Objective To explore the relationship of gallbladder emptying function and its hemodynamics in diabetic patients. Methods Gallbladder volume ,emptying function and its arterial blood flow were measured by ultrasound. Results The gallbladder volumes of fasting (FV ) and postprandial (RV) increased and the ejection fraction (EF) of gallbladder was decreased in DM group than in NC group (P<0.01). In DM group ,the gallbladder artery’s resistance index (RI) was higher than in NC group [(0.61 ± 0.06) vs (0.70 ± 0.08)](P<0.01). Minimum diastolic blood flow velocity (Vmin) was lower than in NC group [(8.72 ± 1.43) vs (6.05 ± 1.89)cm/s](P<0.01). RI was associated with HbA1c (r= 0.827 ,P< 0.01) and LDL‐C(r= 0.820 ,P< 0.01). Conclusion Gallbladder emptying dysfunction in diabetic patients is associated with the hemodynamics of gallbladder.

Objective To evaluate the clinical value of elasticity imaging and area ratio by ultrasonography in differential diagnosis of benign and malignant thyroid nodules.Methods Gray-scale ultrasound and elasticity imaging was used to examine 88 patients with thyroid nodules.The elasticity classification and area ratio were retrospectively reviewed and compared with pathology.The elasticity grades 1 - 3 predicted benign,grades 4 - 5 predicted malignant.Results Eighty-eight patients with 116 thyroid nodules were detected,93 nodules were benign and 23 nodules were malignant.( 1 )An elasticity grades of 1 - 3 was observed in 82 (95.3％) of 86 benign nodules,while elasticity grades of 4 - 5 in 19 (63.3％) of 30 malignant nodules.The diagnosis sensitivity,specificity and accurate rate of the elasticity grades was 82.6％,88.2％,87.1％.(2) The mean of elasticity imaging and area ratio of 93 benign nodules (1.31 ± 0.13 ) was statistically lower than that in 23 malignant nodules ( 1.73 ± 0.13 ) (t =13.536,P =0.001 ).( 3 )According to ROC analysis,the cut-off point of elasticity imaging and area ratio was determined as 1.52.With elasticity imaging and area ratio ＜ 1.52,89 nodules [98.9％(89/90)] were confirmed as benign and 22 nodules [84.6％ (22/26)] were confirmed as malignant by pathology.The diagnosis sensitivity,specificity and accurate rate of elasticity imaging and area ratio was 95.7％,95.7％,95.7％.(4)The area under the ROC curve of elasticity imaging and area ratio ≥ 1.52 was 0.996,significantly higher than that of elasticity grades ≥ 4 (0.891).The diagnostic accurate rate of elasticity imaging and area ratio was significantly higher than that of elasticity grades(95.7％ vs.87.1％,x2 =5.472,P=0.019).Conclusions The elasticity imaging and area ratio by ultrasonography can be used in the differential diagnosis of thyroid lesions.It is a new diagnostic indicator for diagnosis of thyroid lesions.

