ObjectiveTo explore the feasibility of detecting liver stiffness by virtual touch tissue quantification (VTQ) technique and establish a reference range of shear-wave velocity in healthy liver of adults.MethodsOne hundred and sixty-one healthy adults underwent VTQ detection to obtain the shearwave velocities of livers.Each subject received VTQ measurement in four parts of liver.Ten subjects were performed twice by two sonographers,respectively.Results① The liver shear-wave velocities of 161 healthy adults had a 95％ confidence interval from 1.089 to 1.105 m/s.Shear-wave speed values of intrahepatic different parts had no statistically significant.The ICC of measurement value of four parts in healthy liver was 0.80(95 ％ CI:0.75- 0.85).②The difference of shear-wave velocities in healthy livers in different age groups had no statistically significant,whereas the mean values in different gender had statistically significant (P =0.001).③No statistically significant was observed between the mean shear-wave velocity values obtained by different operators (P =0.82).ConclusionsThe liver shear-wave velocities of the healthy group have a reference range from 1.089 to 1.105 m/s.VTQ technique has a good reproduction and stability,therefore,using this technology to assess hepatic stiffness is noninvasive and feasible.

Objective To assess the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of BI-RADS-US 4 breast lesions.Methods A total of 123 lesions underwent CEUS.The CEUS features of lesions were categorized into 5 malignant or benign indexes respectively,lesions displaying any two of the five features were diagnosed as malignant or benign.The diagnostic effect of CEUS for BI-RADS-US 4 lesion was analyzed according to the pathological results as the gold standard.Results CEUS of the 123 BI-RADS-US 4 breast lesions indicated that 75 lesions were malignant while 48 were benign.Pathological results confirmed that there were 72 malignant lesions and 51 benign.The proportions of malignant lesions in 4A category,4B category and 4C category were 16.2 ％,58.5 ％ and 93.3 ％ respectively.The accuracy,sensitivity,specificity,positive predictive value,and negative and positive predictive value of CEUS for the diagnosis of BI-RADS-US 4 lesions were calculated as 92.7％,95.8％,88.2％,92.0％ and 93.7 ％ respectively.Lesions showing false positive in CEUS mainly needed surgical treatment,such as fibroma with active growth mesen-chyme,intraductal papilloma and granulomatous mastitts.Conclusions Surgical treatment rather than aspiration biopsy are suggested for those diagnosed being malignant in CEUS of the BI-RADS-US-4 lesions,as they can be treated as BI-RADS5 lesions.Short-term visit or aspiration biopsy are suggested for BI-RADS-US-4 lesions diagnosed being benign in CEUS.

Objective To investigate diagnostic efficiency of vascular parameters in the diagnosis of BI-RADS Ⅳ breast masses using three-dimensional power Doppler ultrasound (3D-PDUS).Methods After adjusting the ultrasonic instrument under property conditions,3D-PDUS were applied to scan BI-RADS Ⅳ breast masses before surgery with QLab software,the following parameters of breast masses were obtained:total tumor volume,vascularization index (VI),flow index (FI),and vascularization flow index (VFI).According to the pathological results,the diagnostic value of vascular parameters from 3D-PDUS were assessed with receiver operating characteristic (ROC) curve,and the diagnostic efficiency were analyzed by best cut-off limits of various vascular parameters.Results The volume and vascular parameters of benign group were remarkably lower than those of malignant group (all P ＜0.001).The area under the ROC curve (AUC) of VI (0.873) ＞VFI (0.866) ＞FI (0.778).AUC of FI was significantly smaller than that of VI (P =0.016) and of VFI (P =0.039),while no statistical difference between that of VI and of VFI (P =0.294).The diagnostic accuracies of VI (cut-point:1.2,sensitivity:84.1％,specificity:83.3 ％,accuracy:83.8 ％) and of VFI (cut-point:0.5,sensitivity:82.5 ％,specificity:85.2％,accuracy:82.9％) were higher than that of FI (cut-point:35.3,sensitivity:74.6％,specificity:70.4 ％,accuracy:72.6 ％).AUC of VI (P =0.001) and of VFI (P =0.033) in small-volume group (＜2cm3) were both larger than those of large-volume group (≥2 cm3),no significant difference in AUC of FI between these two groups (P =0.09).Conclusions Vascular parameters obtained using 3D-PDUS have affirmative value in the diagnosis of BI-RADS Ⅳ breast masses,especially in masses less than 2 cm3 in volume.

