Objective To discuss the combined value of gray-scale ultrasound ( GSUS) and contrast-enhanced ultrasound (CEUS) in the diagnosis of benign and malignant thyroid lesions and to explore the optimal diagnostic point of scoring method .Methods Ultrasound images of 178 thyroid lesions confirmed by pathology were synthetically reviewed by scoring 5 GSUS indicators including shape , orientation, interior echogenicity, halo sign, microcalcification and 6 CEUS indicators including relative arrival time of microbubbles in the periphery and interior, peak periphery and interior echogenicity, peripheral ring-enhancement, and homogeneity of enhancement .One positive indicator scored one point .The optimal diagnostic points and their clinical value were explored according to ROC curves .Results Scores of GSUS, CEUS and the combination of GSUS and CEUS were significantly different (Z =10.188,9.843,10.705,all P <0.001). Areas under ROC curves of GSUS, CEUS and the combination of GSUS and CEUS were 0.936, 0.919 and 0.964, respectively.Three or more positive GSUS indicators of five in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 79.6% and the specificity of 91.2%.Two or more positive CEUS indicators of six in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 91.8% and the specificity of 81.2%.Five or more positive GSUS and CEUS indicators of eleven in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 93.6%and the specificity of 92.3%.The areas under the ROC curve of GSUS and CEUS were 0.936 and 0.919.The area under the ROC curve of the combination of GSUS and CEUS was 0.964, larger than the areas under the GSUS ROC curve and the CEUS ROC curve.Conclusion Ultrasound is valuable in the differential diagnosis of benign and malignant thyroid lesions , and the combination of GSUS and CEUS is the most valuable with 5 points as the optimal diagnostic scoring method .

Adult ; Foot Diseases ; diagnostic imaging ; Humans ; Male ; Melorheostosis ; diagnostic imaging ; Radiography ; X-Rays

Some locally advanced tumors involving multiple abdominal organs without distal metastasis may cause digestive tract obstruction.Some of these patients can achieve long-term survival after Ro resection,others can obtain digestive tract obstruction relief,pain anesis and survival prolongation after R1 resection combined with postoperative comprehensive treatment.In this review,the efficacy of complex pancreaticoduodenectomy combined with organs resection was introduced based on reviewing the literatures.After the surgery,some patients achieved R0 resection and long-term survival,and the quality of life was significantly improved in some patients.

Tendinopathies are chronic diseases of an unknown etiology and associated with inflammation. Mesenchymal stem cells (MSCs) have emerged as a viable therapeutic option to combat the pathological progression of tendinopathies, not only because of their potential for multidirectional differentiation and self-renewal, but also their excellent immunomodulatory properties. The immunomodulatory effects of MSCs are increasingly being recognized as playing a crucial role in the treatment of tendinopathies, with MSCs being pivotal in regulating the inflammatory microenvironment by modulating the immune response, ultimately contributing to improved tissue repair. This review will discuss the current knowledge regarding the application of MSCs in tendinopathy treatments through the modulation of the immune response.