Objective To observe the effects of parathyroidectomy(PTX) on bone metabolism and bone mineral density(BMD) in maintenance hemodialysis patients with secondary hyperparathyroidism (SHPT).Methods A total of 26 dialysis patients with SHPT were treated with PTX.Serum calcium,phosphorus,alkaline phosphatase(ALP) levels were determined by standard methods.The levels of serum intact parathyroid (iPTH),osteocalcin (OC),procollagen type Ⅰ aminoterminal propeptide (PINP),β-crosslaps (β-CTX) were measured by chemiluminescence.BMD was measured by dual energy X ray absorptiometry.iPTH,OC,PINP,β-CTX,serum calcium,phosphorus,ALP were measured before parathyroidectomy and 1,3,6,12,18,24 months after operation.Lumbar spine (LS) and femoral neck (FN) BMD were measured before and 24 months after PTX.Results Compared with that before operation,serum OC[(104.49±25.42) μg/L vs (695.46±355.62) μg/L,P ＜ 0.01] and PINP levels [(248.36 ± 159.38) μg/L vs (809.28 ± 283.50) μg/L,P＜ 0.01] progressively decreased 3 months after PTX,and serum β-CTX levels [(1.60±0.64) μg/L vs (3.37±1.34) μg/L,P ＜ 0.01] decreased 1 month after PTX.Compared with that before operation,BMD levels increased 24months after PTX in LS[(0.88±0.23) g/cm2 vs (0.78±0.23) g/cm2,P ＜ 0.01] andFN[(0.96±0.19) g/cm2 vs (0.84±0.24) g/cm2,P ＜ 0.01],and Z-scores were also increased in both LS[(-1.24±0.55) vs (-1.66± 0.24),P ＜ 0.01] and FN[(-1.51 ±0.72) vs (-1.93 ± 0.40),P ＜ 0.01].Correlation analysis showed that baseline iPTH was positively correlated with ⊿Z-score in FN (r=0.584,P=0.002) and LS (r=0.400,P=0.043),and so did the OC with ⊿Z-score in FN (r=0.651,P ＜ 0.001) and LS (r=0.509,P=0.008).Conclusion The levels of OC,PINP and β-CTX are reduced and BMD is improved in hemodialysis patients with SHPT after PTX.

Rheumatoid arthritis (RA) is a chronic aseptic inflammatory disease characterised by synovial inflammation leading to progressive joint involvement with joint swelling,tenderness,and functional impairment.After therapeutics,some patients still have persistent synovitis and structural damage while they are in clinical remission.Musculoskeletal ultrasonography (MSUS) is playing a more important role in diagnose,therapy monitoring and prognosis of RA in the case of its character-non-invasive,easy to accept,cost-effective,and repeatable examination in the short term,especially multiangle of all aspects in the interesting area.Application of grey scale ultrasonography,power doppler ultrasonography,CEUS in RA clinical remission and evaluation on the therapeutic effect and prognosis were reviewed in this article.

Objective To investigate the relationship between gallbladder wall-typing and the main portal vein, right portal vein hemodynamics in patients with liver cirrhosis. Methods The main portal vein, right portal vein hemodynamics and the thickness of gallbladder wall were examined in 69 patients with cirrhosis and 30 normal subjects (control group) with two-dimensional ultrasound, color Doppler ultrasound and high-frequency ultrasound. According to the gallbladder wall-typing, 69 patients with liver cirrhosis were divided into not thickened, simple thickening and bilateral subgroups. The paremeters of hemodynamics and the thickness of gallbladder wall were compared among groups. Results There was statistical difference in thickness of gallbladder wall among all 3 subgroups. Statistical difference of the diameter of main portal vein (D_(pv)) was found among the subgroups (P<0.01), except between not thickened and simple thickening subgroup. Statistical difference of the velocity of the main portal vein (V_(pv)) was found between simple thickening subgroup and control group, as well as between bilateral subgroup and the control group (P<0.01). Statistical differences of quantity of blood flow in the main portal vein (Q_(pv)) were detected between bilateral subgroup and other 2 subgroups and control group (P<0.05). No statistical difference of diameter of right portal vein (D_(rpv)) and quantity of blood flow in the right portal vein (Q_(rpv)) was found among all groups and subgroups. The velocity of the right portal vein (V_(rpv)) of bilateral subgroup was statistically different with that of the control group and the simple thickening subgroup (P<0.05). No statistical difference of Q_(rpv)/Q_(pv) existed between the patients with liver cirrhosis and the normal subjects (P>0.05). There was positive correlation between the gallbladder wall thickness and D_(pv) (r=0.886, P<0.01). Conclusion The gallbladder wall-typing has no correlation with the right portal vein hemodynamics, but is related with the main portal vein hemodynamics. The bilateral and the thickness of gallbladder wall can indirectly reflect the hemodynamic changes of main portal vein. Obstruction to flow of cystic vein is not the main hemodynamic cause for the gallbladder wall changes in patients with liver cirrhosis and portal hypertension cause, indicating that there may be some intrinsic mechanisms of this phenomenon.

