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

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.

Objective To explore the guiding role of double volume reconstruction (DVRT) in interventional embolization of intracranial aneurysms. Methods Ninety?six cases of subarachnoid hemorrhage with 115 aneurysms underwent total cerebrovascular angiography and interventional endovascular embolization of intracranial aneurysms in our hospital from January 2017 to December 2017 were retrospectively analyzed. They were randomly divided into observation group (n=48) and control group (n=48) according to random number method. In the control group, guided by the results of 2D?DSA and 3D?DSA 3D reconstruction, the aneurysm neck and tumor were fully exposed with the optimal position. the responsible aneurysms were performed with the interventional endovascular embolization. The operators finished the embolization According to the size and shape of aneurysms and the operative experience. In the observation group, the operators could speculate the embolization density of aneurysms by using the data of 3D reconstruction and digital subtraction reconstruction and adjusted the surgical plan to make the aneurysms had been completely embolized. The baseline data, treatment status, adverse cerebrovascular reaction and recurrence rate of aneurysms were compared between the two groups. All patients in the two groups were operated by Deputy chief surgeons or above of the neurosurgery department. The comparison of the counting data were tested by χ2. The measured data conformed to normal distribution were tested by independent sample t. Results Statistically, There was no significant differences in baseline data including sex, age, blood glucose, blood pressure and cerebral atherosclerosis between the two groups (P>0.05). Comparing the responsible aneurysms in different positions and sizes, the differences was not statistically significant (P>0.05).There was no statistically significant differences in the dosage of contrast media and the cost of operation between the two groups (P>0.05). The radiation dose and operation time in the observation group were smaller and shorter than those in the control group, but there was no statistical differences between the two groups (P<0.05). Statistically, The incidence of rerupture of aneurysm and thrombosis in the observation group was significantly lower than that in the control group (P<0.05). and The incidence of cerebral infarction and the recurrence rate of aneurysm in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in sex, age, blood glucose, blood pressure and cerebral atherosclerosis between the two groups (P>0.05).There was no significant difference in the location and size of responsible arterial tumors (χ2=0.148, P=0.929).There was no significant difference in the dosage of contrast agent and the cost of operation between the two groups (t=-0.769, 0.225; P>0.05). The radiation dose and operation time were (479.81 ± 51.21)mGy, (103.52 ± 10.18) minin the observation group and (511.95 ± 53.26)mGy, (114.60 ± 9.51)min in the control group. The difference was statistically significant (t=-1.376,-2.516; P<0.05).There were 1 case of rerupture of aneurysm in the observation group, 4 cases in the control group;There were 0 cases of thrombus, respectively, 3 cases in the control group. The difference was statistically significant (χ2=11.748, 4.256; P<0.05).There were 0 cases postoperative cerebral infarction occurred in the observation group, and aneurysm recurrence in 1 case. Four cases postoperative cerebral infarction occurred in the control group, and aneurysm recurrence in 3 cases, respectively. The difference was statistically significant (χ2=5.719, 10.811; P<0.05). Conclusions The clinical effect of interventional embolization of intracranial aneurysms under the guidance of double volume reconstruction is remarkable, and the effect of interventional embolization and the relationship with the peripheral vessels can be clearly demonstrated. It can reduce the incidence of adverse cerebral vascular reactions and the recurrence rate of aneurysms and reduce the intraoperative risk. It is worthy to be popularized in interventional embolization of intracranial aneurysms and follow?up after operation.

Objective To investigate the effects of different tube voltages on the dose of superficial radiation-sensitive organs and image quality when using organ dose modulation( ODM) in chest CT. Methods Based on clinical chest CT protocol with the sameother parameters, chest phantom was scanned using 140, 120, 100, and 80 kv ( 100 kV was the recommended by the CT system) without ODM ( ODM off ) or with ODM from the starting layer to the breast area ( ODM part ) . A long rod ionization chamber was placed iat a fixed position in front of the right breast area. The scans were repeated for 7 times with each group of scanning parameters and dose values were measured for each scanning, the CTDIvol and breast skin dose measurements( D) were recorded. Coronal images of 5 mm thickness for the lung and soft tissue algorithms were reformatted. The images were divided into 8 parts along the z axis direction, the contrast noise ratios( CNR) for every region were measured. For CTDIvol , D, CNR for different ODM and tube voltage scanning modes, two factor non-repeat test ANOVA was performed. LSD method was used for comparison among groups. Results The CTDIvol was lowest at 80 kV, and the breast skin dose measurement was lowest at 100 kV, CTDIvol decreased in turn from140 to 80 kV ( F=105. 5795, P<0. 05) . The breast skin dose measurement decreased in turn from140 to 100 kV, but increased instead at 80 kV. The difference was statistically significant(F=27. 736, P<0. 05). Compared with ODM off , the CTDIvol and D for ODM part both declined and the differences were statistically significant ( F=39. 732, 81. 961, P<0. 05). The CNRs of the lung and soft tissue images decreased at every tube voltage(F=12. 809, 11. 261, P<0. 05 ) . The CNRs decreased from140 to 100 kV, but there was no statistical difference( P>0. 05) , and the difference was significant at 80 kV( P<0. 05) . Compared with ODM off, the CNRs of lung and soft tissue algorithm images with ODM part decreased, withnot statistically significant differences ( P>0. 05 ) . Conclusions In clinical practice, with the tube voltage not less than the recommended(100 kV), the optimal reduction of breast radiation dose can be achieved by reducing kV and using ODM on the premise of resonable image quality.

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