Objective To determine whether low frequency ultrasound mediated microbubbles destruction (UMMD) could inhibit VX2 orthotopic hepatic tumor growth in rabbit models.Methods Twenty-four New Zealand white rabbits were implanted with VX2 tumor in left hepatic lobe to establish a homograft rabbit model of liver neoplasms in situ,which were randomly divided into four groups(6 rabbits in each group):group A (intravenous saline only),group B (intravenous microbubbles only),group C (intravenous saline+ low frequency focused ultrasound exposure),and group D (intravenous microbubbles+low frequency focused ultrasound exposure).After 3 days consecutive treatment,tumor volume(TV),and peak intensity (PI) were monitored by conventional ultrasound and contrast enhanced ultrasound(CEUS) on 0,1,7,14 and 21 days after treatment.The rabbits were euthanized at the end of the experiment.Tumor tissues were evaluated by HE stain.Results The parameters of TV and PI of each tumor had no significant difference among four groups before treatment(all P>0.05).TV had no significant difference among four groups on 1 day after treatment(all P>0.05);PI in group C and group D were significantly lower than those in group A and group B (all P<0.05).TV and PI in group D were significantly smaller than those in other groups on 7,14,21 days after treatment(all P<0.05).There was no statistical difference in TV and PI among group A,group B and group C(all P>0.05).The pathological changes of necrosis tissue,hemorrhagic damage of microvessel and thrombosis were observed in the tumors of group D only,whereas these changes occurred rarely in other groups.Conclusions UMMD can inhibit the growth of VX2 hepatic tumors in rabbits,and be used as a promising novel therapeutic strategy to liver neoplasms.

Objective To evaluate the diagnostic value of puncture feeling combined with fine-needle aspiration cytology (FNAC) for thyroid nodules.Methods One thousand and fourteen thyroid nodules were retrospectively analyzed.Eighty-six thyroid nodules were performed repeat FNAC.All nodules were confirmed by pathology,the agreement of puncture feeling at different time was evaluated by Kappa test.Results There were 751 malignant nodules and 263 benign nodules.Sensitivity and accuracy of FNAC combined with puncture feeling were higher than those of single FNAC or single puncture feeling (x2 =11.609,4.433 and P =0.00,0.04;x2 =19.369,6.697 and P =0.00,0.01,respectively).There were no statistically differences in the sensitively and accuracy between single FNAC and puncture feeling (x2 =1.230,0.242 and P =0.27,0.62,respetively).The Kappa values of inter-observer and intra-observer were 0.829(P =0.00) and 0.885(P =0.00) respectively with statistically significance.Conclusions Puncture feeling combined with FNAC can improve the sensitivity and accuracy in the diagnosis of thyroid nodules,the reproducibility of puncture feeling is excellent.

Objective To explore the effect of NGAL knockdown by NGAL siRNA encapsulated with urocanic acid-modified chitosan nanoparticles (UAC).MethodsNGAL siRNA encapsulated by UAC and chitosan (CTS) respectively, which were then used to transfect human colon cancer cell lines HT29.The expression level of NGAL protein were detected by Enzyme Linked Immunosorbent Assay(ELISA).ResultsThe ELISA study revealed that the expression level of NGAL protein in UAC group(average 0.583μg/L) was significantly lower than in CTS group (average 0.772μg/L) and control group(average 1.071μg/L) (P<0.05).ConclusionThe NGAL expression of mRNA and protein in HT29 cells could be down-regulated by siRNA encapsulated by UAC.

Objective To assess the therapeutic efficacy of subcutaneous transplantation pancreatic cancer in nude mice model with different size microbubbles. Methods Eighteen Balb/C nude mice with subcutaneous pancreatic carcinoma xenografts were divided into three groups:group A( 6 mice) did not received microbubbles and ultrasonic irradiation;group B(6 mice) received standard microbubbles and ultrasonic cavitation treatment;group C(6 mice) received up-sized microbubbles and ultrasonic cavitation treatment.Body weight and tumor size of nude mice were measured respectively at the time points of 0,7, 14,21 days after three times ultrasound radiation and before ultrasound treatment. Tumor volumes were calculated.Then the mice were sacrificed finally. Results There was no significant difference in tumor volumes among three groups before treatment( P > 0.05). Tumor volume continued to increase in all groups.Compared with group A,growth rate in group B and group C were lower,growth rate in group B was higher than that in group C,the difference was statistically significant( P < 0.05). There was no significant difference in the parameters of regional blood volume(RBV) and regional blood flow(RBF)among three groups before treatment( P > 0.05). RBV and RBF were decreased significantly after 3 days treatment in group B and group C( P <0.05),the RBV and RBF in group C were lower than those in group B,the differences were statistically significant( P <0.05).There was no significant difference in the body weight of nude mice before and after radiation among three groups during the follow-up period( P >0.05). Conclusions The cavitation effect of up-sized microbubbles is more efficient for mice subcutaneous pancreatic cancer xenograft tumor inhibition compared with standard microbubbles.

