Objective To evaluate the role of two-dimensional ultrasound combined with contrast-enhanced ultrasonography (CEUS) in the classification of liver nodules in cirrhotic patients.Methods Consecutively cirrhotic patients with intrahepatic nodules at Xixi Hospital of Hangzhou were included from November 2015 to December 2016.All (142 nodules in 109 patiens) presented as non-cancerous focal lesions on conventional magnetic resonance imaging and CT examination and had available information of liver biopsy.Each lesion was percutaneous biopsied under the guidance of two-dimensional ultrasound.Ultrasonographic parameters evaluated were as following:(1) sizes of nodules under US;(2) ultrasonographic characteristics of the nodular;(3) CEUS enhancement features of the nodules.Four types of hepatic nodule suggesting different histology were defined according to the ultrasonographicparameters.x2 test was used to compare the difference of hepatocellular carcinoma (HCC) incidence among liver nodules with varying sizes and nodules with different enhancement features under CEUS.As for the statistical differences of HCC and high-grade dysplastic nodule (HGDN) incidence between type Ⅲ & Ⅳ nodules and type Ⅰ & Ⅱ nodules,x2 test was also used for analysis.Results A total of 142 eligible nodules were detected in 109 patients with cirrhosis,including 16 HCCs,2 intrahepatic cholangiocellular carcinomas (ICC),41 HGDNs,40 low-grade dysplastic nodules (LGDN) and 43 regenerative nodules (RN).In terms of diameter,all (6/6) the nodules larger than 2.0 cm,20.0％ (8/40) of middle size nodules (1.5-2.0 cm),were HCCs.The remained 2 lesions of HCC came from two subgroups with even small size nodules [1.0-1.4 cm (n=93),and ＜ 1.0 cm (n=3),in diameter],respectively.Two lesions of ICC were attributed to nodules with a 1.0-1.4 cm diameter.About 28 nodules with a diameter of 1.5-2.0 cm,13 nodules with a diameter of 1.0-1.4 cm were HGDN.HCC incidences between these 4 groups were different significantly (x2=61.425,P ＜ 0.001).Asfor the CEUS,14 nodules exhibited a rapid enhancement feature in arterial phase,12 of which were HCC.In56 nodules with a slow enhancement feature,4 nodules were HCC.HCC incidences between these 3 groups were different significantly (x2=75.752,P ＜ 0.001).Under the combined ultrasonography,HCC incidences of type Ⅲ and type Ⅳ nodules were significantly higher than that of type Ⅰ and type Ⅱ lesions [21.9％ (16/73)vs 0 (0/65),x2=15.222,P ＜ 0.001],similar result was observed in the comparison of HGDN incidences between type Ⅲ & Ⅳ and type Ⅰ & Ⅱ nodules[53.4％ (39/73) vs 3.1％ (2/65),x2=38.842,P ＜ 0.001].Conclusion The classification presented by this study,combining the three ultrasonographic parameters,which is nodule size,nodular echo characteristics and enhancement features of the nodules under CEUS,could be helpful for the diagnosis of HCC in cirrhotic patients with ill-defined nodule on routine image examination.

