Objective To explore the difference of normal breast artery feeding pattern between benign and malignant breast neoplasms with color Doppler flow imaging (CDFI).Methods CDFI were performed for 248 cases breast neoplasms confirmed by pathology.Spatial location were observed between normal breast arteries and breast neoplasms.The difference of breast artery feeding pattern was compared between benign and malignant breast neoplasms.Resnlts CDFI showed that penetrating vessels,branches of penetrating vessels,branches of direct vessels and central large vessels were characteristic breast cancer vascular distribution patterns,which were completely different from that of breast benign neoplasms.Conclusions The patterns of breast artery feeding breast cancer were different from that of breast benign neoplasms,that can identify both.

Ultrasonography can clearly show pelvic anatomic structures,as well as the location and length of mesh after pelvic floor reconstructive operation.The consistency of ultrasonic diagnosis of severe pelvic organ prolapse with pelvic organ prolapse quantitation is good.Furthermore,ultrasonography can provide imaging basis for evaluating the safety and efficacy of pelvic floor reconstruction.The progresses of ultrasound in diagnosis of severe pelvic organ prolapse and postoperative evaluation of pelvic floor reconstruction were reviewed in this article.

Aim To observe the effects of effective fraction of Epimedium,Astragalus,Radix Puerariae on behavioral and pathological changes in a transgenic mouse model of Alzheimer’s disease.Methods Six-month-old APPswe /PS1 ΔE9 transgenic mice were ran-domly divided into 2 groups:model group and effective fraction group,1 0 mice each group.The mice in the effective fraction group were treated with the effective fraction of Astragalus,Radix Puerariae,Epimedium compound for 8 weeks.The C57BL/6J mice were used as negative control group.After 8 weeks,the learning and memory function were measured by Morris water maze,the pathological changes in brain tissue were ob-served by Modified Bielschowsky staining and Nissl 's staining.Results During place navigation trial,the escape latency in the APPswe /PS1 ΔE9 double transgenic model mice was longer than those of the mice of C57 (P <0.05),the escape latency in the mice of effec-tive fraction group was significantly reduced than those of the mice in model group (P <0.05).During spatial probe trail,the platform-crossing times in the APPswe /PS1 ΔE9 double transgenic mice were different from the mice of C57 (P <0.05),the platform-crossing times in the mice of effective fraction group were significantly increased than those of the mice in model group (P <0.05).The average swimming velocity in the APPswe /PS1 ΔE9 double transgenic model mice was increased than that of mice of C57 (P <0.05 ),there was no significant difference between effective fraction group and model group (P > 0.05 ). The Modified Bielschowsky staining shows that the neuron fibers of the cerebral cortex of APPswe /PS1 ΔE9 double transgenic mice were enlarged,swelling,and dense.There were senile plaques and nerve fiber tangles in the cerebral cortex of APPswe /PS1 ΔE9 double transgenic mice.The neuron fibers of mice in the effective fraction group were relieved;there was a small amount of senile plaque.The Nissl’s staining shows that the neurons of the cerebral cortex of APPswe /PS1 ΔE9 mice were edema, the number of cells were decreased.The mice in the effective fraction group were free of the disease.Con-clusion The double transgenic APPswe /PS1 ΔE9 mice of AD can simulate the specific pathogenesis of AD, which may be the efficient experimental animal model. The effective fraction of epimedium,astragalus and ra-dix puerariae may have a neuroprotective effect against AD via improving the learning and memory ability,and reduce the cerebral cortex nerve fiber tangles,senile plaques and neurons edema changes.

