Objective To compare real -time tissue elastography (RTE)and ultrasound in the diagnosis of papillary thyroid carcinoma (PTC)with cervical lymph node (LN)metastasis.Methods A retrospective analysis was carried out on the clinical data of 72 patients with PTC.Eighty -four LNs of them were performed with ultrasound-guided fine -needle aspiration biopsy.Patients were divided into two groups:with cervical lymph node metastasis group and without cervical lymph node metastasis group.All patients were reviewed their B -mode ultrasonography (BUS)on cervical lymph node and RTE on thyroid.RTE elasticity indices (EI)of mean (Emean),minimum (Emin),maximum (Emax)and the ratio of Emean in LNs and surrounding muscle (Emean -m)were measured at the thyroids.The performances of RTE and BUS in predicting of PTC with LN metastasis were compared and ana-lyzed.Results The sensitivity and specificity of BUS on diagnosis of the cervical lymph nodes metastasis were 84.0% and 90.0%.The RTE Emea,Emax,Emin and SI in meta -static LNs were significantly higher than those in benign LNs(P =0.001,0.002,0.001,0.007).The RTE results of PTC patients with lymph node metastasis was ana-lyzed by ROC curve.The largest area was Emin.AUC was 0.918,the critical value was 0.240.AUC of SI was 0.896, AUC of Emean was 0.718,AUC of Emax was 0.670.The sensitivity and specificity were 94.0% and 99.4%,respec-tively.Conclusion Co -operation of RTE and BUS was more accurate than simple BUS in diagnosis of PTC with lymph node metastasis.SI and Emin has a high diagnostic value.

Objective To evaluate the diagnostic value of high frequency echocardiography on mice with doxorubicin-induced cardiotoxicity and find out the most valuable monitoring indexes for early doxorubicin-induced myocardial damage.Methods Forty mice were divided into doxorubicin-injection group (ADM group) and control group randomly.Twenty mice in each group were injected with doxorubicin and saline at the same dose for 5 weeks continuously.The parameters of cardic function of ADM group and contol group were observed by high-frequency echocardiography after infection.Brain natriuretic peptide (BNP) tested by euzymelinked immunosorbent assay(ELISA) and pathological findings were used as the golden standard.Results ①The left ventricular long axis view and the apical four chamber view could be displayed clearly by transthoracic high-frequency echocardiography.②After 5 weeks intervention,weight,heart rate,left ventricular ejection fraction (LVEF),left ventricular fractional shortening (LVFS),E/A,E wave deceleration time(EDT) and other parameters showed marked difference between ADM group and control group(P ＜0.05).③The decrease of diastolic function was earlier than systolic function in ADM group.④LVEF and E/A presented good negative linear correlation to BNP(r =-0.622,P ＜0.05; r =-0.593,P ＜0.01).EDT showed positive linear correlation to BNP(r =0.501,P ＜0.05).Conclusions Cardic function of mice with doxorubicin-induced myocardial damage could be early evaluated accurately by high-frequency echocardiography,which contained good relativity with BNP.

Objective To assess the clinical significance of three-dimensional speckle tracking imaging (3D-STI) in the evaluation of left ventricular myocardial function in breast cancer survivors with postoperative anthracycline-based chemotherapy.Methods A total of 51 breast cancer survivors with postoperative anthracycline-based chemotherapy were recruited and 31 female healthy volunteers as the controls.Conventional echocardiography and 3D-STI derived parameters [including global longitudinal strain (GLS) and global area strain (GAS)] were measured before and at 3 and 6 anthracycline-based chemotherapeutic cycles.The receiver operating characteristics (ROC) curve was constructed to determine optimal sensitivity and specificity of 3ID-STI derived parameters for the prediction of future cardiotoxicity.Results In comparison with the controls and baseline cases,GLS and GAS deteriorated significantly (P ＜ 0.05 for both).No statistical difference in GCS and conventional parameters showed before and after the initiation of chemotherapy (P ＜0.05,respectively).The ROC curves showed that GAS as the best 3D-STI predictor of patients who develop cardiotoxicity during the follow-up.The area under ROC(AUC) of GAS was 0.894,and its optimal cut-off value was-28.4％,with a specificity of 88.0％ and a sensitivity of 82.9％.AUC of GLS was 0.802,and its optimal cut-off value was-14.3％,with a specificity of 62.0％ and a sensitivity of 85.4％.Conclusions Early decreases in GAS and GLS based on 3D-STI may allow the prediction of subsequent cardiotoxic development accurately in breast cancer survivors with postoperative anthracycline-based chemotherapy.

