Purpose It is still undetermined about the application of regular ultrasound (US) combined with ultrasonic elastography (UE) in diagnosing superficial lymph nodes disease.Therefore our aim is to evaluate the value of US combined with UE in diagnosing superficial lymph nodes disease.Materials and Methods The ultrasonography and pathological data of 214 patients (with 266 superficial lymph nodes) were analyzed retrospectively.The US and UE data were compared with the pathologic results.Results The elastic classification of reactive hyperplastic and lymphomatous lymph nodes were no greater than grade 3,respectively;that of malignant metastatic lymph nodes was greater than grade 4.The accuracy of UE or US+UE was higher in diagnosing reactive hyperplastic lymph nodes and metastatic lymph nodes' nature compared with US (P＜0.05).The sensitivity and accuracy of US+UE in diagnosing malignant superficial lymph nodes were higher than those of US (90.13％ vs.72.37％;86.09％ vs.68.05％,P＜0.05).Compared with UE alone,those of US+UE were also higher (90.13％ vs.77.63％;86.09％ vs.72.56％,P＜0.05).Conclusion The accuracy of differential diagnosis of benign or malignant superficial lymph nodes can be improved by US+UE method.

Objective To evaluate the efficacy and toxicity of induction chemotherapy with nedaplatin and docetaxel plus concurrent intensity?modulated radiotherapy ( IMRT) with nedaplatin or cisplatin in the treatment of locally advanced nasopharyngeal carcinoma (NPC). Methods A total of 223 patients with pathologically diagnosed locally advanced NPC in five treatment centers from 2011 to 2012 were randomly divided into two groups. In the test group, one hundred and thirteen patients received two cycles of induction chemotherapy with docetaxel (65 mg/ m2 on day 1) and nedaplatin (80 mg/ m2 on day 1) plus concurrent IMRT with nedaplatin (40 mg/ m2 on day 1). In the control group, 110 patients received two cycles of induction chemotherapy with the same regimens plus concurrent IMRT with cisplatin (40 mg/ m2 on day 1). The survival rates were calculated with the Kaplan?Meier method and the differences in the survival rates between the two groups were analyzed using the log?rank test. Comparison of the incidence rates of adverse reactions between the two groups was made by the chi?square test. Results The follow?up rate was 99?? 1%.The response rates at 3 months after treatment in the two groups were both 100%. The 2?year local recurrence?free, regional recurrence?free, distant metastasis?free, and overall survival rates were 94?? 0%, 94?? 2%, 88?? 2%, and 90?? 3%, respectively, in the test group, versus 93?? 4%, 94?? 1%, 86?? 7%, and 87?? 3% in the control group ( P= 0?? 757、 0?? 478、 0?? 509、 0?? 413). The incidence rates and severity of leucopenia, neutropenia, and thrombocytopenia were significantly higher in the test group than in the control group ( P= 0?? 027 , 0?? 028 , 0?? 035 ) . The incidence rates and severity of hemoglobin reduction and nausea /vomiting were significantly lower in the test group than in the control group (P= 0?? 000,0?? 023). There were no significant differences in the incidence rates of mucositis and xerostomia between the two groups ( P=0?? 483,0?? 781). Conclusions The short?term efficacy of induction chemotherapy with nedaplatin and docetaxel plus concurrent IMRT with nedaplatin is similar to that with cisplatin in the treatment of locally advanced NPC. The mild gastrointestinal reactions can be tolerated by patients. However, the severe myelosuppression should be closely monitored during the treatment.

Objective To evaluate the treatment efficacy,toxicities and prognostic factors of nasopharyngeal carcinoma ( NPC ) treated with intensity modulated radiation oncology ( IMRT ).Methods Between January 2006 and August 2008,300 patients with pathologically diagnosed NPC from 6 center received IMRT.The number of patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳa+b disease (UICC/AJCC 2002 staging system) were 6,45,141 and 108,respectively.The prescription doses were as follows:70-74 Gy/30f toplanning target volume of primary nasopharynx tumor ( PTVRλ),68-70 Gy/30f to planning target volume of positive lymphnode (ptvnd),60-64 Gy/30f to higher risk region (PTV1),50-54 Gy/30f to lower risk region (PTV2).Patients with stage Ⅲ and Ⅳa+b disease also received cisplatin-based chemotherapy.Cox method was used for Multivariate analysis.ResultsThe follow-up rate was 99.7％.The 4-year rate of local control,regional control,metastasis-free survival (DMFS),disease-free survival (DFS) and overall survival (OS) was 94.0％,95.5％,87.4％,80.8％,86.1％,respectively.Mucositis was the most severe acute toxicity,with 18.0％grade 1,48.7％grade 2,33.3％grade 3.No patient suffered from grade 4mucositis.Xerostomia was the most common late toxicity,with 12.0％ grade 0,75.7％ grade 1,12.3％grade 2.No grade 3-4 xerostomia was observed.There were 18,15 and 42 patients failed in local,regional and distant metastasis,respectively.Multivariate analysis showed that N stage was the only prognostic factor for OS (x2 =5.17,P=0.023),DMFS (x2 =6.91,P=0.009) and DFS (x2 =8.15,P=0.004) in these patients.ConclusionsIMRT can improve the treatment efficacy of NPC.The acute and late toxicities were tolerated.Distant metastasis becomes the main treatment failure.N stage is a significant prognostic factors.

