Objective To investigate the correlation of ultrasonographic characteristics and pathologic features for malignant mullerian mixed tumor(MMMT)and determine the diagnostic value of ultrasonography.Methods The uItrasonographic features of 10 MMMTs were analyzed retrospectively and the sonographic findings were compared with histological results and discussed the correlation.Results The morphologic features of US and histology were well associated.Large,solitary lesion,ill-defined irregular shape,honeycombed heterogenous echo-pattern,scattered cystic areas and increased irregular peripheral/internal color flow were typical US findings.Logistic regression analysis showed the type of tumor liquefaction to be the most significant independent predictor of vascularity.Conclusions Ultrasonography is helpful for the diagnosis of MMMT,the uhrasonographic characteristics of MMMT are well correlated to its pathologic features.

Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS), and compare it with contrast-enhanced CT(CECT). Methods Eighty-one focal liver lesions were evaluated with CEUS and CECT, diagnostic value of two modalities were calculated, vaseularity manifestations of two modalities in arterial phase were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CEUS were 96.6 %, 86.9 %, 94.9 %, 90.9 %, 93. 80%, respectively, and the diagnostic value of CECT were 98.3%, 82. 6%, 93.4%, 95.0%, 93.8%, respectively. Among all the metastasis, hypervascular manifestation lesions in arterial phase of CEUS and CECT were 72% (18/25) and 32% (8/25)( P <0.05). Conclusions The diagnostic value of CEUS and CECT in focal liver lesions are comparably satisfying,and there is no significant difference between them, the combination use of two modalities would improve the diagnosis performance. CEUS can show more hypervaseular metastasis than CECT in arterial phase.

Objective To investigate the diagnositic value of uhrasonography in fetuses with persistent right umbilical vein.Methods Three cases of persistent right umbilical vein diagnosed in our hospital were analyzed,including the sonographic findings and clinical outcome.Results In all cases the fetal gallbladder was located between the intraabdominal umbilical vein and the stomach,the umbilical vein was connected to the right portal vein,and the portal vein curved toward the stomach.Other intracranial malformations were detected in one case,and the baby died after birth.No addional malformations were found in the other two babies,and both of them were healthy at the age of 6 months.Conclusions Persistent right umbilical vein has typical prenatal sonographic appearances.The neonatal prognosis is favorable when other anomalies are ruled out.It's clinically important for early diagnosis and genetics consultation.

Objective To observe the clinical, mammographic and sonographic features of pure invasive lobular breast carcinoma (ILC), and to explore the value of combined imaging assessment of ILC. Methods Sonographic appearances of 55 patients of ILC were retrospectively reviewed in correlation with mammographic, pathologic and clinical findings, and the causes of false negative were analyzed. Results The main features found in clinical examination were mass (96.15%) and thickening in the size of breast (3.85%). The main mammographic features were spiculated or ill-defined mass (65.38%) and architectural distortion (23.08%). The most common sonographic patterns were mass (98.00%) and distortion (2.00%). The accuracy for detecting ILC of clinical examination, mammography and ultrasonography was 94.55%, 83.87% and 98.04%, respectively, while combining the three modalities, the detection rate increased to 100%. Conclusion Sonography has higher accuracy than mammography in detecting ILC. Combining clinical examination, mammography and ultrasonography can increase the pre-operative diagnostic accuracy of ILC.

Objective To observe the ultrasonographic features of intravenous leiomyomatosis (IVL). Methods Ultrasonographic features, pathological results and the clinical manifestations of 7 patients with IVLs were analyzed retrospectively, and the causes of misdiagnosis were discussed as well. Results The median age of 7 IVL patients was 40 years old. Five patients underwent previously hysterectomy due to probable diagnosis of leiomyoma with the mean recurrent time of 13.8 months. Three lesions extended into the right atrium, 3 involved the inferior venous cava and 1 was confined in the pelvis venous. Ultrasonographic findings of IVL included uterine solid lesions with intravascular disease, solid occupied lesions in the pelvis with intravascular disease after hysterectomy, solid occupied lesions in the pelvis, large abdominal vessels and cardiac chambes with intravascular disease after hysterectomy. The main misdiagnosis cause was that IVL had similar ultrasonographic features with hysteromyoma, and intravascular lesions of IVL was hard to detect in the early stage. Conclusion Color Doppler ultrasonography is a valuable imaging mortality for detection and follow-up of IVL.

Objective To investigate the diagnosis measures and treatment methods of white line hernia. Methods Analyze the clinical data of 12 cases of white line hernia who were treated by surgery. We performed peritoneal adipose tissue before resection on hernia without hernial sac type. And for those with hernial sac type, apothesis of material in hernia were firstly made, then ligated the hernia sac neck and resection were made. Then according to the white line defect size, we used pure involution suture and Onlay without tension patch repair to repair defect in the white line. Results Surgery of all the 12 cases were successful. 2 cases of them merged postoperative renal dysfunction and infection, and after hemodialysis and anti-infection treatment, they both recoverd well without recurrence. Conclusion There is no spe-cific symptoms and signs in white line hernia, but incarceration and strangulation may cause life threaten, so we should pay more attention to it. For symptomatic, large, difficult, incarcerated or strangulated white line hernia,we should take timely surgical treatment.