Objective To study the effects of different iodine intakes on rat iodine metabolism during pregnancy.Methods One hundred and fifty female Wistar rats (body weight 80-100 g) were randomly divided into five groups:control group(NI),lower iodine 1 and 2 groups(LI1 and LI2),High iodine 1 and 2 groups(HI1 and HI2) by weight,30 rats in each group.These rats were given deionized water containing different concentrations of iodine,50(NI),0 (LI1),5(LI2),3000(HI1) and 10000 μg/L(HI2),respectively.After 12 weeks,urine samples were collected before copulation.The rats were sacrificed at the first(6-7 days),second (12-13 days) and third trimesters(19-20 days),respectively,serum and amniotic fluid samples were collected.Urinary iodine and iodine level in the fetal amniotic fluid were measured by As3+-Ce4+ catalytic spectrophotometry.Serum iodine was measured by mild acid digestion method.Results The baseline medians of urinary iodine of LI1 and LI2 groups(5.96,15.92 μg/L) were significantly lower than that of the NI group(43.75 μg/L,all P ＜ 0.01),and the values of HI and HI2 groups(5263.96,20389.64 μg/L) were significantly higher than that of the NI group (all P ＜ 0.01).The median of urinary iodine during pregnancy was significantly lower than that of the baseline of no pregnancy(all P ＜ 0.01).The medians of urinary iodine of the NI group at the first and the second trimesters (28.97,34.34 μg/L) were significantly lower than that of the third trimester(42.31 μg/L,all P ＜ 0.01).The means of serum iodine of LI1 and LI2 groups[(3.68 ± 1.69),(10.45 ± 4.16) μg/L] were significantly lower than that of the NI group [(23.68 ± 3.85)μg/L,all P ＜ 0.05],and the means of serum iodine of HI1 and HT2 groups [(502.67 ± 97.03),(822.15 ± 139.45)μg/L] were significantly higher than that of the NI group (all P ＜ 0.01).Although the mean of serum iodine of HI group gradually decreased with the progression of gestation,the difference was not statistically significant(all P ＞ 0.05).The iodine levels in amniotic fluid of fetal rats at the second and the third trimesters in LI1 group(0.85,3.00 μg/L) were significantly lower than that of the NI group(3.56,7.91 μg/L,all P ＜ 0.01),but the difference was not statistically significant between the iodine level in amniotic fluid of fetal rats of the LI2 and the NI groups at the second and the third trimesters(all P ＞ 0.05).The iodine levels in amniotic fluid of fetal rats at the second and the third trimesters in the HI1 group(49.59,171.21 μg/L) were significantly higher than that of the NI group(all P ＜ 0.01).The iodine levels in amniotic fluid of fetal rats at the second and the third trimesters in HI2 group (98.76,544.77 μg/L) were significantly higher than that of the NI group(all P ＜ 0.01).The iodine level in amniotic fluid of fetal rats in the third trimester was significantly higher than that of the second trimester in all the groups (all P ＜ 0.01).The ratios of serum iodine and urinary iodine of the LI1 and the LI2 groups (1.29 ± 1.14,1.70 ± 1.01) were significantly higher than that of the NI group(0.51 ± 0.37,all P ＜0.01),and that of the HI1 and the HI2 groups(0.21 ± 0.07,0.11 ± 0.07) were significantly lower than that of the NI group (all P ＜ 0.01).The ratios of amniotic fluid iodine and serum iodine of the LI and the LI2 groups (0.19 ± 0.15,0.32 ± 0.17) were significantly higher than that of the NI group(0.13 ± 0.05,P ＜ 0.01),but the difference was not statistically significant between HI1 and HI2 groups(0.09 ± 0.03,0.11 ± 0.04) and NI group(all P ＞ 0.05).The ratio of amniotic fluid iodine and serum iodine of the third trimester was significantly higher than that of the second trimester(all P ＜ 0.05).Conclusions Different iodine intake leads to changes in the levels of maternal iodine metabolism in rats during pregnancy.There probably is a protection mechanism in the mother's body,which protects the mother and the fetal from injury by iodine excess or iodine deficiency.

Objective To observe the clinical efficacy of abdominal acupuncture plus Chinese medication in treating ureteral calculus. MethodA total of 106 patients with ureteral calculus were randomized into an abdominal acupuncture group (53 cases) and a medication group (53 cases). The abdominal acupuncture group was intervened by abdominal acupuncture plus medication, with Shuifen (CV9), Xiawan (CV10), Jianli (CV11), Zhongji (CV3), Guanyuan (CV4) and Qihai (CV6) selected as the major points. The removal of stones and the release of pain were observed in the two groups, and the efficacies were compared between the two groups.Result The two treatment methods both effectively improved the pain and promoted the removal of stones; the Visual Analogue Scale (VAS) scores were significantly changed after the intervention in both groups (P<0.05). The time taken to mitigate and release pain was significantly shorter in the abdominal acupuncture group compared to the other group (P<0.01). The total effective rate was 88.7% (47/53) in the abdominal acupuncture group, superior to 73.6% (39/53) in the medication group (P<0.05).ConclusionAbdominal acupuncture plus medication can effectively mitigate pain, promote the removal of stones and reduce patient's sufferings in treating ureteral calculus.

AIMTo determine whether the cardioprotection of ischemic postconditioning and heptanol in ischemic heart against ischemia/reperfusion (I/R) is mediated by gap junction.

METHODSThe effect of ischemic postconditioning, heptanol at different doses (0.03, 0.06, 0.30, and 0.60 mg/kg) and AAP10 (10 mg/kg) on the intact rat heart during 30 min ischemia and 2 h of reperfusion was observed. Ischemic postconditioning was achieved by 3 cycles of 10 s reperfusion/10 s regional ischemia starting at the beginning of the reperfusion. The infarct size and the arrhythmia scores were measured. The effect of ischemic postconditioning, heptanol at different doses (0.05, 0.10, 0.50 and 1.00 mmol/L) and AAP10 (1 x 10(-7)mol/L) on the isolated heart during 30 min ischemia and 2 h of reperfusion was observed. Ischemic postconditioning was achieved by 6 cycles of 10 s reperfusion/10 s global ischemia starting at the beginning of the reperfusion. The arrhythmia scores and conduction velocity of ventricle muscle were measured.

RESULTSIn the intact rat heart model, ischemic postconditioning and heptanol reduced infarct size and arrhythmia scores. In the Langendorff perfused rat heart model, ischemic postconditioning and heptanol reduced arrhythmia scores and conduction velocity of ventricle muscle. Administration of AAP10, an opener of gap junction attenuated the cardioprotection of ischemic postconditioning and heptanol.

