Objective To detect the tissue stiffness of liver lesions by using acoustic radiation force impulse imaging (ARFI) and to evaluate the clinical value on the characteristics of liver lesions.Methods ARFI was perforrned in 91 patients with 103 liver lesions (56 benign,48 malignant).Tbe elastographic images of virtual touch tissue imaging (VTI) and the values of virtual touch tissue quantification (VTQ) were analyzed.The area under the curve and cutoff value for VTQ value were used to assess diagnostic performance.Results On the elastographic images of VTI,79.17 ％ (31/55) malignant liver lesions and 56.36 ％ (38/48) benign liver lesions appeared stiffer compared with the surrounding liver parenchyma.There was statistical difference between malignant and benign liver lesions (x2 =0.627,P ＜ 0.01).The VTQ values of malignant and benign liver lesions were (2.64±0.65) m/s and (1.72±0.39) m/s,respectively,and there was statistical difference between them (t =8.638,P ＜ 0.01).With a cutoff value of 2.10 m/s for VTQ value,the sensitivity and specificity of diagnosis for liver malignancy were 83.3 ％ and 81.8 ％,respectively.Conclusion ARFI can provide information of the tissue stiffuess in live lesions,which is helpful in the differentiation between benign and malignant liver lesions and might become the imaging modality in the future.

Objective To evaluate the application value of three‐dimensional ultrasonography OmniView technology in diagnosis of fetal cleft lip/palate . Methods Three‐dimensional volume data was acquired from 100 normal singleton fetuses and 18 cleft lip/palate fetuses ,and was analysed by OmniView technology . Two‐dimensional ultrasonography and three‐dimensional OmniView technology were compared in the displaying rate of different planes of the lip and palate and the diagnosis accordance rate of cleft lip/palate.Results ①ThedisplayingrateofthelipandpalateofOmniViewtechnologywashigherthanthatof two‐dimensional ultrasonography ( the displaying rates were 64% -88% and 30% -65% ,respectively , P <0 .05) . Further more ,the curved plane tiled imaging of palate was successfully reconstructed by OmniView technology ,displaying the nonplanar panorama of the palate . ② There was no significant difference in diagnosis accordance rate of fetal cleft lip/palate between two‐dimensional ultrasonography and OmniView technology( the accordance rate was 89% -94% and 78% -100% ,respectively , P >0 .05) . Conclusions Three‐dimentional ultrasonography OmniView technology can improve the displaying rate of the hard and soft palate .The application of this technology in the fetuses who has a high risk of cleft palate may be beneficial to the diagnosis of cleft palate .

Objective To investigate the characteristics and risk factors of central lymph node metastasis in clinically node negative (cN0) papillary thyroid carcinoma (PTC) (T1 or T2 stage) coexisting with Hashimoto' s thyroiditis (HT).Methods A total of 398 patients undergoing thyroidectomy with central lymph node dissection were enrolled in the study.Patients were divided into the trial group (PTC with HT)and the control group (PTC without HT).The difference of the clinicopathological characteristics between the 2 groups and risk factors for central lymph node metastasis were analyzed.Results Among the total 398 patients,98 (24.6％)had coexistent HT.Central lymph node metastasis rate was similar in the 2 groups (40.8％ vs 41.3％).The number of dissected central lymph nodes was significantly more in the trial group than in the control group (4.9 vs 2.9,P＜0.01) while the number of metastatic lymph nodes had no statistical significance between the 2 groups (1.0 vs 1.0).Univariate analysis showed that tumor size＞1 cm was significantly associated with central lymph node metastasis in the trial group (P＜0.01).Male,＜45 years,tumor size＞1 cm,and tumor located in the middle/lower third of lobe were all significantly associated with central lymph node metastasis in the control group (P＜0.01).Multivariate analysis showed that tumor size＞1 cm was independent predictor for central lymph node metastasis in the trial group,while female,＜45 years,tumor size＞1 cm,and tumor located in the middle/lower third of lobe were all independent predictors for central lymph node metastasis in the control group.Conclusions The number of central lymph nodes was larger in cN0 PTC coexisting with HT patients than that in PTC patients,but there was no statistical difference in the number of metastatic lymph nodes between cN0 PTC with and without HT.Central lymph node dissection is recommended when tumor size 1 cm in cN0 PTC coexisting with HT patients.

