Objective To evaluate the application of ultrasound elastography (UE) 5-point scores and ratio of traced area in diagnosis of breast diseases. Methods One hundred and thirty foure patients with 178 lesions were examined with UE. And 5-point scores were applied at first, and then the area ratios were calculated. The receiver operating characteristic (ROC) curve was established to evaluate diagnostic value. The histology results were used as the golden standard. The optimal cut-off point was calculated. Results The sensitivity, speciifcity and accuracy of 5-point scores (score≥4) were 78.8%, 93.8%and 91.0%respectively. The sensitivity, speciifcity and accuracy of ratio of traced area were 75.8%, 95.8%, 92.1%respectively. There was no signiifcant difference between these two diagnostic methods (Ρ>0.05). The cut-off of ratio of traced area was 1.45. When combining these two methods, the sensitivity, speciifcity and accuracy were 90.9%, 98.6%, 97.2%respectively. The accuracy was signiifcantly improved (Ρ<0.05). Conclusions The ratio of traced area and 5-point scores were both valuable diagnostic approaches. The combination of the two methods can improve the accuracy of diagnosis.

Objective To investigate the protective effects of alpha-lipoie acid (ALA) against beta-cell damage in streptozotocin (STZ)-induced diabetes in rats. Methods Thirty SD rats were randomly divided into three groups: normal control (NC) group, STZ group and ALA + STZ group, with 10 rats in each group. mg/kg, intraperitoneal injection), till the end of the study (4 weeks later). Blood glucose were measured every 3 days after STZ injection. Malondialdehyde (MDA) and reduced glutathione (GSH) levels were measured in pancreatic homogenates. Pancreatic beta-cells were examined by immunohistocbemical methods, Results STZ induced a significant increase of the level of blood glucose. Body weight of rats in ALA + STZ group was (341±26)g, which significantly lower than (368±3)g in NC group, and high than (301±2)g in STZ group with stas(P < 0. 05). Meanwhile the MDA levels in STZ group and NC group were(1.22 ± 0. 14) and(0.57 ± 0.04)nmoL/mg prot, respectively, and there was significant difference between the two groups (P < 0.05) ; the GSH levels in STZ group and NC group were(16.54 ± 1.10) and(25.46 ± 0.62) mg/g prot (P < 0.05), respectively; degeneration of islet cells and decreased blood glucose were observed in STZ + ALA-pretreated rats; MDA level in pancreatic homogenates was(0.72 ± 0. 23)nmoL/mg prot, which was significantly lower than that in STZ group (P < 0.05) ; the GSH level was (35.33 ± 2.66) mg/g prot, which was significantly higher than that in STZ group (P < 0.05) ; increased staining of insulin and preservation of islet ceils functions were more obvious in the STZ + ALA-pretreated rats. Conclusions ALA exerted its protective effect through reducing the oxidative stress and preserving pancreatic beta-cell integrity.

ObjectiveTo investigate the expression of T lymphocytes and activated subsets in patients with HIV/AIDS and early latent syphilis. MethodsT lymphocytes and activated subsets ( HLADR+ CD3 +/CD3 + , HLA-DR+ CD4 +/CD4 + and HLA-DR+ CD8 +/CD8 + ) as well as rapid plasma reagin (RPR) and treponema pallidum particle agglutination (TPPA) test were detected by flow cytometry in 78 patients with HIV/AIDS, 66 patients with HIV/AIDS and early latent syphilis, and 30 healthy subjects. SPSS 13.0 was used for statistical analysis, and t (for normal distribution) or Mann-Whitney U (for skew distribution) tests were performed to compare between the groups. ResultsThe absolute counts of CD4+ T cells in patients with HIV/AIDS and early latent syphilis were significantly higher than those in HIV/AIDS patients ( t = 2. 041 and 2. 223, P ＜ 0.05 ), but no difference in the counts of CD3 + T cells and CD8 + T cells was observed (tcD3 =0. 362 and 0.692, tcD8 =0.043 and 0.617, P＞0.05). HLA-DR+ CD4 +/CD4 +level in AIDS plus syphilis group was much higher than that in HIV plus syphilis group ( t = 2. 647, P ＜ 0. 05 ), but no difference was observed in HLA-DR+ CD3 +/CD3 + and HLA-DR+ CDs +/CDs + ( t = 1. 112 and 0. 093, P ＞ 0.05). ConclusionsImmune function in patients with HIV/AIDS and early latent syphilis may be enhanced temporarily.