Objective To investigate the left ventricular (LV) performance in patients with essential hypertension(EH) by global performance index (GPI) based on three-dimensional speckle tracking imaging (3D-STI).Methods A total of 164 EH patients were enrolled and divided into four subgroups according to LV configuration:LV normal group (LVN,n =67),concentric cardiac remodeling group (CCR,n =49),concentric cardiac hypertrophy group (CCH,n =28) and eccentric cardiac hypertrophy group (ECH,n =20).Thirty age and sex matched healthy volunteers were enrolled as controls.3D-STI was performed to assess LV 3D global strain and LV torsion,then LV systolic dyssynchrony index (SDI) and global performance index (GPI) were calculated.Global strain parameters were investigated among the groups,and correlations with GPI were studied.Results GPI,global longitudinal strain(GLS),global area strain(GAS),global radial strain(GRS) and global 3D strain(G3DS) in EH groups were respectively lower than those in the normal controls,and there were statistical differences among the respective parameters (P ＜0.05,respectively).SDI in group CCH and ECH were significantly higher than that in normal controls (P ＜ 0.05,respectively).In multivariate stepwise regression analysis,GAS was the most influential to GPI.Conclusions GPI based on 3D-STI may accurately reflect LV performance in patients with EH,and has potential applications in clinical practice.

Objective To explore the impact of morphological changes of mitral valve coaptation on ischemic mitral regurgitation (IMR),and observe coaptation image of mitral valve in systole in patients with IMR by using real-time three-dimensional transesophageal echocardiography (RT3D-TEE).Methods RT3D-TEE was performed on 112 patients with IMR and 38 patients without MR as the control.Patients with IMR were divided into group of mild IMR (n =46),group of moderate IMR (n =45) and group of severe IMR (n =21),according to the severity of mitral regurgitation.Mitral valve quantification (MVQ)software of Qlab 8.1 was used for image post-processing of RT3D-TEE.The coaptation parameters was measured,included length of anterior combination(LCA3dlf),length of posterior combination(LCP3dlf),area of anterior combination(A3DTANT) and area of posterior combination (A3DTPOST) at end-systole.Then,these coaptation parameters of mitral valve were compared statistically.Logistic regression assessing was applied for analyzing the results.Results Coaptation line of anterior and posterior leaflets was almost same in normal subjects.With increasing of mitral regurgitation,a tendency to prolong in LCA3dlf and LCP3dlf were observed in IMR (P ＜0.05).Compared to that in mild and moderate IMR groups,besides A3DTANT and A3DTPOST,LCA3dlf and LCP3dlf were also increased significantly in severe IMR group (P ＜0.05).LCP3dlf was an independent correlation factor of IMR by Logistic regression analysis.The sensitivity was 73.3％ and the specificity was 94.7％ when LCP3dlf≥32 mm was regarded as cut-off point,and the area under the ROC curve was 0.949 (0.900～0.999).Conclusions Abnormal coaptation of anterior and posterior leaflets of mitral valve might be one of main cause of IMR.Involution structure of mitral valve before surgery is helpful for surgeon to select an optical surgical procedure and evaluate effects of treatment in patients with IMR.

