Objective To evaluate the value of contrast-enhanced ultrasound and ultrasonic elastography in the diagnosis of breast lesions with BI -RADS Ⅲ -Ⅴ.Methods 169 patients with BI -RADS Ⅲ -Ⅴ breast lesions were underwent contrast -enhanced ultrasound and ultrasonic elastography 1 week before surgery.Pathological findings were used as the gold standard to evaluate the diagnostic accuracy of contrast -enhanced ultrasound and ultrasonic elastography in diagnosis of BI -RADS Ⅲ -Ⅴ breast lesions.Results The combination of contrast -enhanced ultrasound and ultrasonic elastography in diagnosis of BI -RADS Ⅲ -Ⅴ breast lesions,with the sensitivi-ty,specificity and accuracy of 96.15%,94.34%,and 95.11%,respectively.The difference was statistical signifi-cance compared with single method(χ2 =4.659,P =0.032,χ2 =4.146,P =0.041).Conclusion The combination of contrast -enhanced ultrasound and ultrasonic elastography improves the diagnostic accuracy of Ⅲ-Ⅴ breast lesions.

Objective To study the spatial distribution of set-up errors for cervical cancer with intensity modulated radiation therapy (IMRT) and to provide referential safety margin out of clinical tumor volume (CTV) during treatment plan design. Methods Six patients with cervical cancer were treated with IMRT in prone position, belly board and thermoplastic cast was used for immobilization. Measurement were made on a daily basis setup under five consecutive treatments with electron portal images device (EPID).Portal films from two projection (one anter-posterior and one opposite lateral)were taken. Sixty portal films were analyzed. The translational and rotational deviations were analyzed by registering and comparing the bony structures of EPID and digitally reconstructed radiographs (DRR). Results The translational deviations were (3.1 ±1.8) mm, (3.9 ±3.3) mm, (4.2 ±2.6) mm in medi-lateral, cranio-caudal and anterior-posterior directions, the rotational deviations were in coronal plane (0.8±0.9)° and sagittal plane (1.2±1)°. Conclusion For the patients with cervical cancer undergoing IMRT, the margins between the CTV and PTV should be 7.1 mm in lateral direction, 10.4 mm in cranio-caudal and 10.8 mm in anterior-posterior directions. The sign on patients body can help to reduce the setup errors.

Objective To explore oral contrast-enhanced ultrasonography findings in superior mesenteric artery syndrome (SMAS).Methods Twenty-nine patients with SMAS were examined using oral contrast-enhanced ultrasonography,which was confirmed by contrast-enhanced spiral computerized tomography.Results Abdominal ultrasonography with oral contrast-enhanced ultrasonography revealed a significant reduction of the SMA angle and diminished SMA-aorta distance in 29 subjects.Duodenum was showed the indentation and funnel shaped or dumbbell shaped findings which was caused by pressure of the SMA in patients with recumbent position.The proximal part of duodenum expanded distinctively with contrast media movement fro.Ultrasonography and CT examinations had a good agreement in diagnosing pathological aortomesenteric angle and distance.Conclusions Oral contrast-enhanced ultrasonography presents characteristic findings in patients with SMAS,which is useful in epidemiological screening of suspicious cases of SMAS in children.

Objective To investigate the value of contrast enhanced ultrasound (CEUS) in diagnosing metastatic adrenal carcinoma. Methods Twenty two metastatic adrenal carcinoma lesions in 18 patients were examined using CEUS. The features and detected rate of gray scale and CEUS were analysed and compared. Results Fourteen lesions of metastatic adrenal carcinoma were detected by two dimensional ultrasonography(2DU), the detected rate of 2DU was 58. 3%. While 20 lesions were detected by CEUS, the detected rate was 83. 3%. There was a significant difference of detected rate between 2DU and CEUS (P<0.05). The adrenal metastatic carcinomas were enhanced rapidly with the peek intensity slightly low or same to the surrounding liver or renal parenchyma. The lesions number, size and range were clearly presented by CEUS. Conclusions CEUS can markedly improve detected rate of metastatic adrenal carcinoma compared with 2DU.

Objective To explore the value of real time contrast-enhanced ultrasound (CEUS) in differential diagnosis of benign and malignant adrenal lesions.Methods Totally,57 adrenal lesions (26malignant and 31 benign) underwent conventional ultrasound and real-time CEUS.The enhancement patterns including types of time-intensity curve,centripetal fill-in,homogeneity and intensity of enhancement were analyzed.Results The enhancement pattern of normal adrenal gland was homogeneous,centrifugal and rapid perfusion from the medulla to the cortex.Four enhancement patterns were significantly different between benign and malignant adrenal lesions (P ＜0.05).If enhancement in the early arterial phase and rapid washout was suggestive of malignancy,the sensitivity and specificity of CEUS were 96.2％ and 77.4％,respectively.If peripheral to central filling was suggestive of malignancy,the sensitivity and specificity of CEUS were 76.9 ％ and 80.7 ％,respectively.Conclusions The patterns of real-time CEUS are helpful in differential diagnosis of malignant and benign adrenal lesions.

Objective To analyze the difference of irradiation dose and volume of organs at risk (OAR) particularly in small intestine between supine position and prone position on intensity-roodulated radiotherapy(IMRT) for cervical cancer. Methods 11 patients with Ⅱ_B-Ⅲ_B cervical cancer were scanned with supine position and prone position by CT.The CT images were transported to TPS,then target volumes were delineated and the IMRT plans were designed respectively.The prescribed dose was 95%PTV receiving 45 Gy in 23 fractions of 2 Gy.The exposure volumes of the OAR at different position and different dose levels in the dose volume histograms (DVH) were compared and analyzed.Results When tlle dose di8tributions met to the clinic request,the exposure volumes of small intestine at prone position were redueed than that at supine position in dose range 46-30 Gy(P<0.05),but this phenomenon Was not distinct in low dose range(< 20 Gy)(P>0.05).The exposure volumes of bladder, rectum, femur head and spine cord were no obviously differences at dissimilar position. Conclusion IMRT of cervical cancer should adopt prone position.because their small intestine will be protected better.

