Objective To extract principal components from valuable indicators on conventional ultrasoundand contrast-enhanced ultrasound (CEUS) in the differential diagnosis of thyroid benign and malignant lesions and to discuss the diagnostic value of each indicator.Methods One hundred and three patients with 125 thyroid lesions (65 malignant lesions and 60 benign lesions) underwent preoperative grayscale ultrasound (GSUS),color Doppler ultrasound (CDUS) and CEUS examinations.Eighteen indicators were chosen to evaluate every lesion and principal components were extracted by principal component and valuable indicators were ordered by importance.Results There were significant differences on GSUS and CEUS indicators between benign and malignant lesions.The first principal component was the representation of contrast enhanced ultrasound and was valuable in the differential diagnosis of thyroid benign and malignant lesions.The rank of valuable CEUS indicators were homogeneity of enhancement,filling defect,relative arrival time of periphery,peak interior echogenicity,relative arrival time of interior,peak peripheral echogenicity and ring enhancement.Conclusions GSUS and CEUS are valuable in the differential diagnosis of thyroid benign and malignant lesions.

Objective To preliminarily evaluate the feasibility of elastography point quantification (ElastPQ) technology in the determination of liver stiffness as well as its impact factors.Methods Amount to 235 patients with liver neoplasms underwent liver stiffness measurement in the right lobe of liver using an ultrasound scanner (iU Elite,Philips).ElastPQ values were obtained and compared with the liver fibrosis stage (S),the grade of necroinflammatory activity (G) and steatosis assessed histologically as well as gender and age.The factors related to ElastPQ values were explored by stepwise regression in multiple linear regression analysis and the regression equation was established.Results In the multiple linear regression model of ElastPQ values,liver fibrosis and necroinflammatory activity were associated with ElastPQ (P ＜ 0.05) while other factors including age,gender and hepatic steatosis had no effect on ElastPQ statistically (P ＞0.05).The equation of linear regression was ElastPQ =1.205S + 1.075G + 4.537.Conclusions ElastPQ technique is a reliably noninvasive tool in the liver stiffness measurement.Liver fibrosis and necroinflammatory activity are the main factors affecting liver stiffness measured by ElastPQ.

Objective To test the effects of Vitamin D (VitD) on endothelial nitric oxide(NO) production and to study the signal pathway leading to NO release.Methods In vitro cultured human umbilical vein endothelial cells (HUVEC) were treated with various concentrations of VitD(0 mmol/L,0.01 mmol/L,0.10 mmol/L,1.00 mmol/L,10.00 mmol/L) for 60 min,and VitD at concentration of 1.00 mmol/L at different time points (30 min,60 min,90 min,120 min).The effect of VitD on NO production in presence of VitD receptor(VDR) agonist(ZK191784) or antagonist(ZK159222) for 60 min were examined in cell culture supernatant with kit for the detection of nitric oxide fluorescent probe(DAF-FM DA).HUVEC was cultured with VitD in presence of VDR agonist or antagonist for 60 min,and the effect of VitD on NO production with DAF-FM DA and the protein expression and phosphorylation of Caveolin-1 and endothelial nitric oxide synthase(eNOS) were detected by Western blot,respectively.Results VitD caused a concentration-dependent increase in NO production.The maximum effect was observed at a concentration of 1.0 mmol/L and the optimal time of stimulation was 60 min.Effects induced by VitD were enhanced by VDR agonist,and abolished by antagonist.VitD and VDR agonist maintained the expression of Caveolin-1 at the same low phosphorylation level the same as normal,increased the phosphorylated level of eNOS.However,VDR antagonist increased the phosphorylation of caveolin-l,but reduced the level of eNOS phosphorylation,respectively.Conclusions VitD can induce a significant increase in endothelial NO production through VDR.VitD interaction with VDR causes the low phosphorylation of caveolin-1 leading to eNOS activation and NO production.

