1.The value of contrast-enhanced ultrasonography in differential diagnosis of cystic renal carcinoma
Xiaojie XIN ; Yiran MAO ; Sheng ZHANG
Tianjin Medical Journal 2016;44(2):230-233
Objective To evaluate the values of contrast-enhanced ultrasound in diagnosis of cystic renal cell carcino-ma. Methods A total of 73 patients with renal cystic lesions were included in this study. The image features of ultrasound and contrast-enhanced ultrasound examination were analysed. All of patients underwent surgical treatment and had patholog-ical results. The diagnostic values of the ultrasound and contrast-enhanced ultrasound were analyzed by evaluating the im-age features of cystic renal cell carcinoma. Results There were 64 cases of cystic renal cell carcinoma, 9 cases of benign cyst. With ultrasound and color doppler ultrasound,irregular shape, thickness wall, solid ingredients, divisions and more blood flow signals were found in cystic renal cell carcinoma. Renal cyst showed regular shape, few solid component and thin separation and inconspicuous blood flow signals. In contrast-enhanced ultrasound, cystic renal cancer contrast agent appear-ing time was (15.13±4.21)s, and reached the peak time (23.42±5.68)s, fade time was (28.42±4.27)s. The enhanced mode for fast in and fast out was found in 22 cases (34.3%), fast in and slow out in 30 cases (46.8%), slow in and fast out in 2 cases (3.2%), slow in and slow out in 4 cases (6.4%), and synchronously in and out in 6 cases (9.3%). The hyper-enhancement was found in 42 cases (65.6%), the iso-enhancement and hypo-enhancement in 22 cases (34.4%). In renal cyst, There were three cases out of contrast filling. In other 6 cases, the contrast agent appearing time was (16.67±2.73)s, the peak time was (25.83±3.06)s and fade time was (34.17±4.26)s. The enhanced mode for fast in and fast out was found in 1 case (16.7%), fast in and slow out in 1 case (16.7%) and synchronously in and out in 4 cases (66.6%). The hyper-enhancement was found in 2 cases (33.3%), the iso-enhancement and hypo-enhancement in 4 cases (66.7%). The sensitivity, specificity, positive predic-tive value, negative predictive value and accuracy of ultrasound were 85.9%, 66.7%, 94.8%, 40.0%and 83.6%. The sensitiv-ity, specificity, positive predictive value, negative predictive value and accuracy of contrast-enhanced ultrasound were 92.2%, 77.8%, 96.7%, 58.3%and 90.4%. Conclusion Contrast-enhanced ultrasound can be used in benign and malignan-cy identification of renal cystic lesion.
2.Research advances in contrast-enhanced ultrasound in the diagno-sis of renal lesions
Xiaojie XIN ; Yiran MAO ; Chunxiang LI ; Sheng ZHANG
Chinese Journal of Clinical Oncology 2015;(6):363-365
Renal cell carcinoma is one of the most common tumors in the urinary system. Most of these tumors are malignant. The incidence of renal tumors has increased in recent years. Contrast-enhanced ultrasound examination is increasingly applied in clinics and has become a common diagnostic method for renal lesions. Contrast-enhanced ultrasound can clearly show the organization of tu-mor blood vessels and capillaries and provide dynamic observation of the blood perfusion status of normal human tissues and tumor tis-sues. This review discusses the situation and value of contrast-enhanced ultrasound in renal tumor treatment.
3.Effect of community-based rehabilitation training on cognitive disorders of cerebral apoplexy patients
Fangjun WANG ; Furong MAO ; Fang WANG ; Huilan JIANG ; Yanfang WANG ; Yiran ZHAO ; Xu JIN ; Lixia XU
Chinese Journal of Primary Medicine and Pharmacy 2011;18(8):1014-1016
Objective To study the effects of community-based rehabilitation on cerebral apoplexy patients with cognitive disorders.Methods 30 cases of cerebral apoplexy patients were enrolled according to relevant standards,who were given standard rehabihtation care in Community Health Service Center(training group) ,while another 30 similar cases from subordinate health service stations (control group) given only rehabilitation guidance once a week.Two groups were not do professional cognitive training.All patients were assessed with Mini Mental State Examination( MMSE), Fugl-Meyer Assessment(FMA) and modified Bathel index rating scale(MBI) to evaluate their cognition ,movement function and activity of daily living(ADL) before training as well as after 4-week and 8-week training.Results There was no signficant difference in cognition,movement functions and ADL between training group and control group before treatment(P>0.05).The differences in the assessment of Brounnstrom scale and MBI between two groups after 4-week training were not significant( P > 0.05 ).The scores of Fugl-Meyer scale, MMSE and Barthel index of the training group after 8-week training were significantly higher than those of control group( all P < 0.05 ).Conclusion Community-based rehabilitation training could improve the movement functions and ADL,and cognitive functions of cerebral apoplexy patients.