The study is to investigate the effect of angiotensin II (Ang II) and its receptor blockers on migration and endothelin-1 (ET-1) expression of rat vascular adventitial fibroblast subpopulations. Vascular adventitial fibroblasts were individually expanded by using cloning rings, and the effects of Ang II on the migration of adventitial fibroblast subpopulations were evaluated by Transwell. Fluorescence quantitative-PCR detected the expression of preproET-1 mRNA induced by Ang II, and its receptor antagonists losartan and PD-123319. The concentration of ET-1 was determined by ELISA. It showed that spindle shaped and epithelioid shaped cells were isolated by using cloning rings, named as spindle cells and round cells. RT-PCR showed that fibroblast subpopulations did not have leukocytes, endothelial cells and smooth muscle cells, namely pure cell lines. Compared with respective control cells, two subpopulations had transferring ability. Ang II significantly improved round cells migration in a concentration-dependent manner, and had no obvious influence on spindle cells migration. Ang II (1 x 10(-8) - 1 x 10(-6) mol x L(-1)) significantly increased the expression of preproET-1 mRNA in round cells (P < 0.01), and had no significant effect on the expression of preproET-1 mRNA in spindle cells. Losartan blocked the expression of preproET-1 mRNA induced by Ang II in round cells, and had no significant effect on the expression of preproET-1 mRNA in spindle cells. The effects of Ang II and ET-1 receptor inhibitors on the release of ET-1 were similar to the expression of preproET-1 mRNA. The results indicate that there are two cell subpopulations: round cells and spindle cells in rat vascular adventitial fibroblasts. Ang II significantly improved cells migration, and increased the expression of ET-1 in round cell subpopulation. It suggested that there may be different migratory mechanisms in two cell subpopulations, and the two subpopulations may play a different role in vascular remodeling and reparative process.

Endometrial lesions are common gynecological diseases in women,including submucosal fibroids,endometrial polyps,endometrial hyperplasia and endometrial cancer,etc.Endometrial hyperplasia is one of the precancerous lesions,and early diagnosis can effectively reduce the rate of malignancy.Ultrasound elastography has been gradually used in gynecology.The classification,principles of ultrasound elastography and its application in diagnosis of endometrial lesions were reviewed in the article.

The injury of anal sphincter complex during childbirth can result in long-term anal incontinence problems.Recently,several new techniques in ultrasound have been used to evaluate the function and injury of anal sphincter,such as tomographic ultrasound imaging,volume contrast imaging and speckle reduction imaging.The diagnosis rate of the injury of anal sphincter complex has been improved rapidly.The development of 2D and 3D ultrasound in evaluating function and injury of postpartum anal sphincter complex were reviewed in this article.

Objective To observe the effect of different doses of esketamine on early mood in pa-tients with preoperative anxiety after thoracoscopic surgery.Methods Eighty patients with preoperative anx-iety before thoracoscopic surgery,37 males and 43 females,aged 25-64 years,BMI 18-26 kg/m2,ASA physical statusⅠ-Ⅲwere selected.According to random number table,the patients were randomly divided into four groups:control group(group C),esketamine 0.1 mg/kg group(group E1),esketamine 0.2 mg/kg group(group E2),and esketamine 0.3 mg/kg group(group E3),20 patients in each group.In groups E1,E2,and E3,the patients were slowly injected with corresponding doses of esketamine intrave-nously 30 minutes before the end of the operation,and the patients in group C were given 10 ml of normal saline at the same time.The 7-item generalized anxiety disorder scale(GAD-7)score and hospital anxiety and depression scale(HADS)score were evaluated 24 hours before surgery,24,48,72,and 120 hours af-ter surgery,respectively.Peripheral venous blood(5 ml)was collected at the same time points,and serum brain-derived neurotrophic factor(BDNF)concentration was detected by ELISA.NRS scores at rest and ex-ercise were recorded 12 and 24 hours after surgery.The number of remedial analgesia and the number of ef-fective compressions of analgesia pump within 48 hours after surgery were recorded.Results Compared with group C,the scores of GAD-7 and HADS in groups E1,E2,and E3 were significantly decreased 24,48,and 72 hours after surgery(P＜0.05).And compared with groups E1 and E2,the scores of GAD-7 and HADS in group E3 were significantly lower(P＜0.05).The serum BDNF level in groups E1,E2,and E3 were significantly increased compared with group C 24,48,and 72 hours after surgery(P＜0.05).Compared with group E1 and E2,the serum BDNF level in group E3 was significantly higher(P＜0.05).Compared with group C,the NRS scores at rest 12 and 24 hours and the scores at exercise 12 hours after surgery in groups E1,E2,and E3 were significantly decreased(P＜0.05).And compared with groups E1 and E2,the scores in group E3 were significantly lower(P＜0.05).The number of postoperative remedial analgesia and the number of effective compressions of analgesia pump in groups E1,E2,and E3 were signif-icantly decreased compared with group C within 48 hours after surgery(P＜0.05).And compared with groups E1 and E2,the number in group E3 was significantly lower(P＜0.05).Conclusion Single intra-venous injection of esketamine 0.1,0.2,and 0.3 mg/kg can improve early postoperative mood of patients with anxiety before thoracoscopic surgery,and esketamine 0.3 mg/kg has better anti-anxiety effect.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.