Objective To investigate the value of ultrasonography in diagnosis and preoperative TNM staging for neuroendocrine breast cancer(NEBC).Methods The ultrasonic characteristics of 12 NEBC and 104 invasive ductal carcinoma(IDC) confirmed by pathology,as well as the metastatic lymph nodes were analyzed retrospectively.The TNM-staging for NEBC by preoperative ultrasonography was evaluated according to pathology.And the relation between lesions size and Ki-67 was then analyzad.Results NEBC lesions mainly showed solid and heterogeneous hypoechoic(66.67％),irregular shape(66.67％),clear border (58.33 ％),posterior enhancement(58.33 ％) and internal blood flow(grade 0-Ⅰ) (66.67 ％).The detection rate of unclear border,irregular edge,hyperechoic halos and uneven internal echo was lower than IDC(P ＜ 0.05).Meanwhile,NEBC had a lower detection rate of calcification and internal blood flow(grade Ⅱ-Ⅲ)than IDC (P ＞0.05).And the detection rate of more round or oval lesions were higher in NEBC than that in IDC (P =0.001).According to pathology,the ultrasonic coincidence rate for T staging of NEBC and pathology was 75％,and for T1-staging was 100％,for T2-staging was 80％.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasonic diagnosis on lymph node metastases was 66.67％,88.89％,66.67％ and 88.89％,respectively.There was a positive correlation between focal maximum diameter with Ki-67 (r=0.026,P=0.004).Conclusions It shows certain value of ultrasonography in diagnosis and preoperative TNM staging for NEBC.

Purpose To explore ultrasonic characteristics of complex fibroadenoma (CF) of breast and its differential diagnosis from invasive ductal carcinoma (IDC).Materials and Methods Sixty-one patients with CF and 81 patients with IDC from January 2010 to February 2016 in the Affiliated Union Hospital of Fujian Medical University were enrolled,and the CF and IDC were confirmed by pathology after operation.The preoperative sonographic findings of CF and IDC were retrospectively analyzed and compared.Results Fifty-nine cases with CF were detected by ultrasonography in 61 cases.Ultrasonic findings of 59 cases of CF showed as follows:79.7％ (47/59) of the CF cases with an aspect ratio ＜0.7;79.7％ (47/59) with blood flow signal of 0 to 1 level;72.9％ (43/59) with liquid dark area,including 67.8％ (40/59) with round or oval cystic fluid area showing local sievelike or diffused distribution;72.9％ (43/59) with irregular shape;61.0％ (36/59) with obscure boundary;61.0％ (36/59) with the largest diameter of tumor ＜2 cm;59.3％ (35/59) with calcifications,including 33.9％ (20/59) with coarse calcification,25.4％ (15/59) with microcalcification and 85.7％ (30/35) with distribution of calcified lesions along the linear high echo zone;54.2％ (32/59) with echo heterogenicity showing linear high echo and high echo in the middle and low echo.There were significant differences in the detection rates of internal regular fluid area,internal linear high echo or high echo area,and alcification distribution along the linear high echo between CF and IDC lesions (all P＜0.01).Compared with IDC,there were higher rates in CF for detecting lesions of largest diameter of tumor ＜2 cm,more regular shape,more clear border,poorer blood flow signal (P＜0.05),but there were lower rates in CF for detecting axillary lymph node enlargement,lesions with edge or spiculation and hyperechoic halo (P＜0.01).Conclusion Color Doppler ultrasonography is of great value in the diagnosis of CF and its differential diagnosis from IDC.

