The standardized resident training is an important and necessary way to cultivate high-quality medical talents.The goals between clinical and imaging residents in standardized training of ultrasound department are different.For clinical residents,the purpose is to understand the ultrasound images of various common diseases,combine clinical manifestation with ultrasound images,and improve the level of clinical diagnosis and treatment.For imaging residents,the goal is much higher and stricter;they need to master solid ultrasonic knowledge,independent operational and diagnostic ability,in order to provide reliable and accurate ultrasonic diagnosis.We individually design the teaching plan and methods in ultrasound department,in order to improve teaching efficiency and quality.

Thyroid cancer is the most prevalent cancer of endocrine tumors. Its correct diagnosis and differential diagnosis play very important roles in its treatment and prognosis. Ultrasonography, as its powerful tool, is clinically widely used. This article made a review about its main diagnostic methods, including conventional ultrasound, contrast-enhanced ultrasonography and ultrasonic elastography, in order to relfect their panorama.

Small cell carcinoma of cervix (SCCC) is a rare and high malignant neuroendocrine tumor.Because of its strong invasion,metastasis in early stage and easy recurrence,the prognosis is poor.Its diagnosis is based on pathomorphology,and immune-histochemistry biomarkers can improve its diagnosis.Combined therapy is recommended.Postoperative platinum/etoposide (PE),vincristine/adriamycin/cyclophosphamide (VAC) or taxel/carboplatin(TP) chemotherapy can improve the prognosis.

Objective To study role of color Doppler ultrasonography in predicting the benignity and malignancy of the peripheral hypoechoic lesion of the prostate.Methods Seventy-seven patients who had peripheral hypoechoic lesions were detected with transrectal color Doppler ultrasonography.The black and white color ratio (BCR) in peripheral hypoechoic was calculated by color histogram and compared with prostate BCR.The amount of flow signal was considered increasing if BCR in the lesions was higher than 5% in their prostate.Results Transrectal ultrasound-guilded biopsy of the hypoechoic lesions revealed prostate cancer in 51 patients and benign prostate hypertrophy in 26 patients.The increase of flow signal was in 50 patients,41 of them were prostate cancer.For an increased flow signal within a peripheral hypoechoic lesion as a signal of prostate cancer,color Doppler ultrasonography has a sensitivity of 80.4% ,a specificity of 65.4% ,and a positive predictive value of 82.0% .Conclusions Color Doppler ultrasonography through rectum on blood flow in peri-prostate hypoechoic nodules with BCR account for their rich degree in malignancy and benignity differentiation.

Purpose:To evaluate the efficacy and toxicities of gemcitabine plus cisplatin for patients with relapsed ovarian cancer. Methods:Twenty-eight patients with recurrent ovarian carcinoma received gemcitabine (1000 mg/m~(2)) plus cisplatin (35 mg/m~(2)) on days 1 and 8 of each 21-day cycle. Of 28 patients, sixteen who relapsed within six months of previously platinum-based regimen were platinum-resistant and the other twelve were platinum-sensitive. Results:Of 28 patients, there were 5 (17.9%) complete and 12 (42.9%) partial responses, for an overall response rate of 60.7% (95%CI: 41.7%–79.6%). The median time to progression for objective responders was 5.5 months with a range of 2.5 to 20 months. Median overall survival for all 28 patients was 12.5 months. Among 16 platinum-resistant patients, a 56.3% response rate occurred. The median survival time was 10.5 months. Among 12 platinum-sensitive patients, a 66.7% response rate occurred. The median survival time was 14.5 months. There were leukopenia grade Ⅲ in 35.7%, grade Ⅳ in 17.9%; thrombocytopenia grade Ⅲ in 28.6 %, grade Ⅳ in 14.3% of patients. Conclusions:Cisplatin plus gemcitabine is active in patients with relapsed ovarian cancer. The adverse effects are tolerable. Hematologic toxicities are manageable with dose modifications.

Purpose:To study the expression of CK19 and CK2 0mRNA in peripheral blood patients with FRGO Stage ⅠA to ⅡA cervical carcinoma and to investigate its clinical significance. Methods:Using the reverse transcription polymerase chain reacti on(RT-PCR),CK19 and CK20mRNA expression was examined in peripheral blood fro m 250 patients with early cervical carcinoma before operation,50 Patients with benign gynecological tumors and 18 healthy volunteers. In 250 patients,possible correlations between clinical pathological factors were analyzed. Results:The positive expression rates of CK19 and CK20mRNA were 36% and 24% in 250 cervical carcinomas respectively,in comparison with 3.0% an d 0% with benign gynecological tumors and all subjects in healthy volunteers wer e negative; The expression of CK19 and CK20 mRNA were significantly correlated w ith lymph vascular space involvement,but was not associated with prognostic fac tors including stage,differentiation,pathological types ,lymph node metastasis ,bully tumor size . In patients with CK19 mRNA(+)/CK20 mRNA(+),the rate of lymp h node metastasis and vascular space involvement and recurrence outside the pelv is was significantly higher than that of patients with CK1R mNA9(-)/CK20 mRNA(- )(P

Background and purpose:To evaluate the treatment regimens used for patients with yolk sac tumors of the ovary and prognostic factors in our hospital. Methods:Clinical data for the patients with yolk sac tumors of the ovary were analyzed retrospectively. Patients were divided into four groups: patients in A group received nonsparing surgery and platinum-based chemotherapy; in B group received nonsparing surgery and non-platinum-based chemotherapy; in C group received fertility-sparing surgery and platinum-based chemotherapy; in D group received fertility-sparing surgery and non-platinum-based chemotherapy. 5-year survival rate and prognostic factors were analyzed.Results:The overall 5- year survival rate was 69.2 %. The 5- years survival rates were 81.8 %, 40.0 %, 82.6% and 50.0% for A, B, C and D group, respectively. Platinum-based chemotherapy achieved significant survival benefit (82.4% vs. 44.4%, P0.05). Clinical stage, the size of residual tumor and Platinum-based chemotherapy were the mainly prognostic factors in multianalysis.Conclusions:Fertility-sparing surgery with a postoperative plainum-based chemotherapy should be the ideal modality for the treatment of yolk sac tumors of the ovary. Staging and tumor-reductive surgery were most associated with the prognosis of the patients.

