BACKGROUND: Stem cell factors are hypoxia-induced neural regeneration factors. They stimulate animals' neural regeneration.OBJECTIVE: To observe Nestin and stem cell factor mRNA expressions after ischemia/reperfusion injury in rat brain, and to analyze the time rule of the two.DESIGN: A randomized controlled animal experiment.SETTING: Department of Ultrasound Diagnosis, Affdiated Hospital of Qingdao University Medical College.MATERIALS: Thirty-six healthy female adult Sprague-Dawley (SD) rats were provided by the Shanghai Laboratory Animal Center, Chinese Academy of Science. Nestin and stem cell factor mRNA in situ hybridization kits and 3,3'-diaminobenzidine (DAB)kit were provided by Boster Bioengineering Co.,Ltd (Wuhan, China).METHODS: This study was performed at the Shangdong Key Laboratory for Prevention and Treatment of Encephalopathy from January to June 2005. Thirty-two rats were created into models of ischemia/reperfusion models by occluding left middle cerebral artery with suture. At ischemia 1.5 hours and reperfusion 2, 6, 12, 24 hours, 2, 3, 7, 14 days, 4 rats were separately used in order to observe the expressions of Nestin and stem cell factor mRNA. The other 4 rats were used for sham-operation,in which, suture insertion was omitted, and the other procedures were identical to experimental groups. The expressions of Nestin and stem cell factor mRNA were detected in the cortex, corpora striatum and paraventricular nucleus region in rat brain by in situ hybridization.MAIN OUTCOME MEASURES: Nestin and stem cell factor mRNA expressions in the cortex, corpora striatum and paraventricular nucleus region in rat brain.RESULTS: Thirty-six rats were included in the final analysis. Nestin mRNA and stem cell factor were weakly expressed in the cortex, corpora striatum and paraventricular nucleus region in rats of sham-operation group. After ischemia/reperfusion, Nestin mRNA expression at each time point was significandy higher in the experimental groups (except in the cortex at ischemia 1.5 hours and reperfusion 2 hours, in the corpora striatum at ischemia 1.5 hours and reperfusion 2 and 6 hours and in the paraventricular nucleus region at ischemia 1.5 hours and reperfusion 2, 6 hours and 14 days) than in the sham-operation group (P＜0.05). While stem cell factor mRNA expression at each time point was significandy higher in the experimental groups (except in the cortex at ischemia 1.5 hours and reperfusion 2,6 and 12 hours, in the corpora striatum at ischemia 1.5 hours and reperfusion 2 and 6 hours and in the paraventricular nucleus region at ischemia 1.5 hours and reperfusion 2 hours and 14 days) than in the sham-operation group (P＜0.05).CONCLUSION: The time rule of stem cell factor mRNA expression is basically the same as that of neural stem cell proliferation. It indicates that following cerebral ischemia/reperfusion, stem cell factor mRNA expression may promote the proliferation of neural stem cells.

Objective To observe the effect of propofol target controlled infusion with different blood plasma target concentration on stress reaction during the nasal endoscope operation. Methods Sixty patients with ASA Ⅰ - Ⅱ scheduled for the nasal endoscope operation were divided into three groups by random digits table: each group was 20 patients, group A, B, C was given propofol target controlled infusion with blood plasma target concentration 3,4,5 μ g/mi respectively. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2), blood glucose, serum cortisol, bispectral index ( BIS ), extubation time were recorded before anesthesia,at 30 min after the operation starting and 60 min after the extubation.Results The descent degree of HR and MAP at 30 min after the operation starting were group C ＞ group B ＞ group A (P = 0.024,0.010 );the descent degree of MAP at 60 min after the extubation were group C ＞group B ＞ group A (P = 0.011 ). BIS and extubation time were 65 ± 8 and (25 ± 7) min in group A, 53 ± 11 and( 36 ± 13 ) min in group B, 45 ± 12 and(45 ± 9 ) min in group C, there were significant differences among three groups(t = 2.476,P= 0.023;t = 2.657,P= 0.012). The blood glucose was increased at 30 min after the operation starting and 60 min after the extubation, the ascensus degree were group A ＞ group B ＞ group C (P= 0.000、0.000);the serum cortisol was decreased at 30 min after the operation starting, the descent degree was group C ＞ group B ＞ group A (P= 0.000), increased at 60 min after the extubation, the ascensus degree was group A ＞ group B ＞ group C (P= 0.001 ). Conclusions Propofol target controlled infusion with blood plasma target concentration 4-5 μ g/ml can ensure eligible depth of anesthesia, decrease pain stimulus, remain stable vital sign,depress the stress reaction caused by nasal endoscope operation efficiently,with short extubation time. It is an eligible blood plasma target concentration.

