Objective To evaluate the value of acoustic radiation force impulse imaging (ARFI) technique in differential diagnosis of renal tumors.Methods Totally 86 patients with 86 renal tumors underwent conventional ultrasound and ultrasound with ARFI technique.The shear wave velocity (SWV),virtual touch tissue imaging (VTI) score between tumors and the surrounding renal parenchyma,benign and malignant tumors were compared.Results In 86 patients with renal tumors,32 cases were renal benign tumors and all them were angiomyolipomas (AML),54 cases were renal malignant tumors,inculding 26 cases of renal clear cell carcinoma (ccRCC),8 cases of renal color cell carcinoma (cRCC),5 cases of renal papillary carcinoma (pRCC),15 cases of invasive urothelial carcinoma (IUC).The difference of SWV and VTI scores between lesions and the surrounding renal parenchyma were statistically significant (both P＜0.05).The SWV and VTI score renal benign tumors were lower than those of malignant tumors (both P＜0.05).The area under the ROC curve with SWV＞1.37 m/s or VTI score＞3.83 to distinguish benign and malignant renal tumors were 0.898,0.847,sensitivity were 88.9％,83.3％,specificity were 84.4％,78.1％,respectively (P＜0.05).Among renal malignant tumors,SWV and VTI score of ccRCC significantly higher than those of other malignant tumors,and the area under the ROC curve with SWV＞2.06 m/s or VTI score＞4.31 to distinguish ccRCC and other renal malignant renal tumors were 0.766,0.729,sensitivity were 65.4％,57.7％,specificity was 82.1％,78.6％,respectively (P＜0.05).Conclusion ARFI has important value in differential diagnosis of renal tumors,and can help to distinguish ccRCC with other renal malignant tumors.

The roots of Pittosporum glabratum Lindl. (Pittosporaceae) have been used as a folk medicine for the treatment of rheumatic arthritis, insomnia and hypertension. Only a few chemical or biological studies on P. glabratum have been reported. As part of our ongoing phytochemical research on this plant, four compounds were isolated. Their structures were identified as 3beta, 6beta, 19alpha, 21alpha, 24-pentahydroxy-12-en-28-oleanolic acid (1), 3-O-beta-D-glucuronopyranosyl-28-O-beta-D-glucopyranosyl siaresinolic acid (2), 3, 4, 5-trimethoxyphenyl-1-O-beta-D-(5-O-syringoyl)-apiofuranosyl-(1 --> 6)-beta-D-glucopyranoside (3) and 3, 4, 5-trimethoxyphenol-1-O-beta-D-apiofuranosyl-(1 --> 6)-beta-D-glucopyranoside (4) on the basis of physical evidence and spectroscopic analysis. Among them, compound 1 is a new triterpenoid, and compounds 2-4 are isolated from the genus Pittosporum for the first time.

OBJECTIVETo compare the clinical efficacy between the combined acupuncture therapy of acupoint injection and fire needling and the oral administration of vitamin C and B2 as well as subcutaneous injection of transfer factor.

METHODSOne hundred and fifty-eight patients of recurrent oral ulcer (ROU) differentiated as heat accumulation in the heart and spleen were randomized into an observation group and a control group, 79 cases in each, one. In the observation group, Xinshu (BL 15), Pishu (BL 20) and Zusanli (ST 36) were selected for acupoint injection of shuang huanglian injection, 1 mL at each point, three times a week, for 2 weeks totally. Additionally, fire needling was applied to the ulcer lesion and peripheral mucosa, once a day, totally for 3 times. In the control group, vitamin C 100 mg and vitamin B2 20 mg were prescribed for oral administration, three times a day; and subcutaneous injection of transfer factor was applied, 2 mL (3 mg), twice a week, for 2 weeks totally. The score of symptoms and physical signs and the visual analogue scale (VAS) were observed before and after treatment, as well as the time of ulcer healing and ulcer recurrence in the patients of the two groups. The clinical efficacy was compared between the two groups.

