasound (HIFU) treatment for advanced pancreatic cancer.Methods In this study,25 patients with advanced pancreatic cancer received high-intensity focused ultrasound (HIFU) treatment.Liver and kidney function,CA19-9 levels,tumor size changes,pain relief,survival rate before and after treatment were evaluated.Results The blood routine test,liver and kidney function,blood amylase did not alter significantly after HIFU treatment in all patients.The CA19-9 level of 12 patients decreased.The appetite of 15 patients improved,5 patients with body weight gain after HIFU treatment.Pain was relieved after HIFU treatment in 18 cases,pain relief rate was 72％ (18/25).In 15 cases tumor ablation volume ＞ 90％ after HIFU treatment,5 patients with tumor ablation volume ＞ 50％,tumor ablation effective rate was 80％ (20/25).There were no major complications such as acute pancreatitis,gastrointestinal injury after HIFU treatment.After HIFU treatment,the median survival period was 8 months,1 year survival rate was 30％.Conclusions High-intensity focused ultrasound is a safe and effective method of palliative treatment for advanced inoperable pancreatic cancer.

Objective To study the efficacy and the safe dosage of high intensity focused ultrasound (HIFU) ablation in pancreatic cancer.Methods From November 2010 to May 2013,21 patients with advanced pancreatic cancer were treated by HIFU at the First Affiliated Hospital of Zhengzhou University.These patients who were randomly divided into two groups (10 and 11 patients respectively),were given a low-power (100～249 W) treatment and a high power (250 ～350 W) treatment.These two groups of 21 patients received a total of 25 times of HIFU treatment (3 patients received twice of low-power treatment,while 1 patient received twice of high-power treatment).The two groups were compared by analyzing the treatment parameters (average power,total treatment time,treatment total energy,treatment volume,etc.) and volume of tumour response as shown on postoperative imaging (CT or MRI) examinations.Also,the complications,degree of pain relief and survival were compared.The energy efficiency factor (EEF) and the ablation ratio were calculated.A preliminary study was conducted on the relationship of the ultrasound dose and the ablation effect of HIFU treatment for pancreatic cancer.Results (1) The EEF of the high-power group (≥250 W) and the low-power group (＜ 250 W) were (10.39 ± 5.71) J/mm3 and (21.62 ± 9.81) J/mm3,the former group was significantly lower than the latter group (P ＜0.05) ; the ablation ratio of the high-power group was higher than the low-power group,(91.52 ± 4.18)％ versus (51.59 ± 7.66)％ respectively,the difference was statistically significant (P ＜ 0.001).(2) The efficiency factor and the ablation volume for the HIFU treatment showed a linear trend,and both were negatively correlated (Pearson correlation coefficient r =-0.485,P ＜ 0.05).(3) There was no serious complication after the HIFU treatment.In the low-power group,six of ten patients were alleviated of his pain (60％) ; the CA19-9 decreased in four of ten patients after HIFU treatment (40％).In the high-power group,nine of eleven patients were significantly relieved of pain after treatment (82％),the CA19-9 decreased in five of nine patients after HIFU treatment (56％).(4) On Kaplan-Meier survival analysis,HIFU treatment of patients with pancreatic cancer,the median survival was 8 months and 9 months in the low-power group and high power group,respectively (Log-rank test x2 =0.05,P =0.944).Conclusion During HIFU treatment of patients with pancreatic cancer,if the ultrasound power was between 250 W and 350 W,there was a higher proportion of tumor ablation,but with no serious complications.Thus,this dose was safe.