Objective To explore the emergency PCI symptom-onset-to-balloon time (SOTBT) influence on the local cardial function in patients with acute ST-segment elevation myocardial infarction (STEMI) by two-dimensional speckle tracking imaging (2D-STI) technology.Methods Sixty cases were ifrst diagnosed with ST-elevation myocardial infarction (STEMI) and undergone emergency PCI surgery in Huangshi central hospital from June 2014 to June 2016. According to SOTBT, patients were divided into two groups: SOTBT≤6h myocardial infarction group, 6 h

ObjectiveTo investigate ultrasonographic signs as the factors for the recurrence of gallstones and polypoid lesion of the gallbla-dder in patients undergoing gallbladder-preserving surgery. MethodsRelated signs including gallbladder size, sound transmission of the gallbladder, gallbladder wall thickness, cholestasis, gallbladder contraction function, and common bile duct diameter measured by preoperative and postoperative ultrasonography, as well as the recurrence of gallstones and polypoid lesions of the gallbladder after surgery, were collected from 700 patients who underwent gallbladder-preserving surgery in Huangshi Central Hospital from January 2011 to February 2015. The Fisher′s exact test and Cox proportional hazards regression model were applied for univariate and multivariate analysis of related factors for recurrence after gallbladder-preserving surgery. ResultsThe shortest and longest follow-up time was 6 months and 48 months, respectively, and the mean follow-up time was 18±12 months. Among the 700 patients, 1 experienced recurrence of gallstones at 1 month after surgery, 2 experienced recurrence of gallstones at 6 months after surgery, 1 experienced recurrence of gallstones at 12 months after surgery, and 1 experienced recurrence of polypoid lesions of the gallbladder at 24 months after surgery. The mean time to recurrence of gallstones and polypoid lesions was 9.8 months after surgery, and the recurrence rate was 0.71% (5/700). The univariate analysis showed that gallbladder wall thickness ≥4 mm, gallbladder contraction function ＜30%, and cholestasis were significantly associated with the recurrence of gallstones and polypoid lesions (all P＜0.05). The multivariate analysis showed that gallbladder wall thickness ≥4 mm, cholestasis, and gallbladder contraction function ＜30% were independent factors for recurrence after gallbladder-preserving surgery (P=0000 3, 0.040 0, and 0.040 0). ConclusionUltrasonography shows that gallbladder wall thickness ≥4 mm, gallbladder contraction function ＜30%, and cholestasis are closely associated with the recurrence of gallstones and polypoid lesions of the gallbladder.

Depression jeopardizes human health and brings heavy burden to both related families and societies. However, pathogenesis of depression has not been fully clarified yet. Previous studies show that there are some connections seen between dietary factors and depression, which are affected by various lifestyles. This paper aims at providing evidence for the prevention and treatment of depression by evaluating the relationships between factors as nutrients, dietary patterns, lifestyle and depression, based on the published literature.

Objective To study the variation characteristics of cognitive impairment and its influencing factors using telephone interview for cognitive status-modified (TICS-m) in patients after cerebral ischemia,and evaluate the application value of TICS-m.Methods Ninety-five patients with cerebral ischemia,matched the criteria and admitted to our hospital from December 2014 to December 2015,were chosen.Their related information was recorded,their cognitive function was assessed by face-to-face neuropsychological tests,including Montreal Cognitive Assessment (MoCA),Hamilton Depression Rating Scale,activities of daily living (ADL) and Chinese Neuropsychiatric Inventory (CNPI),in the acute stage (10-14 d),and then,their cognitive function was assessed by TICS-m 4,12 and 18 weeks after cerebral ischemia and their rehabilitation was followed up.Results The incidence of cognitive impairment after cerebral ischemia in the acute stage was 78.9％;when cutoffs of dementia was ＜28 points and mild cognitive impairment (MCI) was 28-33 points in TICS-m,the incidences of cognitive impairment 4,12 and 18 weeks after cerebral ischemia were 69.4％ (MCI:45.8％,dementia:23.6％),57.3％ (MCI:42.6％,dementia:14.8％),44.9％ (MCI:34.7％,dementia:10.2％).And the TICS-m total scores 12 and 18 weeks after cerebral ischemia were significantly increased than that 4 weeks after cerebral ischemia,amplification reaching to 7.9％ and 10.7％ (P＜0.05);subtests analysis indicated that 12 and 18 weeks after cerebral ischemia,the memory recovered obviously:the scores were significantly increased,amplification reaching to 34.5％ and 49.0％ as compared with those 4 weeks after the cerebral ischemia (P＜0.05).Logistic regression analysis indicated that age (OR=66.615,P=0.001,95％CI:5.449-814.349),education level (OR=0.134,P=0.009,95％CI:0.029-0.608) and work type (OR=0.090,P=0.004,95％CI:0.017-0.464) were closely related to the cognitive impairment after cerebral ischemia.The follow-up visit analysis showed that most patients (91.8％) could take the drug for the secondary prevention of stroke and return to the clinic regularly,and only a small part of patients (31.8％) took the related drugs to improve their cognitive impairment;about 77.6％ patients recovered good after discharge,54.7％ patients supported and hoped the doctors continue the follow-up visit by telephone.Conclusions The incidence of cognitive impairment is high after cerebral ischemia and it declines over time,and advanced age,low education level and manual work are the important factors affect the incidence.TICS-m is an effective and convenient tool to assess the characteristic and prognosis of patients with cognitive impairment after the cerebral ischemia,and it' s suitable for clinic follow-up study and scientific research.

