Objective To retrospectively study the quantitative features and diagnostic value of 3-dimensional shear wave elastography (3D-SWE) in breast lesions.Methods A total of 198 consecutive women with 198 breast lesions (125 malignant,73 benign) were included,who underwent conventional ultrasound (US) and 3D-SWE before surgical excision.Quantitative parameters of transverse planes,sagittal planes and coronal planes were calculated,including maximum elasticity (Emax-w),mean elasticity (Emean-w),standard deviation (Esd) of the whole lesion and ratio between the stiffest elasticity (Emean-s)in the lesion and the fatty tissue (Eratio).Area under ROC curve(AUC) for combination of quantitative parameters and US were calculated.Results The AUC,sensitivity and specificity for US were 0.919,88.0％ and 78.1 ％,respectively.In the total 198 lesions,Emax-w,Emean-w,Esd,Eratio and Emean s were significantly lower in coronal planes than those in transverse and sagittal planes (all P ＜0.001).AUC for combination of each quantitative parameter and US were significantly higher than those of US (all P ＜0.05),except Emean-w of transverse plane,while there was no significant difference among the three orthogonal plane (P＞0.05).Sensitivity significantly increased by combining US with Emean-s,Eratio (transverse,sagittal and coronal planes),Emean-w (coronal and sagittal planes) or Esd (coronal and transverse planes) (all P＜0.05).Combination of US and Emean w of coronal plane yielded significantly higher sensitivity than those of transverse and sagittal planes.Conclusions Combination of quantitative features of 3D-SWE and US can significantly increase diagnostic accuracy and sensitivity in breast lesions.Emean-w of coronal plane yields the highest sensitivity.

Objective To retrospectively study the anisotropy of shear wave elastography (SWE)quantitative parameters of breast lesions,and the correlation with histopathology.Methods A total of 281 consecutive women with 281 breast lesions (179 malignant,102 benign) were included,who underwent conventional ultrasound (US) and 2D SWE before surgical excision.Three acquisitions each for transverse and longitudinal planes were obtained,and maximum elasticity (Emax),mean elasticity (Emean),standard deviation (Esd) of the whole lesion and ratio between the elasticity in the mass and the fatty tissue (Eratio)were recorded.Anisotropic difference (AD) and anisotropy factors (AF) were calculated,and correlation with histopathology was analyzed.Results The average Emax,Emean and Esd of transverse planes were significantly higher than those of longitudinal planes.AF showed positive correlation with quantitative elasticity (Emax,Emean,Esd and Eratio) (P =0.000),and was significantly higher in malignant lesions than that in benign besions (P =0.000).AUC of AF was significantly higher than that of AD (P ＜0.001).AF was significantly higher in invasive ductal carcinoma than that in ductal carcinoma in situ.Higher AF was associated with higher histopathological grades of invasive ductal carcinoma (P =0.000),and correlated with ER/PR(+).Conclusions Anisotropy of SWE is an indicator of malignancy of breast lesions,and is of predictive value for prognosis in breast cancer.

Objective To investigate the influence of breast pure mucinous carcinoma size on sonographic characteristics and diagnostic accuracy.Methods Sonographic characteristics of 101 breast pure mucinous carcinoma in 1 00 patients were analyzed retrospectively.All lesions were divided into three groups according to maximum diameter at ultrasound.These were group Ⅰ with lesions less than 20 mm,group Ⅱwith lesions greater than or equal 20 mm,less than 40 mm,and group Ⅲ with lesions greater than or equal 40 mm.The relationship between lesions size and ultrasound parameters were analyzed.Results There were 38 lesions in group Ⅰ,52 lesions in group Ⅱ and 1 1 lesions in group Ⅲ.The patients age in group Ⅲwere older than that in group Ⅰ(F=3.442,P =0.036).Among these sonographic appearances,only shape (χ2=9.813,P =0.005)and blood flow (χ2=27.952,P =0.000)indicated significant differences.The accuracy of ultrasound diagnosis of breast cancer was 85.1%,the smaller the lesions were,the higher misdiagnosis rate the lesions were.Conclusions With lesions size increased,the lobular and internal blood flow of pure mucinous carcinoma increased.More smaller the lesions were,more higher misdiagnosis rate of lesions were.

