Purpose To investigate the value of strain ratio (SR) measure and improved 5-scoring system of ultrasonic elastography in the differentiation of benign and malignant breast tumors.Materials and Methods The data of 213 patients with breast cancer confirmed by pathology or surgery were retrospectively studied.All the patients underwent ultrasonic elasticity imaging examination and were evaluated by strain ratio (SR) method and improved 5-scoring system.Taking pathology as gold standard,we measured the sensitivity,specificity and accuracy of the two methods and evaluated the diagnostic efficiency.Results The area under curve (AUC) and 95％ CI of SR measure was 0.926,0.871-0.980 and that of improved 5-scoring system was 0.921,0.870-0.973.The best diagnostic limit of SR was 3.055,when SR ＞ 3.055,the lesions was malignant,when SR＜3.055,the lesions was benign.The sensitivity,specificity and accuracy of SR and improved 5-scoring system in diagnosing malignant breast lesions were 92.1％,92.7％,92.5％ and 85.5％,83.9％,84.5％,respectively.The specificity and accuracy of SR was higher than the improved 5-scoring method,the difference was statistically significant (P＜0.05),but there was no significant difference in sensitivity (P＞0.05).Conclusion SR is more objective in diagnosing malignant breast tumors,which has higher diagnostic value than improved 5-scoring system.

Objective To study the alteration of surfactant protein A and D(sp-A,SP-D)result-ing from pneumcystis carinil pneumonia(PCP)and investigate its implication in the pathogenesis of PCP.Methods SD rat models of PCP were induced by subcutaneous injection of 25 mg cortisone acetate,normal control and negative control as well as bacterial pneumonia group were set up for comparison.During 8～12weeks.broncboalveolar lavage fluid (BALF) of rats was collected.Total nucleate cells of BALF were counted and differentiated as well as the concentrations of surfactant protein A(SP-A)and surfactant pro-tein D(SP-D)were measured by immunoblotting assay.Results The rats were divided into three im-munosuppressive groups,plus a norrflal control group. Group A: normal control(n=6)consisted of healthy SD rats;group B:negative control(n=6)employed rats with cortisone acetate injection over 8weekz without tung infection;group C:bacterial pneumonia(n=11),rats were injected with cortisone ac-etate over 8 weeks and resulted in bacterial pneumonia without other pathogens isolated;group D(n=14):rats were injected with cortisone acetate during 8～12 weeks and resulted in PCP without other pathogens isolated.During PCP infection,the total cell counts and the percentage of polymorphonuclears (PMNs)in BALF were significantly increased(P<0.01),but were lower than those in the bacterial pneumonia group.The concentration of SP-A of BALF in PCP(45.1 μg/ml 4±22.1 μg/m1)was signifi-cantly increased in comparison with that in negative control group(16.2 μg/ml±9.9 gg/ml,P<0.05)and that in bacterial pneumonia group(6.2 μg/ml±5.6 μg/ml,P<0.001).We also found that the rela-tive content of SP-D was significantly higher in PCP(24 249±4 780 grey values)than that in both nega-tive control(13 384±2 887 grey values,P<0.001)and bacterial pneumonia group(11 989±2 750 grey values,P<0.001).SP-A and SP-D were also higher in moderate to severe group of PCP than those seen in mild group(P<0.01,P<0.001).Conclusion There was obvious increase of SP-A and SP-D in PCP rats,and particularly,the change of which was greater than that in bacterial pneumonia.Therefore,the alteration of SP-A and SP-D may be of implication in the prevention and management of PCP.

