Objective To determine staging accuracy of double contrast-enhanced ultrasonography (DCUS)after neoadjuvant chemotherapy,and to evaluate effect during neoadjuvant chemotherapy for advanced gastric carcinoma(AGC).Methods A total of 29 patients with AGC diagnosed by endoscopy were examined and staged using ultrasound after taking oral contrast agent and bolus injection of SonoVue (DCUS)pre-and post-neoadjuvant chemotherapy.T-stage accuracy of post-neoadjuvant chemotherapy and pathological T status of postoperative were compared.All of the subjects were divided into two groups according to RECIST(Response Evaluation Criteria in Solid Tumors):chemotherapy benefit group(22cases,including:complete response 0 cases.partial response 14 cases,stable disease 8 cases)and progressive group(7 cases).The findings of DCUS of AGC tissues were assessed by auto-tracking contrast quantification(ACQ)software.The baseline intensity(BI)and peak intensity(PI)of gastric carcinoma tissues were measured automatically,and the enhanced intensity(EI)of gastric carcinoma tissues was calculated manually(EI =PI-BI).The quantitative analysis findings of DCUS of each patient pre-and postneoadjuvant chemotherapy between two groups were compared adopting repeated measures method.Results The overall accuracy of T staging in AGC patients after neoadjuvant chemotherapy were 65.52％ by DCUS,and 0,42.86％and 92.86％respectively for T2 stage,T3 stage and T4 stage.The agreement of this method was weak between T-stage accuracy post-neoadjuvant chemotherapy and pathological T status of postoperative.The Kappa value was 0.33.The difference value of PI and EI between pre-and postneoadjuvant chemotherapy in AGC patients for benefit group was more than that in progressive group.The main effect of BI in AGC tissues between pre-and post-neoadjuvant chemotherapy was no significant difference between two groups(P＞0.05).Conclusions Restaging by DCUS after neoadjuvant chemotherapy in AGC patients was found to be inaccurate.However,the difference value of PI and EI between pre-and post-neoadjuvant chemotherapy in AGC tissues for benefit group was more than that in progressive group.Thus,the value of PI and EI by ICUS may be a useful clinical parameter with which to evaluate the effect during neoadjuvant chemotherapy and guide therapeutic regimen for AGC patients.

Objective To evaluate the accuracy of double contrast-enhanced ultrasonography(DCUS) and endoscopic ultrasonography (EUS) in the preoperative T staging of gastric cancer.Methods A total of 136 consecutive patients with histologically confirmed gastric carcinoma were enrolled into this study.DCUS and EUS were performed in all patients to estimate depth of invasionin (T stage) before surgery.All patients underwent surgery.The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS.Results The accuracy of DCUS and EUS in determining the T stage of gastric cancer were 80.1％ ( T165.5 ％,T2 79.5％,T386.5％,T487.5％) and 81.60％ ( T182.8％,T276.9％,T382.7％,T487.5％) respectively.There was no significant difference between two methods ( P ＞0.05) except T1 staging.Conclusions There is no significant difference between DCUS and EUS in overall T-staging of gastric cancers,but there is a significant difference between two methods in T1 staging.Either of these two methods has its advantages and disadvantages.If two methods are carried out simultaneously to make up for each other,the accuracy of preoperative T-staging of gastric cancers can be improved and this improvement can influence treatment algorithms.

Objective To analyze sonographic characteristics of the automated breast volume scanner (ABVS) in non-mass-like breast carcinoma.Methods 49 patients with non-mass-like breast carcinoma were confirmed by pathology after operation.All of the patients underwent ABVS,the sonographic characteristics of internal echo and microcalcifications in the lesions,the retraction phenomenon in coronal plane and surrounding change were analyzed.All the lesions were assessed by breast imaging reporting and data system (BI-RADS).Results In 49 patients with non-mass-like breast carcinoma,27(55.10％) cases were ductal carcinoma in situ,21 (42.86％) cases were infitrating ductal carcinoma,and 1 (2.04％) case were infitrating lobular carcinoma.The findings of ABVS:43 (87.76 ％) lesions appeared as segmental hypoechoic areas,41 (83.67％) lesions appeared as scattered or clustered microcalcifications,6(12.24％) lesions appeared as the retraction phenomenon in coronal plane,and 1 (2.04％) lesion appeared as pachyderma and subcutaneous dropsy.Microcalcifications in ductal carcinoma in situ appeared more than that in infitrating ductal carcinoma (85.19 ％ vs 80.95 ％,P =0.715) ;the retraction phenomenon in coronal plane of infitrating ductal carcinoma were higher than that of ductal carcinoma in situ(19.05％ vs 7.41％,P =0.383),but there were no significant difference in those between ductal carcinoma in situ with infitrating ductal carcinoma(P ＞0.05).All the cases were assessed according to BI-RADS,including 4a-5 category 44 cases,0-2 category 5 cases.The coincidence rate in diagnosis of ABVS were 89.80％.Conclusions The ABVS features of non-mass-like breast carcinoma are characteristic.Segmental hypoechoic areas,microcalcifications and the retraction phenomenon in coronal plane are important for the diagnosis of non-mass-like breast carcinoma,ABVS can improve the detect ability and decrease the missed diagnosis of non-mass-like breast carcinoma.