RESULTSThe total effective rate was 92.4% (73/79) in the observation group, better than 77.2% (61/79) in the control group (P < 0.01). The differences in the score of symptoms and physical signs and VAS score before and after treatment were significant statistically in the observation group and the control group (all P < 0.01). The score of symptoms and physical signs and VAS score after treatment in the observation group were reduced significantly as compared with those in the control group (both P < 0.01). The time of ulcer healing in the observation group was earlier than that in the control group [(3.87 +/- 1.01) d vs. (6.22 +/- 0.53) d, P < 0.01]. The recurrence rate in the observation was lower than that in the control group [22.7% (17/75) vs. 50.0% (36/72), P < 0.01].

CONCLUSIONThe combined therapy of acupoint injection and fire needling achieves the better efficacy on ROU compared with oral administration of vitamin and subcutaneous injection of transfer factor. This therapy has the good and quick effect of analgesia, relieves the relevant symptoms, shortens the time of ulcer healing and reduces the recurrence rate.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Heart ; physiopathology ; Humans ; Male ; Middle Aged ; Oral Ulcer ; drug therapy ; physiopathology ; therapy ; Spleen ; physiopathology ; Treatment Outcome ; Young Adult

Purpose To investigate the relationship of infundibular bladder neck formation with pelvic floor support structure injury and urethral sphincter defect and its significance in female stress urinary incontinence.Materials and Methods The pelvic floor images of seventy-four female patients with stress urinary incontinence treated in the outpatient Department of Lanzhou University Second Hospital from April 2015 to August 2016 were analyzed retrospectively.The location of the bladder neck,posterior vesicourethral angle and the infundibular bladder neck formation were observed by the transperineal ultrasound under the resting state and the maximum Valsalva status.Meanwhile the thickness of middle urethral sphincter was measured under resting state.At the same time,eighty-one women visiting our hospital for regular physical examination were enrolled as control group.Results The infundibular urinary bladder neck formation rate (66.2％) in the stress urinary incontinence group was significantly higher than that in the control group (4.9％) under maximum Valsalva state,the difference was statistically significant (P＜0.05).The extent of the bladder neck descending and posterior vesicourethral angle in the stress urinary incontinence group were notably higher than those in the control group,both of the difference was statistically significant (P＜0.05).Stress urinary incontinence was confirmed with urethral sphincter defect by urodynamics in nine patients,in whom the infundibular bladder neck occurred.The thickness of the middle urethral sphincter in these nine patients showed no obvious difference with that in patients without sphincter defect and subjects in normal control group (P＞0.05).Conclusion The infundibular bladder neck formation,which is closely related to the pelvic floor support structure dysfunction and urethral sphincter defect,is an important indication of stress urinary incontinence.However,the assessment of urethral sphincter defect through urethral sphincter thickness need to be further studied.

Objective To explore the mediating effect of attentional control between negative automatic thoughts and social anxiety.methods A total of 1 504 college freshmen of medical university were surveyed with the Interaction Anxiety Scale (IAS),the Automatic Thoughts questionnaire (ATQ) and the Attentional Control Scale (ACS).Result sThe scores of IAS,ACS and ATQ of medical freshmen were (39.36±8.15),(53.50±7.48) and (48.93±19.72) respectively.Correlation analysis showed that ATQ total score was significantly positively correlated with IAS total score(r=0.313,P<0.01),ATQ total score was significantly negatively correlated with ACS total score(r=-0.275,P<0.01),and ACS score was significantly negatively correlated with IAS total score(r=-0.455,P<0.01).Mediating effect analysis showed that attentional control partly-mediated the relationship between negative automatic thoughts and social anxiety among medical freshmen (x2/df=1.650,GFI=0.998,AGFI=0.993,RMSEA=0.021),and accounted for 50.8% of the mediating effect.Conclusion Negative automatic thoughts is an important factor which plays direct and indirect roles in social anxiety.Attentional control is the intermediate link between negative automatic thoughts and social anxiety.

