Objective:To investigate the value of ultrasound in evaluating pathologically complete response(pCR) of neoadjuvant chemotherapy(NAC) for breast cancer.Methods:A retrospective analysis was performed in 67 breast cancer patients who received NAC in the Second Affiliated Hospital of Harbin Medical University from January 2018 to December 2019. Ultrasound examination was performed before and after NAC, and two-dimensional, color and elastic images were stored for subsequent analysis. According to the operation pathological results after NAC, the patients were divided into two groups, pCR group and npCR group, using the Miller-Payne criteria as the evaluation criteria. Chi-square test was used to compare the ultrasound characteristics of breast masses in pCR group and npCR group before NAC. The accuracy, sensitivity, specificity, positive predicative value(PPV) and negative predicative value(NPV) of pCR were analyzed using ROC curve. The difference of pCR estimated by ultrasound in different molecular types was also analyzed.Results:①Of the 67 patients, 16 achieved pCR and 51 achieved npCR. Among the 16 pCR patients, 11(68.8%) were evaluated correctly and 5(31.2%) were wrong.Among the 51 npCR patients, 49(96.1%) were evaluated correctly and 2(3.9%) were wrong. ②There was no statistically significant difference between pCR and npCR in ultrasound features of pre-NAC breast masses( P>0.05). ③After the whole process of NAC, the accuracy, sensitivity, specificity, PPV and NPV were 89.6%, 68.8%, 96.1%, 84.6%, and 90.7%, respectively; The area under ROC curve was 0.824. ④The diagnostic efficiency of pCR estimated by ultrasound was higher for Luminal B and HER-2 breast cancer. Conclusions:The accuracy of pCR after NAC evaluated by ultrasound is 89.6%, with different diagnostic efficiency in different molecular types.

Objective: To observe the immediate effect of small-angle Tui-Pushing and An-Pressing anti-rotation bone-setting manipulation in improving the correction of braces for adolescent idiopathic scoliosis. Methods: A total of 50 cases of adolescent idiopathic scoliosis were selected and given brace correction first. The whole spine anteroposterior and lateral radiographs were taken, the Cobb angle was measured, and the visual analog scale (VAS) score of pain caused by brace wearing was recorded. After removal of the brace, small-angle Tui-Pushing and An-Pressing anti-rotation bone-setting manipulation was performed once. After treatment, the same brace was put on again to take a whole spine anteroposterior radiograph, the Cobb angle was measured, and the VAS score was recorded. The changes in Cobb angle and VAS score after manipulation were compared, and the immediate efficacy was evaluated. Results: After the manipulation, the Cobb angle was significantly smaller than that before treatment (P<0.01) and the VAS score was significantly lower than that before treatment (P<0.01). Conclusion: Small-angle Tui-Pushing and An-Pressing anti-rotation bone-setting manipulation can improve the immediate efficacy of brace in treating adolescent idiopathic scoliosis and relieve the pain caused by brace wearing at the same time.

Objective: To explore the correlation between the expression status of human epidermal growth factor receptor 2 (HER-2) and the characteristics of conventional ultrasound, shear wave elastography(SWE) and contrast enhanced ultrasound(CEUS) images in breast cancer patients with negative expression of estrogen receptor (ER). Methods: In this study, 117 patients with 117 lesions were selected from the Second Hospital of Harbin Medical University Hospital, who had definite pathology and ER negative expression, including 62 patients with positive HER-2 (group Ⅰ) and 55 patients with negative HER-2(group Ⅱ). Conventional ultrasound images and SWE were collected preoperatively, and CEUS images were collected in 62 patients to analyze the correlation between the expression of HER-2 and the ultrasonic characteristics of the three ultrasonic modes. Results: ①Conventional ultrasound: the groupⅠwas characterized by irregular shape, unclear boundary, mainly with spicule edges, microcalcification, axillary lymph node metastasis and higher histological grading. The groupⅡhad no such characteristics (all P<0.05). ②SWE: the Emax, Emean and Eratio of group Ⅰ were higher than group Ⅱ(all P<0.05). ③CEUS: the peak time of group Ⅰ was earlier than group Ⅱ, the slope of ascending branch and the area under the curve were larger, and the characteristics of perforating vessels were easier to be observed, while perfusion defects were more likely to occur in groupⅡ(all P<0.05). Conclusions In the case of ER negative expression, there are obvious differences in multimodal sonograms of different breast cancer HER-2 expression conditions. The analysis of the above sonograms will play an important guiding role in the selection of clinical treatment plans.

