Objective:To compare the diagnostic efficacy and ability of Thyroid Imaging Reporting Data System version (TI-RADS) of American College of Radiology (ACR) and artificial intelligence(AI) TI-RADS in diagnosis of thyroid nodules.Methods:A retrospective analysis was done on 266 patients(276 nodules) proved by ultrasound-guided fine-needle aspiration cytology (US-FNAC) in General Hospital of Eastern Theater Command from January to December 2019. The ROC curve of the two TI-RADS versions was drawn and the area under the curve (AUC) was calculated and compared.Results:AUCs of ACR TI-RADS and AI TI-RADS were 0.747 and 0.853. The sensitivity, specificity, positive predictive value and negative predictive value (96.62%, 62.50%, 74.87%, 94.12%) of AI TI-RADS were higher than ACR TI-RADS (95.27%, 44.53%, 66.51%, 89.06%). AI TI-RADS was able to avoid more unnecessary FNAC (71.74%) than ACR TI-RADS (67.03%).Conclusions:Both ACR TI-RADS and AI TI-RADS have good performances for differential diagnosis of thyroid nodules. AI TI-RADS is a more simple scoring system with better overall diagnostic performance and ability to exclude unnecessary FNAC with high negative predictive value than ACR TI-RADS.

Objective To explore the qualitative evaluation of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between benign and malignant thyroid nodules (TNs).Methods Totally 110 outpatients with 132 TNs underwent CEUS were enrolled in this study in Jinling Hospitall Medical School of Nanjing University (Nanjing General Hospital of Nanjing Military).Nanjing General Hospital of Nanjing Military All the nodules underwent ultrasound guided fine needle aspiration biopsy (FNAB).113 TNs were histologically diagnosed,the characteristics of enhancement for each noudle were scored.The characteristicsof enhancement between benign and malignant TNs were compared by chi-square test.The receiver operating characteristic (ROC) curve analysis were conducted to determine the diagnostic values of thyroid CEUS.Results Contrast-enhanced patterns were significantly different between benign and malignant TNs in the degree,homogeneity of enhancement,enhanced ring and boundary,shape and size of the enhanced lesions (x2=23.85,P ＜ 0.001;x2=7.43,P=0.04;x2=34.54,P ＜ 0.001;x2=25.7,P ＜ 0.001;x2=53.10,P ＜ 0.001;x2=22.78,P ＜ 0.001;x2=30.90,P ＜ 0.001).Contrast-enhanced patterns were not significantly different between benign and malignant TNs in the process and completeness of enhancement.Malignant lesions had concentric (79.5％),inhomogeneous (89.0％) and low (71.1％) enhanced with irregular (79.5％) and unclear (64.4％) boundary and bigger size (63.0％).The typical CEUS feature of benign nodules was peripheral ring hyperenhancement (34.7％).According to ROC curve,the cut off value was 3.5 points.The area under the ROC curve (AUC) for CEUS was 0.862 (95％CI:0.797-0.927).The sensitivity,specificity and accuracy for CEUS were 80.8％,79.6％,80.3％ respectively.Conclusion The pattem of CEUS may assist in differential diagnosis of benign and malignant TNs.

Objective To explore the morphological changes of renal grafts in implantation protocal biopsy,and early stage effect of lesions from donation after cardiac death (DCD) donors.Methods Preimplantation kidney biopsy from 48 cases of DCD donors from August 2016 to March 2017 was retrospectively reviewed.Protocal biopsy was performed on dual kidneys and evaluated according to Banff 2016 donor criteria before transplantation.The Banff score of kidneys was calculated and its effects on renal function were evaluated.Results There were 48 donors and 95 kidneys (there was one kidney with congenital renal indevelopment).In.one case,diffused thrombus in arteriae arcuata occurred on the left side (normal on the right side),and the left kidney was discarded.In one case,diffused arteriolar hyaline (ah3) occurred on the left side (normal on the right side),and the left kidney was discarded.Severe interstitial fibrosis (＞70％) was seen in one pair of kidneys,and the kidneys were discarded.The proportion of glomerulosclerosis (GS) was ＞30％ in one pair of kidneys,and the kidneys were discarded.There was no statistically significant difference in morphometric changes between left kidney group and right kidney group (P＞0.05).Besides GS,the morbidity of interstitial fibrosis (ci) was 17％,that of tubular atrophy (ct) was 16％,that of interstitial inflammation (i) was 13％,that of fibrous intimal thickening (cv) was 19％,that of arteriolar hyaline changes (ah) was 28％,that of glomerolar thrombi (gt) was 0％,and that of acute kidney injury (AKI) was 81 ％.Glomerular filtration rate (eGFR) estimated was compared between ah ＞2 group and ah≤2 group.eGFR in ah＞2 group was significantly higher in 16 days,one month and three months,but not in 7 days.Terminal blood serum creatinine (t-Scr) in ah＞2 group in three months was significantly higher than that in ah≤2 group (152.5 ± 47.38 vs.122.08 ± 36.57 μmol/L,P＜0.05).The eGFR was compared between Banff score ＞3 group and Banff score ≤3 group.The eGFR in ah＞2 group was significantly higher in one month and three months,but not in 7 days and 16 days.t-Scr in Banff score ＞3 group was higher significantly than in Banff score ≤3 group (146.18-± 44.55 vs.115.27 ± 30.67 μmol/L,P＜0.05).Seven patients were diagnosed as having delayed graft function (DGF),there were 2 patients with ah＞2 and Banff score＞3,and 1 patient with primary non-function (PNF).Conclusion Vasculopathy and acute renal tubular injury were most common lesions in donor renal pathology.Kidneys with diffused arteriolar hyaline change (ah＞2) or Banff score ＞3 have poor graft function at 3rd month.

