Objective To describe the sonographic features of abdominal wall endometriosis(AWE).Methods 105 consecutive women with proven pathological endometriosis of the abdominal wall were retrospectively recruited.The clinical data and the result of the sonographic examinations were reviewed and described.The AWE lesions were divided into ＜3 cm and ≥3 cm groups according to their maximum diameter.Results The sonographic feature of AWE includes irregular hypoechoic nodules with ill-defined margins,anechoic and hyperechoic ring maybe exist.In color Doppler,most of them showed few internal vascularity.Compared with≥3 cm group,＜3 cm group nodules manifested as shorter latent period,with more superficial location,round or oval shape,peripheral hyperechoic ring and none or few vascularity were more common.As for ≥3 cm group nodules manifested as longer latent period,with deeper location,irregular shape,abundant of vascularity were more common.Conclusions Specific diagnosis of AWE can be made by using high frequency sonography combined with clinical features.More accurate information can be provided by judging the size,range and infiltrative depth.

Objective To study the effect of selective COX-2 inhibitor NS398 on IL-10 and IFN-γexpression in human keratinocytes induced by UVA,and further to explore the effect on anti human skin photoaging.Methods HaCaT cells were divided into three groups:simple UV exposure group,NS398-intervene group and blank group.For UV radiation,simple UV exposure group and NS398-intervene group were irradiated with UVA at a dose of 30 J/cm2.In order to assess the effect of NS398,HaCat cells were treated with NS398 at the dose of 0,20,40,80μmol/L respectively and then incubated without irradiation for 2h,substrate changed and cultured for 24h,and then the expression of IL-10 and IFN-γ mRNA was detected via RT-PCR.Results Simple UV exposure group had obviously higher expression of IL-10 mRNA and lower expression of IFN-γ mRNA than that of control group,while NS398-intervened group had significantly lower expression of IL-10 mRNA and higher expression of IFN-γ mRNA than that of simple UV exposure group,and dose-dependency existed.Conclusions NS398 may delay photo-damage of human skin via inhibiting the expression of IL-10 mRNA and up-regulating the expression of IFN-γ mRNA in human keractinocytes.

Objective To study the effects of uhrashortwave and low frequency pulsed electromagnetic fields on the expression of vascular endothelial growth factor(VEGF) in fracture healing. Methods Fifty-six New Zeal-and rabbits with artificial fractures were randomly divided into 4 groups:a control group,an ultrashortwave group,a low frequency pulsed electromagnetic field group and an ultrashortwave combined with low frequency pulsed electro-magnetic field group(combined group),with 14 in each group.Radiographic evaluation of callus formation and frac-ture healing,pathohistological examination and detection of VEGF expression through immunohistochemical staining were performed at the 1 st,2nd,4th and 6th week after the operation. Results Radiographic examination showed that there was significantly greater callus formation in the combined group than in the other groups throughout the healing process. Pathohistological examination also revealed significantly more cartilage islets and callus formation in the combined group.At the 1 st,2nd and 4th week after the operation,VEGF positive indexes in the combined group were significantly higher than in the other groups. Conclusion Uhrashortwave combined with low frequency pulsed electromagnetic field exposure can up-regulate the expression of VEGF and thus can accelerate fracture healing.

Objective:The stimulate angiogenes effect and mechanism of Shexiangbaoxin Pills on coronary collateral development in the hearts of experimental myocardial infarction rats were studied. Methods:24 myocardial infarction rats were randomly divided into 3 groups, 8 rats in group A were treated with Shexiangbaoxin Pills, 8 rats in group B were treated with Beifuji and heparin, and 8 rats in group C were treated with 0.9% normal saline as control. Infarct area, the contents of VEGF、bFGF and VⅢ factor, and vascular density in the edge of infarct section were measured after 6 weeks treating.Results: Infarct area in group A was obviously less than that in group C, the contents of VEGF、bFGF and VⅢ factor in the edge of infarct section and vascular density in group were significantly increased compared with those in group C. Conclusions: Shexiangbaoxin Pills could stimulate angiogenesis of the collateral branch of coronary artery in ischemic myocardium of rats and showed good protective on myocardial ischemia.