CONCLUSIONThe cardioprotection of ischemic postconditioning and heptanol may be related to the attenuation of gap junction communication on myocardiac ischemia/reperfusion injury.

Animals ; Gap Junctions ; physiology ; Heptanol ; pharmacology ; Ischemic Postconditioning ; methods ; Male ; Myocardial Ischemia ; physiopathology ; Myocardial Reperfusion Injury ; physiopathology ; prevention & control ; Rats ; Rats, Sprague-Dawley

This study was aimed to investigate whether endothelium-specific deletion of PTEN can affect hemangioblast development in the AGM region of mouse embryos. Based on Cre/loxP system, the Tie2CrePten(loxp/loxp) and Tie2CrePten(loxp/wt) mouse embryos were obtained. The genotype was identified by PCR. After treated with type I collagenase, the AGM region was dispersed into single-cell suspension, and then was cultured in blast colony-forming cell (BL-CFC) media. The number of BL-CFC was counted 4 or 5 days later. The hematopoietic capacity of BL-CFC was detected in methylcellulose culture system and the endothelial potential was assessed by tube-like structure formation on Matrigel. The results showed that the number of BL-CFC in AGM region of Tie2CrePten(loxp/loxp) mouse embryo decreased as compared with Tie2CrePten(loxp/wt) embryo. Whereas the hematopoietic capacity of mutant BL-CFC was enhanced, the endothelial potential, as evaluated by tube-like structure formation in vitro, was significantly reduced. It is concluded that the endothelial PTEN is capable of exerting regulatory functions on both the numbers and the dual potential of hemangioblast in mouse AGM region.
Animals ; Cell Differentiation ; Cells, Cultured ; Hemangioblasts ; Hematopoietic Stem Cells ; cytology ; Mice ; PTEN Phosphohydrolase ; genetics

Objective: To analyze the disease progression of acute leukemia (AL) transformed from myeloproliferative neoplasms (MPN) with Philadelphia chromosome-negative (Ph^-), and to investigate its mechanism and clinical treatments. Methods: The pre-transformation and post-transformation data of 8 AL patients with Ph^- MPN from July 2013 to December 2017 in Ruijin Hospital Affiliated of Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The literature was also reviewed. Results: All 8 cases transformed into acute myelogenous leukemia (AML). The median conversion time was 47.5 months (2-180 months), and the median survival time after transformation was 2 months (1-17 months). Three of 4 patients who undergone AML-related molecular biology after transformation had new mutant genes. One refractory patient achieved stable disease after oral treatment with ruxolitinib. Conclusions AML patients transformed from MPN have poor clinical outcomes and short survival time. Allogeneic hematopoietic stem cell transplantation is the only known potential curative treatment strategy and JAK2 inhibitor may be effective.

Objective:To explore the effect of combined therapy of traditional Chinese medicine on prevention of chemotherapy-related anemia in malignant tumors.Methods:Seventy-nine patients with malignant tumors diagnosed in Zibo Hospital of Traditional Chinese Medicine from January 2019 to January 2021 were selected, and the patients were divided into experimental group (40 cases) and control group (39 cases) according to the random number table method. The control group received chemotherapy and the experimental group received chemotherapy and combined therapy of traditional Chinese medicine (Wuhong Tang combined with moxibustion). The hemoglobin (Hb) level, Karnofsky score and adverse effects were recorded before and on days 7, 14 and 21 after chemotherapy in the two groups.Results:The Hb level in the experimental group was higher than that in the control group [(117±28) g/L vs. (100±31) g/L] on day 21 after chemotherapy, and the difference was statistically significant ( t = -3.08, P = 0.030). The total effective rate of the experimental group was higher than that of the control group [85% (34/40) vs. 66.7% (26/39)], but the difference was not statistically significant ( χ2 = 4.96, P = 0.084). Karnofsky scores were (77±9) points and (77±12) points before and on day 21 after treatment in the experimental group, with no statistical difference ( t = -0.50, P = 0.623); Karnofsky scores were (78±10) points and (67±9) points in the control group, with statistical difference ( t = 8.32, P < 0.001). There was no statistical difference in Karnofsky score before treatment between the two groups ( t = 1.85, P = 0.068), but the experimental group was higher than the control group on day 21 after treatment ( t = 4.88, P < 0.001). The difference in the incidence of nausea and vomiting between the two groups was not statistically significant ( P > 0.05), and no chemotherapy-related hepatic, renal or cardiac adverse reactions were observed in either group. Conclusions:Combined therapy of traditional Chinese medicine could effectively prevent chemotherapy-related anemia and improve the quality of life of patients.