Objective To evaluate the clinical effect and complications of total hip replacement (THR) in novel femoral neck fracture,old femoral neck fracture, aseptic necrosis of femoral head and coxa degenerative osteoarthropathy. To provide instructions to surgical indications and treatment effects analysis.Methods One hundrde and four patients were divided into 4 groups by disease type: novel femoral neck fracture group (n = 32 ), old femoral neck fracture group (n = 22) ,aseptic necrosis of femoral head group (n =34) and coxa degenerative osteoarthropathy group (n = 16). These patients were followed-up for 12 - 144 months after THR, their Harris standard score and complications data, before and after operation, were analyzed retrospectively. Results After operation, the Harris standard scores were 92. 6 ± 5.8,90. 1 ± 5. 2,86. 3 ± 4. 6,81.9 ±4. 1 in novel femoral neck fracture,old femoral neck fracture,aseptic necrosis of femoral head and coxa degenerative osteoarthropathy groups respectively, which were significantly higher than the scores before operation (25.6±1.8,36.7±2.6,52.9±4.3,42. 1 ±3.8,Ps ＜0.05). Conclusion THR has good effects in the four types of diseases. Short length of stay and high healing rate are marked characteristics of THR. More attention shoud be paid to the complications of THR.

Cellular prion protein (PrP(C)) is ubiquitously expressed in the cytomembrane of a considerable number of eukaryotic cells. Although several studies have investigated the functions of PrP(C) in cell proliferation, cell apoptosis, and tumorigenesis of mammals, the correlated functions of chicken PrP(C) (chPrP(C)) remain unknown. In this study, stable chPrP(C)-downregulated Marek's disease (MD) virus-transformed avian T cells (MSB1-SiRNA-3) were established by introducing short interfering RNA (SiRNA) targeting chicken prion protein genes. We found that downregulation of chPrP(C) inhibits proliferation, invasion, and migration, and induces G1 cell cycle phase arrest and apoptosis of MSB1-SiRNA-3 cells compared with Marek's disease virus-transformed avian T cells (MSB1) and negative control cells. To the best of our knowledge, the present study provides the first evidence supporting the positive correlation between the expression level of chPrP(C) and the proliferation, migration, and invasion ability of MSB1 cells, but appears to protect MSB1 cells from apoptosis, which suggests it functions in the formation and development of MD tumors. This evidence may contribute to future research into the specific molecular mechanisms of chPrP(C) in the formation and development of MD tumors.
Animals ; Apoptosis* ; Carcinogenesis ; Cell Cycle ; Cell Proliferation ; Chickens ; Down-Regulation* ; Eukaryotic Cells ; Mammals ; Marek Disease* ; RNA, Small Interfering ; T-Lymphocytes*

Amyloidosis ; Cardiomyopathy, Hypertrophic ; Humans

OBJECTIVEIn order to study the relation between polymorphisms of methylenetetrahydrofolate reductase C677T (MTHFR) and susceptibility of stomach cancer (SC).

METHODSWe conducted a case-control study with 107 cases of SC and 200 population-based controls in Huaian city of Jiangsu province, China. The epidemiological data were collected, and DNA of peripheral blood leukocytes was obtained from all of the subjects. MTHFR genotypes were detected by PCR-RFLP method.

RESULTS(1) The frequency of MTHFR variant genotypes (C/T + T/T) among the cases (79.4%) was significantly higher than the controls (68.5%) (P = 0.041 6); the crude OR for SC was 1.78 (95% CI: 0.99 - 3.22). After adjustment for sex and age, the OR for SC was 1.89 (95% CI: 1.08 - 3.32). (2) Subjects who had MTHFR variant genotypes and having smoking habit were at a significantly higher risk of developing SC (OR = 7.72, 95% CI: 2.23 - 26.79) compared with those who had wild-type homozygotes (C/C) genotype and no smoking habit. Individuals who had variant genotypes and who had habit of frequent alcohol drinking were at an increased risk of developing SC (OR = 3.08, 95% CI: 1.30 - 7.23) compared with those with C/C genotype and low consumption of alcohol. As compared with subjects with C/C genotype and low consumption of alcohol and no smoking habit, individuals who had variant genotypes and who had habits of frequent alcohol drinking and smoking had 12.96 (95% CI: 2.76 - 70.46) folds risk developing SC.

CONCLUSIONSThese results in the present study suggested that the polymorphisms of MTHFR C677T was associated with risk of developing SC, and there was a coordinated effect between MTHFR genotypes and habits of smoking and alcohol drinking in the development of SC.

