Objective To analyze thyroid papillary carcinoma (PTMC) neck lymph node metastasis (LNM) related factors,and further to explore the diagnostic value of ultrasonography in LNM.Methods A retrospective analysis of 384 cases of patients with PTMC confirmed by pathology and ultrasonic data were performed,according to the presence of cervical lymph node metastasis,they were divided into transfer group (116 cases) and nontransfer group (268 cases).Analysis was made to summarize the clinical and sonographic features of the two groups.Chi-square test and the multi-factor Logistic regression analysis were used to study the risk factors.Results ①The single factor analysis of sonographic features showed that the factors of gender (X 2 = 3.893,P = 0.048),age (P = 0.001),tumor diameter (P = 0.008), boundary(X 2 =6.327,P =0.012),acoustic halo (X2 = 15.562,P =0.001),and place (X 2 =9.441 ,P =0.024) were statistical different between the two groups;②Multiariable Logistic regression analysis showed that:patient age,tumor diameter,and acoustic halo were independent risk factors for PTMC neck lymph node metastasis,if Logistic model was used to predict the probability P =0.50 as a threshold,its accuracy was 74.2%,and the area under the ROC curve was 0.744.Conclusions Patients with age ≤ 45 years, tumor diameter ≥ 0.7 cm,located in the lower pole,boundary with uneven acoustic halo,were prone to LNM,and easy to Ⅵ area,suggest preventive cleaning lymph node in central region.

Objective To explore the diagnostic value of quantitative contrast‐enhanced ultrasonography(CEUS) for crush injury in the hind limb muscle of rabbits .Methods A totle of 120 New Zealand white rabbits were randomized to receive compression on the left hind limb for either 2 h( n =56) or 4 h( n = 56) to induce muscle crush injury ,another 8 animals were not injured and served as normal controls .CEUS parameters such as peak intensity(PI) ,area under curve(AUC) ,ascending slop(AS) and descending slop(DS) were measured at 0 5. h ,2 h ,6 h ,24 h ,3 d ,7 d ,14 d after decompression .Results Compared with the uninjured muscle ,reperfusion of the injured muscles showed early and high enhancement in CEUS .The time‐intensity curve showed a trend of rapid lift and gradual drop .The PI and AUC values differed significantly among the three groups and were positively correlated with serum and tissue biomarkers .Rabbits of the 4 h compression group showed significantly higher PI and AUC values compared with the 2 h compression group at each time points .Conclusions CEUS can effectively detect muscle crush injury and monitor dynamic changes of the injured muscle in rabbits .PI and AUC are promising diagnostic parameters for this disease .CEUS might play an important role in the pre‐hospital and bedside settings for the diagnosis of muscle crush injury .

Purpose To investigate the prognosis and influencing factor of hematoma complicated from ultrasonography-guided EnCor vacuum-assisted breast biopsy system in minimally invasive surgery for breast lesions, and to provide reference for clinical treatment. Materials and Methods 280 female patients with 486 benign breast lesions underwent minimally invasive excision using a ultrasonography-guided EnCor vacuum-assisted device, occurrence and the inlfuence factors of hematoma complicated from the operation was observed. Results All the 486 lesions were completely excised with EnCor system, hematoma (≥1cm) were found in 47 cases after 24 hours and almost disappeared in 6 months. After analysis of the occurrence of hematoma, it was found that the following situations would lead to a higher incidence of hematoma, which included lumps ≥ 2.5 cm, more than two lesions removed at one time, lumps locating deep inside the areola or the edge of breasts, bigger and less dense breasts, operation in menstrual period, pressure bandaging after operation less than 12 hours and operation without using adrenaline (P<0.05 or P<0.01). Conclusion Benign lesions breast can be effectively excised using ultrasonography-guided EnCor vacuum device, and the factors listed below could affect the occurance of hematoma complicated from the surgery, including the size, location and number of the resected nodules, breast shape, surgery during menstrual period, postoperative pressure bandaging and the use of hemostatics.