Objective To explore the clinical value of double contrast-enhanced ultrasonography (DCUS) on evaluation of the chemotherapy effect in advanced gastric carcinoma. Methods A total of 21 patients with unresectable and received chemotherapy of advanced gastric carcinoma were examined using ultrasound after taking oral contrast agent and bolus injection of Sono Vue, and findings of DCUS of each patient before and after chemotherapy were compared. Results The thickness of lesions was slightly thinner than that after chemotherapy,but there was no significant difference ( P ＞0. 05). In addition, there was no significant difference in the basal intensity (BI), peak intensity (PI), arrive time (AT) and time to peak (TTP) of gastric carcinoma tissues after chemotherapy (P ＞0.05). While the enhanced intensity (EI) value of gastric carcinoma tissues after chemotherapy was significantly less than that before chemotherapy (P ＜0.05). Conclusions The EI value in gastric carcinoma tissues may be considered as a sensitive and effective index in assessing the therapeutic effect of the chemotherapy in patients with advanced gastric carcinoma.

BACKGROUND: Ultra-high molecular weight polyethylene (UHMWPE) is widely used as acetabulum. The hip joint will produce lots of grind particles and lead to loosening of artificial joint because of alternating load and bad lubricate condition.OBJECTIVE: To learn about the lubricate mechanism of joint, introduce the present situation on artificial hip joint of UHMWPE including wear behavior and wear resistance properties, and grope for scientific evaluate method of tribological properties in artificial joints.RETRIEVAL STRATEGY: The articles published between January 2000 and October 2007 were searched by using computer with the key terms "hip joint, ultra-high molecular weight polyethylene, tribology" in CNKI, Weipu Science and Technology Database, Wanfang Database, and its language was limited to Chinese. Meanwhile, the English articles were searched in IEEE/IEE Electronic Library and Elsevier Electronic Journal Database with the key terms "hip simulators, ultra-high molecular weight polyethylene, tribology ". Those referring to the friction and wear property of the joints were included, whereas repeated researches were deleted.LITERATURE EVALUATION: Totally 729 articles were received. After the primary screening of the titles and abstracts, 601 repeated or similar researches were excluded, and other 128 articles were adopted for further analysis, finally 22 articles in accordance with the inclusion criteria were included as references.DATA SYNTHESIS: The study about UHMWPE focused two points, one is surface modification, the other is wear and friction mechanism.①The study indicates that wear properties of UHMWPE can be improved by surface modification, such as ion implantation and nanometer padding have a remarkable elevating ability of the wear and mechanical properties.②At recent years, scholars do many basal experiences about the tribology of hip joints, and have approved that wear rate of friction pairs would reduce under biological lubricate condition using artificial joint simulators or traditional tester in various conditions.CONCLUSION: The study about hip joint in China drops behind the developed counties, this traditional method can not really reflect wear and friction properties in vivo. Therefore, the following research should include making clear the relationships of load, environmental condition and wear of artificial joint in vivo, as well as groping for a scientific evaluate method of tribological properties in hip joints.

Objective To evaluate the safety and efficacy of endoscopic ultrasound (EUS) guided ethanol ablation of benign insulinoma and compare its' advantages and disadvantages with surgical treatment. Methods From April 2011 to February 2016, clinical data of 38 patients with benign insulinoma treated by EUS-guided ethanol ablation or surgical treatment were retrospectively analyzed. Results 97.4% (37/38) patients had a typical clinical manifestation of Whipple's triad, and the I/G ratio of 82.9% patients (29/35) was more than 0.3 with their onset of hypoglycemia. The positive preoperative etiologic diagnosis rates of transabdominal ultrasonography, CT, MRI, PET/CT and EUS were 50.0%, 67.6%, 66.7%, 75.0%, 89.7% respectively. In the current study, 18 patients underwent EUS-guided ethanol ablation (EUS-FNI group) and 20 patients received surgicaltreatment (surgical group). Compared with the surgical group, the operation time, intraoperative hemorrhage volume, postoperative complications, length of stay and hospitalization costs were significantly reduced in the EUS-FNI group (P < 0.05). No treatment-related complications was observed in EUS-FNI group, while 40.0% (8/20) patients in surgical group had complications. During the follow-up period, all these patients maintained stable blood glucose without taking medication, and there's no recurrence of insulinoma in EUS-FNI group after the last treatment with alcohol injection; In surgical group, only 90.0% (18/20) patients had no recurrence, episode of hypoglycemia was less after the operation in 10.0% (2/20) patients. Conclusion EUS-guided ethanol ablation of benign insulinoma is safe and effective, compared with traditional surgical treatment, EUS-guided ethanol ablation is minimally invasive, costs less, recovers fast after treatment and has fewer complications.