4.Clinical value of neoadjuvant chemotherapy in the treatment of local advanced cervical cancer
Yu ZHANG ; Xiaomao LI ; Yuebo YANG ; Mao LIU ; Yiran TAO ; Yu ZHOU ; Qiang ZHAO
Journal of Chinese Physician 2010;12(8):1029-1032
Objectives To evaluate the clinical value of neoadjuvant chemotherapy (NACT) in the treatment of local advanced cervical cancer. Methods We searched the clinical trials on the treatment of local advanced cervical cancer with NACT followed by surgery versus initial surgery on English and Chinese published literatures from the main medical data resources (MEDLINE, PUBMED, ELSEVIER ScienceDirect, CNKI). The data about positive pelvic nodes, interstitial infiltration, vascular invasion, positive surgical margin, 3-year overall survival (OS), 3-year disease-free survival (DFS), 5-year OS, 5-year DFS were extracted from these papers, and a meta-analysis was applied. Result The hazard ratio (HR) of positive pelvic nodes on NACT group versus control group was 0. 54(95% CI 0. 33 ~0. 86), HR of interstitial infiltration was 0. 45(95% CI 0. 24 ~0. 86), HR of vascular invasion was 0. 25(95% CI 0. 16 ~0. 38), all differences were statistically significant. And HR of positive surgical margin was 0. 45 ( 95% CI 0. 21 ~0. 99), P = 0. 05, which indicated the difference was not statistically significant. And there were also no significant difference on the HR of 3-year OS, 3-year DFS, 5-year OS and 5-year DFS, and their RR were 1.18(95% CI 0. 84 ~ 1.66) ,1.31 (95% CI 0. 96 ~ 1.78) ,0. 89(95% CI 0. 68 ~ 1.15) ,and 0. 99(95% CI 0. 71 ~ 1.93) respectively. Conclusion For local advanced cervical cancer, NACT could reduce pathological risk factors but it did not improve the survival.
5.In Situ Investigation on Electrochemical Polymerization and Properties of Polyaniline Thin Films by Electrochemical Surface Plasmon Resonance
Jichang ZHANG ; Yan MAO ; Wei WANG ; Yiran GUAN ; Yu BAO ; Li NIU
Chinese Journal of Analytical Chemistry 2015;(3):350-355
A new type of surface plasmon resonance ( SPR) spectroscopy system was designed and built. Here, a kind of dual photocell sensor was developed as a detection device to achieve a rapid measurement of SPR angle within a certain range. This SPR system was combined and integrated with electrochemical workstation to obtain a new type of electrochemistry-time-resolved SPR ( EC-TR-SPR ) instrument via instrumental technique. This EC-TR-SPR instrument was used to characterize the electrochemical polymerization process of aniline to validate the spectroscopic characteristics. Applications of transient electrochemical characterization methods, including chronoamperometry and differential pulse voltammetry, confirmed the time resolution and the applicability of this instrument system toward the steady state and transient electrochemical methods upon small molecular reactions. The experiment results showed that this EC-TR-SPR possessed the time resolution up to 10000 times per second (0. 1 ms), and could be used to real-time investigate the doping and de-doping of polymerization process of aniline monomer as well as the prepared polyaniline film, which could not be discriminated on a conventional electrochemical current-time curve. .
6.Application value of superb microvascular imaging for diagnosis of renal solid masses
MAO YIRAN ; MU JIE ; ZHAO JING ; ZHAO LIHUI ; XIN XIAOJIE
Chinese Journal of Clinical Oncology 2017;44(21):1082-1085
Objective:To investigate the application value of superb microvascular imaging (SMI) in benign and malignant renal lesions by comparing with power Doppler imaging (PDI). Methods:Retrospective analysis was performed on 48 cases of renal lesions in 47 pa-tients screened via PDI and SMI at Tianjin Medical University Cancer Institute and Hospital. A total of 10 and 38 cases of benign and malignant lesions were identified, respectively. We compared the diagnostic efficiency between the two methods by determining blood flow grade, distribution pattern, morphology, and ring-like blood flow. Results:Statistically significant differences in ring-like blood flow (P<0.05) but not in blood flow grade, distribution pattern, and morphology (P>0.05) were observed between benign and malignant renal tumors as detected by PDI. In SMI, statistically significant differences in blood flow grade, distribution pattern, mor-phology, and ring-like blood flow were identified between benign and malignant renal tumors (P<0.05). The sensitivity, specificity, and area under the receiver operating characteristic curve of PDI and SMI were 71.05%, 70.00%, and 0.705 and 89.47%, 90.00%, and 0.897, respectively. Significance in diagnostic efficacy between PDI and SMI was detected (P=0.025). Conclusion:Compared with PDI, SMI can more accurately describe blood flow grade, distribution pattern, morphology, and ring-like blood. Thus, SMI can improve the accuracy of differential diagnosis of benign and malignant renal tumors.
