Objective To assess the effects of captopril on renal perfusion of diabetic mellitus(DM)rabbits at early stage by contrast-enhanced ultrasound (CEUS).Methods Of 58 rabbits,6 were control group,37 were made as DM model successfully by alloxan and were randomly divided into 4 groups:untreatment group (n =16) and treatment group A,B and C (n =7 averagely).The treatment groups were given captopril(25 mg/kg weight) everyday by intragastric administration after the DM model established and renal pathology appeared Mogensen DN Ⅰ,Ⅱ or / and Ⅲ respectively.The treatment lasted 12 week.Then CEUS was performed on bilateral kidney to observe the renal perfusion,the parameters included:curve ascending slope(K1),time to peak intensity(PIT),peak signal intensity(PSI),area under the curve(AUC) and time to half of peak intensity(HPT).Results At the end of 12 weeks,compared with control group,PIT and HPT delayed,PSI and K1 decreased in untreatment group and group C,AUC of untreatment group increased.Compared with untreatment group,PIT,HPT and AUC decreased,PSI and K1 increased in group A,B and C.Compared with group C,HPT of treatment group A,B decreased.Compared with control group,renal's size increased and the cortex was thickened in untreatment group and group A,B,C.The pathological examination showed:renal were damaged more seriously in untreatment group than that in group A and B.There was no significant difference in Scr and BUN between all groups.Conclusions Assessment of CEUS for renal perfusion of diabetic mellitus rabbits at early stage is feasible and captopril can improve renal perfusion of DM rabbits.

Objective To assess the renal perfusion of different severity of hepatic cirrhosis by contrast-enhanced ultrasound with time-intensity curve.Methods Forty hepatic cirrhosis patients with normal conventional renal function enrolled the study and were subdivided into Child-Pugh A group ( n =14),Child-Pugh B group ( n =14) and Child-Pugh C group ( n =12).Thirty healthy subjects were selected as the control group.The parameters of perfusion were compared among the groups.The correlations between parameters and score of Child-Pugh were analyzed using Pearson correlation.Results The cirrhosis groups showed a decrease of peak intensity,increase of time to peak,and reduce of area under the curve in the renal cortex( P ＜0.05).Compared with Child-Pugh A group,the peak intensity decreased in both ChildPugh B and C groups,time to peak increased in Child-Pugh C group( P ＜0.05 or P ＜0.01 ).The peak intensity had negative correlation with Child-Pugh score( r =- 0.506,P ＜0.01 ).Conclusions Contrastenhanced ultrasound combined with time-intensity curve can assess renal perfusion of hepatic cirrhosis quantitatively.The peak intensity was correlated to the severity of cirrhosis.

Objective:To investigate the contrast-enhanced ultrasound (CEUS) features of inflammatory hepatocellular adenoma (I-HCA).Methods:The contrast-enhanced ultrasound features I-HCA of 28 cases from April 2009 to November 2019 in Zhongshan Hospital, Fudan University were retrospectively analyzed, including arterial phase enhancement pattern, the homogeneity of enhancement, subcapsular enhancement, and the internal perfusion defect. All I-HCA lesions were divided into >5 cm group( n=9) and ≤5 cm group( n=19), the CEUS features between the two groups were compared. Results:All I-HCA lesions were hyper-enhanced in the arterial phase, among which 39.3% (11/28) showed diffuse filling, 39.3%(11/28) showed centripetal filling, and 21.4%(6/28) showed centrifugal filling pattern. Twenty-five percent (7/28) of I-HCAs showed heterogeneous enhancement, 10.7% (3/28) revealed unenhanced areas within the lesions. Subcapsular vessels were observed in 67.7 (21/31) of I-HCA lesions. Heterogeneous enhancement and unenhanced areas were more frequently detected in lesions >5 cm ( P=0.020, 0.026, respectively), while there was no difference in the enhancement pattern and subcapsular vessels between the two groups ( P>0.05). Inportal venous phase, 42.9%(12/28) of I-HCAs showed hypo-enhancement, and 57.1%(16/28) of lesions showed washout in late phase. According to "hyper-enhancement in arterial phase, sustained hyper- or iso-enhancement in portal venous and late phase" by CEUS, the diagnostic accuracy of benign lesion was 42.9%(12/28). According to any of hyper-enhancement pattern in arterial phase, subcapsular vascular enhancement, and sustained hyper- or iso-enhancement in portal venous and late phase, the diagnostic accuracy of I-HCA was 71.4% (20/28). Conclusions:CEUS is valuable in the diagnosis of inflammatory hepatocellular adenoma.

