Objective To analyze the ultrasonographic characteristics of breast cystic-solid lesions and to investigate the diagnostic value of BI-RADS breast imaging reporting and data system in this kind of disease Methods Imaging characteristics of 105 breast cystic-solid lesions of 93 patients were analyzed All the lesions were assessed by BI-RADS Histopathologic examination was used as the reference standard Results Among 105 lesions 57 54 3% were benign and 48 45 7% were malignant Differences in orientation shape margin calcification and vascularity were statistically significant between the benign and malignant lesions P < 0 05 whereas the echo pattern and the posterior acoustic feature did not show significant differences P >0 05).There were 5 1 predominantly solid mass,which appeared as solid mass with little dispersed or centralized cystic regions or solid mass with surrounding cystic regions,including 33 benign lesions and 1 8 malignant lesions.The area under the curves of ROC was 0.956 in this type.There were 25 lesions predominantly cystic,which had regular or irregular thick walls or septa,or had nodules protruding to the cystic component,including 1 1 benign lesions and 14 malignant lesions.The area under the curves of ROC was 0.753.There were 29 mixed solid-cystic mass,in which the solid component equaled to the cystic,including 13 benign lesions and 16 malignant lesions.The area under the curves of ROC was 0.887.The area under curves of ROC was 0.873 for the all breast cystic-solid lesions.The rates of malignant cystic-solid lesions in the three types had no significant difference(P >0.05).Conclusions Ultrasound is a useful tool for diagnosing breast cystic-solid lesions.The proportion of the cystic component is not helpful to differentiate malignancy from benignancy.

Objective To evaluate the ultrasonographic ( US ) findings of granulomatous lobular mastitis( GLM ) ,and to compare the diagnostic accuracy among US ,mammographic ,and magnetic resonance imaging ( MRI) . Methods Imaging characteristics of 56 patients who were pathologically comfirmed as GLM were reviewed .All the lesions were assessed by BI‐RADS ( Breast Imaging Reporting and Data System) . Results Fifty‐eight lesions were found in 56 patients . Thirty ( 51 .7% ) were irregular ,20 (34 .5% ) were lobular and 8(13 .8% ) were round or oval in shape . Forty two lesions (72 .4% ) were hypoechoic ,14 (24 .1% ) were mixed echoic textur ,including 6 lesions (10 .3% ) with tubular connections and 8 lesions ( 13 .8% ) with irregular markly hypoechoic internal echoes . Two ( 3% ) were isoechoic .No calcification were found . Color Doppler signals were detected in 33 cases(56 .9% ) ,and the resistance index ( RI) ranged from 0 .61 to 0 .79 . Forty patients underwent mammography ,there were no distinct lesions in 6 cases(15% ) ,suspicious calcification in two(5% ) , asymmetric density in twenty(50% ) ,and solitary masses in twelve(30% ) . MRI was performed in 36 patients ,and revealed no abnormality in two patients(5 .6% ) , twenty nine lesions ( 80 .6% ) showed hypointensity on T1‐weighted images and hyperimensity on T2‐weighted images ,five lesions ( 13 .9% ) showed isointensity on T1‐weighted images and hyperimensity on T2‐weighted images ,and all the lesions showed heterogeneous enhancement after contrast .The diagnostic accuracy of ultrasonography , mammography and MRl was 63 .8% , 45% and 61 .1% , respectively . Conclusions There were no specific imaging characteristics of GLM ,the combination of ultrasonography , mammography and MRI might benefit the diagnosis of GLM .