Objective To develop the clinical practice guidelines for the management of medication adherence to highly active antiretroviral therapy (HAART) in China. Methods The development methods included qualitative interview of 31 stakeholders, questionnaire survey of 423 PLHIV, adaptation of 30 clinical practice guidelines related to AIDS care, and overviews of reviews of 44 systematic reviews/Meta-analysis. Results 10 clinical practice guidelines and 10 systematic reviews/Meta-analysis were included. The clinical practice guidelines for the management of HAART were formed. Conclusions The formed clinical practice guidelines showed better applicability and higher general quality. It is recommended to use the guidelines in AIDS care.

Objective:To investigate the alteration of right ventricular function after catheter ablation in patients with persistent atrial fibrillation(PAF) and concomitant heart failure with preserved ejection fraction (HFpEF).Methods:The prospective observational study was performed in patients with HFpEF-PAF and undergoing first-time radiofrequency ablation procedures in the First Affiliated Hospital of Nanjing University between May to December 2019. Right ventricular functional parameters were measured before and 5 days, 1, 3, 6 and 12 months after the ablation by transthoracic echocardiography, respectively, including the right ventricular fractional area change (RVFAC), tricuspid annular plane systolic excursion(TAPSE), tricuspid annular diameter (TVAD), tricuspid annular peak systolic speed(TDI-S′) and longitudinal strain of right ventricular free wall (RVFLS). Meanwhile, routine ECG and Holter recordings were performed at each follow-up time point.Results:In this study, atrial fibrillation (AF) recurrence occurred in 4 patients at the 3rd month after ablation, and 7 patients failed to follow up due to the Covid-19. Finally, 19 patients were followed up for the evaluation of cardiac function after catheter ablation. Compared with pre-ablation, right ventricular structural and functional paramters(RVFAC, TAPSE, TVAD, TDI-S′, RVFLS) improved significantly at all stages of follow-up( all P<0.05). Patients with atrial fibrillation recurrence had lower RVFLS and TDI-S′ at the baseline( P=0.039, P=0.019). Conclusions:Right ventricular function could improve in HFpEF-PAF patients who maintain sinus rhythm after radiofrequency ablation.

Objective To investigate the current status of frailty in patients on maintenance hemodialysis(MHD),and explore the correlation of frailty with anxiety and depression.Methods General information,clinical data and blood biochemical data of 101 cases who underwent MHD in Department of Nephrology,Shunde Hospital Affiliated to Jinan University from January 2023 to January 2024 were collected.FRAIL scale was applied to evaluate the frailty of the patients,and they were accordingly classified into frailty group and non-frailty group(including pre-frail and non-frail participants).Anxiety and depression were evaluated by GAD-7 and PHQ-9 scale.Univariate analysis and logistic regression were used to explore the association of frailty with anxiety,depression and other possible influencing factors.Results Among the 101 cases,29 cases(28.71%)were includedin frailty group and 72 cases(71.29%)in non-frailty group.There were 42 patients with depression(41.58%)and 25 with anxiety(24.75%).In the frailty group,the prevalence of depression was 65.52%and that of anxiety 55.17%.There were significant differences in age,grip strength,exercise,stroke and coronary heart disease,anxiety and depression,ferritin and CRP between the two groups(P＜0.01).Multivariate regression analysis showed that depression,anxi-ety,no exercise,stroke and high ferritin concentration were independent risk factors for frailty in MHD patients(P＜0.05).Conclusion In patients on MHD,frailty is closely associated with depression,anxiety,and lack of exercise,and stroke as well as high ferritin concentration are independent risk factors for frailty.

Objective To investigate the application of artificial intelligence-based follow-up plan for patients after percutaneous coronary intervention(PCI).Methods The follow-up plan of artificial intelligence after PCI was constructed through literature review and expert correspondence consultation.A total of 82 patients with coronary heart disease who underwent PCI in the Second Affiliated Hospital of Nanchang University from October 2022 to November 2023 were selected and divided into intervention group and control group according to random number table method,with 41 cases in each group.The control group was given routine nursing program,and the intervention group was added artificial intelligence-based follow-up program on the basis of control group.The incidence of major adverse cardiovascular event(MACE)within 6 months,30 days readmission rate,medication compliance and satisfaction score were compared between two groups.Results The incidence of MACE within 6 months and 30 days readmission rate in intervention group were significantly lower than those in control group(P＜0.05).After 6 months of intervention,Morisky scale score and satisfaction score of patients in two groups were significantly higher than before intervention(P＜0.05),and Morisky scale score and satisfaction score of patients in intervention group were significantly higher than those in control group(P＜0.05).Conclusion Follow-up program based on artificial intelligence technology can reduce the incidence of MACE and 30 days readmission rate of patients after PCI.