Objective To analyze the components of attentional bias on anger and disgust emotional faces in college students with social anxiety disorder.Methods DSM-V was used for clinical diagnosis after the initial screening with Interaction Anxiousness Scale.The subjects meet the inclusion criteria were divided into social anxiety disorder group (SAD group) and healthy control group (HC group).Koster's improved dot-probe paradigm was used in a 2 (group:SAD group,HC group) ×2 (emotion categories:anger,disgust)mixed-design experiment,and the different characteristics of attentional bias between the two groups on different emotional faces were compared.Results In SAD group,under the condition of angry faces,the response times to the probe targets with the same or different positions from the negative faces were (369.7±53.0)ms and (447.2±54.3) ms,while the response times were (429.6±70.2) ms and (444.2±55.8) ms under the condition of disgust faces,and the SAD group showed attentional bias towards both anger and disgust faces (t =24.15 and 2.45,P＜0.05).Under the condition of anger faces,the response time of HC group to the consistent and inconsistent position of probe target were (466.9±40.0) ms and (483.8±43.8) ms,and the HC group had an attentional bias towards anger faces(t=6.58,P＜0.05).The response time under disgust faces was (493.8±43.6)ms and (498.0±46.7)ms in HC group,and did not show an attentional bias towards disgust(t=1.65,P=0.108).The scores of attentional orientation to anger faces in SAD group were significantly higher than those in the HC group(F=19.26,P＜0.001),but there was no significant difference between the two groups towards disgust faces (F=0.02,P=0.897).Compared with disgust faces,the attentional orientation to anger faces was faster in both HC and SAD groups (F=101.66 and 8.00,P＜0.05).Compared with the HC group,the SAD group had an impaired attentional disengagement from anger faces(F=8.66,P=0.004).Conclusion The students with social anxiety disorder have attentional bias towards both anger and disgust facial expressions,which manifested as facilitated attentional orientation and impaired attentional disengagement to anger faces.

Objective:To systematically review evidence for the effect of convalescent plasma and immunoglobulin on treatment of severe acute respiratory syndrome (SARS), and further provide advice on the treatment of coronavirus disease 2019 (COVID-19).Methods:Clinical studies of convalescent plasma and immunoglobulin in the treatment of SARS were collected from a variety of databases such as PubMed, Cochrane Library, Web of Science, Embase, CNKI, VIP, Wanfang, and CBM from November 2002 to March 2020. Two researchers independently screened the literature, extracted the data, and assessed the risk of bias based on the national institute for health and clinical excellence case series quality scale, and systematically evaluated the results.Results:A total of 10 clinical studies, including 212 patients, were eventually included. There were 4 case series studies, 5 case reports and 1 case-control study. Most studies were with low or very low quality. The systematic analysis showed that 107 patients administered convalescent plasma and 16 patients used immunoglobulin during the treatment of SARS. Forty-nine patients were definitely not treated with the above two methods, and the remaining 40 patients were not reported clearly. The treatment of convalescent plasma and immunoglobulin could both improve the symptoms and reduce the mortality (12 died), and most SARS patients got better, while 11 SARS patients who did not receive the above therapies died.Conclusions:Convalescent plasma and immunoglobulin were effective on relieving symptoms of SARS patients. However, due to low quality and lacking of control group, convalescent plasma and immunoglobulin should be used with caution to treat COVID-19 patients.

