Objective To study the clinical value of VACORA vacuum-assisted rotation system in the treatment of benign breast lesions. Methods Under the screening of dynamic ultrasound,122 beast lesions in 93 patients diagnosed as benign lesions from ultrasound were treated with VACORA vacuum-assisted rotation system,and all the patients were examined for follow-up. Results All the lesions were totally rotated and 119 lesions demonstrated to be benign and 3 lesions were atypical hyperplasia from pathologic examination. In the benign lesions, 72 cases were demonstrated to be fibroadenoma, 39 cases were demonstrated to be fibrosis adenosis,4 cases were intraductal papilloma,2 cases were duct inflammation, 1 case was epithelial hyperplasia of the duct and 1 case was lymphode. In 8 cases,bleeding was seen along the needle tract,which was stopped after compression. Small hematoma was formed in 10 patients in the second day of follow-up, which was disappeared in the 3 to 6 months of the follow-up. And all patients had no remnant lesions in the local area and the incisions were not clear in the skin 3 to 6 months of the follow-up. Hypoechoic focuses were detected out at the original location in the 3 benign cases, which were possibly residual focuses. Conclusions Benign breast lesions could be clearly resected with VACORA rotation system under the screening of ultrasound, which is safe, minimal invasive, prosthetic, and has little complications.

Objective To evaluate the value of supersonic shear wave elastrography(SWE) in the diagnosis of benign and malignant breast lesions.Methods SWE was performed on 134 breast lesions of 123 female patients and 74 normal breast glands to determine the values of overall elastic modulus and dispersion,and ROC curves were used to assess the diagnosis boundary value of two kinds of data respectively.Results According to the diagnostic gold standard-histopathology,the values of overall elastic modulus and dispersion were statistically significant when comparing benign lesions and malignant lesions with normal glands.ROC curve displayed that,when the Youden index reached to maximum,the diagnosis boundary value of overall elastic modulus was 41.01 kPa,the sensitivity and specificity of the value were 68.5％ and 83.8％ respectively; the diagnosis boundary value of dispersion was 12.25 kPa,the sensitivity and specificity of the value were 87.0％ and 88.7％ respectively.Conclusions The values of overall elastic modulus and dispersion for solid breast lesions can be used to reflect the elastic characteristics of lesions quantificationally,which is useful to diagnose benign and malignant breast lesions in clinical.

ObjectiveTo evaluate the value of MicroPure software system in the display of calcification and diagnostic accuracy of breast carcinoma.MethodsSixty-three patients with 68 breast lesions were checked by conventional ultrasound,X-ray and MicroPure software technique.The calcification was described and the lesions were classified with BI-RADS.All cases were pathologically confirmed by biopsy or operation.Results ①Compared to the detection rate for calcification of X-ray,the display rate of conventional ultrasound was 80.6% ,and the display rate of MicroPure software technique was 100%.②The area under the curve of diagnosing benign and malignant of breast lesions was 0.916,0.857 and 0.970 respectively with ultrasound,X-ray and MicroPure software technique.③Three lesions was classified Ⅲ in BI-RADS with conventional ultrasound,and Ⅳ in BI-RADS with MicroPure software.The pathologic results were malignant.ConclusionsMicroPure software system obviously raised the ultrasonic display rate of calcification,meanwhile,it raised the diagnostic accurate rate of breast cancer.It especially raised the tendency rate for the patients who were classified between Ⅲ and Ⅳ in BI-RADS.

Objective To compare the value of contrast-enhanced ultrasonography (CEUS) with that of laparoscopic ultrasonography (LUS) in localization diagnosis of insulinoma. Methods Thirty-three patients with insulinoma,who received operation, were retrospectively reviewed. All cases were examined by both CEUS and LUS before the tumor removed. Both imaging modalities in diagnosis of insulinoma were analyzed. Results By this study the sensitivity and accuracy of CEUS were 92.31% and 90.0% respectively. Those of LUS were consistent with pathologic findings completely. The accuracy of CEUS was not different with that of LUS (χ2 = 4.21, P = 0. 04). Conclusions CEUS can be used for location diagnosis of insulinoma. For the patients expecting laparoscopic treatment, combination of CEUS with LUS will be suggested before insulinoma is removed.

Objective To detect all methods of localization in the insulinomas,and promote the rate of localization in insulinomas.Methods Between April 1990 and April 1999,28 patients of insulinomas that confirmed by operation and pathology.US,CT,MRI and DSA were used for preoperative diagnosis,IOUS,PVS and touching were used for intraoperative diagnosis,and analyzed the results of operation.Results The rates of localization were 28.6% with US,32.2% with CT,41.7% with MRI,50.0% with DSA,82.1% with touching,and 92.3% with IOUS and PVS.The rates of preoperative were higher than that intraoperative.Conclusion The rates of localization were so lower in preoperative diagnosis that did not be detected repeatedly,but intraoperative diagnosis was very vital.IOUS not only to promote the localizative sensitivity,but also to discrease the rates of operative complication.