Objective To investigate the influence of two positions for measuring instrument adapter on the measurement of hand-transmitted vibration in grinding machine using the intraclass correlation coefficient (ICC) of reliability assessment index,and to provide a basis for studies on the measurement standard for handtransmitted vibration.Methods With reference to the measurement standard for hand-transmitted vibration ISO 5349 Mechanical vibration-Measurement and evaluation of human exposure to hand-transmitted vibration-Part 1:General requirements and Mechanical vibration-Measurement and evaluation of human exposure to handtransmitted vibration-Part 2:Practical guidance for measurement at the workplace,the domestic AWA5936 hand-transmitted vibration measuring instrument and SVAN-106 hand-transmitted vibration measuring instrument from Poland were used to measure hand-transmitted vibration in 3 workers for grinding machine in a foundry for 5 days continuously from September to October,2014,and Y-axis data were recorded and compared.Results In worker A,the "T"-shaped adapter had a significantly higher mean Y-axis accelerated speed effective value than the "O"-shaped adapter [4.34 m/s2 (95％CI 4.05-4.63) vs 2.32 m/s2 (95％CI 2.27～2.38),t=13.781,P＜0.01]-In workers B and C,AWA5936 "U"-shaped adapter (placed at the position of the handle of grinding machine) had lower degrees of data variation of 12.55％ and 15.77％,respectively,suggesting good data stability.The measurement results showed significant differences across different positions of adapter(P＜0.01) and between all adapters except "O"-shaped and line-shaped adapters (all P＜0.01),while the measurement results showed no significant differences between the"O"-shaped and line-shaped adapters (P＞0.01).The comparison of the measurement results of AWA5936 vibration measuring instrument with an "U"-shaped adapter and SVAN-106 vibration measuring instrument with an "S"-shaped adapter showed an ICC of ＞0.80 (ICC=0.82),while the comparison of the measurement results of AWA5936 vibration measuring instrument with an "O"-shaped adapter and SVAN-106 vibration measuring instrument showed an ICC of ＜0.40.Conclusion SVAN-106 vibration measuring instrument with an "S"-shaped adapter placed at the palm and AWA5936 vibration measuring instrument with an"U"-shaped adapter placed at the handle of grinding machine can give comparable measurement results with good reliability.

Objective To investigate the influence of two positions for measuring instrument adapter on the measurement of hand-transmitted vibration in grinding machine using the intraclass correlation coefficient (ICC) of reliability assessment index,and to provide a basis for studies on the measurement standard for handtransmitted vibration.Methods With reference to the measurement standard for hand-transmitted vibration ISO 5349 Mechanical vibration-Measurement and evaluation of human exposure to hand-transmitted vibration-Part 1:General requirements and Mechanical vibration-Measurement and evaluation of human exposure to handtransmitted vibration-Part 2:Practical guidance for measurement at the workplace,the domestic AWA5936 hand-transmitted vibration measuring instrument and SVAN-106 hand-transmitted vibration measuring instrument from Poland were used to measure hand-transmitted vibration in 3 workers for grinding machine in a foundry for 5 days continuously from September to October,2014,and Y-axis data were recorded and compared.Results In worker A,the "T"-shaped adapter had a significantly higher mean Y-axis accelerated speed effective value than the "O"-shaped adapter [4.34 m/s2 (95％CI 4.05-4.63) vs 2.32 m/s2 (95％CI 2.27～2.38),t=13.781,P＜0.01]-In workers B and C,AWA5936 "U"-shaped adapter (placed at the position of the handle of grinding machine) had lower degrees of data variation of 12.55％ and 15.77％,respectively,suggesting good data stability.The measurement results showed significant differences across different positions of adapter(P＜0.01) and between all adapters except "O"-shaped and line-shaped adapters (all P＜0.01),while the measurement results showed no significant differences between the"O"-shaped and line-shaped adapters (P＞0.01).The comparison of the measurement results of AWA5936 vibration measuring instrument with an "U"-shaped adapter and SVAN-106 vibration measuring instrument with an "S"-shaped adapter showed an ICC of ＞0.80 (ICC=0.82),while the comparison of the measurement results of AWA5936 vibration measuring instrument with an "O"-shaped adapter and SVAN-106 vibration measuring instrument showed an ICC of ＜0.40.Conclusion SVAN-106 vibration measuring instrument with an "S"-shaped adapter placed at the palm and AWA5936 vibration measuring instrument with an"U"-shaped adapter placed at the handle of grinding machine can give comparable measurement results with good reliability.