Objective To measure total hemoglobin concentration (THC) of breast lesion using US-guided diffused optical tomography(DOT) and to investigate the THC optimal threshold value in different size breast lesions.Methods DOT was performed on 500 breast lesions and surgical pathology was as the gold standard.The optimal diagnostic threshold and the efficacy were figured out.Results There were 265 benign and 235 malignant lesions.In malignant lesions,THC of ≥2 cm lesion group was higher than that of ＜2 cm lesion group(P =0.000).In benign lesions,there was no statistical difference between ≥2 cm group and ＜2 cm group (P =0.13).As for ＜2 cm breast lesions,when a THC threshold value of 146.9 μmol/L and 102.2 μmol/L were used,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 74.2％,70.0％,71.7％,62.9％,79.9％ and 86.7％,44.4％,61.6％,51.6％,83％,respectively.As for ≥2 cm breast lesions,when a THC threshold value of 210.4 μmol/L were used,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 74.0％,86.7％,79.1％,89.2％,69.2％.Conclusions THC of breast cancer increased with the increasing size of lesions.The different diagnostic threshold value should be used according to different size lesions so as to enhance sensitivity,specificity and accuracy.

Objective To explore pathological characterization of the enlarged contrast enhanced area of hepatocellular carcinoma ( HCC) on contrast enhanced ultrasonography ( CEUS). Methods Thirty-five HCC patients underwent conventional ultrasonography and CEUS before hepatectomy. The tumor sizes were measured on conventional ultrasonography,CEUS and postoperative resected specimen at the largest section. The infiltration depth of the HCC was observed under microscope in the peripheral area of the tumors. HCC with the size of contrast enhancement area on CEUS 0. 3 cm larger than that on conventional ultrasonography was defined as group A, and the others as group B. The pathological character of the tumor and tissues surrounding the tumor were analyzed and compared between the two groups. Results Among 35 HCC, 40% (14/35) HCC increased in size on CEUS compared with ultrasonography. Of them,9 tumors with increased area on CEUS were confirmed to be invasive HCC on pathology. Using the enlarged contrast enhanced area on CEUS as the diagnostic criteria of invasive HCC, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 90%, 80%, 82.9%, 64.3%, 95. 2%, respectively. Conclusions The contrast enhanced area on CEUS can reflect the infiltrative tumor size more accurately compared with conventional ultrasonography.

Objective To evaluate the clinical value of contrast enhanced uhrasound(CEUS)for uhrasoundguided radiofrequency ablation(RFA)of liver metastasis.Methods One hundred and forty-one consecutive patients with liver metastasis asked for RFA treatment in our department.Of them,102 patients with received CEUS with SonoVue before RFA treatment.Eighty-six of the 102 patients were regarded as indications for RFA by CEUS(Group A).During the same period,another 39 patients who received conventional US without contrast before RFA were served as the control group(Group B).In Group A,the RFA protocol for each case was designed according to CEUS finding,which included perfusion feature,lesion number,size,shape,invasive range,location and relationship between tumor and surrounding structures.In Group B.the RFA protocol for each case was designed according to conventional ultrasound and CT/MRI result.Results In 102 patients who intended to receive RFA treatment,1 6 were excluded from RFA after CEUS examination.Of them,3 patients with 10 tumors received 6-10 sessions of chemotherapy and there were no enhancement within or around tumors.Another 13 cases were found that the invasive range being more than 8 cm in size,tumor number more than 7,and tumor location adhered to diaphragm and second hepatic helium by CEUS.In Grou0 A,CEUS detected additional 1-3 tumors in 36 patients(41.9%).The size range of the 58 new tumors was 8-15 mm.Of these,79.4%(46/58 tumors)were visualized in parenchymal phase.A total of 209 liver metastasis tumors were treated by RFA.CEUS before RFA demonstrated 49.7%(75/151 tumors)were 1arger in size compared with conventional US.Of these,69.3%(52/75 tumors)presented larger in arterial phase,the remaining 30.7%(23/75 tumors)presented larger in parenchymal phase,and the increased area was also ablated.On 1-3 months follow up with CT,the tumor necrosisrate in Group A was 94.7%(198/209 tumors),which was significantly higher than 87.6%(99/113 tumors)in Group B ( P=0.013). During follow-up period, local recurrence were found in 15 tumors (7.1 %) 2-17 months after REA and intrahepatic new tumors developed in 32 patients (37.2%) 2-17 months after RFA in group A,While local recurrence were found in 16 tumors (14.1%) and intrahepatic new tumors developed in 17 patients (43.5%) in group B ( P=0. 041, P ＞0.05, respectively). Conclusions CEUS provides important information for selecting candidation and designing optimal protocol for RFA in liver metastasis. The use of CEUS can increase tumor necrosis rate and decrease post-RFA tumor local recurrence,and then improve efficacy of RFA therapy.