BACKGROUND:Ricin possesses strong cytotoxicity but lacks of specificity.Severe adverse reactions can be caused if ricin is systemically administered.Interstitial chemotherapy with ricin coated by a sustained-release carrier can enhance local therapeutic effects of tumor,avoiding systemic-toxic occurrence.OBJECTIVE:To prepare injectable and biodegradable thermosensitive poly(D,L-lactide-co-glycolide)(PLGA)-polyethylene glycol(PEG)-PLGA copolymer-based hydrogels and to observe the in vitro drug delivery of the PLGA-PEO-PLGA copolymer hydrogel as a sustained-release carrier of ricin.DESIGN,TIME AND SETTING:A controlled observation was performed at the Center for Medical Bioengineering.Fujian Medical University between August and December 2007.MATERlALS:Ricin with a purity of 95%was purified by Fuiian Institute of Ultrasonic Medicine.DL-lactide and L-glycolide were provided by Glycolide Lactide Co.,Ltd..China.METHODS:PLGA-PEG-PLGA-copolymer was synthesized by ring-opening polymerization.MAIN OUTCOME MEASURES:Phase transition temperature was determined by test tube turnover.relativemolecular mass by high-performance gel permeation chromatography,the proportion of block copolymer by nuclear magnetic resonance spectrometry.the in vitro drug delivery of ricin coated by PLGA-PEG-PLGA copolymcr hydrogelby enzyme linked immunosorbent assay.the structural integrity of released ricin by high-performance liquid chromatography,the cytotoxicity of released ricin by methyl thiazolyl tetrazolium assay.RESULTS:The synthesized copolymer PLGA-PEG-PLGA exhibited reverse.thermosensitivity.The phase transition temperature of the copolymer was 26℃at 230 g/L.The weight-average molecular weight and number-average molecular weight of this copolymer was 8 027 and 6 643,respectively,and the multiple-dispersion toefficient was 1.17.The block ratio for PEG and PLGA was 3:2.Drug-loaded PLGA-PEG-PLGA hydrogel could release ricin in vitro for a total of 18 successive days and simultaneously well maintain cytotoxicity and the structural stability of ricin.CONCLUSION:PLGA-PEG-PLGA copolymer is an ideal carrier for sustained delivery of ricin

Objective To discuss color Doppler uhrasonographic (CDU) grading of varicocele (VC) in predicting the changes of the fertility index (FI) after varicocelectomy.Methods One hundred and fifty-one patients with VC were diagnosed and graded by CDU.All patients were grouped by the regurgitant volume and the maximum diameter of pampiniform plexus veins(PPV).The relation between the regurgitant volume and the maximum diameter of PPV and the changes of the FI after varicocelectomy was analyzed.Results The pathological regurgitation could be detected when the PPV diameter > 1.5 mm.The positive correlation was observed between the regurgitant volume and the diameter of PPV (r = 0.89, P <0.01).The pre- and postoperative FIs were extremely significant difference in regurgitation grade Ⅱ and regurgitation grade Ⅲ (P < 0.01) but not significant difference in regurgitation grade Ⅰ (P>0.05).The pre- and postoperative FIs were no significant difference in the group with the PPV diameter ≤ 2.0 mm (P > 0.05), but statistically significant difference in the groups with the diameters 2.1-2.5 mm and 2.6-3.0 mm (0.01 < P <0.05).FIs in the group with the diameter > 3.0 mm exhibited extremely significant difference after varicocelectomy (P < 0.01).Conclusions CDU grading of VC could be used to predict the changes of seminal quality after varicocelectomy.Varicocelectomy isn't necessary to the patients with VC that the PPV diameter ≤ 2.0 mm or pathological regurgitation being detected only on Valsalva maneuver.

ObjectiveTo assess the clinical value of ultrasound-guided percutaneous ethanol injection (PEI) in the treatment of hepatocellular carcinoma (HCC) combined with portal vein tumor thrombosis (PVTT).MethodsNinety HCC patients with different type PVTT underwent ultrasound-guided PEI once or twice a week.The follow-up lasted 12 to 60 months,and the 1-,2-,3-,4- and 5-year survival rates were calculated.ResultsThe median survival time of HCC combined with PVTT patients treated with PEI was 12 months,and the 1-,2-,3-,4- and 5-year survival rates was 52.22％,23.33％,15.56％,12.22％ and 10.00％,respectively.The survival rate correlated significantly to the type of PVTT.The lower the type of PVTT was,the longer the patients lived.ConclusionUltrasound-guided PEI is a safe and effective method for the treatment of HCC combined with PVTT,and can prolong the survival time of HCC patients with low type PVTT.