Objective To investigate the value of shear wave elastography (SWE)for differential diagnosis of benign and malignant thyroid nodules.Methods A total of 1 56 patients referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography.The following characteristics of all the nodules were assessed:location,size,shape,margin,echogenicity,calcification and blood flow.The SWE elasticity indices of maximum (Emax),mean (Emean),minimum (Emin),and standard deviation (Esd) were automatically calculated by the US system.Thresholds were calculated by receiver operating characteristic (ROC ) curve analysis.The diagnostic performance of conventional US and SWE were compared.Histopathologic examination was used as the reference standard.Results Among a total of 1 56 nodules,1 1 8 were malignant and 38 were benign.SWE elasticity indices were significantly higher in malignant than in benign nodules (P ≤0.001 ).Sensitivity and specificity for predicting malignancy were 83.9%,92.1 % respectively using Emean with a threshold of 32.1 kPa,the specificity was significantly higher than using conventional ultrasound (P <0.05 ).Area under the ROC curve (Az)of Emean was highest (0.880,95% CI:0.81 7,0.943),however the differences were not significant(P >0.05).Conclusions SWE provides higher specificity for predicting malignancy without losing sensitivity.

Objective To study the expression of transforming growth factor -β1 (TGF -β1 )in myocardial tissue and the concentration of serum B -type natriuretic peptide (BNP)in myocardial remodeling of SD rats induced by isoproterenol (ISO)and the effects of carvedilol intervention.Methods According to random number table,30 male SD rats were divided into 3 groups:(1 )after 9 g/L saline was injected with 5 mL/(kg·d)for 1 0 days,9 g/L sa-line was used at the dose of 1 0 mL/(kg·d)by way of gavage for 4 weeks in the control group (n =1 0);(2)after ISO was injected with 5 mg/(kg·d)for 1 0 days,9 g/L saline was used at the dose of 1 0 mL/(kg·d)by way of gavage for 4 weeks in the model group (n =1 0);(3)after ISO was injected with 5 mg/(kg·d)for 1 0 days,carvedilol was used at the dose of 1 0 mg/(kg·d)by way of gavage for 4 weeks in the treatment group (n =1 0).Then,all the rats were killed and the cardiac weight index (CWI)was measured.The pathological changes of myocardial tissue were ob-served through HE staining and Masson staining.The mRNA expression of TGF -β1 was detected by adopting reverse transcription -polymerase chain reaction.The protein of TGF -β1 was detected by means of immunohistochemistry and Western blot.The concentration of serum BNP was tested by adopting enzyme -linked immuno sorbent assay.Results (1 )Pathological changes by light microscope:no significant pathological changes were observed in myocardial tissue of the control group.The denaturization,hypertrophy,edema,necrosis of myocardial cells and collagen fibers increased in myocardial tissue of the model group were more serious than those of the treatment group.(2)CWI:CWI of the model group[(3.31 ±0.07)mg/g]was significantly higher than that of the treatment group[(3.03 ±0.04)mg/g],and CWI of the treatment group was significantly higher than that of the control group[(2.98 ±0.1 0)mg/g].There was significant difference among 3 groups (F =54.383,P =0.000).There was also significant difference between any 2 groups (all P <0.01 ).(3)The level of TGF -β1 of myocardial tissue:the level of TGF -β1 of the model group was significantly higher than that of the treatment group,and the level of TGF -β1 of the treatment group was significantly higher than that of the control group by using three detection methods.There was significant difference among 3 groups (F=1 3.62,P =0.000).There was also significant difference between any 2 groups (all P <0.01 ).(4)The concentration of serum BNP:the concentration of serum BNP of the model group[(61 .1 3 ±2.00)ng/L]was significantly higher than that of the treatment group[(57.08 ±1 .52)ng/L],and the concentration of serum BNP of the treatment group was sig-nificantly higher than that of the control group[(51 .56 ±1 .80)ng/L].There was significant difference among 3 groups (F =72.81 ,P =0.000).There also was significant difference between any 2 groups (all P <0.01 ).Conclusions The expression of TGF -β1 in myocardial tissue was up -regulated and the concentration of serum BNP was increased in my-ocardial remodeling of SD rats induced by ISO.The carvedilol intervention can down -regulate the expression of TGF -β1 and decrease the concentration of BNP,then inhibit myocardial remodeling,and improve cardiac function.

