Objective:To explore the characteristics of color Doppler ultrasound images of breast lymphoma, and to improve the coincidence rate of ultrasound diagnosis.Methods:The color Doppler ultrasound images characteristics of 24 lesions in 21 patients with breast lymphoma in Fujian Cancer Hospital from June 2011 to January 2020 were retrospectively analyzed, and the diagnostic coincidence rate was counted.Results:All the patients were female, 18 cases were unilateral, 3 cases were bilateral. ALL cases were confirmed as primary or secondary breast lymphoma by coarse needle biopsy or surgical pathology. Pathological types included 18 cases (85.7%) of diffuse large B-cell lymphoma, 1 case of anaplastic large cell lymphoma kinase (ALK)-negative anaplastic large cell lymphoma, 1 case of Burkitt lymphoma, 1 case of Burkitt lymphoma or unclassifiable lymphoma with features intermediated between diffuse large B-cell lymphoma and Burkitt lymphoma. The maximum diameter of the lesions was (5.7±2.1) cm (range 1.4-16.0 cm), and all lesions were solid in ultrasound images; 19 lesions (79.2%) were mass-type and 5 lesions (20.8%) were diffuse. According to the characteristics of internal echo, the lesions were divided into hypoechogenicity (2 lesions, 8.3%), hyperechogenicity packed with hypoechogenicity (12 lesions, 50.0%), and hyperechogenicity interweaved with hypoechogenicity (10 lesions, 41.7%). According to Adler semi-quantitative method, the blood flow of the lesions was 3 lesions (12.5%) in grade Ⅰ, 6 lesions (25.0%) in grade Ⅱ, and 15 lesions (62.5%) in grade Ⅲ. The detection rate of lesions by color Doppler ultrasound was 100.0% (24/24), but the diagnostic coincidence rate was only 41.7% (10/24).Conclusions:Most of the breast lymphoma is diffuse large B-cell lymphoma, and the lesions can be effectively screened by color Doppler ultrasound, but the diagnostic coincidence rate is low. Most of the breast lymphoma grows in the form of mass with abundant internal blood flow signals. When the ultrasound image of the breast lesion is hyperechoic packed or interweaved with hypoechoic, the possibility of breast lymphoma should be considered.

Objective To explore the application of a three-dimensional simulation system in extended liver resections.Methods A three-dimensional surgical simulation system was used for preoperative assessment and for computer simulation to estimate the resected liver volume,the residual liver volume,and the surgical resection margins.The software virtual liver resection was used to choose the most optimal surgical option.The actual resection,the postoperative liver volume and the actual surgical resection margins were compared.Results 1 patient was diagnosed by ultrasound to develop ascites on post-operative day 2.Another patient was diagnosed by transthoracic ultrasound to have moderate pleural effusion on postoperative day 1.Postoperative liver failure developed in 1 patient.There was no patient who developed bile leakage.The average length of stay was 6 ～ 85 days (average 22 d).There was no recurrence within 1 month after surgery and there was no postoperative deaths.Condusions The three-dimensional surgery simulation system was effective.It gave an accurate evaluation and simulation of the liver surgery.In extended liver resection,it gave good guidance and help.