Objective To investigate the categories of fetal anomalies detected by ultrasound scan in the third trimester.Methods From January 1,2012 to December 31,2013,492 singleton fetuses were found to have structural abnormalities on the first,second or third trimester ultrasound scan in the Peking University First Hospital,only 50 (10.2％) fetuses were detected on the third trimester (≥ 28 weeks of gestation) with no abnormalities detected on the first and second trimester scan,were enrolled.The categories of the fetal structural abnormalities were analyzed.Results The age of the mothers of the 50 fetuses with structural abnormalities was (35.7± 5.2) years (26-43 years) with an average gestation of (32.4±2.8) weeks (28.6-36.8 weeks).These abnormalities were seen in the central nervous system (42％,21/50),digestive system (28％,14/50),urinary system (16％,8/50),cardiovascular system (8％,4/50),respiratory system (4％,2/50) and facial structures (2％,1/50).Intrauterine death occurred in one case and 49 mothers had a live birth.After birth,14 neonates were normal,five needed further treatment,three cases were complicated by other abnormalities,23 had no dysfunction but need follow-up and four were lost to follow-up.Six of the 20 (30％) fetuses with central nervous system abnormalities and 2/4 fetuses with cardiovascular system abnormalities had an adverse prognosis,while 1/12 and 2/7 fetuses with digestive and urinary system abnormalities had an adverse prognosis.Conclusions The central nervous system and cardiovascular system should be examined in priority during the third trimester ultrasound scan.

3T3-L1 adipocytes were cultured and differentiated into mature adipocytes in vitro. The adipocytes were intervened by ACAT inhibitor( 2 μg/ml) and ox-LDL with various concentrations (0,25,50,75,and 100 μg/ml)for 48 h,ACAT inhibitor( 2 μg/ml) and ox-LDL( 50 μg/ml) at the 0,6,18,36,and 48 h,or ACAT inhibitor( 2 μg/ml),ox-LDL( 50 μg/ml),and TUDCA with various concentrations(0,100,200,and 400 μ mol/L)for 48 h,respectively.The levels of visfatin in supernatant were examined by ELISA and the expressions of protein GRP78 and CHOP in adipocytes were detected by Western blot.After the adipocytes were treated with ACAT inhibitor and ox-LDL at different concentrations for 48 h,the cholesterol concentration and the expressions of GRP78 and CHOP protein in adipocytes and the visfatin levels in the supernatant fluid were increased with the increase of the ox-LDL concentration.The differences had statistical significance in the experimental groups compared with blank control group( all P＜0.05 ).After the intervention with ACAT inhibitor and ox-LDL for different durations,the expressions of GRP78 and CHOP protein in adipocytes and the visfatin levels in the supernatant fluid were up-regulated in a timedependent manner.The differences between experimental groups and blank control had statistical significance( all P＜0.05 ).After the intervention with ACAT inhibitor,ox-LDL,and different concentrations of TUDCA for 48 hours,the expressions of GRP78 and CHOP protein in adipocytes and visfatin levels in the supernatant fluid were down-regulated in a dose-dependent manner and as compared with blank control group the difference were statistically significant( all P＜ 0.05 ).The increase of cholesterol load in adipocyte may promote the visfatin secretion,denoting that the mechanism might be due to the enhancement of endoplasmic reticulum stress in aidpocytes.

Objective To investigate the value of retraction phenomenon in coronal plane at threedimensional ultrasonography(3D-US) in preoperative assessment of prognostic factors in breast cancer.Methods Surgical resection specimens of 66 malignant breast lesions in 66 women who had undergone 3D-US were included.The presence of the retraction phenomenon in the coronal plane was evaluated.Pathologic prognostic factors,including tumor size,histologic grade,lymph node status,estrogen receptor (ER) and progesterone receptor (PR) status,and human epidermal growth factor receptor 2 (Cerb-B2) and p53 expression were determined.Correlation of the retraction phenomenon and prognostic factors was analyzed.Results The retraction phenomenon was correlated to the tumor size,histologic grade,and estrogen and progesterone receptor status.Compared with the breast cancer without the retraction phenomenon,the tumor foci with the retraction phenomenon were more likely to show a smaller diameter less than 2 cm (73.7％ vs 46.4％,P ＜0.05),a lower histologic grade with grade Ⅱ (88.2％ vs 42.9％,P ＜0.01),and a higher positive rate of ER and PR (86.8 ％ vs 64.3 ％,P ＜0.05;81.6 ％ vs 57.1％,P ＜0.05).The lymph node status and the expression of the CerB-2 and p53 in the two groups had no significant difference (P ＞0.05).Conclusions The retraction phenomenon in the coronal plane of three-dimensional US may be useful in the noninvasive prediction of prognostic factors of breast cancers.