Objective To evaluate the value of the real-time tissue elasticity imaging quantitative method in differential diagnosis of thyroid nodules.MethodsSeventy-three patients with thyroid nodules，including 95 lesions,were included in the study.A total of thyroid nodules were examined with traditional ultrasonography and elastosonography from which the strain ratios(SR)were derived，with pathologic results as the reference standard.And a receiver-operating charaeterisitc(ROC)curve was used to identify the value of optimal operating point for differential diagnosis of thyroid nodules.Results①The strain ratio of the benign lesions was 2.06 ±1.01，which was significantly different from the value of malignant lesions 5.05±2.23(P＜0.05).②The area under the curve was 0.929，which showed a high statistical significance.③It showed that the optimal operating point of ROC curve was 3.17，with high sensitivity(96.7%)，specificity(90.8%)，postive predictive value (93.3%)and negative predictive value(96.9%).Conclusions The real-time tissue elasticity imaging can provide a quantitative,noninvasive and convenient tool for evaluating the thyroid nodules.

Five kinds of pore-forming agents, including PEG-400, chitosan, the polymer of chitosan and glutin, CaCO3 and NazCO3, were used in this experiment to prepare fast responsive and pH sensitive Polyacrylic acid (PAAc) gel which could be used as the material of punctum plug. The mechanism and effects of pore-forming agents on PAAc gel were studied; besides, the experiment also assessed the effects of the three most effective pore-forming agents on gel's water retention and swelling rate. The results showed that the most suitable dose levels of PEG-400, the polymer and Na2CO3 were 1 ml, 0.8 ml and 1 ml respectively, and PEG-400 was most effective with the same dosage; the gel with PEG-400 as pore-forming agent could finish more than 95% of the swelling process in just 5 minutes, it is suitable for use as punctum plug material.
Acrylic Resins ; chemistry ; Carbonates ; chemistry ; Chitosan ; chemistry ; Hydrogels ; chemical synthesis ; chemistry ; Hydrogen-Ion Concentration ; Ophthalmic Solutions ; chemical synthesis ; chemistry ; Polyethylene Glycols ; chemistry ; Polymers ; Porosity

Objective To explore the value of wave intensity (WI) parameters in evaluating hemodynamic changes of cardiovascular system before and after 131I therapy in hyperthyroid patients.Methods Forty-seven hyperthyroid patients were enrolled as hyperthyroid group,while 47 healthy volunteers were considered as control group.Both of the hyperthyroid and control group took WI examinations,and WI curves of their right common carotid arteries were recorded.WI parameters of WI curve were automatically measured as followed:value of the first positive peak (W1),value of the second positive peak (W2),area of the negative peak (NA),and the square root of NA (A).Twenty-five patients of the hyperthyroid group received 131I therapy were enrolled as treatment group.All these patients were followed up for 3 months.The repeatability of the WI parameters was evaluated in 10 hyperthyroid patients and 10 normal volunteers selected at random from the investigation.Results W1,W2,A in hyperthyroid group increased compared with those in control group,and independent-samples t test showed very significant difference (P=0.000,P=0.000,P=0.000).W1,A decreased after 131I therapy compared with those before treatment,and paired-samples t test showed significant difference (W1:P=0.001;A:P=0.011).A in hyperthyroid group had positive correlation with FT3 (r=0.508,P=0.003);W1 after 131I therapy in treatment group had positive correlation with FT3 and FT4 (r=0.601,P=0.002;r=0.680,P=0.00);W2 after 131I therapy in treatment group had positive correlation with FT3 and FT4 (r=0.549,P=0.005;r=0.570,P=0.004).The repeatability of W1,W2,NA and A were good by consecutive measurement of identical observer.Conclusions WI peak parameters of hyperthyroid patients were higher than those of healthy volunteers,and some sensitive parameters were decreased after 131I therapy,which may provide the basis for assessing the effectiveness of 131I therapy.

Objective:To investigate the prevalences of overweight and obesity and its relationship with the risk factors of cardiovascular diseases among physical examination population in Nanjing Drum Tower Hospital.Methods:A retrospective analysis was performed on 384 061 adults aged 20 years and older. Age- and sex-standardized prevalences of overweight and obesity were calculated using Chinese census data in 2010. Multivariate logistic regression analysis was used to assess the associations of overweight and obesity with the risk factors of cardiovascular diseases.Results:The age-standardized prevalences of overweight and obesity were 42.8% and 13.2% in men and 23.9% and 6.6% in women. A gradually increasing trend was observed in the prevalences of overweight and obesity from 2008 to 2016, especially in subjects aged 20-39 years. Overweight and obesity were significantly associated with increased risks of dyslipidemia, diabetes mellitus, hypertension, and hyperuricemia. These associations were found to be the strongest among subjects aged 20-39 years, which became weaker along with the increasing of age. The OR(95% CI) of dyslipidemia, diabetes mellitus, hypertension, and hyperuricemia were 4.23(4.01-4.47), 3.70(2.97-4.60), 6.19(5.76-6.64), and 3.66(3.45-3.88) in obese men aged 20-39 years, while 5.29(4.63-6.04), 6.38(3.86-10.55), 9.36(7.86-11.13), and 6.65(5.70-7.74) in obese women aged 20-39 years, respectively. Conclusion:The increasing trend in the prevalence of overweight and obesity is a risk factor for cardiovascular diseases in Nanjing adults, especially in individuals aged 20-39 years.