Objective To investigate the tumor chemical ablation and analgesic effects of compound lauromacrogol,and to explore a new method for ultrasound-guided tumor ablation.Methods 18 VX2 tumorbearing rabbits were randomly divided into saline group,ethanol group and compound lauromacrogol group,and the medicine was intratumoral injected guided by ultrasonography.After 4 times treatment,tumor contrast-enhanced ultrasonography,tumor growth inhibition rate and tumor tissue pathology were performed to evaluate the antitumor effects.The analgesic effect was evaluated using the pain model induced by formaldehyde test.Results Ultrasound-guided intratumoral injection of compound lauromacrogol showed significant antitumor effects with a tumor growth inhibition rate of 63.3 ％,which was higher than that of ethanol group.No apparent enhancement was found under contrast-enhanced ultrasonography,and pathology results confirmed wide necrosis.In saline,ethanol and compound lauromacrogol groups,the average accumulated points were 62.25 ± 9.79,21.00 ± 9.13 and 9.87 ± 3.10,respectively by formaldehyde test.Conclusions Ultrasound-guided chemical ablation using compound lauromacrogol showed complete antitumor and strong analgesic effects,which would be a new method for tumor ablation.

Objective To establish the models with human rheumatoid arthritis (RA) synovial fibroblasts (RASFs)-cartilage-severe combined immune deficient (SCID) mice for the study of the RASFs in the pathogenesis of RA.Methods The 4th passage RASFs were marked with 5-bromodexyuridine (5-Brdu)and injected into a cavity of inert sterile gel sponge,then with the normal human cartilage co-implanted in the back subcutaneously of SCID mice to set up a novel model of RA.Osteoarthritis synovial fibroblasts (OASFs)were injected as control group.Thirty days after the surgery,the mice were killed,the grafts and the knee joints were proceed with histological study and immunohistochemistry to detect the expression of 5-Brdu and Vimentin in synoviocytes.The serum level of interleukin (IL)-6 and matrix metalloproteinase (MMP)-3 were detected with enzyme-linked immunosorbent assay (ELISA).Results Twenty-three mice survived except for one mouse in the RASFs group died of anesthesia.① Only in one case in the RASFs group,the IL-6 was detected,the others were unable to be detected.The MMP-3 in the OASFs group was (40±17) pg/ml,but in RASFs group only one case was detected.② There were 4 and 3 implanted cartilages loss in the RASFs group and OASFs group respectively.The histological scores of cartilage invasion by synoviocytes and cartilage degradation in grafts were higher in RASFs groups than in OASFs groups (0.6±0.7 vs 0.3±0.5,2.3±0.8 vs 1.7±1.0 respectively).③ The histological scores of synovial hyperplasia and cartilage invasion in the knee joints was significantly higher in the RASFs group than in the OASFs group (3.1±0.8 vs 1.7±1.0,P＜0.01,1.6±1.7 vs 0.6±1.4,P＜0.05 respectively).④ During the grafts,a lot of 5-Brdu and Vimentin markers positive synovio-cytes were found in the mice subcutaneous tissue,but manipulus positive synoviocytes were found on the area of cartilage invasion in both groups.In knee joints,single positive synoviocytes could be detected in bone marrow and hyperplasic area of the synovial tissue in both groups.Conclusion The isolated RASFs can survival and have the ability to invade and degrade the cartilage in vivo without the limitation of immunity induced inflammations,and can also migrate to the synovial joints in distance and induce arthritis.