Objective To evaluate the diagnostic value of virtual touch imaging quantification (VTIQ) technique in the differential diagnosis between benign and malignant breast lesions.Methods From September to December 2015, the imaging data of 115 breast lesions in 100 patients confirmed by pathology on conventional ultrasound (2DUS) and VTIQ were retrospectively analyzed. The breast nodules were examined by 2DUS firstly and then the lesions were classified by breast imaging reporting and data system (BI-RADS). The maximum, minimum and average of shear wave velocity (SWV) values were obtained from multiple SWV measurement under the VTIQ speed mode. According to the pathology results, receiver operating characteristic (ROC) curve were plotted to determine the most accurate SWV value and the cut-off value for differential diagnosis. And the diagnosis efficiency was compared between 2DUS and VTIQ.Results There were 38 malignant nodules and 77 benign nodules in 115 breast nodules. BI-RADS grading≥4b level was set as the malignant nodules and grading≤ 4a level as the benign nodules. The SWVmax, SWVmin, and SWVmean on VTIQ of benign and malignant breast nodules were (5.11±1.61) m/s, (2.90±0.86) m/s, (3.73±1.02) m/s, and (7.22±0.94) m/s, (4.33±1.31) m/s, (5.73±1.11) m/s. There were significant differences between malignant and benign breast nodules in SWVmax, SWVmin, and SWVmean on VTIQ (t=-7.442,-7.047,-9.356, allP<0.001). Based on the area under curve of ROC, the SWVmean value in the nodule was the best value in comparison with other SWV values. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of diagnose malignant lesion conducted by 2DUS were 89.5％, 85.7％, 87.0％, 0.63 and 0.84, respectively. The cut-off value of VTIQ mean was 4.34 m/s. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for the diagnosis of malignant lesion conducted by VTIQ were 89.5％, 85.7％, 87.0％, 0.76 and 0.95, respectively. The diagnosis efficiency of VTIQ was better than 2DUS.Conclusion The study proved that the VTIQ SWVmean is the best parameter for differential diagnosis and VTIQ plays an important role in differential diagnosis of breast nodules.

Objective To investigate the expression level and clinical application value of serum resistin in patients with systemic lu-pus erythematosus(SLE).Methods Forty-five SLE patients visited Nanjing Drum Tower Hospital,Clinical College of Nanjing Uni-versity of Chinese Medicine from January to August 2023 were enrolled in the study.The patients were scored and grouped according to the SLE disease activity index(SLEDAI),with SLEDAI＜9 score in the inactive group(n=32)and SLEDAI≥9 score in the active group(n=13).Thirty-four healthy individuals who underwent physical examination in our hospital were recruited as healthy controls.The clinical data and laboratory related indicators such as urine protein and serum complement C3 levels were collected from SLE pa-tients and healthy controls.Serum resistin levels were detected by enzyme-linked immunosorbent assay(ELISA).The clinical screening value of serum resistin for SLE was evaluated with the receiver operating characteristic(ROC)curve.The correlations of serum resistin levels with different laboratory indicators were determined by Pearson correlation analysis.Results The serum resistin levels in SLE patients([7.64±0.64]ng/mL)were significantly higher than that in healthy controls([2.56±0.43]ng/mL),and the difference was statistically significant(t=6.195,P＜0.01).The serum resistin levels in active SLE patients([10.10±1.45]ng/mL)were significant-ly higher than that in inactive SLE patients([6.64±0.60]ng/mL),and the difference was statistically significant(t=2.632,P＜0.05).The area under the ROC curve(AUCROC)of serum resistin for screening SLE was 0.897.When the cut-off value was 5.893 ng/mL,the sensitivity was 86.67%and the specificity was 82.35%.The serum resistin level in SLE patients was positively correlated with urine protein(r=0.692,P＜0.01),while negatively correlated with serum complement C3(r=-0.354,P＜0.05).Conclusion The expression levels of serum resistin in SLE patients are significantly increased and positively correlated with SLE disease activity and urine protein.Serum resistin may become a novel biomarker for the diagnosis and therapeutic effect assessment of SLE.

To investigate the effects of ventricular shunt placement in children with post-infective hydrocephalus.
 Methods: A total of 24 cases of post-infectious hydrocephalus, who received ventricular shunt, were enrolled. Age, gender, disease progression, clinical manifestation, laboratory data, treatment, prognosis, complication, and sequela for each patient were retrospectively reviewed.
 Results: Of the 24 cases, 8 had a full recovery, 11 had slight sequela, 2 had severe sequela, 1 was in vegetative state, and 2 died because of bacterial meningitis and tubercular meningitis. Epilepsy, mental impairment, visual and hearing damage were the main sequelae.
 Conclusion: Ventricular shunt is the preferred treatment in children with post-infective hydrocephalus, which shows positive clinical efficacy and can improve the long-term prognosis of such patients.
Child ; Humans ; Hydrocephalus ; Retrospective Studies ; Treatment Outcome ; Tuberculosis, Meningeal ; Ventriculoperitoneal Shunt