7.Early diagnosis and prediction for lateral cervical lymph node metastases of medullary thyroid microcarcinoma
Jing ZHAO ; Weijing HAO ; Yiran MAO ; Jie MU ; Xiaojie XIN ; Sheng ZHANG ; Xiangqian ZHENG ; Xi WEI
Chinese Journal of General Surgery 2021;36(6):416-420
Objective:To evaluate the clinical and ultrasonographic features for early diagnosis and prediction of lateral cervical lymph node metastasis of medullary thyroid microcarcinoma.Methods:From Jan 2010 to Jan 2020 233 patients undergoing primary surgery were categorized as "medullary thyroid microcarcinoma" and "medullary thyroid macrocarcinoma". The preoperative clinical and ultrasonographic characteristics, the diagnostic positive rate of preoperative serum calcitonin and fine needle aspiration (FNA) were investigated between two groups. All patients with medullary thyroid microcarcinoma were divided on the basis of wether there was lateral cervical lymph node metastasis.Results:There were statistically significant differences in initial diagnostic method(χ 2=32.290, P=0.000), TNM staging(χ 2=50.300, P=0.000) between medullary thyroid microcarcinoma and medullary thyroid macrocarcinoma. Medullary thyroid microcarcinoma showed more malignant ultrasonic features. The diagnostic accuracy of preoperative serum calcitonin was higher than FNA for medullary thyroid micro carcinoma(χ 2=47.933, P=0.000). Multivariate regression analysis demonstrated that the abutment/perimeter ≥1/4( OR=25.475, 95%CI: 2.320-279.771), preoperative serum calcitonin >65 ng/L( OR=32.663, 95%CI:2.433-438.409) were the independent factor for lateral cervical lymph node metastases of medullary thyroid microcarcinoma. Conclusions:The combination of ultrasonography and serum calcitonin helps establish early diagnosis of medullary thyroid microcarcinoma. Medullary thyroid microcarcinoma with the abutment/perimeter ≥1/4, serum calcitonin >65 ng/L predicts lateral cervical lymph node metastases.
8.The value of clinical and ultrasound factors to predict postoperative tumor recurrence of medullary thyroid carcinoma
Jing ZHAO ; Lei ZHANG ; Wenjing HOU ; Lihui ZHAO ; Yiran MAO ; Jie MU ; Jialin ZHU ; Xiangqian ZHENG ; Xi WEI
Chinese Journal of General Surgery 2023;38(10):738-743
Objective:This study aimed to investigate the risk features of postoperative tumor recurrence of medullary thyroid carcinoma.Methods:One hundred and seventy two patients with medullary thyroid carcinoma diagnosed at Tianjin Cancer Hospital between Jan 2010 and Jan 2018 were enrolled in this study. Based on the follow-up results, patients were divided into tumor recurrence and non-tumor recurrence group. US features,clinicopathological characteristics and somatic RET mutations were evaluated between the two groups. The cut-off values of pre-and post-operative serum calcitonin were calculated by ROC curve.Univariate and multivariate analysis were adopted between the two groups to determine independent risk factors for tumor recurrence of MTC.Tumor-free survival was determined by Kaplan-Meier analysis.Results:Univariate analysis showed that preoperative serum calcitonin≥1 367 pg/ml ( χ2=18.909, P=0.000), postoperative serum calcitonin ≥61 pg/ml ( χ2=72.278, P=0.000), mulifocality ( χ2=11.787, P=0.001),lesions in both lobes ( χ2=10.452, P=0.003), extrathyroidal invasion ( χ2=14.511, P=0.000), T3+T4-staging ( χ2=11.920, P=0.001)、TNMⅢ+Ⅳ-staging ( χ2=18.915, P=0.000), ACR TI-RADS 5 ( χ2=7.162, P=0.006) and RET mutation ( χ2=10.937, P=0.001) were significantly related to tumor recurrence of medullary thyroid carcinoma. Multivariate analysis demonstrated that postoperative serum calcitonin≥61 pg/ml ( OR=22.323, 95%CI: 6.370-78.236) and RET mutation ( OR=4.054, 95%CI: 1.354-12.139) were the independent factors related to tumor recurrence of medullary thyroid carcinoma.The survival curves of MTC patients showed a significantly lower percentage of surviving patients in the group with postoperative serum calcitonin ≥61 pg/ml ( P=0.000) or RET mutations ( P=0.001). Conclusions:Postoperative serum calcitonin ≥61 pg/ml and oncogenic RET mutation were the independent risk factors for tumor recurrence of MTC.Patients with postoperative serum calcitonin ≥61 pg/ml or a RET mutation tended to have a shorter tumor-free survival.