Objective: To understand the current situation and association of eHealth literacy with physical health of college students, so as to provide a basis for physical health improvement. Methods: By using stratified random clustering sampling method, a total of 1 446 students from first to third year of college in four colleges and universities in Dongguan were selected for the eHealth literacy questionnaire and physical fitness test. Results: The average eHealth literacy score of college students was(29.72±6.19), with a pass rate of 48.8%. The scores for each dimension were application ability (18.57±4.10), judgment ability (7.48± 1.67 ), and decision making ability (3.67±0.91). The differences in eHealth literacy scores among college students with different birthplaces, family upbringing and frequency of participation in outdoor sports were statistically significant( t/F=-2.44, 3.51, 10.19 , P <0.05). The mean score of physical fitness was (73.20±7.86), with a failure rate of 5.0%, a passing rate of 77.0%, a success rate of 17.1%, and an excellent rate of 0.8%. The differences in scores of physical fitness test varied significantly by gender, grade, and frequency of participation in outdoor sports( Z=-2.27, 8.75, 39.90, P <0.05). Pearson correlation analysis showed that eHealth literacy and the three dimensions of application ability, judgment ability, and decision making ability were positively correlated with total physical fitness test scores( r=0.17, 0.18, 0.16, 0.19, P <0.01). Multiple linear regression analysis showed that after adjusted for gender, grade, and frequency of participation in outdoor sports, eHealth literacy application ability, judgment ability, and decision making ability could significantly and positively affect physical fitness test score( β=0.13, 0.12, 0.12, P < 0.05 ). Conclusion Physical fitness of college students is associated with eHealth literacy,promotion of eHealth literacy among college students help improve physical health status.

Objective To explore the value of contrast-enhanced ultrasonography ( CEUS ) breast predictive model in the optimization of BI-RADS classification of breast lesions . Methods A total of 1049 BI-RADS 4 ,5 breast lesions were obtained from 1039 patients in 8 centers . CEUS examination was performed prior to biopsy or surgery . According to the classification of the model ,class 3 ,4A ,4B and 4C were selected as biopsy thresholds ,and the ROC curve was drawn . The diagnostic sensitivity ,specificity , accuracy ,positive predictive value ,negative predictive value and Jordanian index were calculated for the biopsy threshold . The biopsy rate of breast lesions before and after angiography ,cancer detection rate , follow-up cases of malignant risk were compared . Results There were benign lesions 586 ( 55 .9％ ) , malignant lesions 463 (44 .1％ ) in the 1049 breast lesions . The area of ROC with thresholds of 3 ,4A ,4B and 4C were 0 .695 ,0 .838 ,0 .847 and 0 .757 ,respectively ( all P < 0 .01) . Ultrasonography had a certain diagnostic effect on benign and malignant breast lesions . The diagnostic sensitivity ,specificity ,accuracy , positive predictive value and negative predictive value with class 4A after CEUS set as the biopsy threshold were 93 .32％ ,75 .65％ ,82 .75％ ,75 .57％ and 93 .35％ ,respectively ,and the Jordanian index was 0 .690 . When chass 3 after CEUS was set as the biopsy threshold ,the biopsy rate was reduced from 100％ to 76 .74％ ,the detection rate was increased from 44 .23％ to 56 .77％ ,and the risk of cancer was only 0 .67％ in the follow-up cases . When class 4A was set as the biopsy threshold ,the biopsy rate was reduced from 100％ to 55 .58％ after CEUS . The detection rate of cancer increased from 44 .23％ to 74 .44％ . The risk of cancer was 2 .96％ . Conclusions The biopsy rate of breast lesions in category 4 and 5 would be reduced and cancer detection rate of them would be increased after CEUS ,however ,the risk of malignancy in the follow -up cases would be controlled as low as category 3 and 4A in previous BI-RADS . Thus ,CEUS has a good prospect of in optimizing BI-RADS and reducing biopsy rate in unnecessary lesions .