Objective To evaluate the relationship between characteristics of cervical cancer at contrast-enhanced ultrasound and prognostic factors.Methods Thirty-five patients with pathologically confirmed cervical cancer were enrolled in this retrospective analysis.All the patients accepted contrast-enhanced ultrasound examination before the surgery.Relationships between the characters of contrast-enhanced ultrasound and the expression of ki-67 antigen(cell proliferation marker),tumor diameter,lymph node metastasis and histologic grade were studied.Results (1)Compared to the surrounding normal tissue, the cervical cancer had statistically significant differences in time to peak and peak intensity(P <0.05),the former was shortened,and the latter was increased.(2 )The ratio of perfusion defect and heterogeneous enhancement were significantly higher in tissues,including the ki-67 positive expression tissue,poorly differentiated or larger tumors (≥ 2.0 cm in diameter)(P < 0.05 ).(3 )Compared to the ki-67 negative expression group,time to peak of the ki-67 positive expression group was shorter and the peak intensity was higher,the differences were statistically significant (P < 0.05 ).(4 )The peak intensity of poorly differentiated cervical cancers was significantly higher than that of the other groups (P <0.05).Conclusions Enhancement patterns and parameters of contrast-enhanced ultrasound were associated with prognosis, which may be useful in noninvasive prediction of the patients with cervical cancers.

Objective To investigate the ultrasonographic characteristics of angiofollicular lymph node hyperplasia (AFH). Methods The ultrasonographic and pathological characteristics in nine patients with pathologically confirmed AFH were retrospectively analyzed. Results All the 9 patients were hyaline vascular type of AFH. Ultrasonic manifestations included complete capsule, regular shape and clear boundary, internal solide low echo, mild posterior echo enhancement and without cystic degeneration, which was relative to the less incidence of necrosis and hemorrhage on pathologic findings. Calcification in the lesions were found in two patients. Color Doppler flow signals were observed in the periphery of lesions in 9 patients, and rich flow signals were observed in the center of lesions in 2 of them. Conclusion The ultrasonic manifestations of AFH has its own characteristics. The ultrasonic manifestations combined with clinical features are helpful to the differential diagnosis. The final diagnosis depends on pathologic examination.

Objective To explore the value of virtual touch tissue quantification (VTQ) elastography and its influencing factors in identifying benign and malignant thyroid nodules.Methods A retrospective analysis was conducted in 210 cases of 240 thyroid nodules.Their images,including 2D ultrasound,color Doppler flow imaging (CDFI) and VTQ elastography,were reviewed,and the scanning view,the maximum diameter of the nodule,inside blood flow,calcifications and its depth beneath the skin were recorded.The value of shear wave velocity(SWV) in identifying benign and malignant thyroid nodules was calculated using receiver operating characteristic (ROC) curve.The influences of the maximum diameter of the nodules,calcifications,internal blood flow,the depth beneath skin and scanning views as well as type of pathology on the value of SWV were analyzed using multiple linear regressions (MLR).Results The sensitivity and specificity of VTQ in differential diagnosis of benign and malignant thyroid nodules was 74.8％ and 73.4％,respectively,and the area under ROC curve was 0.799.MLR indicated that the maximum diameter of the nodule,the type of pathology and internal blood flow were correlated with the SWV value (P ＜0.05),of which,the type of pathology was the important factor (standardized coefficient was-0.312).Microcalcifications,the depth of the nodules located and the scanning surface were not significantly related to SWV value (P ＞0.05).Conclusions VTQ can quantitatively provide the information on the hardness of thyroid tissue,which is of a definite value in the differential diagnosis of the nodules.The pathology of the nodule,its internal blood flow and maximum diameter are the factors that affect the value of SWV,and not its depth,scanning views and microcalcifications.