Background Peters anomaly is a rare eye disease.Understanding the clinical features of Peters anomaly is helpful for us to correctly manage this disease.Objective This study was to investigate the clinical characteristics and treatment methods of Peters anomaly and provide available basis for the diagnosis and individualized treatment of Peters abnormal.Methods A descriptive study was performed.The clinical data from 8 eyes of 4 patients with Peters anomaly who were diagnosed and treated in Beijing Children's Hospital from January 1,2014 to March 30,2016 were retrospectively analyzed.The clinical manifestations of the anterior ocular segment were examined by handheld slit-lamp microscope,and corneal curvature,corneal thickness,axial length and intraocular pressure were measured.The therapy and outcomes of the patients were evaluated.Results Peters anomaly was classified into type Ⅰ,type Ⅱ and Peters plus syndrome based on the findings and literature'criteria.Regarding to the clinical findings,the adhesion of peripheral angle with cornea,shallow or disappeared anterior chamber were found in all the eyes,and these manifestations were type Ⅰ Peters anomaly and occurred in 2 eyes of 2 patients.The opacity and adhesion of the central lens capsula to corneal endothelium was seen in 6 eyes which belonged to type Ⅱ Peters anomaly.The mean corneal thickness was (680± 127) μm in 4 measured eyes,which was thicker than normal eyes;the mean corneal curvature was (37.40±1.79)D in 4 measured eyes;the mean axial length was (21.06±0.19)mm and the mean diameter of cornea was (9.4 ± 0.5) mm in 4 measured eyes.Iridocoloboma was found in 4 eyes and congenital aniridia was in 4 eyes.In addition,esotropia appeared in 1 patient,and nystagmus occurred in 3 patients.The 3 patients of type Ⅱ in this study were found to have the disorders associated with systemic neurogenic developmental abnormalities and diagnosed as Peters plus syndrome.Trabeculectomy with anterior vitrectomy was performed in 2 eyes with the intraocular pressure ＞30 mmHg(1 mmHg =0.133k Pa) and the introcular pressure reduced to below 21 mmHg after operation.Penetrating corneal transplantation was carried out on 1 eye with central opacity.However,rejection of graft occurred at 1 month and became complete cloudy at 3 months after surgery.Cataract extraction surgery was performed on 4 eyes with lens opacity and intraocular lens were implanted in 2 eyes or iridectomy was carried out in another 2 eyes,and the visual quality was evidently improved after operation.Conclusions The clinical characteristics of Peters anomaly include leukoma,shallow anterior chamber,peripheral iris adhesion with cornea and lens opacity due to adhesion of lens anterior capsule to corneal endothelium.Personalized operative regimen should be determined based on the clinical findings of the eyes with Peters anomaly.

lusions WI parameters reflect both cardiac and vascular changes of hyperthyroid patients. Mid-systolic hemodynamic turbulence appears in a portion of hyperthyroid patients.

Objective To assess the value of quantitative color Doppler sonography in patients with systemic lupus erythematosus (SLE). Methods The right renal in 21 patients with SLE and 22 normal subjects were examined with Philips IU22 ultrasonic diagnostic device. Resistence index (RI) of interlobar artery and interlobular artery were measured with color Doppler sonography, vascularity index (VI), flow index (FI) and vascularization flow index (VFI) which reflecting the renal cortical blood flow were calculated with quantitated analysis software. All the parameters between two groups were compared and analyzed. Results The color signals of renal cortical blood flow in patients with SLE were inferior to those of the normal group, especially in the area near the edge of renal. No statistical difference of RI was found between the two groups (P>0.05), while VI, FI and VFI in SLE group were significantly lower than those of the normal group (VI, VFI, P<0.01, FI, P=0.01). Conclusion Color Doppler sonography combined with blood flow quantitative technique provide a helpful, sensitive and convenient tool to detecte the renal changes in SLE patients.

This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1st), interval between W1 and W2 (1st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the W1, W2, NA, and (1st-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with W1, W2, NA, (1st-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.

lerosis of the lower extremity artery in patients with type 2 MD.

Objective:To investigate the factors influencing the prognosis of talar neck fractures of Hawkins type Ⅲ.Methods:A retrospective analysis was performed of the 18 patients with complete follow-up data who had been treated from October 2013 to December 2016 at Department of Orthopedic Trauma, Beijing Jishuitan Hospital for talar neck fractures of Hawkins type Ⅲ. They were 14 males and 4 females with an average age of 35.1 years (range, from 17 to 50 years). There were 3 open fractures. All the patients were treated with one-stage open reduction and internal fixation. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system was used to evaluate the functions of ankle and hindfoot during follow-up. The correlations were analyzed between the ankle-hindfoot AOFAS scores and the factors which might have influenced the prognosis, like gender, age, smoking, alcoholic drinking, body mass index, injury cause, medial malleolus osteotomy/fracture, combined fracture, open injury, interval from injury to surgery, operation time, implants (cannulated/plate or Kirschner wire) and infection.Results:The 18 patients were followed up for 21 to 41 months (average, 29.3 months). Of them, 3 had superficial infection which responded to anti-inflammatory therapy and 3 had deep infection which was improved after debridement in 2 cases and led to eventual removal of the talus in one. Tibiotalar arthritis occurred in 6 patients and subtalar arthritis in 10. The AOFAS ankle-hindfoot scores at the last follow-up for this cohort ranged from 12 to 96 points (average, 63.4 points). Ischemic necrosis of the talus was observed in 6 cases and talar collapse in one. The ankle-hindfoot AOFAS scores were strongly correlated with open fracture ( P=0.015,) operation time ( P=0.001), Kirschner wire fixation ( P=0.006), and postoperative infection ( P=0.008). Conclusions:Since open fracture, operation time ≥3 h, Kirschner wire fixation and postoperative infection may be the significant factors that may influence the prognosis of talar neck fractures of Hawkins type Ⅲ, reasonable treatment protocols can help improve the outcomes.