Objective:To evaluate the accuracy of two-dimensional ultrasound(2D-US), three-dimensional volume ultrasound (3D-US) and ultrasound strain elastography (USE) in the measurement of preoperative tumor size of breast cancer and its influencing factors.Methods:A total of 101 patients with breast cancer in Nanfang Hospital of Southern Medical University from April to November 2016 were recruited in this study. The maximum diameter of the lesion was examined by 2D-US 3D-US and USE before core needle biopsy or surgery biopsy. The Bland-Altman analysis and intraclass correlation coefficient (ICC) were used to analyze the consistency between the ultrasonic technique measurements and the pathological measurements of postoperative lesion. Chi-square test or Fisher exact test was used to analyze whether the accuracy of three imaging techniques was affected by different clinical pathologic factors and imaging characteristics.Results:3D-US showed better agreement with histology than 2D-US and USE, with a higher ICC (ICC 3D-US=0.90>ICC 2D-US=0.81>ICC SUE=0.78) and low variation. In 3D-US, the accuracy rate of the age >40 years old group was higher than ≤40 years old group. In 2D-US, the measurement accuracy of invasive ductal carcinoma (IDC) without intraductal carcinoma in situ (DCIS) group was higher than DCIS with DCIS group, non-microcalcifications group was more accurate than microcalcifications group. The long diameter of lesion ≤2 cm group was more accurate than >2 cm group, IDC group was more accurate than invasive lobular carcinoma(ILC) group. In USE, the measurement accuracy of IDC without DCIS group was higher than DCIS with DCIS group, non-microcalcifications group was more accurate than microcalcifications group. All the differences mentioned above were statistically significant(all P<0.05). Conclusions:For accurate measurement of the size of breast cancer lesions, 3D-US is the best, which is least affected by clinicopathological factors and imaging features, followed by 2D-US and USE. This has certain significance for clinically determining the extent of breast cancer lesions.

Purpose/Significance To study the typical characteristics of urban residents when they choose internet medical services,and to establish patient behavior portraits,so as to provide decision-making basis for improving internet medical services.Method/Process Taking patients in Beijing as the research object,patient group portraits are constructed from three dimensions:individual attrib-ute characteristics,online consultation behavior and medical demand preference,and online patient groups are classified by the clustering method.Result/Conclusion Online patients are classified into five distinct groups:value potential,platform loyalty,potential conver-sion,strong demand,and service transfer.Overall,online patients from major cities tend to have lower case severity and lower levels of activity.They typically prefer lower-cost text-based consultations and show a preference for doctors from top-tier hospitals with higher professional titles and superior online service quality.These five different patient groups possess their own typical characteristics,and specific measures need to be taken to meet their personalized medical needs.

Objective To investigate the neurodevelopmental toxicity of ACR by studying the expression of DCX and GAP-43 in the hippocampal dentate gyrus of rats after maternal exposure to acrylamide. Methods Pregnant rats were randomly divided into low-dose ACR(4.5 mg/kg),medium-dose(9 mg/kg),high dose groups(18 mg/kg)and the control group(0 mg/kg),8 in each group,and were exposed to toxicant from gestation-al day 15 to postnatal day 13. All rats and their pups were killed on postnatal day 14. ABC immunohistochemistry was used to detect the expression of GFAP in the hippocampus of mother rats and offspring. Results Compared with the control group,the expression of DCX and GAP-43 in hippocampus dentate gyrus of the pregnant rats in middle and high dose groups was significantly decreased(P < 0.05). Conclusion ACR may interfere with the growth and development of neurons by reducing the expression of DCX and GAP-43.

Objective:To determine the role of type Ⅱ alveolar epithelial stem cells (AEC Ⅱ) in radiation-induced pulmonary injury and investigate the potential mechanism by observing the dynamic changes in the expression levels of anti-prosurfactant protein C (proSP-C) proSP-C (AEC Ⅱ biomarker), homeobox only protein X (HOPX, type I alveolar epithelial cell biomarker) or vimentin (a mesenchymal marker) and transforming growth factor β 1(TGF-β 1), a profibrotic cytokine. Methods:Eight-week old C57BL/6j female mice were exposed to X-ray thoracic irradiation. Mouse lungs were collected at 8 different time points of 24 h, 1 week, 1 to 6 months after irradiation. The histopathological changes of the lungs at different time points were observed with H& E staining to determine the time of formation of pulmonary fibrosis. In addition, the co-expression of proSP-C with HOPX or vimentin in AEC Ⅱ was confirmed by immunofluorescence staining to track AEC Ⅱ phenotypes at different injury phases following thoracic irradiation. The expression levels of those proteins and TGF-β 1 were quantitatively detected by Western blot. Results:After thoracic exposure to a single dose of 20 Gy X-ray for 3 months, the fibrotic lesions in the lungs could be noted. The co-expression of proSP-C with vimentin or HOPX could be observed in AEC Ⅱ. Western blot demonstrated that the expression levels of TGF-β 1 and those proteins were also changed along with the lung injury. Conclusion:AEC Ⅱ can be differentiated into mesenchymal-like cells after X-ray irradiation due to the up-regulated expression of TGF-β 1, which is a potential cause of radiation-induced pulmonary fibrosis.

Emerging therapies based on localized delivery of siRNA to lungs have opened up exciting possibilities for treatment of different lung diseases. Localized delivery of siRNA to lungs has shown to result in severalfold higher lung accumulation than systemic route, while minimizing non-specific distribution in other organs. However, to date, only 2 clinical trials have explored localized delivery of siRNA for pulmonary diseases. Here we systematically reviewed recent advances in the field of pulmonary delivery of siRNA using non-viral approaches. We firstly introduce the routes of local administration and analyze the anatomical and physiological barriers towards effective local delivery of siRNA in lungs. We then discuss current progress in pulmonary delivery of siRNA for respiratory tract infections, chronic obstructive pulmonary diseases, acute lung injury, and lung cancer, list outstanding questions, and highlight directions for future research. We expect this review to provide a comprehensive understanding of current advances in pulmonary delivery of siRNA.