Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of small renal cell carcinoma (SRCC) and renal angiomyolipoma (AML) with minimal fat.Methods The images and data of conventional ultrasound (US) and CEUS were retrospectively reviewed in 47 cases of small renal cell carcinoma and 8 cases of AML with minimal fat (d ＜ 30mm),which were confirmed by operation and pathologicall study,including 39 males and 16 females.The mean age of the patients was (54.8 ± 9.8) years old,ranged from 31 to 73 years old.The size,echo,boundary and color flow signals of renal lesions were observed by conventional US.Then the modality and phases of enhancement were observed,including the arrival time,the peak time,the washout time and the appearance of internal structures.Results On contrast-enhanced sonography,fast wash-in and wash-off were observed in most of SRCC,while slow wash-off were observed in most of RAML with minimal fat.The statistically significant differences were found between SRCC and RAML with minimal fat in the values of TFP (time a to peak) and PI (peak-intensity).The occurrence of round pseudo-capsule and contrast-enhancement characteristics in SRCC was far more often than RAML with minimal fat.Conclusions Contrast-enhanced sonography combined with time-intensity analysis provides more useful information for the diagnosis of SRCC and AML with minimal fat.

Objective To promote the clinical practice of bone morphogenetic proteins (BMP) coated prosthesis in order to improve its biological fixation. Methods There were 12 healthy mongrels, weighted from 20 to 25 kg. They were randomly divided into 3 groups according to the scarified time. The bilateral femurs were adopted as the graft areas, and 4 kinds of implant were transplanted into each femur randomly. The transplant consisted of porous-coated anatomic(PCA group), PCA combined with BMP (BMP group), PCA combined with hydroxyapatite(Composite group), and polish PCA combined with HA (HA group). The femurs of the mongrels were retrieved at the 4th, 8th and 12th week respectively. Bone ingrowth and shear strength between the interfaces of the bone-implant were studied, using X-ray, soft X-ray, fluorescence tag, non-decalcification ground section, computer-aided image analysis, and histological examinations. Results By gross observation, the composite for the group of PCA with BMP was the most stable in all the experimental groups. All implants showed good histocompatibility, the bone ingrowth on the implant surface appeared earlier in the BMP group than any others, and so did the maturation of new bone. At 4th week, the percent of new bone formation in the BMP group was 26.58%?4.56%, which was also much higher than PCA group (18.28%?2.46%), Composite group (17.23%?2.11%), and HA group(16.89%?3.13%) through the means of non-decalcified ground section and computer aided image analysis, and the difference was of statistical significance(P0.05). Conclusion The composite of BMP to the PCA is effective and feasible procedure, which could increase biological fixation of the interfaces between the bone and implant. Furthermore, HA coating is also an effective method of prosthesis surface treatment in order to improve bone ingrowth and enhance the interface shear strength, and the technique of HA coating is an essential factor in processing the prosthesis.

Age-related macular degeneration (AMD) has become a leading cause of irreversible visual loss in senior population with serious influence to their ability of living independently.Epidemiological researches have revealed various risk factors of AMD,some of which are not controllable such as age,heredity and race ;while others are modifiable such as lifestyle,eye conditions and other systemic diseases.However,the awareness of AMD risk factors is alarmingly low in public.Meanwhile,the understanding of AMD risk factors among ophthalmologists is also unsatisfactory.Therefore,the risk factors of AMD are reviewed here in order to improve the understanding of the ophthalmologists and better guide the clinical management of AMD.

Objective To compare contrast-enhanced ultrasonography (CEUS), contrast-enhanced CT (CECT) and combined detection of two methods in the diagnosis of small renal masses, and differential diagnosis of different types of small renal masses by CEUS. Methods In 95 cases of small renal masses, there were 79 patients with small renal cell carcinoma and 16 patients with benign tumor. The diagnostic results of the three methods were compared based on the pathological results, which were used as thegold standardfor the diagnostic efficacy. The ROC curve was drawn, and the area under the curve (AUC) was compared. The characteristics of the two groups were analyzed and compared by Q-Lab software in CEUS. The angiographic parameters included arrival time (AT), time to peak (TTP) and peak intensity (PI). CEUS patterns for several pathologic types of renal tumors with larger sample sizes were compared. The characteristic manifestations of small renal masses under CEUS were analyzed. Results The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of CEUS were 87.37%, 93.67%, 56.25%, 91.36%, 64.29%and 0.750, the values for CECT were 88.42%, 93.67%, 62.50%, 92.50%, 66.67%and 0.775, and the values for combined detection of two methods were 95.79%, 98.73%, 81.25%, 96.30%, 92.86%and 0.869 respectively. The sensitivities of the three methods were high, but the specificities were the same. The combined detection showed better diagnostic efficacy than that of single diagnostic method. The AT and TTP of CEUS were earlier in small renal carcinoma group than those of benign nephrotic group, and PI was higher than that of benign nephrotic group (P<0.05). There were significant differences in the contrasts ofcontrast enhancement methods between clear cell carcinoma, papillary cell carcinoma, chromophobe cell carcinoma, and angiomyolipoma (P<0.01). There was little difference in contrast enhancement between the other types of carcinoma. False envelope can be observed by CEUS.'Cystic area'of the detection rate was increased significantly by CEUS than that of conventional ultrasound. Conclusion Combined detection of CEUS and CECT can improve the diagnostic accuracy of small renal tumors. CEUS has great clinical value in the differential diagnosis of small renal masses, which is worthy of clinical promoting.