Alcohol Drinking ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; Middle Aged ; Oxidoreductases Acting on CH-NH Group Donors ; genetics ; Point Mutation ; Polymorphism, Genetic ; Risk Factors ; Smoking ; Stomach Neoplasms ; epidemiology ; genetics

Objective:To investigate the effect of organ dose modulation (ODM) technique on reducing the breast radiation dose in chest CT scanning.Methods:In the phantom test, the PBU-2 adult chest module was used. The clinical chest scan protocol was used and three sets of scans performed on the chest module： (1) ODM off group, ODM was not used; (2) ODM part group, ODM was applied only in the breast region； (3) ODM all group, ODM was applied in the whole scan scope. Other scan parameters were same for the three groups, with smart mA applied. The volume CT dose index (CTDI vol) was recorded for all three groups. A long rod ionization chamber was placed in a fixed position in front of the right breast area to measure the breast skin dose (D). The contrast noise ratio (CNR) and the figure of merit (FOM) were measured respectively. In clinical research, 72 female patients who underwent chest CT scanning in Beijing Tongren Hospital Capital Medical University from August to November 2018 were retrospectively recruited. According to the application of ODM, the patients were divided into ODM off group (without ODM, 36 cases) and ODM part group (ODM applied in the breast region, 36 cases). The CTDI vol and the dose length product (DLP) were recorded. CNR, noise of images were measured and calculated, respectively. The image quality was evaluated by subjective evaluation scores. The one way ANOVA analysis was used in comparing the difference of CNR among the 3 groups in module test. As for clinical cases, the independent samples t test was used to compare the difference in CTDI vol, DLP, CNR and the noise between two groups; and the rank-sum test was used for comparison in image quality subjective evaluation. Results:In module test, the radiation dose was highest in ODM off group, and lowest in ODM all group. The CTDI vol were (6.90±0.02), (6.26±0.02) and (5.99±0.02) mGy, and the D values were (9.17±1.01), (8.01±0.92) and (7.58±0.87) mGy for ODM off group, ODM part group and ODM all group respectively. The CNR values of images with soft tissue algorithm reconstruction were highest in ODM off group and lowest in ODM all group, while no statistically significant difference was displayed ( P>0.05). The CNR values of the images with lung algorithm reconstruction showed the same trend, with statistically significant difference among the three groups ( F=154.732, P=0.006). The FOM of the lung and soft tissue algorithm images was maximized when the ODM was partially applied. As for clinical cases, compared with ODM off group, the dose of ODM part group showed significantly decreased, with CTDI vol decreased by 16.12% ( t=2.604, P=0.011), and the DLP decreased by 16.85% ( t=3.293, P=0.002). No significant difference was found in CNR, noise and subjective score by two doctors between two groups ( P>0.05). Conclusion:The application of ODM in chest CT imaging can reduce the radiation dose of breast with simultaneously maintaining the image quality.

Objective:To investigate the expression of coxsackievirus-adenovirus receptor (CAR) in thymic carcinoma and the relationship between CAR and the antitumor activity of oncolytic adenovirus H101.Methods:The expression of CAR in thymic carcinoma tissues and cells were detected by RT-qPCR and Western blot. H101 expression and virus titers in Bcap-37, MP59 and T1889 cells after infection were detected by RT-qPCR and 50% tissue culture infectious dose (TCID 50). The proliferation activity and apoptosis rates of T1889 cells infected with H101 at different multiplicity of infection (MOI) were detected by CCK-8 and flow cytometry. CAR expression in T1889 cells treated with different concentrations of trichostatin A (TSA), a histone deacetylase inhibitor, was detected. H101 expression and virus titers in the TSA-treated and H101-infected cells were detected. Cell activity was detected by CCK-8. The phosphorylation levels of MARK and ERK1/2 and the expression of CAR at protein level in TSA-treated or TSA+ TBHQ (ERK activator) treated cells were detected. Results:CAR expression at both mRNA and protein levels were significantly lower in thymic carcinoma tissues than in adjacent normal tissues ( P<0.01), and lower in MP59 and T1889 cells than in thymic epithelial cells (TEC) and Bcap-37 cells ( P<0.01). H101 expression in MP59 and T1889 cells and the titers of H101 in culture supernatants were significantly lower than those in Bcap-37 cells ( P<0.01). Compared with Bcap-37 cell, the activity of MP59 and T1889 cells was significantly increased and the apoptosis rates were significantly decreased 48 h after H101 infection ( P<0.01). The expression of CAR at both mRNA and protein levels in T1889 cells treated with different concentrations of TSA increased in a dose-dependent manner. When T1889 cells were treated with 0.25 μmol/L of TSA, the expression of H101 at mRNA level and H101 titers were significantly increased ( P<0.05); the phosphorylation levels of MAPK and ERK1/2 proteins were continuously decreased; the expression of CAR was continuously increased. Compared with the TSA treatment group, the expression of CAR at protein level in the TSA+ TBHQ treatment group decreased significantly ( P<0.01), and the p-ERK1/2/ERK1/2 ratio increased significantly ( P<0.01). Conclusions:TSA could up-regulate CAR expression in thymic carcinoma by inhibiting the MARK/ERK1/2 pathway, thereby enhancing the antitumor activity of H101.