Objective To evaluate the effect of berberine on fatty liver ischemia-repeffusion (I/R) injury and the relationship with endoplasmic reticulum stress in liver tissues.Methods Thirty-two male Wistar rats,aged 4 weeks,weighing 100-150 g,were divided into 4 groups (n=8 each) using a random number table method:control group (group C),fatty liver group (group FL),I/R group and berberine group (group BBR).Rats were fed a normal fat diet for 12 weeks,normal saline 3.5 ml was given intragastrically for 4 weeks starting from 9th week,and rats only underwent simple laparotomy in group C.Rats were fed a high-fat diet (45％ energy originating from fat) for 12 weeks,and the other treatments were similar to those previously described in group C.Rats were fed a high-fat diet (45％ energy originating from fat) for 12 weeks,normal saline 3.5 ml was given intragastrically for 4 weeks starting from 9th week,and then the model of liver I/R injury was established in group I/R.Rats were fed a high-fat diet (45％ energy originating from fat) for 12 weeks,berberine solution (300 mg/kg) 3.5 ml was given intragastrically for 4 weeks starting from 9th week,and then the model of liver I/R injury was established in group BBR.Hepatic ischemia was induced by clamping the portal vein,hepatic artery,right gastric vein,and supra-and inferior-hepatic vena cava to perform cold perfusion with 4 ℃ lactated Ringer's solution lasting for 30 min,followed by reperfusion.The serum triglyceride (TG) concentrations were determined after 4,8 and 12 weeks of diet.Blood samples were collected at 6 h of reperfusion for measurement of serum aspartate transminase (AST) and alanine transaminase (ALT) concentrations.Livers were removed after blood sampling at 6 h of reperfusion and liver tissues were obtained and stained with oil red O and haematoxylin and eosin for examination of pathological changes and for determination of the expression of Bip,CCAAT/enhancer-binding protein homologous protein (CHOP),protein kinase RNA-like endoplasmic reticulum kinase (PERK) and phosphorylated PERK (p-PERK) (by Western blot).p-PERK/PERK ratio was calculated.Results Compared with group C,the serum TG,ALT and AST concentrations were significantly increased,the expression of Bip and CHOP was up-regulated,p-PERK/PERK ratio was increased (P＜0.05),lipid deposition was increased,and liver steatosis was found in group FL.Compared with group FL,the serum AST and ALT concentrations were significantly increased,the expression of Bip and CHOP was up-regulated,pPERK/PERK ratio was increased (P＜0.05),and the pathological changes of liver tissues were accentuated in group I/R.Compared with group I/R,the serum TG,ALT and AST concentrations were significantly decreased,the expression of Bip and CHOP was down-regulated,p-PERK/PERK ratio was decreased (P＜ 0.05),lipid deposition was reduced,and the pathological changes of liver tissues were significantly attenuated in group BBR.Conclusion Berberine can ameliorate fatty liver I/R injury,and the mechanism may be related to inhibiting endoplasmic reticulum stress in liver tissues of rats.

Objective To explore the effect of berberine (BBR) on steatotic liver ischemia reperfusion injury and analyze the role of endoplasmic reticulum stress and autophagy .Methods Thirty-four Wistar rats were fed with a high-fat diet for 12 weeks and 2 rats were randomly selected after 8 weeks to observe pathological changes and confirm the model of steatotic liver successfully .Then before opening and closing abdominal cavity ,32 rats were divided into I/R group (normal saline was intragastrically 4 weeks before performing cold I/R treatment) ,BBR group (normal saline was replaced by BBR ,BBR was intragastrically at a dose of 300 mg·kg-1 ·d-1 weeks and others were the same as I/R group) and TG group (TG was intraperitoneally at a dose of 0 .2 mg·kg-124h pre-operation and others were the same as BBR group ) .Then the rats were sacrificed at 6h post-reperfusion .Blood samples were collected from inferior vena cava and hepatic tissues harvested .The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected ,histopathologic changes observed by Hematoxylin & Eosin (HE) staining ,oxidative stress and inflammation determined by ELISA kit and the expressions of p-PERK ,CHOP ,Bip ,LC3 ,Beclin-1 and p62 detected by Western blot .Results As compared with Sham group ,the serum levels of ALT and AST were significantly higher in I/R ,BBR and TG groups (P < 0 .05) .And hepatic histological changes were severe and oxidative stress increased in parallel with the enhancement of pro-inflammation (P< 0 .05) .In BBR group ,the level of hepatic enzymes declined ,liver injury was milder ,oxidative stress decreased and pro-inflammation was lesser compared with I/R and TG groups (P< 0 .05) .Additionally ,as compared with sham group ,the expressions of p-PERK ,CHOP ,Bip ,LC3 ,Beclin-1 and p62 were up-regulated in I/R and BBR groups (P < 0 .05) .TG group increased the levels of LC3 ,Beclin-1 and p62 (P< 0 .05) .Interestingly ,compared with I/R group ,BBR pretreatment down-regulated the expressions of p-PERK ,CHOP ,Bip ,LC3 ,Beclin-1 and p62 (P< 0 .05) .TG group had the higher expressions of LC3 ,Beclin-1 and p62 than those of BBR group (P< 0 .05) .Conclusions BBR pretreatment can protect steatotic liver ischemia reperfusion injury .And the mechanisms may be attributed to the inhibitions of endoplasmic reticulum stress and autophagy .