Objective To investigate the value of ultrasound-guided diffuse optical tomography (US-guided DOT) to predict clinical efficacy of breast cancer neoadjuvant chemotherapy (NAC).Methods Eighty-eight breast cancer patients with 93 lesions were included.Pre-and post-last chemotherapy,the size,total hemoglobin concentration (THC) of each lesion were measured by ultrasonography (US) and US-guided DOT.Based on the guidelines to evaluate the response to treatment in solid tumors,the lesions of treated breast cancer patients were divided into 4 types of responses to NAC:complete response (CR),partial response (PR),stable disease (SD),and progressive disease (PD).Efficient groups include CR and PR groups.Results As expected,no significant difference was found in size and THC for untreated lesions (all P ＞0.05).However,for the treated lesions(P =0.001),THC,pre-vs post-treatment size changes (△Size％) (P =0.002) and THC changes (△THC％) (P ＜0.001) were significantly varied among CR,PR,SD,PD groups.When compared with pre-treated,tumor sizes after treatment were changed significantly in all CR(P ＜0.001),PR(P ＜0.001),SD (P =0.023) and PD (P =0.001),while significant change of THC was only found in CR(P ＜0.001),PR(P ＜0.001) and SD (P =0.002).When △THC％ =23.9％ as the threshold for prediction of NAC efficiency,the area under the curve of ROC was 0.75,and the sensitivity was 73.7％,specificity was 76.5 ％,positive predictive value was 93.3 ％,negative predictive value was 39.4％,accuracy was 74.2％.Conclusions △size％ changes in consistent with △THC％ among the intergroups,but their changes levels are different,the highest change percent appears in CR,gradually decreased in PR,SD groups.△THC％ will contribute to predict preoperative clinical NAC efficacy.

Objective To explore effects of midwifery consultation clinic for pregnant women to choose the delivery mode. Methods A total of 200 cases of pregnant women from gynecology clinic were collected and divided into two groups:study group (n = 100) and control group (n = 100). The control group performed routine health education while the study group performed personalized psychological intervention and midwifery consultation clinic on the basis of routine health education. The difference of delivery mode was compared between two groups. Results The delivery mode was similar between two groups before intervention but there were significantly different after intervention. Conclusions Midwifery consultation clinic can correct the cognition of delivery and birth process, mastery the coping skills of delivery, decrease the incidence of abdominal delivery, promote the incidence of normal childbirth and enhance the quality of delivery.

Objective: To assess the risk of public health emergencies in Zhejiang Province, March 2021. Methods: An expert counsel was conducted to assess the risk of coronavirus disease 2019 ( COVID-19 ) , enteritis due to norovirus, chicken pox and influenza by professionals in Zhejiang CDC, based on the information from infectious disease and public health emergency surveillance in Zhejiang Province, domestic health administrative departments, World Health Organization, and European CDC. Results: In March 2021, the risk of imported COVID-19 epidemic will be high in Zhejiang Province, and the possibility of local spread could not be ruled out. The possibility of a large-scale outbreak of enteritis due to norovirus and a small-scale outbreak of chickenpox in schools and kindergartens could not be ruled out after the new term begins. An increased risk of influenza epidemic is predicted in collective units such as schools and kindergartens, yet the risk of a large-scale one will be low. Conclusion High attention should be paid to COVID-19 and enteritis due to norovirus, and general attention should be paid to chicken pox and influenza outbreak.