Objective To explore the effects of detector width and pitch on radiation dose and image quality when using organ dose modulation (ODM) technology in a wide?area detector CT scanning. Methods Based on the clinical chest scan protocol,3 sets of scans of the chest phantom were performed using any combination of two detector width (40 mm and 80 mm) and pitch (0.500,1.000 and 1.375) with the same parameters:1 Do not use ODM technology (ODM off),2 open ODM (ODM part) 240 mm from scan start layer to breast area,3 open ODM (ODM all) in full 320 mm scan range. A long rod ionization chamber was placed in the fixed position in front of the right breast area. The scanning parameters of each group were measured 7 times, and the volume computed tomography dose index (CTDIvol) and breast skin dose measurement values D were recorded and the mean was calculated and recorded as Dav. The coronal 5 mm thick images of lung and soft tissue algorithms were reformed. It was divided into three parts in the Z?axis direction, and the contrast?to?noise ratio (CNR) and figure of merit (FOM) were measured separately. Independent sample t test was used for CTDI and breast skin doses D and CNR at both detector widths. ANOVA was used for dose and CNR of three sets of pitch (0.500, 1.000, and 1.375) and the three ODM techniques. Result The FOM factor was the largest when using an 80 mm detector with a pitch of 0.992 and partially turning on the ODM. The radiation dose of the three ODM groups decreased in turn, and the effect of ODM on CTDIvol (P=0.019) and breast skin dose (P=0.002) was statistically significant. The width of the detector increased and the dose was increased. The width of the detector was statistically significant for CTDIvol (t=-2.723, P=0.015). There was no statistically significant effect on the breast skin dose (t=-0.908, P=0.377). The effects of the pitch were not statistically significant for CTDIvol (P=0.254) and breast dose (P=0.146). The CNR of the three ODM groups decreased in turn, and the effect of ODM on the soft tissue image CNR was not statistically significant (P=0.146). The CNR of lung algorithm image (P=0.030) had significant effects. The multiple comparisons:only ODM all was significantly different from ODM off (P=0.009). With the increase of detector width,the values of CNR increased,the values of CNR (t=-4.128,P=0.001) of lung images were significantly affected. The effects on the soft tissue images were not statistically significant (P=0.187). There was no statistically significant difference in the effect of pitch on the CNR (P=0.660) of the lung images. The effects of the pitch on the values of CNR of soft tissue images (F=11.756,P=0.001) were statistically significant. By multiple comparisons, the difference of CNR between 0.500 (P=0.000) and 1.375 (P=0.013) was statistically significant compared with that when the pitch was 1.000. There was no significant difference among the three ODM modes (P>0.05) on the values of CNR of upper and middle parts of lung and soft tissue arithmetic images. The differences of CNR between ODM all and the other two groups were statistically significant (P<0.05) on the bottom part of images. Conclusion The changes of detector width and pitch will affect the organs dose modulation technique, and then affect the radiation dose and image quality. When using 80 mm detector with the pitch of 0.992 and partially turning on ODM in chest CT scan,achieving the optimized benefits of quality and dose.