Objective To explore the influence of ROI size on the diagnostic performance of shear wave elstography (SWE) of breast masses.Methods A total of 225 consecutive patients with 239 solid breast masses underwent SWE before surgery,and then quantitative SWE parameters,including the maximum stiffness (Emax),mean stiffness (Emean),ratio of stiffness of the mass to stiffness of surrounding fat (Eratio) and standard deviation (SD),were measured by two methods,one method was using larger ROI to include the largest part of a mass,and the other was placing fixed ROI=2 mm over the stiffest part of the lesion to measure.The diagnostic performance of the two methods were evaluated by ROC curve,and the cut-off value,sensitivity and specificity of each SWE parameter were obtained.Results There were no statistically significant differences between the performance of Emax,Emean and SD from the two different methods (all P＞ 0.05),the performance of Eratio of the two methods showed significant difference (P=0.046).The significantly higher specificity of Emax and Emean in the larger ROI were found,and the significantly higher sensitivity of SD and Eratio in the ROI=2 mm was found.Furthermore,the diagnostic performance of combination of SWE and BI-RADS were not greatly affected by the ROI size,the difference had no statistical significance (all P＞0.05).Conclusion The ROI size only affects the diagnostic performance of Eratio,and donot affect the diagnostic performance of the quantitative SWE parameters (Emax,Emean,SD) and combination of SWE and BI-RADS.

Objective To investigate the clinical autopsy results of patients died of cardiovascular disease or other disease complicated with cardiac damage. Methods Complete autopsy was performed on 86 cases with uncertain cause of death. Through integrating clinical diagnosis and treatment with gross autopsy findings and microscopic observations, 86 autopsies were determined the major cause of death. Results In 86 autopsies, 69 cases were heart disease. Differences between pathological diagnosis and clinical diagnosis were compared. Twenty-seven cases were cardiac deaths, with diagnosis accrodance rate of 81. 5%. Fortytwo cases died of non-cardiac disease but complicated with heart disease or involving the heart which accelerated the death in patients, with accordance rate of 78.6%. Conclusion Scientific and correct performance of autopsy was important to determine the causes of death, to promote development of related disciplines and to improve the diagnosis and treatment of the diseases.

Objective To investigate the effects of homocysteinemia (HHcy) and hypertension on left ventricular re?modeling. Methods A total of 275 patients with coronary heart disease were divided into four groups including H-type hy? pertension group (n=96), non-H-type hypertension group (n=44), HHcy+non-hypertension group (n=53) and control group (n=65) based on their blood pression levels and plasma HHcy levels. The serum levels of glucose (Glu), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high-density lipoprotein (HDL) were compared between groups. The left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPWT), ventricular septal thickness (IVST) and left ventricular mass index (LVMI) were observed in four groups. The proportion of patients with left ventricular remodeling was also compared between four groups. The influence fac?tors of left ventricular remodeling were analysed. Results There were no significant differences in biochemical parameters except Hcy level between frour groups. The values of LVMI, left ventricular wall thickness and the proportion of patients with left ventricular remodeling were significantly higher in H-type hypertension group than those of other three groups ( P<0.05). The Hcy level was positively correlated with LVMI and left ventricular wall thickness. Logistic regression analysis showed that HHcy and hypertension were the risk factors of left ventricular remodeling (OR=7.443, 7.754 and 9.948,P<0.05). The risk factors of left ventricular remodeling were higher in patients with both HHcy and hypertension than those in patients with HHcy or hypertension. Conclusion Homocysteine and higher systolic pressure are independent risk factors for left ventricular remodeling and they have a synergistic effect on leading to left ventricular remodeling.

Through a congenital cleft hand cleft foot line analysis of clinical manifestations, the mode of inherit-ance, clinical type of 15 patients. It was found that the pedigrees of congenital foot deformity in patients with cleft hand cleft hand split foot crack were typical, and non-syndromic. The disease presents the typical pedigree body autosomal dominant mode of inheritance, clinical manifestations of the great differences between patients, the pres-ence of significant genetic heterogeneity.

In more than ten years, hematopoietic factors have been approved to be effective in the treatment of radiation sickness. But there are still some problems in the clinical application, such as suitable cases, dosage, administrative timing, and drug combination. Due to those problems, the efficacy was undermined. Our experimental treatment study showed that hematopoietic factors should be administered early after the radiation exposure. The efficacy of early administration group is better than the one treated in acute phase of radiation sickness. There is also a limit of application duration but not the longer the better. RhTPO along can not induce the granulocytopoiesis and rhG-CSF can not improve the recovery of megakaryopoiesis. Hematopoietic factors do not increase the chromosome mutation rate of tumor cells. We did not observe bone marrow stem cell or progenitor cell exhaustion after we treated those animals for a second cycle of hematopoietic factors or exposed those treated animals to radiation again. RhG-CSF is more effective in the recovery of granulocytopoiesis than rhGM-CSF. RhIL-11 can increase the recovery of three cell lines of bone marrow, especially megakaryopoiesis. We recommended the combination of hematopoietic factors in the treatment of acute radiation sickness. RhG-CSF plus rhIL-11 is a preferred combination.

A maxillary first molar with 2 distinct palatal roots and an accessory canal was diagnosed by CBCT and microscope.An enamel protuberance at the cervical area was found.A properly usage of CBCT and microscope is helpful for the diagnosis and treatment of tooth with complex root canal system.