Objective To assess the value of endorectal elastography in the diagnosis of malignant rectal adenoma. Methods Sixty patients referred to the department of basic surgery of Peking Union Medical College Hospital for the evaluation of rectal adenoma from January 2011 to May 2013 were included in this prospective cohort. All patients underwent elasticity score (ES) and strain ratio(SR) examine before operation. To evaluate the reproducibility of the strain-ratio measurements, the intraclass correlation coefficient (ICC) was calculated. Compared with final operational pathological results,the diagnostic values of elasticity score and strain ratio method were assessed. Results Histopathological result showed there were 20 adenomas and 40 adenocarcinomas. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ERUS was 68%(27/40), 40%(8/20), 58%(35/60), 69%(27/39), 38%(8/21), respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of elasticity score was 85%(34/40), 70%(14/20), 80%(48/60), 85%(34/40), 70%(14/20), respectively. The SR of adenocarcinomas was significantly higher than that of adenomas(2.82±1.81 vs 1.23±0.57, t=3.333, P < 0.05). The differences among the SR of benign adenoma, benign adenoma with severe atypical hyperplasia and completely malignant lesions were statistically significant (1.26±0.84 vs 2.94±1.95, 1.42±0.55 vs 2.94±1.95, t=2.619, 2.415, P=0.013, 0.021). When 1.240 was chosen as the best cut-off value of SR, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of strain ratio was 82%(33/40), 75%(15/20), 80%(48/60), 87%(33/38), 68%(15/22), respectively. Conclusion Endorectal elasotgraphy can accurately diagnose the malignant rectal adenoma, which can provide reliable preoperative imaging evidence for clinical operation mode.

Objective To investigate the role of expression in the differential diagnosis of thyroid follicular carcinoma and follicular variant of papillary carcinoma. Methods Seventy cases of thyroid lesions (including 15 cases of follicular adenomas, 15 cases of adinomatous goiters, 30 cases of papillary carcinomas and 10 cases of follicular carcinomas) were collected, and CD10 expression was detected by means of immunohistochemistry in above thyroid lesions. Results Seven of 9 cases of follicular variant of papillary carcinoma were CD10 positive (77.8), and 8 of 10 cases of follicular carcinoma were CD10 positive (80.0). However, CD10 was negative in all cases of non-follicular variant of papillary carcinoma, follicular adenoma, adinomatous goiter and normal thyroid tissue. Conclusion The detection of CD10 expression is useful to the differential diagnosis of thyroid follicular carcinoma and follicular variant of papillary carcinoma.

Objective To construct the lentivirus vector containing the hsa‐miR‐424 gene ,and identify the expression level of miR‐424 in cells .Research the influence of hsa‐miR‐424 on proliferation of cervical cancer Hela cell line .Methods Using the human genomic DNA as template to design the upper and lower primers for synthesis of miR‐424 ,and amplifying the target fragment by polymerase chain reaction (PCR) .Recover the products and conduct sequencing after connecting it into the pMD18T vector .Ampli‐fy the product by PCR template as pMD18T‐miR424 ,and insert the fragment expressing pMD18T‐miR424 into the vector of pLen‐tis‐CMV‐GFP‐MCS‐PGK‐PURO after enzyme cutting to construct the pLentis‐CMV‐GFP‐miR424‐PGK‐PURO .Package the com‐pound with pMD2 .G and pSPAX2 in 293T cell to produce the lentivirus ,and using the supernatant containing lentivirus to infect the Hela cell line .Results The sequencing result proved the sequence of miR‐424 in plasmid vector was correct ,which proved the construction of lentivirus was successful and the target lentivirus was obtained .The expression of miR‐424 almost rise 60 times af‐ter infected the cervical cancer Hela cell by the carrier .The result of M TT method suggested :the cervical cancer Hela cell lines have slowed proliferation with infection miR‐424 lentivirus .Conclusion The miR‐424 lentivirus vector was constructed successfully and the high efficacy expression miR‐424 cell line was established and stable .The cervical cancer Hela cell were infected with the super‐natant containing lentivirus ,inhibited the proliferation of Hela cell successfully ,and laid a good foundation for subsequent research .

Objective To evaluate the inter-observer variability of static breast sonogram final assessment among observers with different breast imaging experience, using the first edition of the Breast Imaging Reporting and Data System(BI-RADS) for ultrasound. Methods Thirty patients with 30 breast lesions were included who underwent beast lesions resection operation. A pathological diagnosis was available for all 30 lesions:16 (53%) malignant and 14 (47%) benign. Twelve radiologists independently reviewed two sonograms of each lesion, and assigned a final BI-RADS assessment category. Inter-observer variability was measured using kappa statistic. Positive predictive value(PPV) and negative predictive value (NPV) for final assessment were also calculated. Results As for the experienced observers,kappa values of categories 3,4 and 5 were 0.72,0.28 and 0.60,NPV of category 3 was 93% ,PPV of category 5 was 97% ,all of which decreased as the breast imaging experience reduced. PPVs of categories 4a,4b and 4c were 56 % ,88% and 69%, respectively. Conclusions Using BI-RADS final assessment, radiologists with sufficient breast imaging experience can provide accurate and consistent assessment for breast ultrasonography,but the agreement of diagnosis decreased as the breast imaging experience reduced. The clinical feasibility of 4a,4b and 4c subcategories is uncertain.