Objective To evaluate the diagnostic value of cerebrospinal lactate for the diagnosis of bacterial meningitis in patients post-neurosurgical operation (PNBM) with blood-contaminated cerebrospinal fluid (CSF). Methods A prospective observational study was conducted. 101 patients underwent neurosurgical operation and clinically suspected PNBM admitted to neurosurgical intensive care unit (NSICU) of the First Affiliated Hospital of Sun Yat-sen University from October 2015 to December 2016 were enrolled. Based on red blood cell quantitative test in CSF, the patients were divided into blood-contaminated and non blood-contaminated CSF groups. According to the PNBM diagnostic criteria of 2008 Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN), all patients were divided into PNBM group and non-PNBM group. The biochemical indexes levels in CSF were compared among the groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic power of CSF lactate for PNBM in blood-contaminated patients.Results A total of 101 suspected PNBM patients were enrolled. In 77 blood-contaminated CSF patients, 39 patients were diagnosed as PNBM (account for 50.6%); in 24 non-blood-contaminated patients, 12 patients were diagnosed as PNBM (account for 50.0%). ① In non-PNBM patients, the lactate level in blood-contaminated CSF was significantly higher than that of non-blood-contaminated CSF (mmol/L: 3.5±1.3 vs. 2.3±1.1,P < 0.01). In PNBM patients, there was no significant difference in lactate level between blood-contaminated CSF and non blood-contaminated CSF (mmol/L: 6.8±2.1 vs. 6.9±2.5,P > 0.05). ② In both blood-contaminated and non blood-contaminated CSF, white blood cell (WBC), protein and lactate levels in PNBM group were significantly higher than those in non-PNBM group [WBC (×106/L): 660.0 (67.5, 1105.0) vs. 41.0 (15.0, 142.5) in blood-contaminated CSF,168.0 (86.5, 269.5) vs. 34.5 (7.0, 83.5) in non-blood-contaminated CSF; protein (mg/L): 4757.8 (2995.2, 10219.8) vs. 1292.8 (924.2, 1936.2) in blood-contaminated CSF, 39247.3 (14900.6, 62552.2) vs. 1441.6 (977.3, 2963.9) in non blood-contaminated CSF; lactate (mmol/L): 6.8±2.1 vs. 3.5±1.3 in blood-contaminated CSF, 6.9±2.5 vs. 2.3±1.1 in non blood-contaminated CSF, allP < 0.05], and glucose and CSF glucose/blood glucose ratio in PNBM group were significantly lower than those in non-PNBM group [glucose (mmol/L): 2.5±1.2 vs. 4.4±1.6 in blood-contaminated CSF, 1.9±1.4 vs. 3.4±0.9 in non blood-contaminated CSF; CSF glucose/blood glucose ratio: 0.28±0.15 vs. 0.46±0.16 in blood-contaminated CSF, 0.24±0.16 vs. 0.45±0.11 in non blood-contaminated CSF, allP < 0.01]. ③ It was shown by ROC curve analysis that CSF lactate level was a good diagnostic parameter for PNBM both in blood-contaminated and non blood-contaminated CSF, and the area under ROC curve (AUC) was 0.91 and 0.97, respectively. When the cutoff value of lactate in non blood-contaminated CSF was 3.35 mmol/L, the sensitivity was 100%, and the specificity was 91.7%. When the cutoff value of lactate in blood-contaminated CSF was 4.15 mmol/L, the sensitivity was 92.3%, and the specificity was 71.1%, and the combination of CSF lactate and glucose achieved better diagnostic specificity (AUC = 0.96, sensitivity was 97.4%, specificity was 84.2%).Conclusions Blood in CSF led to the elevation of CSF lactate as compared with that in non-blood-contaminated CSF of patients with PNBM. CSF lactate was still a good diagnostic parameter for PNBM both in blood-contaminated patients, and the combination of CSF lactate and glucose achieved better diagnostic specificity.

Objective To study the repairing effect of bone marrow mesenchymal stem cells (BMMSCs) on the donor liver after cardiac death (DCD) under normal temperature mechanical perfusion (NMP) in rats.Methods BMMSCs of Wistar rats were cultured in vitro,and 45-min warm ischemia after cardiac death model was established.The 30 Wistar rats were randomly divided into NMP,NMP + BMMSCs (N + B),cold storage (CS) groups,and the parameters were detected at 2 h and 4 h (n =10).Results N + B group was superior to NMP group and CS group in repairing the liver function and liver pathology including ultrastructure,improving the perfusate acidic environment,and increasing adenosine triphosphate level (P ＜ 0.05).The oxygen consumption of NMP group and N + B group were significantly different after 2h [2 h:(24.35 ±0.64) ml/min vs.(29.33 ±0.47) ml/min;3 h:(25.33 ±0.86) ml/min vs.(30.34 ± 0.49) ml/min;4 h:(26.88 ± 1.07) ml/min vs.(31.76 ± 0.96) ml/min;P ＜ 0.05],suggesting that the liver condition in N + B group was significantly better than that in the other two groups.Conclusion Bone marrow mesenchymal stem cells could obviously repair the DCD grafts under normal temperature mechanical perfusion.