Objective To improve the awareness of clinical manifestation, endocrine changes and prognosis in patients with anorexia nervosa (AN). Methods The clinical features and endocrine functions of 28 patients with AN were analysed, and the prognosis was based on the results of 4 months-7 years follow-up of these patients. The change of serum leptin level was observed during different therapeutic periods in 13 patients. Results Most of AN patients were young women (92.9%, 26/28), age of onset was (19.4?3.8)years old and the duration of follow-up was from 4 months to 7 years. Self-starvation, extreme weight loss and amenorrhoea were the characteristic manifestations. This investigation discovered 24 patients with hypofunctional hypothalamus-pituitary-gonad axis, 12 with hyperfunctional hypothalamus-pituitary-adrenal axis, 9 with decreased levels of thyroid hormones, 2 with increased level of GH (n=10), 8 with decreased level of IGF-Ⅰ (n=10). Leptin levels in AN patients (n=9) weresignificantlydecreasedascomparedwiththecontrol group (n=26) 〔(1.21?0.36 vs 7.70?4.15)?g/L, P

Objective: To evaluate the diagnostic value of BRAF V600E mutation combined with shear wave elastography(SWE) for thyroid nodules of Bethesda Ⅲ diagnosed by fine-neddle aspiration(FNAC). Methods: One hundred and seventeen thyroid nodules diagnosed as Bethesda Ⅲ in the department of ultrasound and confirmed by BRAF V600E gene detection, SWE examination and surgery were collected. BRAF V600E detection, SWE examination and both combined with pathological results were using to retrospective analysis. Results: There were 75 benign nodules and 42 malignant nodules according to pathology. Sensitivity and negative predictive value of BRAF V600E combined with SWE were higher than single BRAF V600E mutation detection and SWE with statistically significant(P=0.01, 0.001; P=0.029, 0.01, respectively). There were no statistically differences between single BRAF V600E mutation detection and SWE for Bethesda Ⅲ nodules(P=0.483, 0.645). Conclusions BRAF V600E mutation detection combined with SWE can improve the sensitivity and negative predictive value in the diagnosis of Bethesda Ⅲ thyroid nodules.

Objective To report 1 case with pancreatic cancer after chemotherapy infected by influenza B virus, and complicated with atrial fibrillation, pulmonary infection. Methods Clinical data, treatment, outcome of this case were reviewed and the nursing emphasis was summarized. Results Through active treatment and nursing, with cured influenza, successful cardioversion of atrial fibrillation and controlled lung infection, the patient was transferred to general hospital to treat basic disease. During hospitalization, none infection occurred among medical staff and caregivers. Conclusions Key points of nursing of patient with pancreatic cancer after chemotherapy complicated with influenza B include disease observation of atrial fibrillation, lung infection and influenza B virus infection, nutritional status improvement, skin care, psychological care for patients and care-givers, disinfection and isolation to influenza B virus infection, and staff self-protection.

Objective:To analyze the clinical effects of intraoperative transesophageal echocardio-graphy(TEE)in different surgical methods for nephrectomy combined with Mayo Ⅲ-Ⅳ inferior vena cave(IVC)tumor thrombectomy.Methods:In the study,28 patients who did surgery of nephrectomy and Mayo Ⅲ-Ⅳ IVC thrombectomys in Peking University Third Hospital from 2022 January to 2024 February were included.Of the 28 patients,16 patients did robotic surgery,2 patients did laparoscopic surgery,and 10 patients did open surgery.All patients'clinical data were collected.Results:Intra-operative TEE was used in 9 robotic surgeries,of which 7 cases showed image changes compared with preoperative image results.Intraoperative TEE indicated that tumor thrombus entered the right atrium in 2 cases,showed that tumor thrombus grade rose from Mayo Ⅲ to Mayo Ⅳ in 2 cases,and indicated that tumor thrombus adhered to IC wall in 3 cases.All of these surgical plans were timely adjusted.Intra-operative TEE was used in 6 cases of open surgery,and 4 cases of them showed Mayo grade changes com-pared with preoperative image results.Intraoperative TEE indicated that tumor thrombus adhered to the IVC wall in 3 cases,and tumor thrombus adhered to the IVC wall with thrombus in one case.The surgi-cal plans were adjusted,and the tumor thrombus was left or segmentally removed.Laparoscopic surgery did not use intraoperative TEE.The effects of intraoperative TEE included:the combination of explora-tion and TEE monitoring was used in open surgery,and tumor thrombus removal process was fully moni-tored by intraoperative TEE in the robotic surgery.Intraoperative TEE real-time monitored circulatory sta-tus and cardiac function changes.Conclusion:In different surgical methods for nephrectomy com-bined with Mayo Ⅲ-Ⅳ tumor thrombectomy,intraoperative TEE can re-determine the tumor thrombus grade and degree of tumor thrombus adhered to IVC,track the tumor thrombus removal process in real-time,and monitor circulatory status and cardiac function changes.Intraoperative TEE plays an important role in different surgical methods,but its clinical application is still insufficient.Intraoperative TEE is recommended to such type of surgeries.