ObjectiveTo investigate the protective effect of microRNA-155 (miR-155) antisense oligonucleotid (ASO) on acute lung injury (ALI) mice by establishing a lentiviral expression vector of ASO of miRNA.Methods miR-155 antisense oligonucleotides amplified by polymerase chain reaction (PCR) from genomic, using BamH Ⅰ and Nhe Ⅰ double digestion, ligated into lentiviral expression vector. Sequence and virus titer were measured. According to the random number table method, 54 male BALB/c mice of 4-6 weeks old were divided into three groups. ALI animal models were prepared by intraperitoneal injection of 10 mg/kg lipopolysaccharide (LPS). The three groups were injected with 200μL phosphate buffered saline (PBS) containing 1×108/mL pmiR-155-ASO virus (pmiR-155-ASO group) or 200μL PBS containing 1×108/mL pSMPUW-miR-GFP empty virus (pmiR-cont group) or the same amount of PBS (PBS group) at 24 hours before the molding. Ten mice in each group were used to observe the 7-day survival rate. Blood samples and lung tissues of the remaining 8 mice were harvested after the model was established, and the levels of serum inflammatory cytokines were determined by enzyme linked immunosorbent assay (ELISA); the expression of miR-155 in lung tissue was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR); histopathological changes of lung and distribution of macrophages were observed under microscope.Results There was no significant difference in each index between pmiR-cont group and PBS group. The mature miR-155 expression in lung tissue in pmiR-155-ASO group was significantly lower than that in pmiR-cont group (2-ΔΔCt: 4.92±0.72 vs. 15.38±0.60,P < 0.05). Compared with pmiR-cont group, the injury degree of ALI mice after pretreatment with miR-155ASO was significantly improved, and the 7-day survival rate was significantly increased (72.1％ vs. 61.9％,P < 0.05 ); gross lung observation showed that congestion in lung tissue was significantly reduced, and the ratio of wet/dry weight (W/D) of lung was significantly decreased (4.50±0.13 vs. 5.64±0.61,P < 0.05);hematoxylin-eosin (HE) staining showed that inflammatory cell infiltration in lung tissue was decreased, while immunofluorescence assay showed that macrophage infiltration in lung tissue was significant decreased; the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL- 6) in serum were significantly decreased [TNF-α (ng/L):379.8±48.9 vs. 495.9±33.3, IL-6 (ng/L): 262.3±61.8 vs. 355.4±22.6, bothP < 0.05], but the level of IL-10 did not change significantly (ng/L: 143.6±32.5 vs. 140.4±22.3,P > 0.05).Conclusion miR-155 ASO has the effect of inhibiting LPS-induced inflammatory response and improving prognosis in ALI mice.

Objective:To analyze the viscosity characteristics of liver tumors and investigate the clinical value of shear wave dispersion (SWD) in the differentiation of benign and malignant liver tumors.Methods:A total of 103 patients with focal liver lesions were prospectively collected in Zhongshan Hospital Affiliated to Fudan University from October 2020 to July 2021, including 80 cases with single lesion and 23 cases with multiple lesions, and only the largest lesion was observed in patients with multiple lesions. SWD values were measured within the tumor and in the liver parenchyma 2 cm away from the tumor, and were compared between benign tumor group and maligant tumor group. The ROC curves of SWD value, SWD ratio and their combination in differentiating benign and malignant liver tumors were plotted respectively, and the optimal diagnostic threshold, the sensitivity, specificity and accuracy of different diagnostic methods were analyzed.Results:Among the 103 patients, 35 were benign and 68 were malignant. The SWD value of liver benign tumor group was lower than that of liver malignant tumor group [(16.38±3.58)m·s -1·kHz -1 vs (18.59±3.12)m·s -1·kHz -1], the SWD value of liver parenchyma background in liver benign tumor group was lower than that in liver malignant tumor group [(10.88±3.37)m·s -1·kHz -1 vs (14.31±3.34)m·s -1·kHz -1], and the differences were statistically significant (all P<0.05). The SWD ratio of benign tumor to surrounding liver parenchyma was higher than that of malignant tumor group [1.57(1.25, 2.00) vs 1.27(1.06, 1.57)], and the difference was statistically significant ( P<0.05). When the SWD value >15.60 m·s -1·kHz -1 was used as the cut-off value, the area under ROC curve (AUC) was 0.72, the sensitivity was 88.2%, the specificity was 51.4%, and the accuracy was 75.7%. The sensitivity, specificity, accuracy and AUC were 58.8%, 74.2%, 63.1%, and 0.68, respectively, when the ratio of SWD value<1.32 was used as the cut-off value. SWD value combined with SWD ratio for the diagnosis of liver malignant tumor, the AUC was 0.88, the sensitivity was 82.3%, the specificity was 83.0%, and accuracy was 81.6%. The diagnostic efficacy of the two in combination for liver malignant tumor was superior to SWD value ( Z=2.678, P=0.007 4) and SWD value ratio ( Z=3.822, P=0.000 1). Conclusions:SWD imaging can reflect the viscosity information of liver tumors and surrounding liver parenchyma, and has potential clinical application value in the differentiation of benign and malignant tumors.