9.Application of superb microvascular imaging in renal cystic masses
Jie MU ; Xiaojie XIN ; Yiran MAO ; Lihui ZHAO ; Sheng ZHANG
Chinese Journal of Ultrasonography 2017;26(10):887-890
Objective To compare the difference of colour Doppler flow imaging(CDFI)and superb-microvascular imaging(SMI)for detecting blood flow in cystic renal mass,and explore the consistency of conventional ultrasound combined with SMI and Contrast-enhanced ultrasonography(CEUS) in the diagnosis of renal cystic masses based on the Bosniak classification system,so as to evaluate the diagnosis value of SMI in renal cystic masses.Methods Fifty-five patients with renal cystic mass were enrolled in this study and underwent conventional ultrasound,CDFI and SMI.Patients with renal cystic mass at category Ⅱ for higher received contrast-enhanced ultrasonography additionally.The diagnostic performance of SMI and CEUS were evaluated based on final diagnosis obtained by follow-up or pathology diagnosis after surgery.Results In 55 cases,44 cases got the pathological diagnosis afer surgical resection including 38 cases of malignant masses,and 6 cases of benign masses.CDFI and SMI showed significant difference in tumor flow imaging(P <0.05).Kappa Value of SMI and CEUS was 0.866.The sensitivity,specificity, accuracy,positive predictive value and negative predictive value of SMI were 94.8%,75.0%,89.1%,90.2% and 85.7% respectively.Conclusions SMI is superior to CDFI in displaying micro-vascular of separated and solid structure in renal cystic masses.SMI has a better consistency with CEUS in Bosniak classification.SMI can improve the accuracy of non-invasive ultrasound in the diagnosis of renal cystic lesions.
10.Comparative study of superb micro-vascular imaging and power Doppler imaging in the diagnosis of different size solid breast tumors
Yiran MAO ; Jie MU ; Jing ZHAO ; Lihui ZHAO ; Xiaojie XIN
Chinese Journal of Ultrasonography 2018;27(4):328-333
Objective To compare the diagnostic efficiency of superb micro-vascular imaging ( SMI) and power Doppler imaging ( PDI) in differentiating different size breast tumors . Methods Retrospective analysis were performent in a total of 170 cases of breast tumors of 144 patients screened with SMI and PDI in our hospital from August 2016 to July 2017 ,and pathological results were finally obtained . These tumors were divided into two groups according to the maximum diameter 2 .0 cm . SMI and PDI diagnostic efficiency were compared by showing blood flow distribution ,vascular morphology and Alder grade . Results There were 68 benign tumors and 102 malignant tumors .When the maximum diameter was no more than 2 .0 cm ,there were no significant difference in the blood flow distribution ,vascular morphology and Alder grade between PDI and SMI of benign tumors( all P > 0 .05) ;However ,there were significant differences in the vascular morphology and Alder grade of malignant tumors( all P < 0 .05) ,but no difference in blood flow distribution( P = 0 .174) ;The area under the curve of ROC by PDI and SMI were 0 .724 and 0 .844 ,thus , the difference was statistically significant( P = 0 .024) . When the maximum diameter was more than 2 .0 cm ,the between PDI and SMI differences in blood flow distribution ,vascular morphology and Alder grade were not statistically significant ( all P > 0 .05) in benign tumors ,but there was statistical difference in vascular morphology ( P = 0 .001) in malignant tumors ,and there was no significant difference in blood flow distribution ,Alder grade in malignant tumors between PDI and SMI ( all P > 0 .05) . The area under the curve of ROC by PDI and SMI were 0 .768 and 0 .802 ,the difference was not statistically significant ( P = 0 .447) . Conclusions SMI can show the blood flow characteristics more clearly in breast tumors . When the maximum diameter is no more than 2 .0 cm ,SMI diagnostic efficiency is better than PDI .