Objective To measure volume of breast cancer , calculate tumor volume doubling time (TVDT), and analyze the correlated factors affecting TVDT using three-dimensional ultrasound (3D-US). Methods We applied 3D-US to measure the volume of breast cancer of BI-RADS-US 4A classified by conventional ultrasound. The breast cancer case scanned by 3D-US at least twice (the interval is 3 months at least) without any medical intervention were included in the study. We calculated TVDT according to the formula, and analyzed the affecting factors of TVDT using multiple linear regression. Results Sixty-nine cases were enrolled in the study. The TVDT of breast cancer were from 66 to 521 days , in an average of 185 ± 126 days and the median time of 164 days. We found that: ① there were no statistics significances in TVDT between different breast cancer pattern , smoothing border lines , speculated sign , hyperechoic halo , microcalcification and different rear echo (P > 0.05). ② TVDT of different age groups, lymph node metastasis, pathological grade and NPI score were significantly different (P < 0.05), while menstrual cycle, family history of breast cancer and molecular typing showed no difference (P > 0.05). ③ TVDT of patients with different expression of ER, PR and Ki-67, molecular typing showed statistically difference (P < 0.05), but there was no significant difference between different level of HER2 (P >0.05). ④ multi-factor analysis showed that the NPI score, lymph node metastasis, Ki-67 and molecular typing of breast cancer were relative factors in TVDT (P < 0.05). Conclusions The NPI score , lymph node metastasis , Ki-67 and molecular typing significantly correlate with TVDT of breast cancer. Triple-negative breast cancer in molecular typing has the fastest growth rate.

Objective To compare the clinical and ultrasound features of Klebsiella pneumoniae liver abscess(KPLA) in dia‐betes mellitus(DM ) patients with different levels of HbA1c .Methods Totally 146 patients with diabetes mellitus of Klebsiella pneumoniae liver abscesses(KPLA‐DM )were divided into three groups on the basis of their levels of HbA1c:complete glycemic controlled (HbA1c≤7% );good glycemic controlled (7% < HbA1c≤9% );bad glycemic controlled (HbA1c>9% ) .The patients′characteristics ,clinical features ,ultrasound features and complications among the three groups were compared .Results Compared with patients in complete glycemic controlled group and good glycemic controlled group ,patients in bad glycemic controlled group had lower onset age and longer length of hospital stay(P<0 .05) ,are more susceptible to underlying diseases such as hyperlipoi‐demia and chronic renal failure(P<0 .05) ,had more life‐threatening clinical crisis ,and had higher infection rate(P<0 .05) .KPLA‐DM could be characterized by patchy ,mass like enhancement echoultrasound image .Patients in bad glycemic controlled group al‐so had higher risk of biliary pneumatosis ,hepatic venous thrombosis and gas‐forming pyogenic liver abscess than other two groups (P<0 .05) .Conclusion The ultrasound image of KPLA has characteristics .The occurrence of hepatic venous thrombosis and gas‐forming observed by ultrasound is associated with bad glucose control in KPLA‐DM patients ,which suggests that there may be oth‐er complications such as metastatic infection .

Objective To introduce the construction of clinical research information system of a tertiary grade A comprehensive hospital in Shanghai.Methods Based on the database construction,the structured inpatient medical records,surgical records and ancillary diagnostic report are designed and the application terminal is developed.Results A full-link normalized clinical research information system for research-based cases covering all aspects of clinical research is developed,which can provide customized and structured data.Conclusions The clinical research information system provides convenience for clinical medical research,and its practice has certain reference significance.

BACKGROUND: LINC01234, a long noncoding RNA (lncRNA), is overexpressed in several cancers, including colorectal cancer (CRC). We investigated the role of LINC01234 in CRC development and confirmed its correlation with Krüppel-like factor 6 (KLF6), a tumor suppressor gene that is dysregulated in CRC. METHODS: We tested mRNA levels using quantitative reverse transcription PCR (qRT-PCR). Tissue samples from patients with CRC, inflammatory bowel disease (IBD), hyperplastic polyp, and adenoma were included. Correlations between clinicopathological parameters, overall survival (OS) rate, and LINC01234 were analyzed using Kruskal-Wallis H test. Additionally, cell proliferation, apoptosis, and tumor formation in nude mice were tested to investigate the mechanism of LINC01234. Western blotting was used to determine protein levels. RESULTS: LINC01234 expression was significantly upregulated in CRC tissues and CRC cell lines than in non-tumor tissues and normal epithelial cells, respectively. LINC01234 was associated with high tumor stage, larger tumor size, and metastasis. Patients with higher LINC01234 expression showed reduced OS. Cell proliferation was inhibited by LINC01234 knockdown, whereas apoptosis was enhanced. Mice injected with SW480 cells with LINC01234 knockdown displayed decreased tumor volume, weight, and Ki-67 levels compared with those injected with control cells. KLF6 was negatively regulated by LINC01234. Overexpression of KLF6 showed effects similar to those observed following LINC01234 knockdown on cell proliferation and apoptosis. CONCLUSIONS LINC01234 could be a prognostic biomarker in CRC patients. Upregulation of LINC01234 in CRC promotes tumor development through negative regulation of KLF6.