BACKGROUND: A large amount of cell dies of apoptosis in secondary injury stage after spinal cord injury.OBJECTIVE: To probe into the influence of local intraspinal infusion with danshen injection on necrosis and apoptosis of spinal cell after acute spinal cord injury.DESIGN: Randomized controlled experiment was designed.SETTING: Clinical Medical Trial Center of People' s Hospital Affiliated to Yunyang Medical College.MATERIALS: Forty-four Chinese white rabbits of first grade were employed, aged varied from 4 to 5 months, of either sex, mass weighted varied from 2.0 to 2.5 kg.INTERVENTIONS: The experiment was performed in Clinical Medical Trial Center of People' s Hospital Affiliated to Yunyang Medical College from June 2002 to July 2003. Two groups were randomized, named danshen group and the control group, 22 rabbits for each. In both groups, modified Allen method was used to prepare the model of incomplete spinal cord injury. In danshen group, danshen injection was infused from subdural catheter for 4times at 0. 3 mL/kg per day of the total amount (once every 6 hours). In the control group, physiological saline of same dose was injected. The animals were sacrificed at the 8th, 24th and 72nd hours successively after injection for pathological and histomorphologic observation, peroxide dismutase and malondialdehyde determination and determination of positive cell count of B-cell lymphoma-2 (Bcl-2), the apoptosis-inhibition gene.MAIN OUTCOME MEASURES: Cell apoptotic index and cell apoptotic rate in the region of spinal cord injury.RESULTS: Forty-four rabbits entered result analysis for all. ① Results of cell apoptosis: Apoptotic index in danshen group was less remarkably than that in the control group(13.10 ± 1. 38, 20.39±2.96, 4.101, P ＜0.01); cell apoptotic rate was lower remarkably than the control group[ (9.67 ± 1.09)%,(14.68±2.81)%, t=4.072, P ＜0.01] and Bcl-2 expression was more than that in the control group[ (19. 12 ± 4.74) /mm2, ( 13.37 ± 3.68) /mm2,t = 2. 347, P ＜ 0.01 ]. ② POD content: The result in danshen group was higher thanthe control group[ (136.20 ± 13.64) NU/mL, (101.70 ± 15.24) NU/mL,t = 4. 132, P ＜ 0.01 ]. ③ Malondialdehyde content: The result in danshen group was lower than the control group[ (1.27 ± 0. 22) nmol/mL,(2.54±0.69) nmol/mL, t=4.309, P ＜0.01] . ④Degeneration and necrosis of neuron and neural fiber: The result in danshen group was milder than the control group.CONCLUSION: After local infusion with danshen(Radix Salviae Miltiorrhizae), cell apoptosis was decreased in local spinal cord injury and cell necrosis was inhibited and alleviated after acute spinal cord injury.

Objective To investigate the correlation of BRAF mutation frequency with cervical lymph node metastasis ,and to compare the ultrasonic characteristics in patients with BRAF mutation in papillary thyroid carcinoma ( PTC) different subtypes . Methods The tumor samples were collected from 139 PTC patients who underwent thyroidectomy . And they were classified by histological subtype into 3 groups:classic variant of papillary thyroid carcinoma (CVPTC) group( 34 cases) ,follicular variant of papillary thyroidcarcinoma (FVPTC) group(36 cases) ,tall cell variant (TCV) group(69 cases) . The BRAF mutation frequency and the correlation with cervical lymph node metastasis among 3 groups were analyzed , then the ultrasonic characteristics with BRAF mutation in PTC different subtypes were compared . Results①The frequency of BRAF mutation was statistically significant different in different subtypes( χ2 =6 .390 , P =0 .041) ,and the frequency in TCV was 86 .9％ . There was also a statistical difference between BRAF mutation frequency and cervical lymph node metastasis among three subtypes ( χ2 = 13 .106 , P =0 .041) .②There was no statistically significant difference among the three groups in nodule number ,echo level , internal structure ,boundary ,crossbar ,morphology and acoustic halo of patients with BRAF mutation ( P >0 .05) . ③ A single factor analysis was performed for the ultrasonographic characteristics of patients with BRAF mutation ,and there were significant statistical differences among the 3 groups in calcification type (χ2 = 21 .7 , P = 0 .001 ) and close to the envelope (χ2 = 7 .726 , P = 0 .021 ) . ④ Multivariate logistic regression showed that BRAF mutation was an independent influence factor affecting the calcification type of different histological subtypes in PTC patients.Conclusions ①BRAF mutation is correlated with cervical lymph node metastasis in different PTC subtypes . ② BRAF mutation is an independent influence factor affecting the morphology type of different calcification subtypes in PTC . The CVPTC group is mainly microcalcification ,and the TCV group is mainly macrocalcification .