Objective To evaluate the value of high-frequency ultrasound in diagnosing the early reduced function of mice and to make sure the impact of aldosterone in cardiac remodeling after myocardial infarction.Methods Twenty aldosterone silence mice were selected as the experimental group and 20 healthy wild-type mice as the control.Animal models of acute myocardial infarction (AMI) were established by the method of the left anterior descending artery ligation.Cardiac function was measured by highfrequency echocardiography before and 2 weeks,4 weeks,6 weeks after AMI.Produce biopsy and Masson staining in both the experimental and the control groups were made post 6 weeks after AMI.Results ①Left ventricular long axis view and various short-axis views of mice could be clearly displayed by high-frequency echocardiography,and accurate measurements of the cardiac function could be obtained.② Compared with that in the control,left ventricular ejection fraction progressed more gradually in the experimental group than the control group (35.81 ± 2.88 vs 29.10 ± 4.50 at 6 weeks after AMI,P ＜0.05).Conclusions Blocked aldosterone may play a positive effect in reducing the myocardial injury.

Objective To assess the potential clinical signiifcance of myocardial composite index (MCI) in the evaluation of left ventricular myocardial function in breast cancer patients with postoperative chemotherapy by speckle tracking echocardiography (STE). Methods A total of 33 consecutive breast cancer patients with postoperative chemotherapy were prospectively enrolled in Shanghai East Hospital, Tongji University, from February 2012 to February 2013. Thirty-six female healthy volunteers were enrolled as the controls. Routine echocardiographic parameters [left ventricular end diastolic volume (EDV), end systolic volume (ESV), interventricular septum thickness at diastole (IVSTd), left ventricular posterior wall thickness (PWTd) and left ventricular ejection fraction (LVEF)] were obtained. EDV and ESV were corrected for body surface area, and then end diastolic volume index (EDVI) and end-systolic volume index (ESVI) were calculated. STE-derived parameters [left ventricular global longitudinal strain (GLS), global radial strain (GRS), left ventricular twist (LVtw) and myocardial composite index (MCI)] were evaluated. All above data were obtained after 5 anthracycline-based chemotherapeutic cycles and compared with baseline measurements in controls respectively. Receiver operating characteristic (ROC) curves were constructed to determine optimal sensitivity and specificity of continuous variables for the prediction of future cardiotoxicity. Results (1)Changes in EDV, ESV, IVSTd, PWTd and LVEF showed no significant decreases compared with baseline and controls (F=1.35, 2.04, 1.28, 2.34, 2.16, P > 0.05 for all), while the changes in ESVI and EDVI showed statistically decreases (F=4.73, 6.86, P < 0.05 for all);(2)The changes in EDVI and ESVI showed signiifcant decreases compared with baseline (t=6.10, 5.13, P<0.05 for all) and controls (t=5.26, 4.24, P<0.05 respectively);(3)The change in GRS showed no statistical signiifcance compared with baseline and controls (F=1.23, P>0.05), while change in GLS, LVtw and MCI showed statistical significances compared with baseline and controls (F=4.29, 5.02, 12.35, P<0.05 for all);(4)The changes in GLS, LVtw and MCI showed signiifcant decreases compared with baseline (t=5.33, 13.94, P<0.05 respectively) and controls (t=4.97, 4.46, 7.18, P<0.05 all);(5)The area under receiver operating characteristics curve (AUC) of MCI was 0.894, and its optimal cut-off value was-265.7 (%×degree) with sensitivity of 82.6%and specificity of 78.7%. Conclusion MCI based on STE, combining myocardial strain and cardiac twist, may be an accurate predictor in identifying potential cardiotoxicity in postoperative chemotherapeutic survivors with breast cancer.

Objective To investigate the diagnostic value of assisting stress ultrasound elastographic quantitative parameter in determination of the thrombus age in an ex-vivo model of venous thrombi.MethodsAfter 1,3,6 and 9 days,9 saphenous vein samples with venous thrombosis were scanned by both tissue touch elasticity image and acoustic radiation force impulse (ARFI) respectively.For each group of thrombus age,a mean sheer strain was calculated in all thrombosis samples of the respective age.Furthermore,correlation of two sample data was analysed.Results The stiffness of thrombus age group of 1,3,6 and 9 days by tissue touch elasticity image were (49.23±14.91)%,(68.75±10.03)%,(80.82±10.29)% and (91.98±4.10)% respectively with significant differences among the parameters (P<0.05).Quantitative data of thrombus age groups correlated positively by two kinds of these elasticity image significantly (r=0.702,P=0.000).Conclusions The assisting stress ultrasound elastographic method with HM% in this experiment setting of venous thrombosis is proved to be helpful in determination of the age of venous thrombi.The present results obtained in our experiment might provide a potential application in evaluation of deep vein thrombosis by the elastographic technology clinically.