Objective:To explore the value of coronary computed tomography angiography(CCTA)in assessing the relationship between the fat volume around coronary plaque and the abnormal coronary hemodynamics.Methods:A total of 218 hospitalized patients admitted to Cangzhou People's Hospital from June 2022 to September 2023 were selected.In these patients,108 patients without coronary heart disease(CHD)were included in the control group,and 110 CHD patients were included in the observation group.All patients underwent CCTA examination to compare the CT imaging values(FFRCT)of the fat volume around heart and blood flow reserve fraction between the two groups.Receiver operating characteristic(ROC)curve was performed to analyze the efficacy of the fat volume around heart and FFRCT values in predicting coronary artery plaques.Additionally,Pearson's method was used to analyze the correlation between fat volume around heart and FFRCT.Results:The fat volume around heart in the observation group was(168.70±38.16)cm3,which was significantly higher than(98.75±21.19)cm3 in the control group,and the FFRCT value(0.78±0.11)of the observation group was lower than(0.89±0.10)in the control group,with statistically significant differences(t=16.688,8.041,P<0.05),respectively.In the observation group,89 patients occurred plaque,and 21 patients did not occur plaque.In the observation group,the fat volume around heart in patients with plaques was(176.63±34.15)cm3,which was significantly higher than(133.52±36.85)cm3 in patients without plaques,and the FFRCT value in patients with plaques was(0.76±0.10),which was significantly lower than(0.85±0.11)in patients without plaques,with statistically significant differences(t=4.945,3.815,P<0.05),respectively.According to Pearson's analysis,there was a negative correlation between the fat volume around heart and FFRCT value.According to Spearman's analysis,with or without plaques appeared positive correlation with the fat volume around heart in CHD patients,and they appeared negative correlation with FFRct value.According to ROC curve analysis,the area under curve(AUC)values of fat volume around heart,FFRCT,and the combination of them were respectively 0.777,0.726 and 0.930 in predicting the plaques of CHD patients.Conclusion:Hemodynamics and fat volume around heart that is measured by CCTA can predict coronary plaque,and there is a certain of relationship between coronary hemodynamics and the fat volume around coronary artery plaques,which appears negative correlation.

Objective:To investigate the levels of microRNA (miR) -106b-5p and miR-760 in the serum of early lung cancer patients, and the clinical value of the combination of them and low-dose spiral CT in the diagnosis of early lung cancer.Methods:Ninety early lung cancer patients (lung cancer group) who underwent treatment in Cangzhou People's Hospital of Hebei Province from January 2022 to March 2023 were collected as research subjects, meantime, 90 patients with benign pulmonary lesions (benign pulmonary nodules) diagnosed by pathology were selected as the control group. The levels of miR-106b-5p and miR-760 in the serum of two groups were compared, the results of low-dose spiral CT examination were analyzed; receiver operating characteristic curve was drawn to determine the optimal cut-off values of serum miR-106b-5p and miR-760; four grid table method was applied to analyze the diagnostic efficacy of serum miR-106b-5p, miR-760 combined with low-dose spiral CT for early lung cancer.Results:The level of miR-106b-5p in lung cancer group was higher than that in control group (1.39±0.31 vs. 1.04±0.30), serum miR-760 level was lower than that in control group (0.75±0.24 vs. 1.02±0.26), with statistically significant differences ( t=7.70, P<0.001; t=7.24, P<0.001). The area under curve (AUC) of miR-106b-5p, miR-760 and low-dose spiral CT in the diagnosis of early lung cancer was 0.83, 0.81 and 0.82, the accuracy was 76.67%, 77.22% and 81.67%, the sensitivity was 84.44%, 81.11% and 76.67%, and the specificity was 68.89%, 73.33% and 86.67%, respectively. The AUC, accuracy, sensitivity, and specificity of serum miR-106b-5p, miR-760 combined with low-dose spiral CT in diagnosing early lung cancer were 0.96, 90.00%, 94.44%, and 85.56%, respectively. The accuracy of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p, miR-760 and low-dose spiral CT ( χ2=11.52, P=0.001; χ2=10.72, P=0.001; χ2=5.14, P=0.023), the sensitivity of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p, miR-760 and low-dose spiral CT ( χ2=4.77, P=0.029; χ2=7.46, P=0.006; χ2=11.51, P=0.001), the specificity of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p, miR-760 ( χ2=7.11, P=0.008; χ2=4.12, P=0.042) . Conclusion:The serum level of miR-106b-5p is significantly increased in early lung cancer patients, while the serum level of miR-760 is significantly reduced. The combination of miR-106b-5p, miR-760 and low-dose spiral CT has high diagnostic value for early lung cancer.