Objective To evaluate the significance of sonographically detected thyroid calcification in the diagnosis of thyroid carcinoma.Methods Five hundred and twenty-two patients with thyroid disease,including 119 with thyroid cancer,were included in the study.Each patient underwent preoperative,highresolution sonography to evaluate the thyroid gland for the presence of calcification.Calcifications were classified:type Ⅰ,microcalcification;type Ⅱ,coarse calcification;type Ⅲ,annular or"egg-shell"calcification;typeⅣ,calcified nodules within a cyst.Results The incidence of calcification and microcalcification was significantly higher in thyroid cancer than in benign nodules(P＜0.001).The appearance of microcalcifications was highly specific for malignancy with a sonographic specificity of 88%.The sensitivity was 60%,and the odds ratio(0R)was 11.28.The incidence of calcifications of type Ⅱ and type Ⅲ did not differ significantly between the benign and malignant groups.Calcifications of type Ⅳ were showed totally in benign groups.Patients younger than 45 years with calcified nodules constituted a highrisk group,with a OR of 11.33 versus 2.96 in patients older than 45 years with calcified nodules.In the group of solitary thyroid nodules,the incidence of cancer in the calcified nodules was higher than in the nodules without calcifications,with a OR of 20.48.Conclusions The detection of thyroid calcifications by sonography is diagnostically valuable,especially in eases involving a solitary nodule or a young person.The presence of calcifications in these cases should raise the suspicion of malignancy,especially microcalcification.

Objective To explore the enhancement patterns of pulmonary carcinomas by contrast-enhanced ultrasound(CEUS).Methods Thirty-eight patients with pulmonary carcinomas proven by pathology[28 with peripheral pulmonary carcinomas and 10 central pulmonary carcinoma with obstructive atelectasis(OA)]were examined by baseline ultrasound and contrast-enhanced ultrasound,then the arrival time(AT),time to peak(TTP)were analyzed with time-intensity curve analysis software and the dynamic enhancement pattern of each lesion was assessed.Results Twenty-four peripheral pulmonary carcinomas demonstrated delayed AT about 6-16 s after application of contrast medium,three lesions demonstrated early AT about 4-5 s and one lesion demonstrated absence of contrast enhancement.The lesions exhibited hyper-,hypo- and non-enhancement were 14,13 and 1,respectively.Seventeen lesions were heterogenous enhanced with non-enhanced necrosis areas and enhanced septa,while ten lesions homogeneous enhanced and one lesion no enhanced.Ten central pulmonary carcinoma with OA demonstrated a characteristic pattern:OA appeared a short AT(mean AT 4.8 s)until enhancement and strong contrast enhancement,while the central tumors appeared a delayed AT(mean AT 10.5 s)and faint enhancement.Conclusions CEUS can be useful in differentiation between solid and cystic pulmonary lesions,and detection of the latent lesions underlying the atelectasis.

Objective To preliminarily test the value of gastroesophageal reflux disease questionnaire (GERD-Q) in auxiliary diagnosis of gastroesophageal reflux disease(GERD) in infants and young children.Methods From January 2011 to February 2014,148 infants and 87 young children with suspected GERD symptoms were enrolled in the outpatient and inpatient departments of Wuhan Women and Children's Medical Care Center.The diagnosis of GERD were made through 24 h esophageal pH monitoring and upper gastrointestinal hysterosalpingography.Those with any examinations being positive were brought into GERD group,and the others into the control group.All cases had been surveyed with GERD-Q.Using SPSS17.0 statistical software,the ratio was compared with chi-square test,and the difference of the scores between groups with t test.Results In infants (1 to 11 months),the individual symptom scores (ISS) of the 6 symptoms in the GERD group (n =111) were all higher than those in the control group (37 cases) (P ＜ 0.05),and the composite and symptom scores (CSS) [(131.43 ± 66.56) scores] in the GERD group was higher than that [(33.70 ± 40.03) scores] in the control group (t =8.42,P ＜ 0.05).In young children (1 to 3 years old),the ISS in the GERD group(55 cases) were all higher than those in the control group(32 cases),and the CSS[(98.58 ± 66.75) scores] in the GERD group was also higher than that [(28.50 ± 35.95) scores] in the control group(t =5.49,P ＜ 0.05).Conclusions There is a good correlation for age-specific GERD-Q to distinguish GERD symptoms in infants and young children,which is suitable for the assessment of GERD.

This paper introduced the position setup and initial recruitment initiated in publicfunded institutions in Beijing, i.e. Beijing Stomatological Hospital. It stated that position setup should fit actual needs and recruitment standards should comply with long-term development strategy. In addition, the paper highlighted such principles as transparency and all-staff involvement, along with the supervising function of departments and experts of the hospital. Thus, position setup and initial recruitment can be smoothly accomplished, forming a long-standing incentive for medical staff.