Carthamus tinctorius L. is a traditional Chinese medicine with the effect of promoting blood circulation and removing blood stasis. HSYA (hydroxysafflor yellow A) is the main effective component of Carthamus tinctorius L. In order to study the inhibitory effects of HSYA against PMN (polymorphonuclear) activation induced by LPS (lipopolysaccharide), rabbit PMN adhesion potency which was activated by LPS through colorimetry method was observed. Cellular free calcium concentration was determined by fluorescence spectrophotometry. RT-PCR was applied to study the effect of HSYA on PMN TNF-alpha and IL-6 mRNA expression; The inhibition of HSYA on NF-kappaB activation was monitored with immunofluorescence. The results showed that after treated with HSYA, the increase of adhesion potency (HSYA dose 1.01 x 10(-4) mol x L(-1)), free calcium concentration (HSYA dose 3.1 x 10(-5) mol x L(-1)), TNF-alpha and IL-6 mRNA expression elevation (HSYA dose 5.2 x 10(-1) mol x L(-1)) induced by LPS were inhibited. HSYA can inhibit NF-kappaB p65 subgroup nuclear translocation (HSYA dose 5.2 x 10(-5) mol x L(-1)). It is suggested that HSYA is effective in PMN activation induced by LPS.

Objective To evaluate the diagnostic value of shear wave elastography(SWE)and Breast Ima-ging Reporting and Data System -Ultrasonograpy(BI -RADS -US)in benign and malignant breast lesions.Methods 180 patients with pathological -confirmed benign and malignant breast lesions without any treatment were underwent ultrasonography scoring with BI -RADS and the quantitative elasticity parameters was measured by shear wave elastography 1week before operation.Pathological results were regarded as the gold standard,receiver operating characteristic curve(ROC)was used to determine cutoff values of quantitative parameters and diagnostic performance of two methods.Results Maximum elastic value(Emax)and mean elastic value(Emean)of benign breast lesions were (39.17 ±11.48)kPa and (21.56 ±9.68)kPa,which were significantly lower compared with the malignant breast lesions of (121.38 ±28.97)kPa and (62.92 ±18.49)kPa,respectively(t =23.668,P =0.000;t =18.194, P =0.000).Taking 43.79kPa and 65.15 kPa as the threshold of the Emean and Emax value,the sensitivity,specificity and accuracy of SWE were 92.59%,90.78% and 94.84%,respectively.The areas under the curve(AUC)of the SWE and BI -RADS -US were 0.942 and 0.883 (P =0.042).Conclusion SWE can improve the accuracy of ultrasonography in differentiation of benign from malignant breast lesions by quantitative elasticity parameters,which has important significance for clinical treatment.

Clinical data of 23 patients with T2a bladder cancer admitted from March 2008 to August 2013 were retrospectively analyzed.Among 23 patients,11 cases were treated with transurethral resection (TURBT) plus arterial catheterization chemotherapy (study group) and 12 cases were treated with radical cystectomy (control group).The overall survival time and recurrence free survival time of two groups were compared.Patients in study group were followed up for 20-68 months,recurrence occurred in 5 cases (5/11),including 4 cases of invasive recurrence;patients in control group were followed up for 2 ～86 months,1 case had superficial recurrent and underwent TURBT,2 cases dead due to bladder tumor.During the course of chemotherapy,the main adverse effects were digestive reaction (7/11),fever (4/11),bone marrow suppression (2/11),symptomatic treatment was given,which was tolerated.There were no significant differences in overall survival time and recurrence free survival time between two groups (P ＞ 0.05).The quality of life of study group was better than that of control group (P ＜ 0.05).It is suggested that the arterial interventional chemotherapy combined with transurethral resection for T2a stage invasive bladder cancer has a certain curative effect with the advantage of preservation of bladder function and higher quality of life.

Objective To evaluate the effects of isoflurane anesthesia on NR1 expression and neuronal apoptosis in the hippocampus and cortex of adult rats .Methods Thirty-six adult male Sprague-Dawley rats , weighing 250-280 g ,were randomly assigned into 3 groups using a random number table :control group (group C , n=6 ) ,O2 inhalation group (group O , n=6 ) and isoflurane anesthesia group (group I , n=24 ) .The rats were exposed to 2% isoflurane (group I) ,to pure oxygen (group O) ,or to air (group C) for 2 h .At 2 h ,and 1 ,7 and 14 days after the rats were awake (T1-4 ) ,Morris water maze test was performed .The rats were then sacrificed and brains were removed for isolation of the hippocampus and cortex .NR1 expression was detected using SABC immuno-histochemical technique and neuronal apoptosis was determined using TUNEL .Results Compared with group C , the escape latency at T2 and total swimming distance at T1 ,2 were significantly prolonged , and the expression of NR1 in hippocampi was down-regulated at T1 ,2 in group I ,and the expression of NR1 in the cortex was down-regulated in O and I groups ( P<0.05) .There was no significant difference in the apoptosis index between the three groups ( P> 0.05 ) .Conclusion Isoflurane anesthesia can decrease the cognitive function transiently ,which is related to inhibition of up-regulation of NR1 expression in the hippocampi ,but not related to neuronal apoptosis in adult rats .