Objective To investigate the discriminant analysis model of gray-scale ultrasound (GSUS),contrast-enhanced ultrasound (CEUS) and the combination of them in the differential diagnosis of benign and malignant thyroid lesions and the diagnostic values.Methods Ultrasound images of 211 thyroid lesions confirmed by pathology were synthetically reviewed by scoring 5 GSUS indicators including shape (X1),orientation (X2),interior echogenicity (X3),halo sign (X4),and microcalcification (X5),as well as 6 CEUS indicators including relative arrival time of microbubhles in the periphery (X6) and interior (X7),peak periphery (X8) and interior (X9)echogenicity,peripheral ring-enhancement (X10),homogeneity of enhancement (X11).The diagnostic models with their values of GSUS,CEUS and the combination of them were explored by discriminant analysis.Results The discriminant analysis function of GSUS in the diagnosis of thyroid benign and malignant lesions was g1 (X) =0.715 X1+0.276X2 + 1.028X3 +1.197X4 +0.923X5-2.202 with the diagnostic value 86.3％,the discriminant analysis function of CEUS was g2(X) =-0.392X6 +0.541X7-0.117X8 +0.562X9 + 1.173X10 +2.200X11-1.956 with the diagnostic value 89.1％,and the discriminant analysis function of the combination of GSUS and CEUS was g3 (X) =0.418X1 + 0.173X2 + 0.626X3 + 0.558X4 + 0.183X5-0.476X6 + 0.474X7-0.071X8 + 0.399X9 + 0.985X10 +1.639X11-2.530 with the diagnostic value 91.0％.Conclusions GSUS and CEUS were valuable in the differential diagnosis of benign and malignant thyroid lesions,and the combination of GSUS and CEUS was most valuable.

OBJECTIVE To observe the efficacy and safety of ceftazidime and avibactam sodium （CAZ/AVI） in the treatment of carbapenem-resistant organism （CRO） infection. METHODS The information of patients with CRO infection admitted to the Second Affiliated Hospital of Soochow University from September 2019 to March 2022 was collected， and the patients were retrospectively divided into observation group （48 cases） and control group （48 cases） according to the treatment plan. The control group was given Polycolistin B sulfate for injection intravenously at a dose of 500 000 U every 12 hours； no dose adjustment was performed in patients with renal insufficiency or receiving continuous renal replacement therapy （CRRT）. The observation group was given continuous micropump of CAZ/AVI for injection intravenously at a dose of 2.5 g every 8 hours for 2 continous hours； among them， the patients with renal insufficiency received an adjusted dose based on creatinine clearance， and no dose adjustment was performed in patients receiving CRRT. The clinical efficacy and microbiological efficacy as well as body temperature， white blood cell （WBC）， C-reactive protein （CRP） and procalcitonin （PCT） before and after treatment were compared between 2 groups. The prognosis and the occurrence of adverse drug reactions were recorded. The factors influencing the clinical efficacy were screened by Logistic regression analysis. RESULTS The effective rate and microbial clearance rate of the observation group were significantly higher than the control group （P＜0.05）. After treatment， body temperature， PCT and CRP of 2 groups were significantly lower than before treatment， and CRP of the observation group was significantly lower than the control （No.SDFEYJLC2105） group （P＜0.05）. There was no statistically significant differencebetween the two groups in terms of rehabilitation discharge rate， the proportion of patients transferred to general wards，the proportion of dead patients， and the total incidence ofadverse drug reactions （P＞0.05）. CAZ/AVI and prolonging therapy duration were more likely to achieve clinical benefits （odds ratios of 1.146， 7.707，P＜0.05）， while lung infection and CRRT may be independent risk factors for treatment failure （odds ratios of 0.182， 0.236， P＜0.05）. CONCLUSIONS CAZ/AVI has good efficacy and safety in the treatment of CRO infection， the appropriate extension of antibacterial treatment time can achieve a higher clinical response rate， while lung infection or CRRT may lead to treatment failure.

ABSTRACT: Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans ; Meningioma/pathology* ; Consensus ; Neurosurgical Procedures ; Meningeal Neoplasms/pathology*