Objective To study the changes of T-C of apolipoprotein CⅢ (ApoCⅢ)-455C gene and to de-tect the relationship between essential hypertension (EH) and the quantity of ApoCⅢ-455C gene. Methods 606 subjects were divided into hypertension group(n=306) and non-hypertension group(n=300). And the two groups 606 were divided into subgroup A (n=90) who had hypertension companied with hypertriglyceridem, subgroup B (n=216)who had hypertension only, subgroup C (n=51) who had hypertriglyceridem only and subgroup D (n= 249) who had none of the two diseases, by the concentration of triglycerides (TG) (TG≥1.69 mmol/L). The quan-tity of ApoCⅢ-455 C was detected by Real Time PCR. TC, TG, HDL-C, LDL-C, ApeA, ApoB 100, ApoCⅢ, ApoE, blood glucose,plasma insulin and waist circumference were measured in all cases. Results There was no difference in the quantity of ApoCⅢ-455C gene between group B and the group D [(45.16±5.97) vs (46.21±6.13)] (P>0.05). The concentration of ApoCⅢ, ApoB100 and the quantity of ApoCⅢ-455C gene in group A were higher than those in group B [0.14±0.03]g/L, (95.00±15.69)g/L, (28.13±4.11) vs (0.09±0.03)g/L,(81.22± 11.87)g/L,(45.16±5.97)(P<0.01)]. It was similar in ApoE [(0.05±0.01) g/L vs (0.04±0.01)g/L] and LDL-C [(2.54±0.61)mmol/L vs (2.15±0.41)mmol/L] (P<0.05). Conclusions The quantity of ApoC Ⅲ-455C gene is not related to EH.

Objective:To evaluate 131I adjuvant therapy in B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutant patients with non-distant metastatic papillary thyroid cancer (PTC). Methods:From January 2008 to January 2019, a total of 181 PTC patients (65 males, 116 females, age: (38.9±11.8) years) with non-distant metastases from Peking Union Medical College Hospital were retrospectively enrolled. All patients received only one time 131I therapy with complete clinicopathological information, data of follow-up (median time: 63 months) and assessment of response to therapy. Patients were divided into mutant and wild type group in terms of BRAF V600E status or ablation group (1.1 GBq) and adjuvant therapy group (3.7-5.5 GBq) in terms of different 131I dosage. Clinicopathological features and the response to therapy were compared between different groups by using independent-sample t test, Mann-Whitney U test and χ2 test. Results:The levels of preablative stimulated thyroglobulin (ps-Tg) in the BRAF V600E mutant type group ( n=150) was significantly higher than that in the wild type group ( n=31; 6.32(0.90, 8.70) vs 3.92(0.40, 4.40) &mu;g/L; z=-2.413, P=0.016), however, there were no significant differences in other clinicopathological characteristics (including age, sex, tumor size, multifocality, capsule invasion and N staging) between the two groups ( t=-0.663, z=-1.151, χ2 values: 0.003-1.491, all P>0.05) and the therapeutic response was also not different between the two groups( χ2=1.094, P=0.778). Of 81 patients who received 131I adjuvant therapy, the ps-Tg level of BRAF V600E mutant type group ( n=69) was higher than that of the wild type group( n=12; 8.70(1.30, 11.80) vs 3.40(0.30, 4.50) &mu;g/L; z=-2.194, P=0.028), while the therapeutic response was not different between the two groups ( χ2=1.792, P=0.617). Compared with BRAF V600E mutant patients received 131I ablation ( n=81), BRAF V600E mutant patients received 131I adjuvant therapy ( n=69) had larger tumors (1.52(0.95, 2.00) vs 1.21(0.60, 1.50) cm; z=-2.728, P=0.006), more advanced N staging ( χ2=11.460, P=0.003) and higher ps-Tg level (8.70(1.30, 11.80) vs 4.34(0.50, 5.30) &mu;g/L; z=-3.314, P=0.001), but the therapeutic response was not different between the two groups ( χ2=6.478, P=0.091). Conclusion:131I adjuvant therapy may improve the longer-term response to therapy in BRAF V600E mutant PTC patients with lager tumors, more advanced N staging and higher ps-Tg level.