Objective To study the variation of the level of NOS,NO and Ang (1-7) in spontaneously hypertensive rat(SHR).Methods SHR were divided randomly into 3 groups:Bushenyixin group(n=8),valsartan group (n=8),and model group (n=7).Each group was given Bushenyixin tablet,valsartan,and saline by gavage respectively.After 4 weeks,the concentration of NOS,NO,Ang (1-7) in plasma and the concentration of NOS,NO in aorta were be observed.Results The concentration of NO in plasma was significantly lower in the Bushen-Yxin group than for model group(15.500±4.375)μmol/L vs.(26.000±2.828)gmol/L,P＜0.05.The concentration of NO in aorta and Ang1-7 in plasma were significantly higher in the Bushen-Yixin group than in the model group [(35.604±7.505)μmol/L vs.(17.437± 11.649) μ mol/L,(45.542 ± 12.726)ng/L vs.(25.521 ± 2.727) ng/L,P＜0.05].The concentration of NO in aorta was significantly higher in Bushen-Yixin group than in the valsartan group [(21.537± 13.484) μmol/L,P＜0.05].Conclusion Bushen-Yixin tablet had effects of increasing of NO level in aorta and Ang (1-7) level in plasma in spontaneously hypertensive rat.

AIM: The study was designed to explore the autoimmune mechanism of myocardial injury and ventricular remodeling after acute myocardial infarction (AMI). METHODS: An experimental animal model of AMI was adopted in Wistar rats. After 6 weeks, splenocytes were freshly transferred to syngeneic inbred rats. Four weeks later, these recipient rats were anesthetized for hemodynamics analysis by catheter technique. Serum antibody against cardiac myosin heavy chanin (MHC) was screened by ELISA. Histopathological studies were performed on all hearts. The phenotypes of T lymphocytes in myocardium were analyzed by histocytochemistry stain. RESULTS: Histopathological studies showed the lymphocytes infiltration in non-infarction myocardium in AMI rats and the organ specific inflammation of myocardium in all succedent recipient (AMI-T) rats. Histocytochemistry stain revealed the predominant CD4+T cells infiltration in myocardium. The antibody against MHC was examined in 8/22 cases of AMI rats and AMI-T rats, but none in sham-T rats. The left ventricular dysfunction was found in AMI-T rats, which was characterized by slight decline of ~+dp/dt_~max. CONCLUSIONS: The study showed inflammatory response of non-infarction myocardium in AMI rats and demonstrated the lymphocytes-mediated myocardial injury and cardiac dysfunction by adoptive transfer of splenocytes of AMI rats. The autoimmune-mediated myocardial injury might be a novel mechanism of ventricular remodeling after AMI. [

Objective:To investigation of the long-term-siRNA treatment with HBV transgene mice on inhibit replication of hepatitis B virus .Methods:The constructed siRNA expressed vectors was transfected HBV transgene mice by hydrodynamics -based in-jection via vena caudalis .Different groups were set including:specificity siRNA groups ( pSilencer5.1/C2,pSilencer4.1/C2,pSilenc-er3.1/C2),PBS group and negative vector group (n=10).The effect was observed in different periods (6 d,21 d,1 months,3 months, 6 months and 9 months after injection ) .HBsAg was analyzed by Chemiluminescence method , HBV-DNA was analyzed by real time quantitative PCR ( RQ-PCR) .Results:Compared with the PBS group , specificity siRNA groups showed decreased levels of HBsAg and HBV-DNA (P<0.05).Negative vector group did not show such changes ,there were no significant differences (P>0.05).Conclu-sion:The siRNA based on the expression vector can suppress the expression and replication of HBV in HBV transgene mice .The inhi-bition effects of long-term-siRNA treatment was specific .