Objective To investigate correlative relations between the ultrasonic classification diagnosis and the clinicopathological features of thyroid calcification lesions.Methods The clinical data of 198 cases diagnosed as thyroid calcification lesions by ultrasonic,surgery and pathology were retrospectively analyzed.Spearman method was used to analyze the relationship of TCL ultrasonic diagnosis,clinical pathological traits and the classification of differentiated thyroid carcinoma(DTC).Results Among the 198 TCL cases,ultrasonic diagnosis and pathologic diagnosis were accordant in 178 (90.40％) cases.Among 119(60.10％) cases of thyroid carcinoma (TC),101 cases(84.87％)were papillary carcinoma,11 cases(9.24％)were follicular carcinoma,5 cases(4.20％) were medullary carcinoma and 2 cases(1.68％)were anaplastic carcinoma.Among 79 cases (39.90％) of benign lesions,34 cases(43.04％)were adenoma,27 cases(34.18％)were nodular goiter,and 18 cases(22.78％)were hashimoto's thyroiditis (HT).Calcified classification were as following 74 cases (37.37％)were type Ⅰ a and 4 cases (2.02％) were type Ⅰ b(both were TC);20 cases(10.10％)were type Ⅰ c,among which 19 cases were nodular goiter,and 1 case was TC.Among the 37 cases (23.74％) of type Ⅱ,28 cases were TC,and 19 cases were benign lesions.Among the 20 cases(10.10％) of type Ⅲ,8 cases were TC,and 12 cases were benign lesions.Among 22 cases(11.11％) of type Ⅳ,2 cases were TC,and 20 cases were benign lesions.Among 11 cases(5.56％) of type V patients,2 cases were TC,and 9 cases were benign lesions.The rate of TC with cervical metastasis was 41.18％(49/119).68.91％(82/119) of carcinoma nodules were grade Ⅱ-Ⅲ in color Doppler flow imaging (CDFI),grade 0-Ⅰ were mainly benign nodules,and grade Ⅲ with mussy blood flow in CDFI were HT.Conclusions Type Ⅰ a and Ⅰ b micro calcification is the pathological basis of ultrasonic diagnosis of papillary thyroid carcinoma and follicular carcinoma,which is closely related to DTC.Calcified isolation nodule of type Ⅱ and Ⅲ with level Ⅱ-Ⅲ bleeding is a risk factor for TC.Type Ⅰ c,Ⅲ,Ⅳ and Ⅴcalcification is closely related to benign TCL.CDFI has important value for identifying benign and malignant CLT.

Objective To investigate the influencing factors of strain ratio(SR) value in differential diagnosis of benign and malignant thyroid nodules by using real-time tissue elastosonography (RTE).Methods One hundred and seventy-one patients with a total of 171 thyroid nodules were analyzed retrospectively.Their images,including 2D ultrasound,color Doppler flow imaging (CDFI) and RTE were reviewed and conventional ultrasonic features (including the maximum diameter,composition,shape,magin,calcification,intranodular blood flow,depth) and SR value were recorded.Receiver-operating characteristic (ROC) curve was employed to assess the diagnostic efficiency of SR value in differentiating malignant nodules from benign ones.Firstly,the correlation between the aforementioned factors and SR value was assessed by using malignant lesions as the research subjects.And then,the multiple linear regressions (MLR) was employed to evaluate the influence of particular features which turned out to be an important disturbing factor affecting SR value of the lesion in the first step of analysis and pathological type in all nodules (benign and malignant) on SR value.Results With a cut-off point of SR value 3.67,the sensitivity and specificity of SR value in differential diagnosis of benign and malignant thyroid nodules was 85.6％ and 81.1 ％,respectively,and the area under ROC curve was 0.891.Correlation between the maximum diameter and calcification and SR value was significant(r =0.345 and 0.261 respectively,P ＜0.05).However,there was no significant correlation between other features(5 factors) and SR value(P ≥0.05).MLR indicated that the maximum diameter,calcification and the type of pathology of the nodule were associated with SR value (P ＜ 0.05).Among them,pathological nature was the most significant impact factor with a standardized coefficient 0.494).Conclusions SR value can be used to evaluate the hardness of thyroid nodules semi-quantitatively.Its value mainly depends on the pathological nature of the nodules.The maximum diameter and calcification are also the influencing factors of SR value.However,the composition,shape,margin,intranodular blood flow and depth have no obvious effect on SR value.

Objective To investigate the clinical effects of different urinary diversion regimens after minimally invasive resection of bladder cancer. Methods 127 patients with muscular infiltrating bladder cancer from January 2010 to June 2015 were enrolled in this study. According to the patients' condition, they were divided into orthotopic ileal cystectomy group (58 cases), Bricker bladder surgery group (33 cases), ureteral skin ostomy group (36 cases), then compare the clinical data, postoperative complications and quality of life of the three groups. Results There was no significant difference in the ratio of sex, the distribution of age and tumor staging among the three groups. The operation time and postoperative hospital stay in orthotopic ileal cystectomy group were longer than those in the other two groups. The operation time and postoperative hospital stay of the Bricker bladder surgery group were longer than that in ureteral skin ostomy group, the difference was statistically significant; the bleeding in orthotopic ileal cystectomy group was more than the other two groups, and in Bricker bladder surgery group was more than ureteral skin ostomy group, the difference was statistically significant. There was no significant difference in the recovery time of intestinal function among the three groups. The recovery time of intestinal function in ureteral skin ostomy group was shorter than that in the other two groups, the difference was statistically significant. There was no significant difference in the incidence of short-term complications of the three groups of patients. The incidence of long-term complications of orthotopic ileal cystectomy group was significantly higher than the other two groups, the difference was statistically significant. The social function scores, and overall health score of orthotopic ileal cystectomy group were higher than the other two groups, the difference was statistically significance. Conclusion Without external device, closer to the characteristics of physiological urination, orthotopic ileal cystectomy holds higher postoperative quality of life, and higher incidence of long-term complications. With advantages of quick recovery and less complications, ureteral skin ostomy is best for patients who can not stand for long time surgery. It should choose the appropriate surgical approach for patients according to individuals' conditions.