Background Recent researches show that oxidative stress is involved in the progress of keratoconus.Nuclear factor-E2-related factor 2-antioxidant response element (Nrf2-ARE) pathway plays a critical role in the defense against oxidative stress,but its function in keratoconus is unclear.Objective To investigate the differences of Nrf2-ARE signaling activation and matrix degenerating enzymes between keratoconus and normal corneal stromal cells.Methods Corneal stromal cells were isolated from keratoconus and normal cornea by using dispase and collagenase digestion.The cells were treated with hydrogen peroxide (H2O2) to mimic in vivo oxidative stress condition.Reactive oxygen species (ROS) production was measured by fluorescence substrate DCHF-DA incubation.Nrf2 level and the expression of Nrf2-ARE downstream antioxidant genes were analyzed by Western blot and real-time quantitative-PCR(RT-qPCR).The activity of matrix degenerating enzymes,including urokinase-type plasminogen activator (uPA)-uPA receptor (uPAR) system and matrix metalloproteinase-2 (MMP-2) were assessed by Western blot and gelatin zymography respectively.Results In normal culture,keratoconus corneal stromal cells assumed increased basal ROS and Nrf2 level when compared with normal cells(t =18.155,P＜0.01).However,after H2O2 treatment,the keratoconus corneal stromal cells showed increased ROS production,while decreased Nrf2 translocation and no significant difference in expression levels of Nrf2-ARE downstream antioxidant genes (Nrf2:t =62.123,P＜ 0.01 ; (nicotinamide adenine dinucleotide phosphate quinine oxidoreductase-1 [NQO-1]:t =2.209,P =0.092 ; hemo oxygenase-1 [HO-1]:t =0.293,P =0.784 ; superoxide dismutase [SOD2]:t =0.749,P =0.495).The contents of uPA-uPAR and the activity of MMP-2 also showed a higher level in keratoconus corneal stromal cells than normal cells,with significant differences between them (t =19.164,15.458,4.818,all at P＜0.01).Conclusions The defect of Nrf2-ARE signaling activation exists in the keratoconus corneal stromal cells,and correlats with the abnormal expression level of stromal degeneration enzymes,which suggests that the defect of Nrf2-ARE signaling activation may be involved in the progression of keratoconus.

Objective:To investigate the correlation between total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio and unstable carotid plaque.Methods:From February 2021 to May 2021, adult patients with asymptomatic carotid atherosclerotic plaque admitted to the Department of Neurology, the First People's Hospital of Lianyungang were retrospectively enrolled. The demographic and related clinical data were collected. Carotid artery plaques were detected by ultrasound, and the subjects were divided into a stable plaque group and an unstable plaque group. Multivariate logistic regression analysis was used to assess the independent risk factors for unstable carotid plaques. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of TC/HDL-C ratio for unstable carotid plaques. Results:A total of 362 patients with asymptomatic carotid atherosclerotic plaque were enrolled, including 226 (62.43%) in the stable plaque group and 136 (37.57%) in the unstable plaque group. Multivariate logistic regression analysis showed that after adjusting for confounding factors, only TC/HDL-C ratio was the independent risk factor for unstable carotid plaque (taking the 1 st quintile array of TC/HDL-C ratio as a reference, the 4 th quintile array: odds ratio 3.13, 95% confidence interval 1.50-6.55, P=0.002; the 5 th quintile array: odds ratio 6.75, 95% confidence interval 3.21-14.22, P<0.001). ROC curve analysis showed that the area under the curve of TC/HDL-C ratio for predicting unstable carotid plaque was 0.691 (95% confidence interval 0.634-0.748; P<0.001), the optimal cut-off value was 4.38, and the sensitivity and specificity were 50.0% and 82.7%, respectively. Conclusion:TC/HDL-C ratio is an independent risk factor for unstable carotid plaques and has a certain predictive value for unstable carotid plaques.

