Objective To assess the differential diagnosis and characteristics of renal benign and malignant tumors with three-dimensional contrast-enhanced ultrasound (3D-CEUS). Methods Totally 68 patients with renal tumors were examined by conventional ultrasound and two-dimensional contrastenhanced ultrasound(2D-CEUS). 3D imaging was reconstructed from 2D imaging, the differential diagnosis of renal tumors with 3D-CEUS was analyzed by comparing with 2D-CEUS. All patients with renal tumors were proved by operational pathology. Results Eighteen patients with renal benign tumors mostly displayed equal or low enhancement, showed "slowly in and slowly out" with 2D-CEUS, while displayed regular peripheral and internal vessels with 3D-CEUS. Fifty patients with renal malignant tumors mostly displayed high enhancement, showed "rapidly in and rapidly out" with 2D-CEUS,displayed winding peripheral vessels and disordered internal vessels with 3D-CEUS. 3D-CEUS may display the vascular characteristics of tumors and showed superior imaging quality to 2D-CEUS ( P ＜ 0.05). Conclusions 3D-CEUS can display the vascular characteristics of tumors and their spatial positions, it plays an important role in differential diagnosis between renal benign and malignant tumors.

Objective To explore the value of contrast-enhanced ultrasound(CEUS) in the diagnosis of hematoma and active hemorrhage of renal trauma. Methods Totally 28 patients with renal trauma were examined by conventional ultrasound and CEUS,respectively,including 24 cases caused after renal biopsy,4closed trauma. The detectability of renal hematoma and active hemorrhage with these two methods were compared. All patients were identified by CT or follow-up studies with ultrasound. Results The detectability of renal hematoma with conventional ultrasound and CEUS were 67. 86% (19/28), 92. 86%(26/28), respectively. There was statistically different for detectability in the diagnosis ( P ＜0.05), and the extent of hematoma was more obvious with CEUS. CEUS diagnosed 7 of 26 were renal hematoma with active hemorrhage,which were difficult to be detected with conventional ultrasound. For renal hematoma,the features of CEUS were no enhancement found in every phase; for renal hematoma with active hemorrhage,the contrast agents overflowed from injured blood vessels and formed irregular remarkable enhanced regions. Conclusions CEUS is useful in diagnosing hematoma and identifying the extent and active hemorrhage of renal trauma,in addition,CEUS is valuable in detecting complications after renal biopsy.

Objective To discuss the imaging characteristics of chromophobic cell renal carcinoma (CCRC) and study the features on the contrast-enhanced ultrasound (CEUS). Methods The CEUS features of CCRC in 28 cases identified by pathology were reviewed. The blood supply and enhancement characteristic were observed and analyzed on time intensity curve parameters. Results The 28 cases of CCRC showed poor blood supply in contrast with the renal cortex. The CCRC presented with heterogeneity enhancement, part of the tumor took on a high wash-in and wash-out, and enhanced less intense than the surrounding renal cortex. The actinomorphous strong echo of the tumors might be revealed with CEUS in 15 cases (54%). The time intensity curve analysis demonstrated that the CCRCs' difference of peak intensity and area under the curve were lower than the renal cortex (P＜0.05), but arrival time, time-to-peak and slope of ascending curve were higher than the renal medulla (P＜0.05). Conclusion The actinomorphous enhancement and poor blood supply in the tumor of CEUS could provide diagnostic evidence for CRCC.

Objective To investigate the value of contrast enhanced ultrasound(CEUS) with microbubbles targeted to vascular endothelial growth factor receptor type 2 (VEGFR2) for imaging tumor angiogenesis in murine tumor models.Methods Established human renal cell carcinomas(RCC) subcutaneous xenograft tumor model in nude mice,microbubbles targeted to VEGFR2(MBV) was prepared,control microbubbles(MBC) and MBV were injected respectively in each mouse,the intensity of each microbubble was compared,the expressions of VEGFR2 in tumors were tested by immunohistochemistry.Results CEUS imaging showed the intensity of MBV and MBC was (6.50±1.43)dB,(2.59±0.99)dB,respectively.There was significantly higher intensity when using MBV compared with MBC (P<0.01).The time to wash out was longer in MBV contrast group compared with MBC group.Immunohistochemistry showed VEGFR2 was highly expressed in novel vessel walls.Conclusions Contrast microbubbles targeted to VEGFR2 can specially enhance the images of RCC and has tremendous significance in the assessment of angiogenesis.