Objective · To investigate the impacts of hepatitis B virus (HBV) infection on the metabolomic phenotype of HepG2 human hepatoma cells.Methods · With gas chromatography-mass spectrometry (GC-MS), metabolite composition of HepG2 and HepG2.2.15 cells (derived from HepG2 cells transfected with a plasmid containing HBV) were analysed. Results · GC-MS analysis mainly found 34 metabolites in both HepG2 and HepG2.2.15 cells,including glycine (Gly), alanine (Ala), valine (Val), leucine (Leu), isoleucine (Ile), proline (Pro), serine (Ser), threonine (Thr), methionine (Met), cysteine (Cys), cystine, aspartic acid (Asp), glutamic acid (Glu), pyroglutamic acid, phenylalanine (Phe), tyrosine (Tyr), tryptophan (Trp), hypoxanthine, uracil,myo-inositol, lactic acid, succinic acid, linoleic acid, linolenic acid, palmitic acid, stearic acid, urea, cholesterol, etc. These metabolites were involved in multiple metabolic pathways including glycolysis and metabolism of fatty acids, amino acids, purines and pyrimidines. Compared with HepG2 cells,HepG2.2.15 cells had significantly higher levels in lactic acid, linolenic acid, Ala and Cys, but lower levels in Leu, Ile, Val, Phe, Met, Trp, Pro, Tyr, myoinositol and uracil. Conclusion · HBV infection dysregulates the metabolism of amino acids and fatty acids in hepatocytes. GC-MS analysis provides complimentary information about HBV-induced metabolic changes of host cells.

Adolescent ; Brain ; pathology ; Child ; Craniopharyngioma ; pathology ; physiopathology ; therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Pituitary Neoplasms ; pathology ; physiopathology ; therapy

Abstract: Objective　To analyze the association between drug resistance and the risk of latent tuberculosis infection and disease among household contacts of patients with pulmonary tuberculosis, and to explore whether the compensatory mutation of drug-resistant Mycobacterium tuberculosis will enhance its pathogenicity or transmission ability. Methods　The English and Chinese databases, including PubMed, web of science, EMBASE, Cochrane library database, CNKI and Wanfang database, were searched by computer from the time of establishment of the database to January 2022. Cohort studies on the risk of infection and disease among household contacts of patients with drug-resistant and sensitive pulmonary tuberculosis were searched and screened according to the inclusion and exclusion criteria. The data were extracted and evaluated by NOS scale, using stata16.0 software meta-analysis to calculate the combined effect of tuberculosis infection and disease risk of family contacts, and carry out heterogeneity test, subgroup analysis and sensitivity analysis. Results　A total of 7 cohort studies involving 9653 TB index cases and 29, 734 house contacts were included. The results of meta-analysis showed that compared with drug-sensitive pulmonary tuberculosis patients, the risk of tuberculosis infection in house contacts of drug-resistant pulmonary tuberculosis patients was increased (OR=1.56, 95%CI=1.25-1.96, P<0.001), but there was no difference in the risk of incidence (RR=1.06, 95%CI=0.80-1.41, P=0.67>0.05). Subgroup analysis showed that the risk of latent tuberculosis infection in house contacts was affected by the study area, and the size of family contacts had an impact on the risk of TB . Sensitivity analysis showed that the results of meta-analysis were robust. Conclusion　Compared with drug sensitive TB patients, household contacts with drug-resistant TB patients had a higher risk of tuberculosis, but there was no difference in the risk of TB among the two groups.

Objective To describe the current status of adjustment in colostomy patients, and explore the related factor. Methods Ostomy Adjustment Scale (OAS) was used to measure the level and degree of adjustment of. 129 colostomy patients. The data were analyzed with Software SPSS 13.0. Results Colostomy patients had a moderate level of general adjustment(128.6 ±19. 38), while 33. 3% patients had a low level of adjustment, 63. 6% patients had a moderate level of adjustment and 3. 1% patients had a high level of adjustment. Adjustment level of colostomy patients was influenced by some factors, including occupation, payment mode of medical cost (P < 0. 05). Conclusions Most of patients have a low to moderate level of adjustment, only few shows completely adjustment, the level adjustment of colostomy patients need to be improved.