Objective To investigate the diagnostic value of using magnetic resonance imaging (MRI) and transabdominal sonography in antenatal placental adhesive disorders,to provide a theoretical basis for choosing different delivery ways.Methods 75 patients were assessed the placenta structure with MRI and transabdominal sonography.The patients were divided into two groups according placenta in the anterior and posterior uterus(41 cases in anterior group,34 cases in posterior group).Observed relationship between placenta and myometrium,compared imaging finding with pathological or clinical results.Results The sensitivity in diagnosis of placenta in the anterior uterine group was 75.0％ with MRI and 95.0％ for transabdominal Sonography (P＜ 0.05).The specificity was 90.1 ％ with MRI and 80.9 ％ for transabdominal sonography (P＞0.05).The sensitivity in diagnosis of placenta in the posterior uterine group was 95.8％ with MRI and 66.7 ％ for transabdominal Sonography(P＜0.05).The specificity was 90.0％ with MRI and 70.0％ for sonography (P＜0.05).There were significantly difference the imaging feature of uterine bulging,increased subplacental vascularity and dark intraplacental bands on T2-weighted images in placenta accrete group and nonplacenta accretegroup (P＞0.05).Conclusion Both sonography and MRI have fairly good sensitivity and imaging features for prenatal diagnosis of placenta accrete.Especially,MRI is an excellent tool for diagnosis of placenta accrete in the posterior uterine.

Objective To explore the effect of the posterior condylar offset (PCO) on clinical results after total knee arthroplasty (TKA) using a high-flex posterior-stabilized (PS) fixed-bearing prosthesis.Methods Clinical and radiographic materials of 107 consecutive female patients (107 knees),who had undergone primary TKAs for end-stage osteoarthritis was prospectively analyzed.All operations were performed by using the same operative technique.Based on the corrected PCO change,all cases were divided into two groups:66 knees in which the corrected PCO change ≥0 mm (aged 48-73 years,with an average of 61.4 years) and 41 knees in which the corrected PCO change ＜ 0 mm (aged 52-75 years,with an average of 62.2 years).One-year postoperatively,clinical and radiographic variables from the two groups were compared by independent t-test.The associations between the corrected PCO changes and the improvements of clinical variables in all patients were analyzed by Pearson linear correlation.Results The corrected PCO change was 2.49±1.71 mm in the PCO change ≥0 mm group and-1.28±1.41 mm in the PCO change ＜ 0 mm group.One-year postoperatively,the Knee Society scores,the Western Ontario and McMaster Universities Osteoarthritis Index,non-weight-bearing active and passive range of knee flexion,flexion contracture,and their improvements had no statistical differences between the two groups.The corrected PCO change was not significantly correlated with the improvement of any clinical variable.While the PCO change ≥0 mm group (130.40°± 11.63°) demonstrated greater flexion than the PCO change ＜ 0 mm group (123.80°±13.12°) during active weight-bearing one year after TKA,which was significantly different between the two groups (t=2.11,P=0.0401).Conclusion Restoration of PCO plays an important role in the optimization of active knee flexion during weight-bearing conditions after posterior-stabilized TKA,while it had no benefit to non-weight-bearing knee flexion and any other clinical result.

The relationship between the expression of vascular endothelial growth factor (VEGF) and microvascular density (MVD) marked by CD105 (CD105-MVD), and that between CD105-MVD and the clinicopathological characteristics of primary pterygium were investigated. The streptavidin-biotin complex (SABC) immunohistochemical staining in paraffin-embedded tissues was used to detect the expression of VEGF in 23 cases of primary pterygia and 7 normal conjunctival specimens. The antibody against CD105 was used to display vascular endothelial cells, and MVD was examined by counting the CD105-positive vascular endothelial cells. The correlations of VEGF and CD105-MVD, and those of CD105-MVD and clinicopathological data were analyzed by using SPSS 12.0. The expression of VEGF was significantly increased in epithelia (P=0.000), endothelia and stroma cells (P=0.005) in primary pterygia as compared with normal conjunctivae. The CD105-MVD in pterygia (mean 19.22±6.68) was higher than that in normal conjunctivae (mean 4.00±2.15, P=0.000). MVD in pterygia was significantly associated with the Tan classification (P=0.000) and the VEGF expression level in the stroma (P=0.020), but not with sex (P=0.61), age (P=0.150) or the VEGF expression level in the epithelia (P=0.518). Our results suggest that over-expression of VEGF and high CD105-MVD in primary pterygium may contribute to the progression by increasing angiogenesis and growth of primary pterygium.

OBJECTIVE To study how to properly evaluate the curative effect of chronic sinusitis and nasal polyps management with endoscopic sinus surgery(ESS). METHODS Nasal airway resistance, olfactory function, the morphological character of mucosa in nasal and sinus cavity after ESS were surveyed by anterior rhinomanometry,T&T olfactometer standard odors for measuring olfactory sense,acoustic rhinometry and scoring measure of mucosa. RESULTS After ESS, nasal airway resistance decreased and olfactory functions improved obviously. The morphological characters of mucosa in nasal and sinus cavity affect the surgical result directly. CONCLUSION As the determining methods of nasal function after/before ESS,anterior rhinomanometry,T&T olfactometer standard odors,acoustic rhinometry and scoring measure of mucosa can be used to comprehensive estimate the curative effect of ESS objectively.