Objective To evaluate the clinical value of elasticity imaging and area ratio by ultrasonography in differential diagnosis of benign and malignant thyroid nodules.Methods Gray-scale ultrasound and elasticity imaging was used to examine 88 patients with thyroid nodules.The elasticity classification and area ratio were retrospectively reviewed and compared with pathology.The elasticity grades 1 - 3 predicted benign,grades 4 - 5 predicted malignant.Results Eighty-eight patients with 116 thyroid nodules were detected,93 nodules were benign and 23 nodules were malignant.( 1 )An elasticity grades of 1 - 3 was observed in 82 (95.3％) of 86 benign nodules,while elasticity grades of 4 - 5 in 19 (63.3％) of 30 malignant nodules.The diagnosis sensitivity,specificity and accurate rate of the elasticity grades was 82.6％,88.2％,87.1％.(2) The mean of elasticity imaging and area ratio of 93 benign nodules (1.31 ± 0.13 ) was statistically lower than that in 23 malignant nodules ( 1.73 ± 0.13 ) (t =13.536,P =0.001 ).( 3 )According to ROC analysis,the cut-off point of elasticity imaging and area ratio was determined as 1.52.With elasticity imaging and area ratio ＜ 1.52,89 nodules [98.9％(89/90)] were confirmed as benign and 22 nodules [84.6％ (22/26)] were confirmed as malignant by pathology.The diagnosis sensitivity,specificity and accurate rate of elasticity imaging and area ratio was 95.7％,95.7％,95.7％.(4)The area under the ROC curve of elasticity imaging and area ratio ≥ 1.52 was 0.996,significantly higher than that of elasticity grades ≥ 4 (0.891).The diagnostic accurate rate of elasticity imaging and area ratio was significantly higher than that of elasticity grades(95.7％ vs.87.1％,x2 =5.472,P=0.019).Conclusions The elasticity imaging and area ratio by ultrasonography can be used in the differential diagnosis of thyroid lesions.It is a new diagnostic indicator for diagnosis of thyroid lesions.

Objective To study the diagnosis and treatment of omental torsion.Methods 73 patients with omental torsion from Jan 1995 to Dec 2009 in literatures together with the one we reported were reviewed and analyzed The range of ages was from 3 to 65 years,and the median age was 25.3 years.Among them,35 cases were less than 18 years old(47%,and 27 with obesity) and others more than 18 years old(53%,1 with obesity).The accurate diagnosis before operation exsited in 9 patients.49 patients(66%) were diagnosed as primary omental torsion,and childhood obesity was the most related factor.Conversely,25(34%) were diagnosed as secondary omental torsion,while the most common reason was adhersion.In contrast with other clinical symotoms and signs,abdominal pain and tenderness were occurred in almost every people.Bultro sonography(positive rate:24%,6/25) was hardly useful in diagnosis but CT (positive rate:96%,23/24) and MRI(positive rate:100%,2/2) were beniticial.Operation was applied in all patients,while laparoscopy was uesed in 23 patients.As a rule,the appendix was removed together in 61 persons.The cobort of patients was recoverd fully without serious complications such as hemorrhage and intestinal infarction.Conclusion Omental torsion was a relatively rare disease,and the diagnosis should be easy with the help of CT and MRI,and the laparoscopy was the better choice for surgeons.

Objective To observe the effects of hedysari polysaccharide (HPS) on myocardial fibrosis and the expression of MMP-2/TIMP-2 in model mice of diabetic cardiomyopathy; To discuss the mechanism of action of prevention and treatment of myocardial fibrosis in diabetes.Methods Sixty mice were randomly divided into model group, rosiglitazone group and HPS high-, mediume- and low-dose groups. The normal group was 12 non-transgenic male BKS.Cg-Dock7m+/+Leprdb/JNjumice with the same age. Each group was given relevant medicine for gavage, for 8 weeks. Blood glucose of mice before and after medication 2, 4, 6, and 8 weeks was detected. The levels of MMP-2, MMP-2 and MMP-9 in myocardium were measured by Masson staining. The protein expressions of MMP-2 and TIMP-1 in myocardium were detected by Western blot.Results Compared with the model group, the blood glucose of HPS (high- and medium dose) groups and rosiglitazone group decreased significantly. Masson staining showed that the green fibers in the model group significantly increased and rosiglitazone group and HPS high-dose group decreased compared with the model group. Western blot showed that the expressions of MMP-2 in model group and MMP-2/TIMP-2 ratio were declined significantly, while the expression of MMP-2 was increased and TIMP-2 was decreased significantly, and the ratio of MMP-2/TIMP-2 increased in rosiglitazone group and HPS high- and medium-dose group.Conclusion HPS may reduce the degree of myocardial fibrosis in model mice with diabetic cardiomyopathy. The therapeutic effect of HPS may be to relieve myocardial fibrosis in model mice by increasing the ratio of MMP-2/TIMP-2.

Objective To explore the effect of hedysarum polybotrys polysacchcaide (HPS)on myocar-dial fibrosis of db /db mice with diabetic cardiomyopathy (DCM)by taking TGF-β1 /Smads signaling pathway as the index.Methods Altogether 60 six-week-old male db /db mice were randomly divided in-to five groups:HPS high-,mid-,low-dose group,rosiglitazone group and model group,additional 12 non transgenic db /m male mice with the same background were assigned into the normal group.The mice ex-cept for those of the normal group were intragatrically administered (i.g.)corresponding medicines for consecutive 8 weeks.Before treatment and every two weeks during the period of i.g.drugs,the body weight and blood glucose were detected.At the end of Week 8,HE staining was used to observe the pathological changes of left ventricular myocardial fibers,Masson staining was used to observe the degree of left ventricular myocardial collagen fibrosis,and Western blot,RT-PCR were used to measure the pro-tein and mRNA expressions of TGF-β1 and Smad2,Smad3 in cardiac muscle tissue.Results Eight weeks after treatment,the blood glucose of rats in HPS high-,mid-dose group,and rosiglitazone group decreased significantly compared with model group (P <0.05).The sections of HE staining showed that the model rats’myocardial cells structure became unclear and some of them were swollen and deformed obviously,even the nucleus disappeared.The sections of Masson staining showed that bright green colla-gen fibers were heaped up between myocardial cells and around blood vessels of the model rats.The pro-tein and mRNA expressions of TGF-β1 ,Smad2 and Smad3 had no significant difference between model group and HPS low-dose group (P >0.05),but the other groups decreased significantly compared with the model group (P <0.05),especially the HPS high-dose group or rosiglitazone group was superior to mid-dose group (P <0.05).Conclusion The effect of HPS against myocardial fibrosis in db /db mice with DCMto slow down the progression of DCMwas proved,and its potential mechanism may be related to inhibitation of TGF-β1 /Smads signaling pathway.