Objective To study the risk factors and prognosis of post-transplant diabetes mellitus (PTDM) in recipients with steatotic donor livers.Method The clinical data of 182 patients who underwent liver transplantation from donors with liver steatosis in Tianjin First Central Hospital from June 2002 to December 2010 were retrospectively analyzed.There were sixteen patients with PTDM and one hundred sixtysix without PTDM.The clinical data of these patients were compared and the risk factors were evaluated by COX regression analysis.The 1-,3-,5-year cumulative survival rates were analyzed after liver transplantation.Result The variables which included sex,pretransplant serum creatinine level,model for end-stage liver disease (MELD) score,intraoperative red blood cell transfusion,and post-transplant biliary complications were significantly different between the two groups.Multivariate Cox regression analysis showed that living-donor,pretransplant fasting blood glucose and post-transplant biliary complications could affect the survival time of patients in PTDM group.The 1-,3-and 5-year cumulative survival rates in the PTDM group were 81.3％,68.8％ and 62.5％,which were significantly lower than those in the non-PTDM group (95.2％,86.1％ and 80.7％ respectively,P ＜ 0.05).Conclusions Living-donation,pretransplant fasting blood glucose and post-transplant biliary complications had a worse prognosis in the PTDM group.A comparatively better long-term survival after liver transplantation can be achieved by reducing the risk factors and the occurrence of PTDM.

Objective To analyze the performance of contrast-enhanced uhrasound(CEUS) in the evaluation of response to neoadjuvant chemotherapy (NAC) for breast cancer in different periods.Methods A prospective study consisting of 46 patients with invasive ductal carcinoma who received NAC and surgery subsequently was conducted.One patient underwent CEUS before NAC,after the second cycle of NAC and before surgery.CEUS outcomes were compared with histopathologic response by Kappa test using the Miller-Payne Grading(MPG) system.The changes of CEUS quantitative parameters in different periods of NAC were compared.Results 31 patients showed a good response by histopathology while 29 patients by CEUS,which showed good consistence.Kappa value was 0.713.The peak intensity (PI) of the lesions decreased significantly after the second cycle of NAC compared with that before NAC (P＜0.05).The peak intensity (PI),wash-in slope (WIS),and area under curve(AUC) of the lesions decreased significantly before surgery compared with those before NAC (P＜0.05).Conclusion CEUS shows good consistence with histopathologic outcomes.The peak intensity (PI) is a sensitive indicator of early changes after NAC.

The use of nitrification inhibitors has been suggested as a strategy to decrease cadmium(Cd)accumulation in crops.However,the most efficient nitrification inhibitor for mitigating crop Cd accumulation remains to be elucidated,and whether and how changes in soil microbial structure are involved in this process also remains unclear.To address these questions,this study applied three commercial nitrification inhibitors,namely,dicyandiamide(DCD),3,4-dimethylpyrazole phosphate(DMPP),and nitrapyrin(NP),to pakchoi.The results showed that both DCD and DMPP(but not NP)could efficiently decrease Cd concentrations in pakchoi in urea-and ammonium-fertilized soils.In addition,among the three tested nitrification inhibitors,DMPP was the most efficient in decreasing the Cd concentration in pakchoi.The nitrification inhibitors decreased pakchoi Cd concentrations by suppressing acidification-induced Cd availability and reshaping the soil microbial structure;the most effective nitrification inhibitor was DMPP.Ammonia oxidation generates the most protons during nitrification and is inhibited by nitrification inhibitors.Changes in environmental factors and predatory bacterial abundance caused by the nitrification inhibitors changed the soil microbial structure and increased the potential participants in plant Cd accumulation.In summary,our study identified DMPP as the most efficient nitrification inhibitor for mitigating crop Cd contamination and observed that the soil microbial structural changes caused by the nitrification inhibitors contributed to decreasing Cd concentration in pakchoi.