Objective:To explore the advantages of the modified right renal artery dissection in the laparoscopic resection of right renal carcinoma combined with venous tumor thrombus.Methods:From January 2016 to June 2016, a retrospective analysis of the three-dimensional CT images of renal blood vessels in 70 patients with full abdominal CT plain scan plus enhanced scan from Shandong Provincial Hospital Affiliated to Shandong First Medical University was performed. On the sagittal plane of the right margin of the aorta, the right renal artery was detected to locate above the left renal vein in 14 cases (20.0%), posterior in 33 cases(47.1%), and below in 23 cases(32.9%). In addition, on the sagittal plane of the left margin of the inferior vena cava, the right renal artery was detected to locate above the left renal vein in 1 case (1.4%), posterior in 26 cases(37.1%), and below in 43 cases (61.4%). Based on this finding, 11 patients with right kidney cancer combined with venous tumor thrombus, admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University from June 2016 to December 2019, were retrospectively analyzed. The average age of the patients was(58.7±6.8)(45-68) years old. The CT three-dimensional reconstruction of the renal blood vessels was shown on the sagittal plane of the right margin of the aorta before the operation, and the right renal artery was detected to locate above the left renal vein in 0 cases, posterior in 7 cases, and lower in 4 cases. On the sagittal plane of the left margin of the inferior vena cava, the right renal artery was detected to locate above the left renal vein in 0 case, behind in 3 cases, and below in 8 cases. Renal tumors are located in the upper middle in 5 cases and in the lower middle in 6 cases. The maximum diameter of the tumor to be resected was 8.5-12.0 cm, with an average of (10.0±1.4) cm. Among them, 4 cases had Mayo grade 0 tumor thrombus, 4 cases were grade Ⅰ tumor thrombus, and 3 cases were grade Ⅱ tumor thrombus. All 11 cases underwent transperitoneal laparoscopic surgery. During the operation, it was found that the relationship between the right renal artery and the left renal vein was consistent with the preoperative three-dimensional reconstruction of renal blood vessels. The modified right renal artery dissection method was used, that is, the right renal artery was detected and ligated between the inferior vena cava and the aorta, using the left renal vein as a mark, and then the right kidneys and vein tumor thrombi were removed.Results:All of the 11 operations in this group were completed successfully. The operation time was (110.5±29.8)(70-150) min, the average time of right renal artery dissection was(28.5±5.8)(16- 33) min, and the amount of intraoperative bleeding was(112.7±83.5)(20-300) ml. No serious complications occurred during the operation in 11 cases. Postoperative pathological examination showed 10 cases of clear cell carcinoma and 1 case of papillary cell carcinoma. The postoperative hospital stay was 4.2 (4.18±0.75) days. There were no complications such as secondary bleeding, infection, lower extremity venous thrombosis or pulmonary embolism. All 11 patients were followed up for 3 to 42 months, with an average of(19.5±12.1) months. One patient died 23 months after the operation, and no tumor recurrence or metastasis occurred in the remaining patients.Conclusions:When the right renal artery runs to the left edge of the inferior vena cava, it is mostly behind the left renal vein. In the laparoscopic resection of right renal cancer with venous tumor thrombus, the modified right renal artery dissection method can quickly find and dissociate the right renal artery. The operation time is short, the intraoperative bleeding is less, and no postoperative complications occur.