Objective To describe the status quo of position rotation in self-injection of insulin, and explore its influencing factors, so as to provide the basis for regulating the rotation of injection. Methods A convenient sample of 176 patients coming from endocrinology in a third grade first-class hospital were surveyed by self-designed self-injection of insulin in patients with site rotation behavior questionnaire survey. Results 176 diabetics of their own insulin injection site rotation score was 12-27 (17.79 ± 2.81) points. The age, knowledge sources, the numbers of injection sites were mainly influence to insulin injection site rotation factor score. Conclusions Diabetics insulin injection site rotation behaviors is not standard, rotation of different parts is worrying. It is necessary to strengthen the education and guidance of the site rotation of the patients.

Objective:To analyze the clinical characteristics of the patients with hyperthyroidism complicated with acute cerebral infarction, and to evaluate the prognosis and safety of intravenous thrombolysis treatment in the patients with hyperthyrodism complicated with acute cerebral infarctron within time window for thrombolysis. Methods:The clinical materials of patients with acute cerebral infarction treated with intravenous tissue plasminogen activator (rt-pA)were retrospectively analyzed.All patients were divided into hyperthyroidism group (n=41) and non-hyperthyroidismin group (n=160) according to whether complicated with hyperthyroidism.The general imformation,the area of cerebral infarction and intracranial hemorrhage of the patients in two groups were analyzed.Results:The NHISS score of the patients in hyperthyroidism group was higher than that in non-hyperthyroidism group for the first time(P<0.05).The NHISS scores 7 d after treatment and the 90 d modified Rankin scale (mRS) scores had no statistical differences between two groups (P>0.05).The proportions of the different infarction sizes had significant differences between two groups (P<0.05).The patients with large area cerebral infarction in hyperthyroidism group accounted for 51.2%, and it accounted for 27.5% in non-hyperthyroidism group.The incidence of asymptomatic intracranial hemorrhage of the patients in hyperthyroidism group was higher than that in non-hyperthyroidismin group (P< 0.05),but there was no statistical difference in the incidence of intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SHA) between two groups (P > 0.05).Conclusion:The patients with acute cerebral infarction complicated with hyperthyroidism could benefit from intravenous thrombolysis, without the increasing of incidence of spontaneous intracranial hemorrhage (sICH) and SHA.

Background Tumstatin is the most active endogenous angiogenesis inhibitor,which has a marked inhibitory effect on pathological neovascularization,and Tum5 is an angiogenesis inhibitors fragment of fulllength tumstatin.Objective This study was to investigate the effects of adenovirus-mediated overexpression of recombinant Tum5 gene on the proliferation,migration and tube formation of human umbilical vein endothelial cells (HUVECs) in physiological status.Methods The empty adenoviral vector expressing green fluorescent protein (rAd-GFP) and the viral vector expressing recombinant Tum5 gene were constructed.The HUVECs cultured in RPMI1640 medium were divided into normal control group,empty vector group (rAd-GFP group) and Tum5 gene infection group (rAd-GFP-Tum5 group).The rAd-GFP and rAd-GFP-Tum5 adenoviral particles at the density of 1 × 1010/ml were added into the medium to infect the cells for 48 hours.The proliferation of the cells was assayed at 24,48 and 72 hours by cell counting kit-8 (CCK-8) to evaluate the proliferative rate;the migration number of the cells was detected at 48 hours after infection by Transwell chamber;the tube formation number of the cells were detected by Matrigel method.The concentration of vascular endothelial growth factor (VEGF) in cell supernatants was assayed by ELISA at 24,48,and 72 hours following adenoviral infection.Results The cultured cells showed green fluorescence in the rAd-GFP group and rAd-GFP-Tum5 group under the inverted fluorescence microscope,and the infection efficiency of rAd-GFP and rAd-GFP-Tum5 was 55.13％ and 50.31％,respectively.No significant difference was found in cell proliferative rate among normal control group,rAd-GFP group and rAd-GFP-Tum5 group both at 24 and 48 hours after infection (both at P＞0.05),and the cell proliferative rate was significantly lower in the rAd-GFP-Tum5 group than that in the normal control group and rAd-GFP group at 72 hours after infection (both at P＜0.01).The migration number of the cells at 48 hours after infection was 2 260.25-±930.44,2 370.00±441.06 and 723.75± 363.80 in the normal control group,rAd-GFP group and rAd-GFP-Tum5 group,showing a significant difference among the groups (F =8.524,P =0.008),and the migrated cells were evidently decreased in the rAd-GFP-Tum5 group compared with the rAd-GFP group and the normal control group (both at P＜ 0.01).The tube number at 48 hours after infection was 95.67±5.86,88.00±4.58 and 20.67±3.51 in the normal control group,rAd-GFP group and rAdGFP-Tum5 group,showing a significant difference among the groups (F=226.498,P＜0.01),and the tube number in the rAd-GFP-Tum5 group was significantly reduced in comparison with the normal control group and rAd-GFP group (both at P＜ 0.01).The considerably differences in VEGF concentration in the cell supernatants were found in different groups and various time points (Fgroup =73.260,P＜0.01;Ftime =73.477,P＜0.01),and VEGF concentration in the cell supernatants was significantly decreased in the rAd-GFP-Tum5 group compared with the rAd-GFP group at both 48 hours and 72 hours (both at P＜0.01).Conclusions The overexpression of the recombinant Tum5 can inhibit the proliferation,migration and tube formation of the HUVECs in physiological status,which may be associated with Tum-5-mediated down-regulation of VEGF protein in the cell supernatant.