Objective To evaluate the diagnostic value of related contrast material(Rel.CM)of the dual-energy CT (DECT) virtual noncalcium (VNCa) for detecting acute traumatic bone marrow edema in knee joint.Methods A total of 17 patients(18 knees)with definite trauma history and knee joint disorders were prospectively enrolled. Conventional CT, VNCa and MRI images were obtained by MRI and DECT scan. Each knee was divided into 12 regions, respectively, to observe the performance of MRI and VNCa images. The diagnostic efficacy of different Rel. CM values (1.25, 1.45, 1.75) was analyzed for the knee traumatic bone marrow edema,select the best Rel.CM value.And the CT values of bone marrow and bone marrow damage were measured on VNCa of the optimal Rel. CM parameters. Using ROC to evaluate the efficacy of VNCa in different Rel.CM values for diagnosing traumatic bone marrow edema,the difference of CT value between bone marrow lesion and bone marrow in normal region of bone marrow was obtained by using rank sum test. Results DECT and MRI were performed in 17 patients (18 knees). Eighteen knees were divided into 216 areas.MRI showed 94 areas of bone marrow edema,including 35 in distal portion of femur, 59 in proximal tibia. Rel.CM values of 1.25, 1.45, 1.75 of the VNCa map were used to diagnose traumatic bone marrow edema in the knee with the area under the ROC curve of 0.643, 0.871, 0.656, respectively. Rel.CM with 1.45 VNCa diagram was the most accurate. The CT values of the bone marrow edema region and the normal region were -64.3(-20.6 to-90.8)HU,-93.4(-70.5 to-120.7)HU, respectively, on the VNCa graph with the optimal Rel.CM parameters (1.45) (Z=-8.270, P<0.05). Conclusions The VNCa image with a Rel.CM value of 1.45 has a better diagnostic performance for traumatic bone marrow edema in knee joint. CT value measurement in VNCa image can be used for quantitative analysis of traumatic bone marrow edema.

Objective To investigate the clinical features of bilateral medial medullary infarction (BMMI)in elderly patients.Methods Clinical and imaging data of 8 elderly BMMI patients with different morphology on diffusion-weighted magnetic resonance imaging (DWI-MR) were retrospectively analyzed.All patients were diagnosed by MRI,while 4 patients received CTA and vascular ultrasound testing,and the other 4 patients received vascular ultrasound testing.Results All 8 cases(100.0％) had acute-onset BMMI.Patients showed varying degrees of acroparalysis(7/8,87.5 ％),dizziness (5/8,62.5 ％),dysarthria(6/8,80.0 ％),dysphagia(3/8,37.5 ％),deep or superficial sensory dysfunction(5/8,62.5 ％),consciousness disorders (2/8,25.0 ％),dyspnea (2/8,25.0 ％),and tinnitus(1/8,12.5 ％).Lesions in most patients were located in the upper part of medulla oblongata(7/8,87.5 ％).In the transverse direction of DWI,the lesions as the inverted V shape were seen in 3 cases (37.5％),the V shape(12.5％)in 1 case,the Y shape(37.5％)in 3 cases,and the heart shape(12.5％) in 1 case.All 8 patients were complicated with posterior cerebral artery stenosis or occlusion,of whom patients with heart-or Y-shaped lesions showed progressive exacerbation.After treatment,4 cases (50.0 ％) recovered,3 cases (37.5 ％) improved,and 1 case (12.5 ％) unrecovered before discharge from the hospital.Conclusions Most elderly BMMI patients have concurrent posterior circulation artery stenosis,and patients with heart-or Y-shaped lesions on MR-DWI show rapid progression and have a poor prognosis.Cranial examination with MR-DWI is helpful for early clinical diagnosis of BMMI,prediction of disease progression and effective prevention of complications.

Objective To investigate the clinical value of ultrasound-guided catheterization in intraperitoneal perfusion chemotherapy for postoperative abdominal malignant tumor without ascites. Methods A retrospective analysis were performed in 146 postoperative patients with abdominal malignancies who were admitted to Fujian Cancer Hospital from April 2013 to September 2018, and there were no ascites founded in these patients before abdominal catheterization. Two hundred and seventy-nine times ultrasound-guided catheterization in intraperitoneal perfusion chemotherapy were performed under clinical guidance. Results Two hundred and seventy-seven times abdominal catheterization was completed, with a success rate of 99.3％(277/279), and the one-time success rate was 83.2％(232/279), 2 times (0.7％, 2/279) had to be abandoned for peritoneal adhesions. Fifty-three patients (36.3％, 53/146) underwent catheterization ≥ 2 times. The intraperitoneal perfusion chemotherapy was successfully completed after catheterization, no intestinal injury and bleeding occurred. Conclusions In the absence of ascites, ultrasound guided catheterization in perfusion chemotherapy is safe, reliable, simple, accurate and has a high success rate. This new approach is good for clinical application when the conventional catheterization with ascites is blocked.