Objective To investigate the ultrasound characteristics of microinvasive breast carcinoma (MBC),and to improve its detection rate.Methods Sixty-five MBC,85 breast ductal carcinoma in situ (DCIS)and 99 breast invasive ductal carcinoma(IDC)confirmed by pathology were divided into mass type and ductal type according to ultrasonic manifestaions,and the ultrasound characteristics were retrospectively analyzed.Results MBC showed 89.23%(58/65)mass type with 64 lesions and 10.77%(7/65)ductal type. DCIS showed 88.24% (75/85 )mass type with 78 lesions and 1 1 .76% (10/85 )ductal type.IDC group showed all mass type with 102 lesions.In MBC,most mass type lesions were solid and hypoechoic with a mean maximum diameter,which was larger than DCIS,but similar with IDC(P >0.05).More mass type lesions with irregular shape and calcification were found in MBC than in DCIS(P < 0.05 ),while similar with IDC(P >0.05).The detection rate of spiculate margin in mass type lesions of MBC was higher than DCIS(P <0.05),but lower than IDC(P <0.05).Less mass type lesions showed unclear border,high A/T ratio and hyperechoic halos in MBC than in IDC(P <0.05),but similar with DCIS(P >0.05).More ductal type lesions displayed indistinct duct wall in MBC than DCIS(P <0.05 ).Meanwhile,MBC had a higher detection rate of internal blood flow(grade 2-3)than DCIS.Conclusions There are more lesions with large diameter,irregular shape,short spiculate margin and calcification in MBC than DCIS.Compared with IDC, MBC lesions are atypical in spiculate margin,and less lesions show hyperechoic halos and high A/T ratio. To be familiar with ultrasound characteristics of MBC is significant for improving its ultrasound detection rate.

ObjectiveTo assess the protective effect of ischemic postconditioning in different ways after rabbit's testis completely torsion and detorsion and to assess the value of contrast-enhanced ultrasonography(CEUS) in it.MethodsForty male white rabbits were divided into 5 groups randomly:a control group,directly perfusion group (R),ischemic postconditioning groups (IP1,IP2 and IP3),with 8 in each.The acute testicular hemodynamic disorder models were established in R,IP1,IP2,IP3 groups by completely blocking the left testicular blood flow for 4 hours,then group R was directly subjected to perfusion,group IP1 was subjected to 15 s release and 15 s occlusion (15 s/15 s),IP2 was subjected to 30 s/ 30 s,IP3 was subjected to 45 s/45 s,each group was taken 3 cycles.All the groups underwent CEUS before operation and after 3 days,examined for the contents of malonaldehyde(MDA),superoxide dismutase(SOD) and histology,and observed for the pathobgieal changes of the testicular tissue.ResultsThe CEUS parameters of bilateral testes showed no significantly difference in all group before operation( P ＞0.05),3 days after reperfusion.The half of declining time of intensity was extended significantly in all operation groups comparing with control group (P ＜ 0.05),but the difference of peak and base intensity were increased in group IP1 and IP2,comparing with control group( P ＜0.05).The contents of MDA and SOD were remarkable differences in group IP1,IP2 comparing with group R and IP3 ( P ＜ 0.05).Johnsen' s score,apoptosis index showed significantly differences in group IP1,IP2 comparing with group R and IP3 (P ＜ 0.05).ConclusionsMicrocirculation of the complete torsion testicular was significantly improved by ischemic postconditioning after reperfusion,and the effects of ischemic postconditioning could be evaluated by CEUS.

Objective To investigate the ultrasonic characteristics of invasive micropapillary carcinoma(IMPC) of breast and the metastatic lymph nodes,and to evaluate the value of ultrasonography for preoperative TNM staging.Methods The ultrasonic characteristics of 16 IMPC and 81 invasive ductal carcinoma (IDC) confirmed by pathology,as well as the metastatic lymph nodes were analyzed retrospectively.The TNM-staging for IMPC by preoperative ultrasonography was evaluated according to pathology.Results Compared with IDC group,the masses showed higher A/T ratio (＜ 0.7),larger maximum diameter,more calcification,unclear border and lymph node metastasis rate,while less acoustic halo in IMPC group.Meanwhile,similar ultrasonic characteristics,such as irregular shape,uneven internal echo,spiculate margin,posterior acoustic attenuation and internal blood flow were seen in IMPC and IDC groups (P ＞0.05).According to pathology,the ultrasonic coincidence rate for T staging was 56.3 ％,and T2-staging was 85.7％.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasonic diagnosis on lymph node metastases was 70.0％,83.3％,87.5％ and 62.5％,respectively.Conclusions Ultrasonography displayed more typical malignant signs,higher lymph node metastasis rate and diagnosis accuracy for IMPC,which possessed certain value for preoperative TNM staging.