Objective To analyze the misdiagnosis reasons in renal tumors with contrast-enhanced ultrasound (CEUS) and to improve cognition on CEUS. Methods Two-hundred and eighty-five cases were compared with pathology, the images in 22 cases misdiagnosed on CEUS were reviewed retrospectively and the reasons were analyzed. Results The diagnosis accuracy and misdiagnosis rate of CEUS were 92. 28 % (263/285) and 7. 72%(22/285), respectively. In these 22 cases, 9 cases misdiagnosed as renal cell carcinoma (RCC) were conformed by pathology as renal angiomyolipoma(RAMD), showed 5 cases "fast wash-in and fast wash-out", 4 cases "fast wash-in and slowly wash-out". Seven cases were conformed as RCC, in which 5 were misdiagnosed as RAML, showed 4 cases "fast wash-in and slowly wash-out", 1 cases "simultaneously wash-in and simultaneously wash-out", and 2 were misdiagnosed as renal cyst with no enhancement founded. Four cases misdiagnosed as hematoma were conformed as pyelo-carcinoma, with no enhancement founded in renal pelvis. The remaining 2 cases misdiagnosed as inflammatory pseudotumor were conformed as RCC, showed "fast wash-in and slowly wash-out". Conclusions With the high diagnosis accuracy,CEUS is an important method in diagnosis of renal tumors. Analyzing the misdiagnosed reasons may improve the cognition on CEUS and decrease the misdiagnosis.

Objective To investigate the source of the blood flow through ventricular septum in normal subject caused by slice-thickness artifact in echocardiography. Methods Echocardiography was performed in 50 normal subjects without ventricular septum defect by two models of echocardiography unit equipped with two models of transducer, observing the conditions and sections in which the blood flow through ventricular septum could be detected. Results The blood flow through ventricular septum was detected in 8 normal subjects using the certain model of echocardiography unit,especially in parasternal four chambers section and parasternal irregular sections, while the blood flow through ventricular septum wasn't detected in the other 42 subjects by any echocardiography unit. The blood flow through ventricular septum was caused by coronary vessel in atrioventrieular groove proved by combining dynamic observation with anatomy analysis. Conclusions The blood flow through ventricular septum in normal subjects, a kind of slice-thickness artifact in echocardiography,is caused by coronary vessel in atrioventricular groove mapped into intact ventricular septum.

Objective To investigate the expression and significance of FoxM1 in esophageal squamous cell carcinoma ( ESCC) cell lines and tissues.Methods Western blot assay was used to detect the expression of FoxM1in human esophageal epithelial cells and esophageal squamous cell cancer cell lines TE1, TE10, TE11 and Eca109 cells.To determine whether down-regulation of FoxM1 expression could inhibit the aggressive phenotype of ESCC cells, we knocked down the expression of FoxM1 by using FoxM1-shRNA in TE1 cells.Then we detected the cell proliferation, migration and invasion of TE1 cells by MTT assay, scratch assay and transwell assay.Furthermore, the effect of FoxM1 knockdown on tumorigenicity in nude mice was evaluated.Finally, immunohistochemical staining was used to detect the expression of FoxM1 in 99 cases of ESCC tissues and adjacent normal esophageal tissues.χ2 test was used to analyze the correlations between the expression of FoxM1 and clinicopathologic characteristics and prognosis of ESCC patients.Results Western blot data showed that FoxM1 expression was lower in normal esophageal epithelial cells and highly expressed in four esophageal cancer cell lines, especially in TE1 cells.Knockdown of FoxM1 inhibited the growth, invasion and migration of TE1 cells and reduced their tumorigenicity in nude mice.The positive expression rate of FoxM1 in ESCC was 61.6%(61/99), significantly higher than that in the paired adjacent normal tissues (24.2%, 24/99) (P<0.05).The positive expression rate of FoxM1 in ESCC tissues was 61.6%( 61/99 ) , significantly higher than that in the paired adjacent normal tissues ( 24.2%, 24/99) ( P<0.05) .FoxM1 expression was significantly and positively correlated with lymph node metastasis, clinical stage and invasive depth ( P<0.05).The median survival time was 42.3 months in 38 cases of patients with negative FoxM1 expression, and 33.0 months in 61 cases of positive FoxM1 expression, and the difference was statistically significant (P=0.036).Conclusions FoxM1 is highly expressed in ESCC, and significantly correlated with the initiation, development and prognosis of esophageal cancer. FOXM1 might be an indicator to predict the prognosis and serve as a potential target for therapy in esophageal cancer.

