Objective To investigate the value of CEUS quantitative analysis in diagnosis of different pathological stages of small hepatocellular carcinoma (HCC).Methods Data of 112 patients with HCC confirmed by surgical or biopsy were analyzed retrospectively.All the diameter of single tumor or the sum of the largest two lesions in multiple tumors were within 3 cm.Three groups were classified based on the Edmonson stage:High differentiation group (n=50,stage Ⅰ or Ⅱ),median differentiation group (n=30,stage Ⅲ),low differentiation group (n=32,stage Ⅳ).Qontraxt ultrasound imaging analysis software was utilized to measure CEUS parameters,including the maximum intensity of tumor (TMAX),nontumor's intensity (NT),maximum intensity of nontumor (NTMAX),appear time,time to peak,washout time,and the ratio of TMAX/NT and TMAX/NTMAX were calculated.The differences among the three groups was compared by statistics test.Results The values of TMAX,TMAX/NTMAX and washout time were statistically different among the three groups (all P＜0.05).The maximum values of TMAX,TMAX/NTMAX and the shortest washout time were found in the low differentiation group.And the minimum values of TMAX,TMAX/NTMAX and the longest washout time were found in the high differentiation group.There were no statistical differences of NT,NTMAX,TMAX/NT,appear time and time to peak among the three groups (all P＞0.05).Conclusion The quantitative parameters of CEUS is helpful in distinguishing different Edmonson stage of small HCC.

Objective To evaluate the value of shear wave elastography(SWE) in the diagnosis of gastroesophageal varices in patients with hepatitis B-related hepatocellular carcinoma(HCC). Methods From October 2016 to May 2017,a total of 325 patients with hepatitis B-related HCC received conventional ultrasonography and SWE examinations in Shanghai Eastern Hepatobiliary Surgery Hospital were selected. The basic clinical data,conventional ultrasonography,SWE examination parameters and gastroscopy results of 192 patients were successfully collected. The training group ( 120 cases) and the validation group (72 cases) were divided from these patients according to the time order of entering the study.The gastroscopy results were used as the gold standard and the training group were analyzed using univariate and multivariate analysis.A new GOV diagnostic model was established and the diagnosis value of which were validated and evaluated in the validation group. Results Among 9 parameters studied,the maximum flow velocity of the portal vein,the thickness of the spleen and the stiffness of the spleen were independent factors affecting GOV in patients with hepatitis B-related HCC with odds ratio of 0.755(95% CI 0.617-0.924),1.375(95%CI 1.171-1.614) and 1.093(95% CI 1.043 -1.145),respectively(all P < 0.01).T he area under ROC curve of GOV diagnostic model that containd these 3 parameters diagnosing GOV in validation group was 0.914 (95% CI,0.832~0.995).The -1.49 was the best cut-off value with sensitivity,specificity,positive predictive value,negative predivtive value and coincidence rate of 79.0%,92.5%,91.3%,81.5% and 85.8%,respectively. Conclusions The GOV diagnostic model established by combining SWE and conventional ultrasonography is of certain value in diagnosis of GOV in patients with hepatitis B-related HCC yet needs further validation.

Knee osteoarthritis (KOA) is the main cause of knee pain and disability in the elderly. KOA is a complex disease that is controlled by a variety of pathogenic factors, including general physical factors such as age, gender, obesity, family history, and mechanical factors, and unfavorable mechanical factors to the knee joint, such as trauma, sports injuries, and daily routines. The prevalence of KOA is related to genetic factors. Currently, conservative treatment has limited effects to this disease, and knee joint replacement is usually associated with many complications. Mesenchymal stem cells(MSCs) were first discovered in the bone marrow and subsequently found in peripheral blood, cord blood, skeletal muscle, heart and adipose tissue, which have high plasticity and pluripotency. The discovery of MSCs provides a new method for the treatment of KOA. Due to its powerful cartilage repair and regeneration function, researchers have conducted a large number of experimental studies on the efficacy, safety and mechanism of MSCs in the treatment of KOA in recent years. In this paper, the above studies presented were systematically reviewed.

Objective To evaluate the efficacy of high tibial osteotomy(HTO) and unicompartmental knee arthroplasty(UKA) for knee unicompartmental osteoarthrits(KOA) using Meta analysis. Methods The controlled clinical trial literatures of HTO and UKA treating KOA were retrieved, the database including Chinese Biomedical Literature Database, Wanfang Data, CNKI, VIP Data, PubMed, Cochrane Library, EBSCO and Embase, and the search period was limited to the beginning of the database to July 2018. The literature was screened and evaluated, and Review Manager 5.3 software was used for Meta analysis. Results A total of 19 articles including 1359 knee joints were included. Meta analysis results showed that HTO was superior to UKA in range of motion (ROM) (P<0.05). For the indicators, including excellent rate, Lysholm score, visual analogue scale (VAS) score, complications, repair rate, blood loss, length of stay, ambulation time, Hospital for Special Surgery (HSS) score and femorotibial angle (FTA), UKA was superior to HTO (all P<0.05). There was no significant difference in the repair rate between open wedge HTO (OWHTO) and UKA in the sub-group analysis. There were no significant differences in the operation time and Tegner exercise score between HTO and UKA ( all P>0 . 05 ) . Conclusions Both HTO and UKA have their own advantages and disadvantages. It is necessary to properly choose the operation according to the patient's condition and psychological expectation.

OBJECTIVETo investigate the epidemiological characteristics of human infections with avian influenza A (H7N9) in China and to provide scientific evidence for the adjustment of preventive strategy and control measures.

METHODSDemographic and epidemiologic information on human cases were collected from both reported data of field epidemiological investigation and the reporting system for infectious diseases.

RESULTSA total of 433 cases including 163 deaths were reported in mainland China before June 4, 2014. Two obvious epidemic peaks were noticed, in March to April, 2013 and January to February, 2014. Confirmed cases emerged in 14 areas of China. Five provinces, including Zhejiang, Guangdong, Jiangsu, Shanghai, and Hunan, reported about 85% of the total cases. Median age of the confirmed cases was 58 years (range, 1-91), with 70% as males. Of the 418 cases with available data, 87% had ever exposed to live poultry or contaminated environments. 14 clusters were identified but human to human transmission could not be ruled out in 9 clusters.

CONCLUSIONHuman infections with avian influenza A (H7N9) virus showed the characteristics of obvious seasonal distribution, with certain regional clusters. The majority of confirmed cases were among the elderly, with more males seen than the females. Data showed that main source of infection was live poultry and the live poultry market had played a significant role in the transmission of the virus.

Adaptation, Psychological ; Aged ; Animals ; China ; epidemiology ; Demography ; Environmental Pollution ; Female ; Humans ; Influenza A Virus, H7N9 Subtype ; Influenza, Human ; epidemiology ; prevention & control ; transmission ; Male ; Meat ; Poultry ; Research Design