Objective:To explore the influencing factors of chronic atrophic gastritis (CAG) with peripheral neuropathy.Methods:Patients with CAG in Zhoupu Hospital Affiliated to Shanghai University of Medical&Health Science from October 2015 to October 2018 were prospectively selected and divided into peripheral neuropathy group (149 cases) and no peripheral neuropathy group (398 cases). Serum creatinine, serum gastrin, vitaminA, vitaminB1, vitaminB6, vitaminB9 (folic acid), vitaminB12, vitaminE, Serum 25 hydroxyvitamin D3(25(OH)D3) and helicobacter pylori (HP) were measured.The peripheral nerve conduction velocity was detected before and after the treatment.The influencing factors of CAG with peripheral neuropathy were analyzed, and the correlation between potential vitamin content and peripheral nerve conduction velocity was analyzed.One way ANOVA was used to assess changes in patients after treatment.Results:Folic acid ( OR=0.412, 95% CI 0.280-0.607, P<0.001), vitamin B12 ( OR=0.974, 95% CI=0.968-0.979, P<0.001) and 25(OH)D3 ( OR=0.759, 95% CI=0.711-0.810, P<0.001) were the independent protection factors of CAG with peripheral neuropathy.The motor nerve conduction velocity of the median nerve was positive related with serum folic acid ( r=0.443, P=0.019), vitamin B12 ( r=0.482, P=0.028) and 25(OH)D3 level ( r=0.331, P=0.020). After treatment, serum folic acid ( F=5.013, P=0.028), vitamin B12 ( F=6.051, P=0.016) and 25(OH)D3 levels ( F=5.630, P=0.020) gradually increased, the motor nerve conduction velocity of median nerve ( F=8.336, P=0.005) also gradually increased. Conclusion:Vitamin B12, folic acid and vitamin D are protective factors for CAG patients with peripheral neuropathy.

Objective To understand the molecular characteristics of Streptomycin(SM)resistance in multidrug-resistant tuberculosis(MDR-TB)in Jiangxi Province,and to explore the relationship between SM resistant genes(rpsL,rrs and gidB)mutations and SM resistant phenotypes in Beijing genotype TB.Methods 106 non-replicated MDR-TB isolates were collected from Gaoxin Branch of The First Affiliated Hospital of Nanchang University and Jiangxi Provincial Chest Hospital from January to December 2021,and tested for drug-resistance phenotypes,whether they were Beijing genotype or not and the characteristics of rpsL,rrs and gidB gene mutations.Chi-square test was performed to determine whether rpsL,rrs and gidB mutations were related to genotypes and drug-resistance phenotypes.Results Among 106 cases of MDR-TB,76 cases were resistant to SM.A total of 58 cases had rpsL 43A>G mutation,8 cases had 88A>G mutation,5 cases had rrs mutation,and 3 cases had gidB mutation.Statistical analysis showed that the coincidence rate of gene mutation and phenotypic drug-resistance detection was 89.6%,and the specificity and sensitivity were 86.7%and 90.8%,respectively.The isolated rate of Beijing genotype TB was 88.7%,and the drug-resistant gene mutations were mainly concentrated in rpsL and rrs,while the drug-resistant mutations of non-Beijing genotype were mainly concentrated in gidB;in addition,Beijing genotype bacteria were more prone to gene mutations(P = 0.013),but there was no difference in phenotypic drug-resistance.Conclusions Mutations in rpsL,rrs,and gidB genes have a good coincidence rate with phenotypic drug-resistance,and molecular biology can be used to detect directly drug-resistance genes to predict bacterial resistance;TB genotypes are strongly associated with streptomycin resistance characteristics.