Objective To investigate the expression and significance of FoxM1 in esophageal squamous cell carcinoma ( ESCC) cell lines and tissues.Methods Western blot assay was used to detect the expression of FoxM1in human esophageal epithelial cells and esophageal squamous cell cancer cell lines TE1, TE10, TE11 and Eca109 cells.To determine whether down-regulation of FoxM1 expression could inhibit the aggressive phenotype of ESCC cells, we knocked down the expression of FoxM1 by using FoxM1-shRNA in TE1 cells.Then we detected the cell proliferation, migration and invasion of TE1 cells by MTT assay, scratch assay and transwell assay.Furthermore, the effect of FoxM1 knockdown on tumorigenicity in nude mice was evaluated.Finally, immunohistochemical staining was used to detect the expression of FoxM1 in 99 cases of ESCC tissues and adjacent normal esophageal tissues.χ2 test was used to analyze the correlations between the expression of FoxM1 and clinicopathologic characteristics and prognosis of ESCC patients.Results Western blot data showed that FoxM1 expression was lower in normal esophageal epithelial cells and highly expressed in four esophageal cancer cell lines, especially in TE1 cells.Knockdown of FoxM1 inhibited the growth, invasion and migration of TE1 cells and reduced their tumorigenicity in nude mice.The positive expression rate of FoxM1 in ESCC was 61.6%(61/99), significantly higher than that in the paired adjacent normal tissues (24.2%, 24/99) (P<0.05).The positive expression rate of FoxM1 in ESCC tissues was 61.6%( 61/99 ) , significantly higher than that in the paired adjacent normal tissues ( 24.2%, 24/99) ( P<0.05) .FoxM1 expression was significantly and positively correlated with lymph node metastasis, clinical stage and invasive depth ( P<0.05).The median survival time was 42.3 months in 38 cases of patients with negative FoxM1 expression, and 33.0 months in 61 cases of positive FoxM1 expression, and the difference was statistically significant (P=0.036).Conclusions FoxM1 is highly expressed in ESCC, and significantly correlated with the initiation, development and prognosis of esophageal cancer. FOXM1 might be an indicator to predict the prognosis and serve as a potential target for therapy in esophageal cancer.

Objective:To identify new prognostic markers and therapeutic targets for gastric adenocarcinoma.Methods:The public datasets of gastric adenocarcinoma collected from GEO database (GSE33335 and GSE63089) were downloaded for analysis. There were 70 GC tissues and paired normal tissues in the two profile datasets. Differentially expressed genes (DEGs) between GC tissues and normal stomach tissues were selected by the R software. Protein-protein interaction (PPI) of these DEGs were visualized by the Search Tool for the Retrieval of Interacting Genes (STRING). The key gene sets were analyzed by Cytoscape and Molecular Complex Detection (MCODE). The mRNA and protein expression levels of prognosis related genes identified by public database were confirmed by using GC tissues and paired normal tissues collected from July 2019 to September 2019 in Affiliated Hospital of Nantong University.Results:DEGs were identified in the two datasets by using R software. A total of 128 DEGs were detected, including 85 up-regulated genes ( log2FC>1.2 and FDR<0.01) and 43 down-regulated genes ( log2FC<-1.2 and FDR<0.01) in the GC tissues. PPI network model and MCODE model were established by using the Online String tool and Cytoscape software, and 27 key genes were obtained, including 25 genes related with prognosis of GC patients ( P<0.05). We identified 14 significant DEGs in GC tissues, including cyclin B1 (CCNB1), polo-like kinase 1 (PLK1) and pituitary-tumor transforming gene (PTTG1), which were significantly enriched in the cell cycle pathway through KEGG pathway enrichment analysis. The positive expression rate of PTTG1 in GC tissues was 68.8% (22/32), significantly higher than 18.8% (6/32) in normal gastric tissues ( P<0.05). Conclusions:The expression of PTTG1 is different in GC and gastric tissues, implicates it is the key gene in gastric carcinogenesis. The prognoses of GC patients with higher PTTG1 expression are worse. PTTG1 might participate in the development of gastric adenocarcinoma by regulating cell cycle.

Objective:To identify new prognostic markers and therapeutic targets for gastric adenocarcinoma.Methods:The public datasets of gastric adenocarcinoma collected from GEO database (GSE33335 and GSE63089) were downloaded for analysis. There were 70 GC tissues and paired normal tissues in the two profile datasets. Differentially expressed genes (DEGs) between GC tissues and normal stomach tissues were selected by the R software. Protein-protein interaction (PPI) of these DEGs were visualized by the Search Tool for the Retrieval of Interacting Genes (STRING). The key gene sets were analyzed by Cytoscape and Molecular Complex Detection (MCODE). The mRNA and protein expression levels of prognosis related genes identified by public database were confirmed by using GC tissues and paired normal tissues collected from July 2019 to September 2019 in Affiliated Hospital of Nantong University.Results:DEGs were identified in the two datasets by using R software. A total of 128 DEGs were detected, including 85 up-regulated genes ( log2FC>1.2 and FDR<0.01) and 43 down-regulated genes ( log2FC<-1.2 and FDR<0.01) in the GC tissues. PPI network model and MCODE model were established by using the Online String tool and Cytoscape software, and 27 key genes were obtained, including 25 genes related with prognosis of GC patients ( P<0.05). We identified 14 significant DEGs in GC tissues, including cyclin B1 (CCNB1), polo-like kinase 1 (PLK1) and pituitary-tumor transforming gene (PTTG1), which were significantly enriched in the cell cycle pathway through KEGG pathway enrichment analysis. The positive expression rate of PTTG1 in GC tissues was 68.8% (22/32), significantly higher than 18.8% (6/32) in normal gastric tissues ( P<0.05). Conclusions:The expression of PTTG1 is different in GC and gastric tissues, implicates it is the key gene in gastric carcinogenesis. The prognoses of GC patients with higher PTTG1 expression are worse. PTTG1 might participate in the development of gastric adenocarcinoma by regulating cell cycle.