Objective To investigate the influence of IL-8 on the tight junction of vascular endothelial cells.Methods Immunofluorescence was used to observe the modality and the distribution of three tight junction proteins (occludin,claudin-5 and ZO-1) of the EA.hy926 cells treated with IL-8 under different concentrations and different times.RT-PCR was used to measure the mRNA expression of these three proteins.Results The results demonstrated that IL-8 could change the distribution of occludin,claudin-5 and ZO-1 in EA.hy926 cells,and the mRNA expression of occludin,claudin-5 and ZO-1 decreased with the increase of IL-8 concentration and treated time.Conclusion The effects of IL-8 on the distribution and the expression of occludin,claudin-5 and ZO-1 are dose and time-dependent.

ObjectiveTo evaluate the value of MRI diffusion weighted imaging in localization of prostate cancer with whole-mount step section pathology.MethodsWe treated 36 patients using laparoscopic radical prostatectomy from Oct. 2009 to Jun. 2010. Patients who did not have an MRI/DWI examination or a surgical history of prostate and previous hormonal therapy were excluded, leaving 19 patients in our study. We analyzed the MRI and DWI collected before radical prostetectomy surgey and the post-surgery step section pathology made by the whole mount technique. The prostatic gland was divided into six sections. Two doctors read the MRI/DWI without knowing the patients' information and scored, using a 5 point scale, for each section. The tissue was graded according to the following scale: 1-definitely no cancer, 2-probably no cancer, 3-possible cancer, 4-probable cancer and 5-definite cancer. When the average score ≥4 the region was assumed to be the prostate cancer region by MRI or MRI/DWI.ResultsIn 19 patients with 114 regions, there were 48 (42％) prostate cancer regions approved by whole-mount step section pathologically.The number of prostate cancer regions was 15 (39％), 21 (55％) and 12 (32％) in base, mid and apex parts respectively. The sensitivity and specificity of the MRI was 62.5％ and 69.7％. When considering DWI, the specificity and sensitivity was elevated to 79.1％ and 83.3％. As for the apex and mid parts, the sensitivities of MRI were a little bit low (46.7％ and 66.7％ ). But the sensitivities of localization of prostate cancer for the apex and mid of prostate were elevate to 73.3％ and 85.7％ respectively when DWI was also used.ConclusionsWith whole-mount step-section pathology, the combination of MRI and DWI can improve the sensitivity of MRI for localized diagnosis in prostate cancer, especially in apex and mid parts of the prostate.

ObjectiveGeneration of human induced pluripotent stem cells from human skin fibroblasts.MethodsSox2, Klf4, Oct4, c-Myc were transfected into HSF cells with retrovirus, and then HSF cells was reprogrammed to iPS cells.Detecting cells endogenous and exogenous gene, analyzing karyotype,cells alkaline phosphatase staining and immunofluorescence staining, differentiating into teratomas in vivo and embryoid bodies in vitro were performed.ResultsiPS cell morphology was similar to embryonic stem cells (ES).The expression of Nanog, Oct4, Rex1, Sox2 in iPS cells were higher than HSF cells, and Sox2, Klf4, Oct4, c-Myc were silenced for the iPS cells.Exogenous genes were inserted into the nucleus of iPS cells, which was confirmed by 1％ agarose gel electrophoresis.iPS cell karyotype was normal, alkaline phosphatase activity increased, ES cell-specific protein expressed.iPS cells were differentiated into a teratoma in vivo and embryoid bodies in vitro.ConclusionsiPS cells were similar to ES cells, which have pluripotency.