Objective:To investigate the value of two-dimensional ultrasound combined with shear wave elastography (SWE) in assessing perineal body characteristics in patients with stress urinary incontinence(SUI).Methods:Sixty-four patients with stress urinary incontinence from December 2019 to August 2020 in the Affiliated Hospital of Qingdao University were selected as the SUI group, in addition, seventy healthy females at the same time were selected as the control group. The clinical information data were collected, two-dimensional ultrasound and SWE examination were performed to obtain the perineal body length, height, perimeter, area and the maximum(Emax) and the mean(Emean) modulus of elasticity both at the resting and maximum Valsalva conditions, ROC curve was plotted to evaluate the effectiveness of elastic modulus in evaluating perineal body in SUI.Results:In the resting state, the length, height, perimeter and area of perineal body in the SUI group were not significantly different from those of the control group ( P=0.590, 0.291, 0.082, 0.063). At the maximum Valsalva, the perineal body length, height, perimeter and area in the SUI group were significantly different from those of the control group ( P=0.005, 0.010, 0.001, 0.008). In the resting, the Emax and Emean values of perineal body elastic modulus in the SUI group were higher than those in the control group, but the difference was not statistically significant [(36.61±9.81)kPa vs (34.66±10.38)kPa, (27.43±9.78)kPa vs (26.97±8.85)kPa, all P>0.05]. At the maximum Valsalva, the Emax and Emean of the SUI group were significantly smaller than those of the control group, with statistically significant difference[(47.73±8.03)kPa vs (58.06±10.02)kPa, (35.78±7.89)kPa vs (44.33±9.62)kPa, all P<0.001]. The area under ROC curve of Emax and Emean at the maximum Valsalva was 0.738 and 0.647 respectively, the Emax was better than the Emean in assessment of the characteristics of perineal body in SUI patients. Conclusions:Two-dimensional ultrasound combined with SWE technique can quantitatively evaluate the characteristics of perineal body and provide an important imaging method for the diagnosis of SUI.

Objective: To explore the correlation between ultrasound features and tumor biological variation with calcification morphological types in differentiated thyroid carcinoma (DTC). Methods: The clinical data of 598 patients with DTC calcification diagnosed by ultrasound, surgery and clinicopathology were retrospectively analyzed. According to the 2017 edition of the American College of Radiology (ACR) Thyroid Imaging Report and Data System (TI-RADS) classification system standard, DTC ultrasonic calcification morphological characteristics were divided into 5 types, and the correlation between DTC ultrasonic calcification morphological types and tumor biological characteristics and their variations were analyzed by Spearman correlation analysis. Results: Of the 598 patients, 527 cases (88.13%) were typical papillary thyroid cancer(PTC), 27 cases (4.52%) were typical follicular thyroid cancer(FTC), and 44 cases (7.36%) were variant subtype (including 25 cases of follicular type, 9 cases of high cell type, 6 cases of clear cell type and 4 cases of eosinophilic type). TI-RADS diagnosis: 44 cases (7.36%) were Ⅰ~Ⅲ class, 179 cases (29.93%) were Ⅳ class performing fine needle aspiration cytology(FNAC), 375 cases (62.71%) were Ⅴ class. The coincidence rate between ultrasound and clinicopathological diagnosis was 92.64% (554/598). Morphological types of ultrasonic calcification in 554 cases of DTC: type Ⅰ microcalcification in 416 cases (75.09%); type Ⅱ calcification in 71 cases (12.82%); type Ⅲ calcification in 41 cases (7.40%); type Ⅳ calcification in 20 cases (3.61%); type Ⅴ calcification in 6 cases (1.08%). There were correlations between type Ⅰ, Ⅱ, Ⅲ ultrasonic calcification morphological types and the tumor biological characteristics and its variant subtypes of DTC(r=0.634, 0.592, 0.479; all P=0.01). Conclusions TI-RADS Ⅳ-Ⅴ class level+ Adler Ⅱ-Ⅲ blood flow has a high practical value for the ultrasonic diagnosis of DTC, and FNAC can be performed in suspicious type Ⅳ DTC. Type Ⅰ-Ⅲ ultrasonic calcification morphological types and the main types of tumor biological characteristics and its variant of DTC, and has an important clinical value for the diagnosis of DTC by ultrasound, which provides an important reference basis for guiding FNAC, selecting surgical procedure, postoperative follow-up and prognosis judgment.