Objective To investigate the clinical effects of different urinary diversion regimens after minimally invasive resection of bladder cancer. Methods 127 patients with muscular infiltrating bladder cancer from January 2010 to June 2015 were enrolled in this study. According to the patients' condition, they were divided into orthotopic ileal cystectomy group (58 cases), Bricker bladder surgery group (33 cases), ureteral skin ostomy group (36 cases), then compare the clinical data, postoperative complications and quality of life of the three groups. Results There was no significant difference in the ratio of sex, the distribution of age and tumor staging among the three groups. The operation time and postoperative hospital stay in orthotopic ileal cystectomy group were longer than those in the other two groups. The operation time and postoperative hospital stay of the Bricker bladder surgery group were longer than that in ureteral skin ostomy group, the difference was statistically significant; the bleeding in orthotopic ileal cystectomy group was more than the other two groups, and in Bricker bladder surgery group was more than ureteral skin ostomy group, the difference was statistically significant. There was no significant difference in the recovery time of intestinal function among the three groups. The recovery time of intestinal function in ureteral skin ostomy group was shorter than that in the other two groups, the difference was statistically significant. There was no significant difference in the incidence of short-term complications of the three groups of patients. The incidence of long-term complications of orthotopic ileal cystectomy group was significantly higher than the other two groups, the difference was statistically significant. The social function scores, and overall health score of orthotopic ileal cystectomy group were higher than the other two groups, the difference was statistically significance. Conclusion Without external device, closer to the characteristics of physiological urination, orthotopic ileal cystectomy holds higher postoperative quality of life, and higher incidence of long-term complications. With advantages of quick recovery and less complications, ureteral skin ostomy is best for patients who can not stand for long time surgery. It should choose the appropriate surgical approach for patients according to individuals' conditions.

Objective:To explore the characteristics of attention during visual search tasks in adults with attention-deficit/hyperactivity disorder (ADHD).Methods:Totally 45 adult patients with ADHD who met the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-IV) and 44 healthy controls matched with age,gender and IQ were selected.The reaction time and accuracy rate of two groups were compared under visual search tasks of low and high visual working memory load.Results:The reaction time was longer in patients with ADHD than in the healthy controls in both low-load task [(823 ± 144) ms vs.(754 ± 123) ms,P ＜ 0.01] and highload task [(912 ± 163) ms vs.(851 ± 162) ms,P ＜ 0.01].Compared with the performance in low load task,the search reaction time was longer in high load task [ADHD group:(823 ± 144) ms vs.(912 ± 163) ms,P ＜ 0.01;control group:(754 ± 123) ms vs.(851 ± 162) ms,P ＜0.01] and the accuracy rate was lower during high load task than low load task[ADHD group:(95.9 ±4.3)％ vs.(91.2 ± 14.29)％;control group:(95.8 ± 4.2)％ vs.(94.4 ±4.9) ％,P ＜ 0.01] in both ADHD and control groups.Conclusion:The results suggest impairment in top-down attentional control in ADHD adults.When the visual working memory load is increasing,ADHD patients allocate more working memory resources on storing the target representation and less resources on visual attention,so the search efficiency may be influenced.

Objective The research aimed at evaluating whether non-invasive endolymphatic MR imaging could be used in aged patients(≥60 years)suffering from Meniere's disease.Methods Under guidance of nasal endoscopy,a diluted gadopentetate dimeglumine injection was administrated through eustachian tube into mid-ear cavity in four patients (≥60 years old) suffered from Meniere's disease.3D-FLAIR MRI scan was performed one day after the administration.Results The administration succeeded through eustachian tube into mid-ear cavity in those four patients.A rise of fluid level on tympanic membrane while administrating a diluted gadopentetated meglumine injection was observed.Imaging of inner ear endolymphatic spaces were visible in vestibule and cochlea in imaging of patient 1.As to patient 2,in cochlea the scala tympani of the first and second turns were enhanced while scala vestibule weren't;Vestibules couldn't be recognized.In images of patient 3,the scala tympani of the three turns in cochlea were enhanced while scala vestibule weren't;Vestibules couldn't be recognized.For Patient 4,in cochlea the scala tympani of the first turn were enhanced while scala vestibule weren't,and the second turn was partially enhanced;and endolymphatic space of vestibule could be distinguished from perilymphatic space.Conclusions This technique could be adopted in investigation of Meniere's disease in elderly patients.MR imaging of endolymphatic spaces in vestibule and cochlea can be visualized,which may partially provide data for diagnosis of Meniere's disease.