Objective To evaluate eutopic endometrial blood supply and vessels in patients with endometriosis(EMs) with contrast enhanced ultrasound (CEUS),to explore a newmethod to estimate vascularization of eutopic endometrium in EMs patients.MethodsThirty patients with EMs were enrolled and 20 patients who were diagnosed as other gynecological diseases as control.Informed consent of each case was obtained. AllcasesunderwentconventionalultrasoundexaminationandCEUSexamination.Characteristics of CEUS in each patients were observed and analyzed using off-line Qontrast software.Parameters of CEUS including peak intensity(PEAK),time to peak(TTP),regional blood volume(RBV),regional blood flow(RBF) were obtained automatically.ResultsComparing with control group,the eutopic endometrium in EMs group presented higher enhancement.The parameters of CEUS,including PEAK,TTP,RBV,RBF were (41.18 ± 3.29) dB,(29.01 ± 4.46) s,(29.07 ± 4.59) ml,(48.61 ± 5.35) ml/min in EMs group and (13.36 ± 2.34)dB,(24.59 ± 2.29)s,(26.51 ±- 3.80)ml,(48.71 ± 3.80)ml/min in controls respectively,the value of PEAK in EMs group was higher than that of controls ( P =0.000).Conclusions CEUS can be regarded as a new method which can be used to assess vascularization of eutopic endometrium in endometriosis.

ObjectiveTo investigate the expression of TESTIN gene in endometrial carcinoma and explore the functions of this gene in tumor development and progression.MethodsqRT-PCR and immunochemical staining assay were used to determine the mRNA and protein level of TESTIN in the tumor tissues,and the relationship between TESTIN expression and clinical pathology characteristics was analyzed.Results Compared to normal tissue,76.5％ (52/68) tumor tissues showed TESTIN reduced ( P ＜ 0.01 ),furthermore,this reduction in the subgroup of endometrioid adenocarcinoma was significant,but it was rarely observed in the subgroup of serous papillary adenocarcinoma.ConclusionsTESTIN was obviously down regulated in endometrail carcinoma,especially in endometrioid adenocarcinoma,which indicated TESTIN played an important role in tumorigenesis of uterine.

Objective To prepare human vascular endothelial growth factor receptor 2 (VEGFR2)-targeted liquid perfluorocarbons-filled nanocapsules ultrasound contrast agent,and to investigate its ability of targeting human umbilical endothelial vein cells(HUEVC) and the peculiarity of the enhancing ultrasound imaging in vitro.Methods Rotary evaporation/emulsion technique was used to prepare biotinylated liquid perfluorocarbons-filled nanocapsules (LNCs).VEGFR2-tageted LNCs (V2-LNCs) was further made through conjugating the ligand (biotinylated anti-VEGFR2 antibody) to the surface of LNCs by biotin-avidin system and its appearance,distribution,size and zeta-potential properties were assessed.Immunofluorescent staining assay was used to identify the combination of ligand with the nanocapsules.The ability of V2-LNCs targeting with HUEVC in vitro was evaluated under the fluorescence microscope.Quantitative and statistical analysis were performed to evaluate the ultrasound contrast enhancement of the nanocapsules in vitro.Results The V2-LNCs are uniform and stabilized with size about (98.45 ± 0.07)nm.The ligation of antiVEGFR2 antibody and nanocapsules was positive in immunofluorescent straining assay.In vitro,targeting ability research showed the V2-LNCs could actively adhere to HUEVC,while the control was negative.At the same time,using anti-VEGFR2 antibody to pre-incubation with HUVEC could effectively block the interaction between V2-LNCs and HUEVC.The ultrasound images proved both V2-LNCs and LNCs can significantly enhanced ultrasound imaging contrast agent effect at a concentration of 5 mg/ml in vitro.Conclusions A stable VEGFR2-targeted liquid perfluorocarbons-filled nanocapsules was prepared successfully with biotin-avidin method and effectively bound to HUVEC specially in vitro.Also the liquid perfluorocarbons-filled nanocapsules can strongly enhance the ultrasound contrast in vitro,which might be taken as a kind of vascular ultrasound contrast agent and to get the basic experimental data for the later research.