Objective To evaluate the nutritional status in maintenance hemodialysis patients using objective score of nutrition on dialysis.Methods Patients on maintenance hemodialysis were randomly selected and divided into three groups based on objective score of nutrition on dialysis:normal nutritional status group,moderate nutritional status group,and low nutritional status group.Logistic regression analysis was performed to identify factors of malnutrition.Furthermore,the results were compared with those of subjective global assessment.Results Totally 75 patients(male:female =1.13∶1)with a mean age of(54.90 ± 12.10)years and a mean vintage of (85.37 ± 54.17)months were enrolled.As determined by objective score of nutrition on dialysis,15 patients (20％)were divided into normal nutritional status group,42(56％)into moderate nutritional status group,and 18(24％)into low nutritional status group.Compared with the normal nutritional status group,the low nutritional status group had significantly different body mass index[(19.81 ± 2.22)vs(23.90 ± 2.44)kg/m2,P =0.030]and dry weight[(50.85 ± 7.60)vs(59.94 ± 10.89)kg,P =0.020].In addition,compared with normal nutritional status group,the moderate nutritional status group and low nutritional status group had significantly different total cholesterol[(4.60 ± 0.84)and(3.73 ± 0.68)mmol/L vs(5.71 ± 1.64)mmol/L,P =0.011,P =0.000],normalized protein catabolic rate[1.17 and 1.15 g/(kg · d)vs 1.45 g/(kg · d),P =0.030,P =0.010],triceps skinfold thickness[(1.44±0.77)and(1.00±0.41)cmvs(1.80±0.63)cm,P=0.032,P=0.020],mid-ann circumference[(24.85±1.48)and(21.66±1.48)cmvs(24.99 ±2.30)cm,P=0.046,P =0.037].Logistic regression analysis indicated C-reactive protein(OR =12.482,95％ CI =0.190-130.928,P =0.035)and normalized protein catabolic rate(OR =0.128,95％ CI =0.022-0.736,P =0.021)were significantly correlated with malnutrition.Conclusion Malnutrition is common in hemodialysis patients,with inflammation and low protein intake being its independent factors.

Objective In the context of worldwide shortage of amytal,explore the intracarotidpropofol test for lateralizing language area and assessing hemispheric memory function.Methods Fourteen patients with refractory partial epilepsy who were candidates for surgical intervention were included in the study.With guide under a digital subtraction angiography,propofol was injected in bilateral intracarotidsequentially.Muscle power deceasing to level 0 at the contralateral limb and eyes gazing to contralateral side were used as the mark of hemispheric anesthesia completely.The immediate language alterations were recorded.To evaluate the bilateral language and memory functions,the visual and auditory memory tasks were performed sequentially once patient could concentrate his attention ; and after limb muscle power recovering to normal level,patients were required to perform a free recall test.Any abnormal responses were recorded.Results Language dominant hemisphere was determined in 14 patients.Nine patients were confirmed as left language dominance,2 patients were right language dominance.The remained 3 patients were considered as bilateral language dominance.Meanwhile,the hemispheric memory function was able be evaluated in 13 patients.More than 67％ memory function was sustained in hemisphere contralateral to mesial temporal lesions.Transient responses including eye pain,facial muscle spasms,laughers and involuntary movements were observed.Conclusion Hemispheric language and memory functions can be assessed with direct intracarotidpropofol injection,and propofol could be an alternative drug to amobarbital used in the Wada test.

Objective To investigate the relationship between serum phosphorus variability and mortality in maintenance hemodialysis (MHD) patients. Methods A total of 502 MHD cases from Renji hospital hemodialysis center were registered in Shanghai Registry Network from January 2007 to April 2015. They were recruited with general information, laboratory results and outcomes. According to their median of coefficient of variation (CV) of blood phosphorus, the patients were divided into high variation group (CV≥0.226 mmol/L) and low variation group (CV<0.226 mmol/L). The relationship of serum phosphorus CV with all?cause mortality and cardiovascular disease mortality was assessed respectively. Results The average age was (63.9±14.6) years, the median dialysis age was 82.0 (43.0, 139.0) months, 118 patients (23.5%) died for all cause and 64 patients (12.7%) died for cardiovascular disease. Compared with patients in low phosphorus variation group, patients had a higher all?cause mortality in high phosphorus variation group (27.7% vs 19.3%, P=0.028). Higher cardiovascular disease mortality was observed in high variation group as well, but this difference was no statistical significant (15.4% vs 10.0%, P=0.082). COX regression analysis showed that >60 years of age (HR=2.762, 95%CI 1.707?4.468, P<0.001), low hemoglobin (HR=0.466, 95%CI 0.317?0.686, P<0.001), low albumin (HR=0.555, 95%CI 0.366?0.840, P=0.005), high CV of phosphorus (HR=1.479, 95%CI 1.023 ? 2.139, P=0.037) were independent risk factors for all ? cause mortality. Moreover, >60 years of age (HR=2.666, 95%CI 1.469?4.837, P=0.001), low hemoglobin (HR=0.480, 95%CI 0.238?0.801, P=0.005), and high CV of phosphorus (HR=1.655, 95%CI 1.003?2.729, P=0.049) were independent risk factors for cardiovascular disease mortality. There was no significant statistical difference between patients phosphorus on target and patients phosphorus below target in all?cause disease mortality (P=0.065) and cardiovascular disease mortality (P=0.425). High variation group whose phosphorus on target had higher all?cause mortality and cardiovascular disease mortality than those in low variation group (29.2% vs 16.9%, P=0.047; 15.0% vs 6.0%, P=0.033). Kaplan?Meier method showed that patients with high phosphorus variation had higher all?cause (P=0.023) and cardiovascular disease mortality (P=0.047) than patients with low phosphorus variation. Conclusions The high CV of phosphorus is independently correlated with all?cause and cardiovascular disease mortality. Patients with standard ? reaching phosphorus in the low variation group have a lower mortality. A serum phosphorus level sustainably reaching the standard may improve the survival in MHD patients.