Objective:To investigate the comparative analysis of multimodal ultrasound features and clinicopathology of different molecular types of breast cancer, so as to improve the diagnostic accuracy of different types of breast cancer.Methods:A retrospective analysis of 112 patients with invasive breast cancer in the Second Affiliated Hospital and Affiliated Cancer Hospital of Harbin Medical Univeristy from August 2017 to November 2018 was carried out. With reference to St.Gallen standard, breast masses were divided into four subtypes, including Luminal A (LA), Luminal B (LB), Her-2 overexpression (Her-2+ ) and triple negative (TN). Two-dimensional greyscale, color Doppler flow imaging, shear wave elastography and contrast-enhanced ultrasound images were performed before operation. Complete clinicopathological data were collected. The differences between different subtypes of breast cancer in terms of multimodal ultrasound and clinicopathological features were analyzed.Results:①Luminal breast cancer showed posterior echo attenuation, low Alder grade, low Emax and Eratio value. LA was more likely to show a speculated or angular margin and concentric enhancement; LB was more frequently to show a indistinct margin, low enhancement and no perfusion defect (all P<0.05). ②Her-2+ cancers were characterized with a indistinct margin, enhanced posterior echo, a high Alder grade, Emax and Eratio value, and a high contrast enhancement and perfusion defect. The TTP value was lower than other subtypes (all P<0.05). ③TN cancers were associated with microlobulated margin, posterior echo enhancement, low Alder grade, high Emax and Eratio value and Ki67 expression, contrast concentric enhancement have and perfusion defect (all P<0.05). Conclusions:Different molecular subtypes of breast cancer have different multimodal ultrasound features and clinicopathological appearances, which can provide more imaging information for clinical diagnosis, treatment, and prognosis.

Objective:To construct a quantitatively diagnostic nomogram model by analyzing the clinical information of patients and the features of multi-modality ultrasound images of thyroid lesions, so as to preoperatively predict the malignant probability of suspicious thyroid nodules and provide effective references for clinical decision-making.Methods:A total of 933 patients, 1 121 thyroid nodules of C-TIRADS 3-5 categories, who underwent surgery in the Second Affiliated Hospital of Harbin Medical University from September 1, 2020 to June 10, 2021 were collected. The nodules were randomly divided into training ( n=897) and test groups ( n=224) in 8∶2 ratio. Finally, the diagnostic performance was evaluated by area under the curve (AUC). Results:①After preliminary screening by univariate analysis, multivariate analysis showed that age, echogenicity, orientation, echogenic foci, margin, posterior features, and elastic score were significantly correlated with benign and malignant nodules (all P<0.001), and the difference of halo between benign and malignant nodules was also statistically significant ( P=0.012). ②The AUC of nomogram was up to 0.903(95% CI=0.862-0.944) in the test set, and 0.889(95% CI=0.832-0.946) and 0.960(95% CI=0.925-0.994) in nodules with maximum diameter of ≤10 mm and of >10 mm respectively, which showed high diagnostic performance. Conclusions:The nomogram model could accurately differentiate malignant from benign thyroid nodules preoperatively, with the highest diagnostic performance for the nodules with maximum diameter of >10 mm, and effectively avoid the unnecessary fine-needle biopsy and surgical operation.

Objective    To analyze the effect of type 2 diabetes (T2DM) on the short-term prognosis of patients with non-small cell lung cancer (NSCLC) after resection surgery. Methods    Clinical data of 207 NSCLC patients who underwent resection surgery in our hospital from January 2016 to January 2019 were retrospectively analyzed. The 100 NSCLC patients with T2DM were allocated to a T2DM group (58 males and 42 females, with an average age of 65.26±7.26 years), and 107 patients without T2DM were allocated to a non-T2DM group (66 males and 41 females, with an average age of 64.21±7.51 years). The short-term prognosis of the patients was compared between the two groups. Results    Compared with the non-T2DM group, the postoperative atelectasis (P=0.012) and pulmonary infection (P=0.040) were statistically different in the T2DM group. The postoperative complication rate in the T2DM group was significantly higher than that in the non-T2DM group (66.0% vs. 33.6%, P<0.001). The postoperative hospitalization time in the T2DM group was longer than that in the non-T2DM group (9.83±6.35 d vs. 8.09±4.40 d, P=0.007). Conclusion    T2DM will increase the incidence of postoperative complications, prolong the length of hospital stay and increase the economic burden of the NSCLC patients, which is not conducive to the postoperative prognosis of patients.