Breast cancer is the second malignant tumor of female reproductive system.With the development of modern medical imaging technology,conventional ultrasound and mammography are the most popular methods in breast examination and cancer screening.While CT,MRI and nuclear medicine diagnosis act as the additional methods of breast cancer diagnosis.In addition,CEUS and biopsy might be used in diagnosis of lesion lacking imaging characteristics.The imaging methods in diagnosis of breast lesions were reviewed in this paper.

Objective With multi?center investigation, to assess the life quality of patients with maintained hemodialysis (MHD) in Liaoning Province and to explore the relationship among the mineral metabolism, the life quality of the patients with MHD, and the repeated hospitalization within the latest three years. Methods 1192 patients with hemodialysis (at least 3 months) from January to March in 2015 at ten blood purification centers in Liaoning Province were selected for the cross?————————sectional survey. The Kidney Health?related Quality of Life (HRQOL) version 1.3 was used to evaluate the MHD patients' life quality. The total length of hospitalization was divided into four groups: 0 days, 3 to 15 days, 16 to 30 days and above 30 days. Results When serum calcium value ranged from 2.1 to 2.5 mmol/L, kidney?disease component summary (KDCS), mental component summary (MCS), physical component summary (PCS) and SF?36+KDCS corresponded to a higher value (P<0.05). When serum phosphorus value ranged from 1.13 to 1.78 mmol/L, KDCS and SF?36+KDCS corresponded to a higher value (P<0.05). When the calcium phosphorus product value ranged from 40.68 to 49.94, MCS corresponded to a higher value (P<0.05). KDCS showed a linear correlation with age (P<0.001), dialysis age, serum calcium (less than or equal to 2.5 mmol/L) (P<0.05); PCS showed a linear correlation with age (P<0.001) and dialysis age (P<0.05); SF?36+KDCS showed a linear correlation with age (P<0.001), and serum calcium (less than or equal to 2.5 mmol/L) (P<0.05), while age and dialysis age were negatively correlated. The hospitalization days showed a linear correlation with age, dialysis age (P<0.001) and serum phosphorus, calcium phosphorus product value (P<0.05), while dialysis age and calcium phosphorus product value were negatively correlated. Among different groups of total hospitalization days in three years, age, hemodialysis age, serum calcium, serum phosphorus, calcium?phosphorus product value and quality of life values were all statistically significant (P<0.05). Conclusions The life quality of patients with MHD were correlated with serum calcium, phosphorus, calcium and phosphorus product value, iPTH, dialysis age and age, while age and dialysis age were of negative correlation. The total number of hospitalization days in 3 years was closely linearly correlated with age and dialysis age, significantly correlated with serum phosphorus, calcium and phosphorus product value, while dialysis age, calcium and phosphorus product value were in a negative correlation. The total number of hospitalization in 3 years was correlated with the patients' age, dialysis age, serum calcium, serum phosphorus, calcium and phosphorus product value and quality of life.