Objective To investigate the expression of Circulating tumor cells ( CTCs ) in peripheral blood cells of patients with different stages of Small-Cell Lung Cancer ( SCLC) ,and to evaluate its significance in early diagnosis of lung cancer metastasis.Methods Thirty-five patients with SCLC ( 12 in limited stage and 23 in extensive stage ) and 25 patients with benign lung disease were recruited at the Shanghai Changhai Hospital from April 2011 to April 2013.Samples were prepared from 7.5 ml peripheral venous blood and collected in CellSave tubes.The CTC counts were determined using CellTracks AutoPrep fluorescence scanning system according to the manufacturers′instructions.The expression of CTCs in peripheral blood of SCLC patients and benign lung disease patients were analyzed.The expression of CTCs in different stages of SCLC was measured and compared.Furthermore, samples were prepared from 2 ml peripheral venous blood by centrifugation.The serum levels of NSE Neuron specific enolase were measured.The relationship between the expression of CTC and NSE was analyzed.Results CTCs positive rates in SCLC were significantly higher than in benign lung disease controls [ Positive rates of CTC≥1 were 80.0%and 12.0%(χ2 =27.003,P<0.000 1),CTC≥5 were 51.4%and 0 (χ2 =18.367,P<0.000 1), CTC≥10 were 34.3%and 0(χ2 =10.714,P<0.001),CTC≥50 were 17.1 and 0(P=0.036,P<0.05), respectively ].CTCs positive rates in SCLC extensive stage were significantly higher than limited-stage [Positive rates of CTC≥1 were 58.3% and 91.3%(P=0.033,P<0.05), CTC≥5 were 65.2% and 25.0%(P=0.035,P<0.05), respectively].The expression of CTCs was significantly correlated with NSE (r=0.743 7, P<0.000 1).Conclusion The expression of CTC in SCLC patients is significantly higher than those in control group , and is closely related to clinical stages , which may provide new clues to early predicting of SCLC metastasis and deterioration.

Objective:To systematically assess the diagnostic value of automated breast volume scanning (ABVS) versus hand-held ultrasound (HHUS) in benign and malignant breast lesions.Methods:The Cochrane Library, PubMed, Embase, Ovid, China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biology Medicine (CBM) and other databases were searched from the beginning of database construction to January 2022. Relevant literatures were screened and included, and the characteristics of the literatures were extracted. Meta-disc 1.4 statistic software was used to analyze the pooled diagnostic odds ratio (DOR), specificity, sensitivity, 95% CI, the summary receiver operating characteristic (SROC) curve and the area under the curve of ABVS and HHUS. The heterogeneity and publication bias were also evaluated. Results:A total of 26 studies were included. Heterogeneity test showed no threshold value effect; random effect model was used to pool specificity, sensitivity and DOR.The pooled sensitivity of ABVS and HHUS was 0.86 (95% CI 0.84-0.87), 0.80 (95% CI 0.78-0.82), respectively; I2 was 89.7% and 82.3%, respectively; the pooled specificity of ABVS and HHUS was 0.91 (95% CI 0.90-0.92), 0.84 (95% CI 0.83-0.86), I2 was 89.7% and 92.2%, respectively. AUC of ABVS, HHUS, and joint diagnosis of the two was 0.954, 0.883, 0.958, respectively. No evidence of publication bias was shown in the funnel plot analysis. Conclusion:ABVS has a higher clinical value compared with HHUS in the diagnosis of benign and malignant breast lesions.

Objective To observe the effect of oral massage combined with trial feeding on dysphagia in neonates with hypoxic- ischemic encephalopathy (HIE). Methods We enrolled 30 hospitalized newborns who were diagnosed moderate to severe HIE with dysphagia in the NICU of our hospital from January 2016 to December 2017. According to the random number table method, these newborns was divided into control group and study group. Oral massage combined with trial feeding were given in the study group, nasogastric feeding in the control group and family participatory care and the treatment of nutritional neurodrugs were also given in two groups. To campare the oral milk remnant, feeding time and sucking action after the flow of milk and swallowing, oral feeding time, gastric tube indwelling time and length of stay in two groups. Results After 5 days intervention, the clinical manifestations of dysphagia in two groups were compared, and there were 6 cases, (8.50 ± 1.05)ml, (36.40 ± 2.87)min and 10 cases of oral milk remnant, feeding time and sucking action after the flow of milk and swallowing respectively in the study group, and 15 cases were 15 cases, (10.80 ± 0.39 )ml, (42.29 ± 1.60) min, 3 cases in the control group, respectively. The difference between the two groups was statistically significant ( χ2=12.86, t=7.52, 6.93, χ2=6.66, P<0.05). The oral feeding time, gastric tube indwelling time and hospitalization time of the study group were (15.60±1.35) d, (11.73±1.39) d, and (21.47±2.03)d, and the control group were (17.00±0.65) d , (14.13±0.99) d, (23.27 ± 1.16) d, respectively. The difference between the two groups was statistically significant (t=3.61, 5.45, 2.98, P<0.05). Conclusions For children with dysphagia, oral massage and combined feeding before each feeding can promote the improvement of oral motor nerves in children, and improve feeding effect, and promote rehabilitation of children.