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.

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.

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.

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.

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.

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.

Background The ocular nerve of trigeminus is the sensation and nutrition nerve of cornea.Whether trigeminal neuralgia affect the function of ocular surface and the morphology of corneal nerve plexus or not is below understanding.Confocal microscope is a non-invasive method for in vivo corneal examination.Objective This study was to analyze the ocular surface findings and observe the morphology and density of corneal nerve under the confocal microscopy in patients with trigeminal neuralgia.Methods Thirty-three eyes of 33 patients with trigeminal neuralgia were collected from the Department of Pain Management in Henan Provincial People's Hospital.The corneal perceptual sensitivity was examined using corneal aesthesiometer,and the function of lacrimal secretion (Schiemer Ⅰtest),tear break-up time (BUT) were performed to evaluate the influence of trigeminal neuralgia on ocular surface.The change of corneal nerve was observed under the confocal microscopy.The fellow eyes served as controls.The informed consent was obtained from the subjects before any examination.Results The fiber length of corneal perceptual sensitivity was (54.348±6.793)mm and (55.217±6.480)mm in trigeminal neuralgia group and control group without a significant difference between them (t=0.641,P=0.528).No significant differences were found in the mean value of Schiemer Ⅰtest (9.390±6.583mm vs 9.300±5.295mm) and BUT result (6.09±4.177s vs 6.13±4.799s) between trigeminal neuralgia and control group(t=0.070,P=0.945;t=-0.085,P=0.933).The densities value of corneal subepithelial nerve plexus at the nasal,temporal,superior,inferior and central area was insignificantly changed between trigeminal neuralgia group and control group(P=0.840,0.459,0.268,0.120,0.607).Tenuous,bending and circling nerve fibers were seen in corneal stroma under the confocal microscope,while the nerve fibers were strict in controls.Conclusion Trigeminal neuralgia does not dramatically affect eye surface function and corneal subbasal nerve plexus density,but corneal nerve fibers with trigeminal neuralgia are more bending than normal people.

Objective To assess the effects of music intervention on physiological and psychological responses of patients with cancer. Methods A computerized search in China Biology Medicine, China National Knowledge Infrastructure,Wanfang data ,VIP, Cochrane library, Web of Science and PubMed was performed for relevant randomized control trials comparing the effects of music intervention on physiological and psychological responses of patients with cancer. The quality of studies was critically appraised and data were extracted by two reviewers independently. The Cochrane-Handbook5.0 was used to evaluate the quality of studies. Data was analyzed by RevMan5.0 software. Results A total of 29 randomized control trials were involved. Eleven studies about the effects of music intervention on anxiety level of patients with cancer were assessed with Self-rating Anxiety Scale,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-11.74, 95%CI-11.94--8.53, P<0.01). Four studies about the effects of music intervention on anxiety level of patients with cancer were assessed with state-trait anxiety inventory,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-8.24, 95%CI-9.44--7.04, P<0.01). Meta-analysis showed that music intervention was able to relieve anxiety, depression, pain of patients with cancer. Two studies about the effects of music intervention on anxiety level of patients with cancer were assessed with Hamilton Anxiety Scale,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-3.37, 95%CI-4.93--1.82, P<0.01). Fourteen studies about the effects of music intervention on depression level of patients with cancer were assessed with Self-rating Depression Scale,Meta analysis confirmed that music intervention could effectively reduce the depression level of patients with cancer (WMD=-8.12, 95%CI-10.75--5.49, P<0.01). Three studies about the effects of music intervention on depression level of patients with cancer were assessed with Hamilton Depression Scale,Meta analysis confirmed that music intervention could effectively reduce the depression level of patients with cancer (WMD=-3.27, 95%CI-6.34--0.21, P=0.04). A total of 9 studies were conducted to evaluate the effects of music intervention on patients with the pain Visual Analogue Scale,Meta analysis confirmed that music intervention could effectively reduce the pain level of patients with cancer (WMD=-0.83, 95%CI-1.23--0.44, P<0.01).A total of 6 studies were conducted to evaluate the effects of music intervention on heart rate in cancer patients,Meta analysis confirmed that music intervention could stabilize the heart rate of patients (WMD=-3.38, 95%CI-5.13--1.62, P=0.002).A total of 6 studies were conducted to evaluate the effects of music intervention on systolic blood pressure in patients with cancer,the results of Meta analysis showed that music intervention could stabilize the systolic pressure in patients (WMD=-5.34, 95%CI-7.95--2.73, P<0.01). Conclusions Music intervention has effects on reducing potentially harmful psychological responses of patients with cancer,which deserve to be explored and spread in clinical practice.

Objective To investigate the expression of human epididymal protein 4 (HE4) in chronic kidney disease (CKD) and its clinical value.Methods From April 2014 to December 2015,Serum samples of 92 non-cancer patients diagnosed as CKD and 84 healthy controls were collected in Nantong University Hospital.HE4,BUN,Scr,Cys C and β2MG were detected.The difference of HE4 expression in different stages of CKD and the correlation of HE4 with Urea,Scr,Cys C and β2MG were analysized,respectively.ROC curve was used to evaluate the auxiliary diagnostic value of HE4,BUN,Scr,Cys C and β2MG.Results The serum HE4 expression in patients with impaired renal function was 388.2 (130.1～1 659.5)mIu/ L,(F=16.237,P=0.001).Which was significantly higher than that in the control group [38.1 (32.77 ～ 48.17)mIu/L].The serum HE4 expression was increased by the stage of renal damage and the difference was existed among different groups (P＜0.05).HE4 expression was positive related with Cys C and β2MG.The AUC of HE4,BUN,Scr,Cys C and β2MG were 0.878,0.785,0.816,0.874 and 0.819,respectively.Conlusion It needs to consider the exsits of impaired renal function when the HE4 was detected.The HE4 might be a novel early diagnostic indication for CKD.