Objective:To investigate the clinical characteristics and structural and functional cardiac changes in heart failure with preserved ejection fraction(HFpEF)complicated with atrial fibrillation(AF)in elderly patients.Methods:As a cross-sectional study, 835 patients with HFpEF aged ≥60 years admitted to the Department of Geriatric Cardiovascular Medicine of the First Hospital of Lanzhou University between April 2009 and December 2020 were divided into an HFpEF+ AF group(267 cases)and an HFpEF group(568 cases)according to whether they had AF in addition to HFpEF, and their cardiac structure and function were evaluated.The optimal cutoff point of the ratio of the peak early diastolic velocity(E)to the maximum early diastolic velocity(e')of the mitral annulus(E/e')was analysed using the receiver operating characteristic(ROC)curve.The HFpEF+ AF group was divided into two subgroups, E/e'>11 and E/e'≤11, and differences in their clinical presentation, cardiac structural and function, and the relationship between the left and right heart were compared.Results:Compared with the HFpEF group, the left atrial volume index(LAVi)was larger[(60.0±23.3)ml/m 2vs.(43.9±19.0)ml/m 2, t=10.130, P<0.01]and the left ventricular ejection fraction(EF), mitral annular septal systolic velocity(s' S)and E/e' were smaller than in the HFpEF+ AF group(all P<0.01), whereas the right ventricular diameter(RVD), right atrial diameter(RAD)and area(RAA), tricuspid regurgitation velocity(TRv), and pulmonary arterial systolic pressure(PASP)in the HFpEF+ AF group were all greater than those in the HFpEF group(all P<0.05).In the E/e'>11 subgroup of HFpEF+ AF, the prevalence of hypertension, coronary heart disease and diabetes were higher, AF courses were shorter, and the decline of s' was more severe(all P<0.05).Furthermore, E/e' was independently correlated with LAVi, as was LAVi with PASP( t=2.114, 1.963, P=0.034, 0.042).The above-mentioned features were similar to those in the HFpEF group.The E/e'≤11 subgroup had a higher proportion of women, longer duration of AF than the E/e'>11 subgroup(median: 5 years vs.1 year, P=0.003), more noticeable enlargement of the right ventricle and right atrium, higher TRv and PASP( P<0.05). Conclusions:In elderly patients with HFpEF complicated with AF, the left atrial volume is increased further, and left ventricular systolic function and right heart morphology show serious deterioration, suggesting there might be two phenotypes of HFpEF+ AF with different pathophysiological mechanisms.

Objective:To explore the value of liver stiffness and spleen stiffness measured by two-dimensional shear wave elastography (2D-SWE) in predicting high-risk varices (HRV) with compensated cirrhosis patients.Methods:Seventy patients with compensated cirrhosis who attended the First Hospital of Lanzhou University from November 2019 to April 2022 were recruited. All patients underwent examinations of liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) by 2D-SWE. Binary logistic regression was used to analyze the risk factors affecting the occurrence of HRV. The diagnostic performances of LSM, liver stiffness (by 2D-SWE)-spleen length-to-platelet (LSPS) score, and SSM in predicting HRV were compared.Results:SSM was not technically feasible in 6/70 (8.6%) patients due to small volume of spleen.Among 64 patients with compensated cirrhosis, 30/64 (46.9%) were HRV. Binary multivariate Logistic regression analysis showed that SSM and platelet counts were independent influencing factors for predicting HRV, with OR values of 1.126 ( P=0.006) and 0.971 ( P=0.039), respectively. The area under the receiver operating characteristic curve (AUC) of LSM, LSPS score, and SSM were 0.660, 0.828 and 0.858, respectively. The AUCs of SSM and LSPS score were significantly higher than that of LSM ( P<0.05), but there was no statistical difference between SSM and LSPS score ( P=0.608). Conclusions:LSM and SSM measured by 2D-SWE have high success rate. SSM and LSPS score have high value in predicting HRV in patients with compensated cirrhosis, and the diagnostic performances of the above two methods are significantly higher than that of LSM.

BACKGROUND: Syringomyelia is a progressive chronic disease that leads to nerve pain, sensory dissociation, and dyskinesia. Symptoms often do not improve after surgery. Stem cells have been widely explored for the treatment of nervous system diseases due to their immunoregulatory and neural replacement abilities. METHODS: In this study, we used a rat model of syringomyelia characterized by focal dilatation of the central canal to explore an effective transplantation scheme and evaluate the effect of mesenchymal stem cells and induced neural stem cells for the treatment of syringomyelia. RESULTS: The results showed that cell transplantation could not only promote syrinx shrinkage but also stimulate the proliferation of ependymal cells, and the effect of this result was related to the transplantation location. These reactions appeared only when the cells were transplanted into the cavity. Additionally, we discovered that cell transplantation transformed activated microglia into the M2 phenotype. IGF1-expressing M2 microglia may play a significant role in the repair of nerve pain. CONCLUSION Cell transplantation can promote cavity shrinkage and regulate the local inflammatory environment.Moreover, the proliferation of ependymal cells may indicate the activation of endogenous stem cells, which is important for the regeneration and repair of spinal cord injury.