Objective To summarize the manifestation of solid pseudopapillary tumor of the pancreas (SPTP) on ultrasound and contrast-enhanced ultrasound (CEUS) and to investigate the diagnostic value of CEUS. Methods The ultrasound and CEUS images of six patients with SPTP confirmed by pathology were reviewed. According to CEUS record,the enhanced and wash-out time,enhanced speed and degree of tumor were analyzed. Results On ultrasound, SPTP presented as solid, well-circumscribed masses, usually heterogeneous in echo texture, and some of them contained macro-calcification. On CEUS, the tumor enhanced simultaneously or slightly late compared with normal pancreatic tissues. The contrast agent washed out quickly in all tumors than in normal pancreatic tissues. The enhanced degrees were equal to or less than that of the normal pancreatic tissues. Some tumors showed capsule and septum enhancement. Conclusions The manifestation of SPTP on CEUS had some features and may be helpful for differentiation diagnosis combine with ultrasound.

Objective To observe the enhancement pattern of focal liver lesions in cirrhotic patients and to evaluate the value of contrast-enhanced ultrasound(CEUS) in the diagnosis of dysplastic nodule with hepatocellular carcinoma(DN-Ca). Methods One hundred and forty-one cirrhotic patients with 163 focal liver lesions with the size of 1 - 3 cm were included in this study. All the nodules were examined using CEUS with SonoVue and underwent biopsy. The biopsies were performed using 18G needles in the different parts of enhancement. The enhancement patterns of DN-Ca, HCC and regenerative nodule(RN) were analyzed.Results Twenty-one lesions were diagnosed as DN-Ca by biopsy,45 lesions as hepatocellular carcinoma (HCC) and 97 lesions as RN. All the 21 lesions of DN-Ca presented partial enhancement during arterial phase or portal phase and wash-out during the late phase; the other areas of the lesions presented delayed or simultaneous enhancement during arterial phase and 23.8 % (5/21 ) slight wash-out in the late phase. Of the 45 lesions of HCC,82.2 % (37/45) presented global enhancement during arterial phase or portal phase, and 17.8% (8/45) presented inhomogeneous enhancement with no-enhancement in the central area during arterial phase, 100% (45/45) presented wash-out during the late phase. In 97 RNs, 96.9% (94/97)presented delayed or simultaneous enhancement during arterial phase, 3.1% (3/97) presented slightly enhancement during arterial phase;25.8% (25/97) showed wash-out and 74. 2% (72/97) showed no washout during the late phase. The pathological diagnosis was HCC in the enhanced area and hepatocytes regeneration in the un-enhanced area in the 21 DN-Ca. Conclusions CEUS is helpful in predicting the progress from RN to HCC by analyzing the hemodynamics. CEUS can improve the diagnostic accuracy of biopsy by providing more accurate information.

Objective To evaluate the inter-observer variability of static breast sonogram final assessment among observers with different breast imaging experience, using the first edition of the Breast Imaging Reporting and Data System(BI-RADS) for ultrasound. Methods Thirty patients with 30 breast lesions were included who underwent beast lesions resection operation. A pathological diagnosis was available for all 30 lesions:16 (53%) malignant and 14 (47%) benign. Twelve radiologists independently reviewed two sonograms of each lesion, and assigned a final BI-RADS assessment category. Inter-observer variability was measured using kappa statistic. Positive predictive value(PPV) and negative predictive value (NPV) for final assessment were also calculated. Results As for the experienced observers,kappa values of categories 3,4 and 5 were 0.72,0.28 and 0.60,NPV of category 3 was 93% ,PPV of category 5 was 97% ,all of which decreased as the breast imaging experience reduced. PPVs of categories 4a,4b and 4c were 56 % ,88% and 69%, respectively. Conclusions Using BI-RADS final assessment, radiologists with sufficient breast imaging experience can provide accurate and consistent assessment for breast ultrasonography,but the agreement of diagnosis decreased as the breast imaging experience reduced. The clinical feasibility of 4a,4b and 4c subcategories is uncertain.