To compare transient elastorgaphy (FibroTouch) and acoustic radiation force impulse (ARFI) in diagnosis of liver fibrosis in patients with chronic hepatitis B.One hundred and forty five patients with chronic hepatitis B underwent FibroTouch and ARFI examinations in Xixi Hospital of Hangzhou from January to November 2015. The liver stiffness (LSM) was detected by FibroTouch and the liver shear wave velocity (VTQ) was detected by ARFI; liver biopsy was performed in all patients. With biopsy results as gold standards, the diagnostic values of FibroTouch and ARFI for liver fibrosis were analyzed with Spearman correlation analysis and receiver operating characteristic (ROC) curve.The correlation coefficient of FibroTouch and ARFI was 0.746 (<0.01). FibroTouch and ARFI were significantly correlated with pathological stage determined by liver biopsy(=0.705 and 0.727, all<0.01). When 8.4 kPa was taken as the cut-off value of LSM and 1.49 m/s was taken as the cut-off value of VTQ, the areas under ROC (AUCs) were 0.857 and 0.836 (>0.05) in diagnosis of fibrosis S≥2 stage; when 10.8 kPa of LSM and 1.49 m/s of VTQ were used as cut-off values, the AUCs were 0.872 and 0.881 (>0.05) in diagnosis of S≥3 stage; when 12.3 kPa of LSM and 1.81m/s of VTQ were used as cut-off values, the AUCs were 0.875 and 0.888 (>0.05) in diagnosis of S=4 stage.Both FibroTouch and ARFI can be effectively used in evaluation of liver fibrosis in patients with chronic hepatitis B.
Biopsy ; Elasticity Imaging Techniques ; instrumentation ; methods ; Hepatitis B, Chronic ; complications ; diagnostic imaging ; Humans ; Liver Cirrhosis ; diagnostic imaging ; etiology ; Predictive Value of Tests ; ROC Curve

The acquired immunodeficiency syndrome patients with compromised immunity are prone to hemophagocytic syndrome secondary to opportunistic infections.This paper reports a rare case of hemophagocytic syndrome secondary to human parvovirus B19 infection in an acquired immunodeficiency syndrome patient,and analyzes the clinical characteristics,aiming to improve the diagnosis and treatment of the disease and prevent missed diagnosis and misdiagnosis.
Humans ; Lymphohistiocytosis, Hemophagocytic/drug therapy* ; Erythema Infectiosum/complications* ; Acquired Immunodeficiency Syndrome/complications* ; Parvoviridae Infections/diagnosis* ; Parvovirus B19, Human

OBJECTIVE: To explore the clinical value of virtual touch tissue quantification (VTQ) technique and the PGA index [prothrombin time (P), γ-glutamyl transpeptadase (GG) and apolipoprotein A1 (ApoAl)] in evaluating the degree of liver fibrosis in alcoholic patients.
 METHODS: A total of 64 patients with long-term alcohol history were enrolled for this study. The liver ultrasonography elasticity was examined by VTQ techniques, the VTQ value was assessed in the liver target region, and then the PGA index was calculated. According the liver biopsy biological results, a golden standard, the patients were divided into a non-fibrosis group (n=11), a fibrosis group (n=10), a significant fibrosis group (n=14) and a cirrhosis group (n=29). The diagnostic value of VTQ and PGA index were compared in alcoholic patients following the classification of liver fibrosis.
 RESULTS: The elastography VTQ values were (1.38±0.33), (1.49±0.30), (1.76±0.22) and (2.28±0.53) m/s; while the PGA indexes were 2.09±0.94, 2.30±1.06, 3.57±1.09, and 2.21±1.99 in the non-fibrosis group, the fibrosis group, the significant fibrosis group and the cirrhosis group, respectively. The VTQ value and PGA index were positively correlated with the classification of liver fibrosis (VTG: r=0.719, PGA: r=0.683; both P<0.01).
 CONCLUSION The alcoholic liver fibrosis can be assessed by noninvasive VTQ technology and PGA index. As a real-time ultrasound elastography technique, VTQ is more accurate than the PGA index. Combination of the two methods is helpful for early diagnosis and treatment in the patients with alcoholic liver fibrosis.
Apolipoprotein A-I ; metabolism ; Biopsy ; Elasticity Imaging Techniques ; Humans ; Liver Cirrhosis, Alcoholic ; classification ; diagnostic imaging ; Predictive Value of Tests ; Prothrombin Time ; Reproducibility of Results ; gamma-Glutamyltransferase ; metabolism