Objective To explore the relationship between the increase of transmural dispersion of repolarization with ventricular arrhythmia,myocardial infarction degree and coronary events in elderly patients with myocardial infarction at T peak-T end interval in order to provide the guidance instruction for the assessment of prognosis of elderly myocardial infarction.Methods One hundred and twenty cases of senile myocardial infarction in the cardiology department of our hospital were selected,including 73 males and 47 females,the average age was (62.37 ± 11.34) years old.In addition,76 elderly cases of other heart disease were selected as the control group,including 42 males and 34 females,the average age was (59.56 ± 12.64) years old.The T peak-T end interval,dispersion and T peak-T end interval and dispersion after correcting the heart ratein different groups were analyzed.Results The T peak-T end interval,dispersion and T peak-T end interval and dispersion after correcting the heart rate had statistical differences between the control group and AMI group at admission and between the acute stage and recovery stage in the AMI group (P＜0.01);the T peak-T end interval and dispersion before and after correcting the heart rate had statistical differences among the patients with different ventricular arrhythmia (P＜0.01);the T peak-T end interval and dispersion before and after correcting the heart rate had statistical differences among the patients with anterior lateral wall,anterior wall,inferior wall,high lateral wall and multiple vessels infarction (P＜0.01);the case death after correcting the heart rate in different degrees and coronary event occurrence at admission had statistical difference (P＜0.01).Conclusion The T peak-T end interval has a close relation with malignant arrhythmia occurrence,which has an important predictive value for the short term prognosis in elderly patients with AMI.

Objective:To evaluate the effect of venous excess ultrasound score (VExUS Score) in the acute kidney injury(AKI) in Patients with sepsis, so as to reduce the risk of disease and improve the prognosis of patients.Methods:This experiment was a single-center prospective cohort study. Include septic patients with AKI who were admitted to the Department of Emergency Intensive Care Unit of the First Affiliated Hospital of Anhui Medical University from February 2022 to February 2023, Those with inadequate window, inferior vena cava (IVC) thrombus, age<18 years and known case of cirrhosis with portal hypertension were excluded from the study. Patients underwent ultrasound examination with serial determination till AKI resolved or patient is initiated on dialysis.Results:Totally 86 patients were enrolled for the study. The mean age was (60.43±15.48) with 50 (58.1%) males. Mean sequential organ failure assessment (SOFA) score was (6.23±1.87). 38 patients (44.2%) were in AKI stage 1, while 24 patients (27.9%) were in AKI stage 2 and stage 3 each. 52 patients (60.5%) had VExUS grade Ⅲ. Resolution of AKI injury showed significant correlation with improvement in VExUS grade ( p value 0.003). Similarly, there was significant association between changes in VExUS grade and fluid balance ( p value 0.005). There was no correlation between central venous pressure (CVP), left ventricular function, and right ventricular function with change in VExUS grade. Conclusions:The study shows a significant correlation between the VExUS Score and AKI staging, With improvement in kidney function, there is decline in the VExUS grade as well. Moreover VExUS Score might reliably demonstrate venous congestion and aid in the clinical decision to perform fluid removal.

Objective: To analyze and summarize the ultrasonographic features of fibrolamellar hepatocellular carcinoma (FLHCC). Methods: The ultrasound images were retrospectively analyzed in 23 FLHCC cases which were confirmed by pathology, including the size, echogenicity, boundary and other features on gray scale ultrasound, color Doppler flow imaging and enhancement patterns on contrast-enhanced ultrasound (CEUS). Results: Twenty-three patients had 23 lesions of FLHCC. The average age was (40.0±17.1) (15-77) years old and among them 3 cases had liver cirrhosis(13.0%). The maximum diameter of FLHCC lesions was 2.5-16.7 cm and the average was (7.2±4.3)cm. On gray scale ultrasound, 82.6% (19/23) lesions were hypoechoic, 78.3% (18/23) lesions showed cord-like or sheet-like hyperechoic area and 47.8% (11/23) lesions displayed strip-like echogenic attenuation in the center, with calcification in 17.4% (4/23) lesions. There were 91.3% (21/23) lesions showed peripheral and internal rich color flow signals on color Doppler flow imaging and 60.9% (14/23) with subcapsular thick blood vessels. All 8 FLHCC lesions displayed early and hyper-enhancement in the arterial phase and wash-out in the portal and delayed phases on CEUS. Internal nonenhanced scar-like area was appeared in all lesions on CEUS. Conclusions Patients with FLHCC are mostly young and few with liver cirrhosis. Ultrasonographic features are characterized by relatively large-sized mass with internal acoustic attenuation or calcification on gray scale ultrasound and hypervascularity with central scar on CEUS.