Objective:To investigate the malignant imaging characteristics of non-palpable Breast Imaging-Reporting and Data System 3 breast lesions (NPBL BI-RADS 3 breast lesions) with ultrasound-guided core needle biopsy.Methods:From February 2016 to February 2018, the ultrasound characteristics of 161 NPBL BI-RADS 3 breast lesions in Beijing Friendship Hospital, Capital Medical University were retrospectively collected with ultrasound-guided core needle biopsy and pathological examination. According to the pathological results, the patients were divided into two groups: benign group (153 cases) and malignant group (8 cases). Associated risk factors were analyzed retrospectively according to general characteristics and characteristics of the ultrasound report. The Fisher exact probability test was used for single-factor comparative analysis. Significant variables based on univariate analysis were included in multivariate regression analysis, and then logistic regression was used to search for clinical risk parameters and ultrasound malignant signs. The receiver operating characteristic (ROC) curve was plotted with statistically significant factors to evaluate the diagnostic efficacy. In combination with the area under the curve (AUC), the parameter integral critical value, sensitivity and specificity were analyzed.Results:The age≥45 years ( OR=35.036, P=0.012), the maximum lesion diameter of 1-1.3 cm ( OR=25.047, P=0.008) and a aspect ratio of the lesion of 0.56-0.72 ( OR=19.860, P=0.013) could significantly affect the benign and malignant nature of the lesions, could be independent risk factors. The AUCs for constructing ROC curves to assess the diagnostic values of the above-mentioned indices were 0.732, 0.724 and 0.751, respectively; the sensitivity was 87.5%, 62.5% and 75%; the specificity was 58.8%, 82.4% and 75.2%; the positive predictive values was 10.0%, 15.6% and 13.6%; the negative predictive values was 98.9%, 97.7% and 98.3%, respectively. Conclusion:Of the NPBL BI-RADS 3 breast lesions, the malignant risk of lesions with an age≥45 years, maximum diameter of 1-1.3 cm and aspect ratio of 0.56-0.72 is high.

Objective:To investigate the relationship of HRAS gene mutation and lymph node metastasis and ultrasonographic characteristics in differentiated thyroid carcinoma (DTC).Methods:The clinical data of 162 patients with DTCs who underwent thyroidectomy and confirmed by postoperative pathological examination in Beijing Friendship Hospital from January 2014 to February 2019 were retrospectively analyzed. There were 139 patients with papillary thyroid carcinoma (PTC group) and 23 patients with follicular thyroid carcinoma (FTC group); the PTC were further classified as classic variant of papillary thyroid carcinoma (CVPTC, n=34), follicular variant of papillary thyroid carcinoma (FVPTC, n=36) and tall cell variant (TCV, n=69). Tissue HRAS mutation frequency was detected in 162 DTC patients and 19 patients with follicular adenoma (FA); blood HRAS mutation frequency was detected in 195 healthy subjects. The correlation between HRAS mutation (IVS1-82del gctgggcctggg) and cervical lymph node metastasis was analyzed, and the ultrasonographic characteristics of DTC patients were also analyzed. Results:The frequency of HRAS mutation in DTC patients was higher than that in healthy controls[37.0%(60/162) vs. 26.2%(51/195), χ2=4.538, P=0.03], while there was no significant difference between FTC and FA [39.1%(9/23) vs. 5/19, χ2=0.769, P=0.38]. In DTC patients there was no significant difference in cervical lymph node metastasis between HRAS mutation group and wild type group [57.3% (43/75) vs. 42.6% (32/75), χ2=1.898, P=0.16]. Among CVPTC, FVPTC and TCV patients, the rates of cervical lymph node metastasis were 7/12, 8/14 and 48.0% (12/25) in HRAS mutation group, while those were 50.0% (11/22), 40.9% (9/22) and 43.1% (19/44) in wild-type group, respectively (χ2=1.009, P=0.98).There were 9 patients with HRAS mutation in FTC group, and the cervical lymph node metastasis in mutation group and wild-type group was 5/9 and 4/14, respectively ( P=0.38). The ultrasonographic characteristics of PTC patients with HRAS mutation were more likely to have clear boundaries [66.7%(34/51) vs. 42.0%(37/88); χ 2=7.833, P<0.01] and not close to the membrane[84.3%(43/51) vs. 65.9%(58/88);χ2=5.506, P=0.02]. Conclusion:DTC patients are more likely to have HRAS (IVS1-82del gctgggcctggg) mutation, and the ultrasonic characteristics of DTC patients with HRAS mutation are likely to have clear boundaries and be not close to the membrane.

Objective: To explore the application effect of fine needle aspiration cytology and sentinel lymph nodes stain assisted by contrast-enhanced ultrasound in early breast cancer. Methods: A patient with early breast cancer enrolled in Beijing Friendship Hospital, Capital Medical University received fine needle aspiration cytology assisted by contrast-enhanced ultrasonography and the sentinel lymph nodes were stained with blue dye before a standard sentinel lymph nodes biopsy traced with indocyanine green. The axillary status accessed by these two methods were compared. Results: Three sentinel lymph nodes were found and aspirated assisted by contrast-enhanced ultrasonography. Seven sentinel lymph nodes were obtained in sentinel lymph nodes biopsy surgery. All of these sentinel lymph nodes were negative. The stained sentinel lymph nodes could be recognized and dissected in open lymph nodes biopsy surgery. Conclusions Fine needle aspiration cytology assisted by contrast-enhanced ultrasonography could be a substitute for open sentinel lymph nodes biopsy. More related researches should be carry out to further compare these two methods.