INTRODUCTIONKnowledge of stroke symptoms is associated with seeking medical attention early, and knowledge of risk factors is an essential factor in stroke prevention. In this study, we evaluated the level of stroke literacy in Singapore.

MATERIALS AND METHODSA cross-sectional study of Singapore citizens and permanent residents aged 21 years and above was conducted in a public housing estate. Participants were randomly sampled using multi-stage stratified sampling. Assessment of awareness of stroke symptoms and risk factors was performed using open-ended questions. In total, 687 respondents were recruited, with a response rate of 69.7%.

RESULTSOverall, 52.4% of respondents identified the brain as the source of pathology, and 47.6% could cite at least 1 of the 3 FAST symptoms (facial droop, arm weakness and speech difficulty), while 40% could name 2 or more of 7 established risk factors for stroke (high blood pressure, high cholesterol, cigarette smoking, diabetes mellitus, older age, previous heart attacks and stroke). Respondents at higher risk of stroke (older individuals and those with stroke risk factors) did not have greater awareness of stroke symptoms and risk factors. The majority of respondents reported they would seek immediate medical care if they experienced stroke symptoms. Only 59.4% knew the emergency ambulance service telephone number.

CONCLUSIONIn a sample of Singaporean adults residing in a public housing estate, we found evidence of poor stroke literacy, highlighting the need for comprehensive population-based education efforts. There is a role for opportunistic education among those at higher risk of stroke.

Adult ; Aged ; Cross-Sectional Studies ; Female ; Health Literacy ; Humans ; Male ; Middle Aged ; Public Housing ; Risk Factors ; Singapore ; Socioeconomic Factors ; Stroke ; Surveys and Questionnaires ; Young Adult

Objective To investigate the role of combined analysis of E2F3a and CASP8AP2 expression in prognosis evaluation in pediatric acute lymphoblastic leukemia (ALL). Methods The study included 141 newly diag-nosed pediatric ALL patients enrolled at the Hematology Center,Beijing Children′s Hospital,Capital Medical Universi-ty between March 2008 and July 2010,including 97 boys and 44 girls(aged 1. 2 - 15. 5 years,median 5. 2 years). E2F3a and CASP8AP2 expressions were quantified in 141 children with ALL by adopting real - time quantitative poly-merase chain reaction (qPCR). Receiver operating characteristic (ROC)curve was used to find the best cut - off point to divide the patients into E2F3a or CASP8AP2 low - and high - expression groups,and the treatment outcome between the groups was compared. Cox regression was used to analyze the prognostic significance of the combined expression of E2F3a and CASP8AP2. Results The estimated 5 - year relapse free survival(RFS)rate,event free survival(EFS) rate and overall survival (OS)rate of patients with low - E2F3a and low - CASP8AP2 expression were (58. 9 ± 10. 0)％,(56. 0 ± 9. 9)％ and (72. 0 ± 9. 0)％,respectively. They were significantly lower than those of patients with high - E2F3a and high - CASP8AP2 expression,whose RFS,EFS and OS were (94. 9 ± 2. 5)％,(93. 7 ± 2. 7)％ and (96. 2 ± 2. 2)％,and the differences were all statistically significant(all P < 0. 05),respectively. Compared with other patients,the one with low expression of both E2F3a and CASP8AP2 had a poorer prognosis. In addition to MLL rear-rangements and minimal residual disease level at the end of remission induction,low expression of both E2F3a and CASP8AP2 remained as independent prognostic factors. Conclusion Low expressions of E2F3a and CASP8AP2 pre-dict poor prognosis in pediatric ALL. Combined assessment of E2F3a and CASP8AP2 expression could predict poor prognosis and relapse more accurately.