Purpose To investigate the prognosis and influencing factor of hematoma complicated from ultrasonography-guided EnCor vacuum-assisted breast biopsy system in minimally invasive surgery for breast lesions, and to provide reference for clinical treatment. Materials and Methods 280 female patients with 486 benign breast lesions underwent minimally invasive excision using a ultrasonography-guided EnCor vacuum-assisted device, occurrence and the inlfuence factors of hematoma complicated from the operation was observed. Results All the 486 lesions were completely excised with EnCor system, hematoma (≥1cm) were found in 47 cases after 24 hours and almost disappeared in 6 months. After analysis of the occurrence of hematoma, it was found that the following situations would lead to a higher incidence of hematoma, which included lumps ≥ 2.5 cm, more than two lesions removed at one time, lumps locating deep inside the areola or the edge of breasts, bigger and less dense breasts, operation in menstrual period, pressure bandaging after operation less than 12 hours and operation without using adrenaline (P<0.05 or P<0.01). Conclusion Benign lesions breast can be effectively excised using ultrasonography-guided EnCor vacuum device, and the factors listed below could affect the occurance of hematoma complicated from the surgery, including the size, location and number of the resected nodules, breast shape, surgery during menstrual period, postoperative pressure bandaging and the use of hemostatics.

Objective To evaluate the diagnostic value of gray scale contrast-enhanced ultrasonography(CEUS) in the diagnosis of active hemorrhage of the kidney.Methods Forty-six active hemorrhage animal models were created within the kidney of 23 New Zealand rabbits heparinized under general anesthesia,rabbit kidneys were examined by routine two dimensional ultrasonography and CEUS.Results Routine ultrasonography showed 26 traumas with irregular and poorly defined margins.CEUS showed all active bleeding sites,contrast agents overflowed from injured blood vessel and formed irregular remarkable enhanced parts.After average 85s for contrast agent was injected,the intensity of the enhanced regions in the kidneys were significantly higher than those of normal renal parenchyma.Conclusions CEUS could clearly demonstrate the active hemorrhage in traumatic kidney and could significantly improve the diagnostic level of ultrasonography.

Objective To investigate the impact of ropivacaine on apoptosis of lippolysaccharide(LPS)-induced ulcerative colitis cell line NCM-460 and on activity of nucleotide oligomerization domain(NOD)-like receptor protein-3(NLRP3)inflammatome.Methods Human colon epithelial cell line NCM-460 was cultured in vitro and divided into control group(no intervention),model group(10 μg/mL LPS treatment),low/medium/high concentration ropivacaine group(10 μg/mL LPS and 0.5,1,1.5 mmol/L ropivacaine co-treatment,respectiv-oly).Cell viability was determined by cell counting kit 8(CCK-8)and the appropriate concentration was selected.The cells were then divided into control group,model group,ropivacaine group(10 μg/mL LPS and 1.5 mmol/L ropivacaine treatment)and ropivacaine+inhibitor group(10 μg/mL LPS,1.5 mmol/L ropiva-caine and 1 μmol/L NF-κB pathway inhibitor BAY 11-7082 treatment),inhibitor group(10 μg/mL LPS+1 μmol/L NF-κB pathway inhibitor BAY 11-7082 treatment)and ropivacaine+activator group(10 μg/mL LPS,1.5 mmol/L ropivacaine and 1 μmol/L NF-κB pathway activator Prostratin),all groups were treated for 24 h.The level of IL-6,IL-8 and TNF-α were detected by enzyme-linked immunosorbent assay(ELISA).The proliferation rate was detected by EdU incorporation.Hoechst 33258 staining microscopy was used to detect the apoptosis rate.Level of cyclinD1,caspase-3,NLRP3 and NF-κB pathway-related proteins were detected by Western blot.Results Compared with the control group,the cell viability of the model group was significantly decreased and the cell viability of high-concentration experimental group was increased after adding ropivacaine(P＜0.05).So,1.5 mmol/L ropivacaine was selected for the follow-up experiment.Compared with the control group,the concentration of inflammatory cytokines IL-6,IL-8,TNF-α,apoptosis rate and the protein expression of caspase-3,NLRP3 and phosphorylated p-NF-κB in model group were all significantly increased(P＜0.05),while the proliferation rate and cycilnD1 protein expression were decreased(P＜0.05).Com-pared with model group,the concentrations of IL-6,IL-8,TNF-α,apoptosis rate and the expression of caspase-3,NLRP3 and p-NF-κB protein in ropivacaine group and inhibitor group were significantly decreased(P＜0.05),while the proliferation and cycilnD1 protein expression were increased(P＜0.05).Compared with ropivacaine group,the trend of the above indexes in ropivacaine+inhibitor group was more significant(P＜0.05),and the trend of these indexes in ropivacaine+agonist group was significantly reversed(P＜0.05).Conclusions Ropivacaine can inhibit the activation of NLRP3 inflammasome and block the signal transduction of NF-κB pathway,further inhibit LPS-induced apoptosis of NCM-460 cells and promote proliferation.

Monoacylglycerol lipase (MGL) is a serine hydrolase that plays a major role in the degradation of endogenous cannabinoid 2-arachidonoylglycerol. The role of MGL in some cancer cells has been confirmed, where inhibition of the MGL activity shows inhibition on cell proliferation. This makes MGL a promising drug target for the treatment of cancer. Recently, the development of covalent inhibitors of MGL has developed rapidly. These drugs have strong covalent binding ability, high affinity, long duration, low dose and low risk of drug resistance, so they have received increasing attention. This article introduces the structure and function of MGL, the characteristics, mechanisms and progress of covalent MGL inhibitors, providing reference for the development of novel covalent small molecule inhibitors of MGL.
Monoacylglycerol Lipases/metabolism* ; Endocannabinoids/metabolism*