OBJECTIVETo investigate the effect of ginseng-derived compound K (C-K) on apoptosis, immunosuppressive activity, and pro-inflammatory cytokine production of myeloid-derived suppressor cells (MDSCs) from mice bearing colorectal cancer xenograft.

METHODSFlow-sorted bone marrow MDSCs from Balb/c mice bearing CT26 tumor xenograft were treated with either C-K or PBS for 96 h and examined for apoptosis with Annexin V/7-AAD, Cox-2 and Arg-1 expressions using qRT-PCR, and supernatant IL-1β, IL-6, and IL-17 levels with ELISA. C-K- or PBS-treated MDSCs were subcutaneously implanted along with CT26 tumor cells in WT Balb/c mice, and the tumor size and morphology were evaluated 21 days later.

RESULTSC-K treatment significantly increased the percentages of early and late apoptotic MDSCs in vitro (P<0.01 and P<0.05, respectively), decreased the expressions of immunosuppression-related genes Cox-2 (P<0.05) and Arg-1 (P<0.01), and suppressed the production of IL-1β (P<0.05), IL-6 (P<0.01), and IL-17 (P<0.05) by the MDSCs . Compared with PBS-pre-treated cells, C-K-pretreated MDSCs showed significantly attenuated activity in promoting CT26 tumor growth in mice (P<0.01).

CONCLUSIONC-K can suppress the immunosuppresive effect of MDSCs to inhibit tumor cell proliferation in mice, which suggests a new strategy of tumor therapy by targeting MDSCs.

Animals ; Apoptosis ; Cell Proliferation ; Colorectal Neoplasms ; pathology ; Disease Models, Animal ; Ginsenosides ; pharmacology ; Humans ; Immunosuppression ; Interleukin-17 ; metabolism ; Interleukin-1beta ; metabolism ; Interleukin-6 ; metabolism ; Mice ; Mice, Inbred BALB C ; Myeloid Cells ; drug effects ; Neoplasm Transplantation

Objective To investigate the value of conventional ultrasound and CEUS in diagnosis of thyroid nodules with Logistic regression models.Methods A total of 218 cases of thyroid nodules (74 cases of malignant,144 cases of benign nodules) confirmed by pathology were enrolled.The boundary,morphology,anteroposterior and transverse diameter ratio,microcalcification,internal echogenicity,blood distribution and enhanced pattern of nodules were observed and analyzed with univariate analysis.The Logistic regression model was established with parameters which were significantly different of those features,and the receiver operating characteristic curves (ROC) were constructed.Results Hypoechoic,irregular morphology,blurred boundary,anteroposterior and transverse diameter ratio≥ 1,microcalcifications,blood distribution (Ⅰ,Ⅱ),heterogeneous enhanced pattern and low enhanced were significantly prognostic factors (all P＜0.01).Irregular morphology,microcalcifications,heterogeneous enhanced and low enhanced were independent prognostic factors (all P＜0.05).The accuracy of Logistic regression model was 82.57％,and the area under ROC curve was 0.906.Conclusion The Logistic regression model of boundary,morphology,anteroposterior and transverse diameter ratio,microcalcifica tions,internal echogenicity,blood distribution and enhanced pattern can help to diagnose malignant thyroid nodules.