No abstract available.
Comorbidity ; Conduct Disorder ; Humans

Purpose: This research was designed to investigate how miR-542-5p regulates the progression of hyperglycemia and hyperlipoidemia. Materials and Methods: An in vivo model with diabetic db/db mice and an in vitro model with forskolin/dexamethasone (FSK/DEX)-induced primary hepatocytes and HepG2 cells were employed in the study. Bioinformatics analysis was conducted to identify the expression of candidate miRNAs in the liver tissues of diabetic and control mice. H&E staining revealed liver morphology in diabetic and control mice. Pyruvate tolerance tests, insulin tolerance tests, and intraperitoneal glucose tolerance test were utilized to assess insulin resistance. ELISA was conducted to evaluate blood glucose and insulin levels. Red oil O staining showed lipid deposition in liver tissues. Luciferase reporter assay was used to depict binding between miR-542-5p and forkhead box O1 (FOXO1). Results: MiR-542-5p expression was under-expressed in the livers of db/db mice. Further in vitro experiments revealed that FSK/DEX, which mimics the effects of glucagon and glucocorticoids, induced cellular glucose production in HepG2 cells and in primaryhepatocytes cells. Notably, these changes were reversed by miR-542-5p. We found that transcription factor FOXO1 is a target of miR-542-5p. Further in vivo study indicated that miR-542-5p overexpression decreases FOXO1 expression, thereby reversing increases in blood glucose, blood lipids, and glucose-related enzymes in diabetic db/db mice. In contrast, anti-miR-542-5p exerted an adverse influence on blood glucose and blood lipid metabolism, and its stimulatory effects were significantly inhibited by sh-FOXO1 in normal control mice. Conclusion Collectively, our results indicated that miR-542-5p inhibits hyperglycemia and hyperlipoidemia by targeting FOXO1.

Objective To investigate the status quo of health literacy,motivation and self-management behaviours of patients with knee osteoarthritis(KOA),to explore the influence of health literacy and motivation on self-management behaviours to the patients with KOA,and to clarify the relationships among the three factors.Methods Convenience sampling method was used to select 169 KOA patients who were treated in 3 tertiary hospitals in Xianyang between September and December 2021.General status table,chronic disease health literacy scale,patient motivation scale and chronic disease self-management behaviour scale were employed in the on-the-spot survey.Pearson correlation was used to analyze the correlation of health literacy,motivation and self-management behaviour of patients with KOA.Results Total scores of health literacy,motivation and self-management behaviour of the patients with KOA were 79.66±11.91,54.97±9.95 and 23.75±8.89,respectively.It was found that health literacy and motivation of the patients were positively correlated with their self-management behaviour(r=0.872,r=0.822,both P<0.01).Health literacy of the patients was positively correlated with motivation of patients(r=0.877,P<0.01).Health literacy of the patients could be used to directly predict self-management behaviour of patients(β=0.708,95%CI:0.539-0.876),as well as to predict self-management behaviour of the patients through the mediating effect of patient motivation(β=0.228,95%CI:0.676-0.787).The mediating effect accounted for 24.36%of the total effect.Conclusions The health literacy,motivation and self-management behaviours of patients with KOA are all poor and they should be further improved.Patient motivation is the mediating variable in health literacy and self-management behaviour of the patients.It is suggested that nursing staff could encourage the motivation of patients hence to improve the self-management behaviour in the patients with KOA based on an improvement of health literacy.