Objective To investigate the effect of fluorescence in situ hybridization (FISH) in increasing the accuracy and detection rate of chromosome aneuploid from spontaneous abortion specimens.Methods Chromosome 13,21,16 and 22 single sequence probes and centromere probes of 18,X and Y chromosome probes were used to detect 100 cases of spontaneous abortion villi samples.The results were compared with conventional karyotype analysis.Results (1) Karyotype analysis:Among 89 successfully cultured villi samples,51 abnormal karyotypes (57.3％) were found,including 37 cases of autosomal aneuploidies,four sex chromosome aneuploidies,two triploids,one tetraploid,one 68,XX and six chromosome structural aberrations.(2) FISH:The detection rate of abnormal karyotype was 38.0％ (38/100),among which 25 cases were autosomal aneuploidies,five sex chromosome aneuploidies,three triploids,four XX chimeras and one triploid in chromosome 13,16,18 and 21.(3) Comparison of the two methods:Among the 11 samples which failed by conventional method,FISH found two abnormal samples.In specimens of 46,XY,three cases showed mosaicism by FISH.In specimens of 46,XX,two cases showed chromosomal abnormalities by FISH.FISH detected overall 65.5％ (38/58) of the chromosomal abnormalities.Conclusions FISH combined with conventional chromosome analysis could improve the accuracy and detection rate of abnormal karyotypes in spontaneous abortion specimens.

OBJECTIVETo explore therapeutic effects of modified anterolateral approach and traditional approach in treating distal tibiofibula fractures.

METHODSFrom September 2009 to December 2012,45 patients with distal tibiofibula fractures were performed reduction and interal fixation with modified anterolateral and traditional approaches. According to Ruedi-All-gower classification, 12 cases were type I ,26 cases were type II, 7 cases were type III. Among 45 patients,there were 16 males and 7 females with an average age of (36.3 +/- 7.2) years old (ranged from 23 to 47) years old in advanced group; while there were 14 males and 8 females with an average of (33.8 +/- 6.4) years old (ranged from 25 to 45) in tradtional group. Operation time, blood loss, complications of incision were compared, and AOFAS scores were evaluated.

RESULTSAll patients were followed up from 6 to 36 months with an average of 21.7 months. In traditional group, operation time was (74.7 +/- 9.9) min, blood loss was (94.4 +/- 10.4) ml, and (73.7 +/- 10.0) min, (100.8 +/- 12.1) ml in advanced group,there was no significant meaning between two groups (P > 0.05); complications of insicion of advanced group was better than that of traditional group (chi2 = 4.078, P < 0.05); AOFAS score in advanced group (86.1 +/- 9.4) was better than that of traditional group, and had significant meaning (t = 3.787, P < 0.05).

CONCLUSIONModified anterolateral group,which has advantages of rapid recovery, less complications, is a good choice for closed distal tibiofibula fractures.

Adult ; Case-Control Studies ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery ; Young Adult

Objective To explore the relationship between parent hostility and adolescent externalizing behavior problems and the mediating role of parenting.Methods The cross-sectional data of 4474 adolescent aged 10-21 of the National Survey of Adolescent Mental Health in China (2008) was used.Adolescents reported their externalizing problems and parents' parenting.Parents reported their hostile behaviors.Results ① Parent hostility((9.18 ± 3.56),(8.94 ± 3.18)) significantly correlated with monitoring,inductive reasoning,harshness of parenting(father(3.39 ± 1.16),(3.21 ± 1.02),(1.39 ± 0.62) respectively,r =-0.108 ～ 0.489,P ＜ 0.01 ;mother (3.96 ± 0.97),(3.38 ± 0.96),(1.37 ± 0.60) respectively,r =-0.148 ～ 0.468,P ＜ 0.01) ; and both parent hostility and parenting were significantly associated with adolescent externalizing problems (0.23 ± 0.21) (r =-0.308 ～ 0.577,P ＜ 0.01).②Parental monitoring,inductive reasoning and harshness discipline partially mediated the relations between parent hostility and adolescent externalizing problems (Z =6.12,5.10,6.36,P ＜ 0.01 ; Z =5.86,6.97,11.84,P ＜ 0.01).Conclusion Parenting partially mediated the effect between parent hostility and adolescent externalizing problems.

Objective To study the efficacy of voice therapy combined with Jinsangsanjie pill in patients with vocal nodule .Methods A total of 146 patients with vocal nodes were randomly divided into three groups :45 cases in group A(single Jinsangsanjie pill therapy) ,47 cases in group B(single voice therapy) and 54 cases in group C(voice therapy combined with Jinsangsanjie pill therapy) ,30 healthy adults were as a normal control group .The treatment lasted 1 month .The results were evaluated by voice handicap index ,voice acoustic analysis and electronic laryngo‐scope which were collected before and after 1 month treatments .Results The VHI ,jitter ,shimmer and NNE of all patients were reduced while the MPT was increased after the treatment .The differences were significant (P<0 .05) .VHI 3 .64 ± 2 .12 ,jitter 0 .30% ± 0 .08% ,shimmer 1 .41% ± 0 .31% ,NNE -16 .83 ± 5 .84 dB of group C were significantly lower while MPT 18 .87 ± 3 .38 s and cure rate(93 .5% ) were significantly higher than those of in groupA(7.39±2.56,0.38% ±0.12% ,1.78% ±0.41% ,-13.38±4.42dB,16.38±3.11s,80.5% )andgroupB (23.6±12.5,0.48% ±0.18% ,1.98% ±0.42% ,-9.42±3.82dB,14.98±3.28s,52.4% )(P< 0.05).The VHI ,,jitter shimmer ,NNE of group A were significantly lower .MPT and cure rate were significantly higher than those of in group B .There were no statistical differences in each vocal indicators between group C and the normal control group (P>0 .05) .Conclusion The voice therapy combined with Jinsangsanjie pill in the treatment of vocal nodules is more efficiently ,and can improve patient’s pronunciation features .