Objective To generate of human induced pluripotent stem cells from umbilical cord matrix cells(UMC).Methods Sox2 and Klf4 and Oct4 and c-Myc were transfected into UMC cells with retrovirus,and thcn UMC cells was reprogrammed to iPS cells.Gene expression was confirmed with RT -PCR and the integration was confirmed with cell karyotype.iPS cells were further validatcd with cell alkaline phosphatase detection and immunofluorescence staining,differentiating into teratomas in vivo and embryoid bodies in vitro.Results iPS cells were similar to embryonic stem cells (ES).The expression of Nanog,Oct4,Rex1 and Sox2 in iPS cells were higher than UMC cells,and Sox2,Klf4,Oct4,c-Myc silenced in iPS cells.Exogenous genes were inserted into the nucleus of iPS cells,which was confirmed by 1％ agarose gel electrophoresis.iPS ccll karyotype was normal,alkaline phosphatase activity increased,ES cell-specific proteins,including SSEA3,SSEA4,TRA-1-60,TRA-1-81 and Nanog,were expressed.iPS cells were differentiated into a teratoma in vivo and embryoid bodies in vitro.Conclusions iPS cells were similar to ES cells,which had pluripotency.

Objective To discuss the clinical value of ultrasonic elastography for thyroid nodules,and compared with pathology.Methods 77 patients with 105 thyroid lesions were analyzed.Tissue stiffness on elastography was scored from one(greatest elastics train)to five (no strain).Results On elastography:scores 1 and 2 were found in 75％ benign lesions.Scores 3 to 5 were found in 97.4％ malignant lesions.There were statistically difference in the scores of elastography between the benign and malignant lesions (P ＜0.01).Conclusions The ultrasonic elastography had positive significance in differentiating benign and malignant thyroid nodules.If the score of elastography is more than or equal to 3,the thyroid nodule is highprobablely malignant.

Objective To evaluate the accuracy of the transcutaneous bilirubin (TcB) at different sites including the chest (covered and uncovered),forehead and scapula,compared with total serum bilirubin (TSB) before and after phototherapy.Method Neonates who underwent blood test of TSB together with the average TcB at chest over 6 mg/dl from September 2015 to July 2016 in our Hospital were enrolled in our study.TcB measurements were done by the transcutaneous bilirubinometer (JH20-1 C) at the sites of the chest,forehead and scapula within 30 minutes after venous or arterious blood sampling for testing TSB after admission.An area of 2 cm diameter over the left chest was covered during phototherpy.TSB was tested immediately and within 12 ～ 24 hours after phototherapy,while TcB was measured within 0.5 hour after blood sampling at the covered sites over the left chest,right chest,forehead and scapula.IBM SPSS 20.0 software was used for data analysis.Data were compared via Pearson correlation analysis,ANOVA of repeated measurement data,student's t test and Bland-Altman analysis.Result A total of 437 data were collected from 364 neonates were enrolled in our study.Before phototherapy,the values of TcB at different sites were highly correlated and consistent with TSB (P ＜ 0.05),especially taken from the chest (the difference value of TcB and TSB-1.2 ± 2.3 mg/dl).Immediately and within 12 ～ 24 hours after the phototherapy,the values of TSB and TcB taken from the covered left chest showed the highest consistency (-1.2±2.3 mg/dl and-0.5 ± 1.6 mg/dl).When TSB exceeded 15 mg/dl before phototherapy,the difference between TSB and TcB taken from chest was 1.5 ± 1.6 mg/dl,while if TSB was below 15 mg/dl,the difference was-1.9 ± 1.9 mg/dl.They were significantly different (P ＜ 0.001).And difference between TSB and TcB taken from chest was not affected by gender gestational age,birth weight,days of birth and different measurements.When TcB taken from the covered or uncovered chest was less than the TSB threshold value of 3.3 mg/dl for phototherapyl,or the TcB of the left covered sternum lower than the threshold value of 2.6 mg/ml for cessation of phototherapy,97.5％ of the TSB would not exceed the corresponding value.Conclusion The TcB values of both uncovered chest before phototherapy and covered chest after phototherapy were highly consistent with TSB,and could be applied in the replacement of TSB in the assessment and management of neonatal jaundice.