Objective:To investigate the application of the parameters of multimodal ultrasound elastography in differential diagnosis for thyroid nodules of patients with diffuse thyroid lesions.Methods:A total of 103 patients with diffuse thyroid lesions who underwent treatment at Affiliated Baoji Hospital of Xi′an Medical University from January 2023 to January 2024 were retrospectively selected,whose thyroid nodules were confirmed by fine needle aspiration biopsy or surgical pathology.They were grouped according to the benign or malignant nodules.56 patients with benign nodules were included in the benign nodule group,while the other 47 patients were included in the malignant nodule group.All patients were examined by conventional ultrasound and multimodal ultrasound elastography,and the relevant parameters were recorded to compare the differences between the two groups.The value of each indicator in diagnosing benign and malignant thyroid nodules was investigated.Results:There were no statistically significant differences between the benign and malignant nodule groups in terms of gender,length diameter of nodule,nodule location,functional abnormalities of thyroid,exposure history of radiation,and the presence of acoustic halos(P＞0.05),the age of patients in the malignant nodule group was lower than that of the benign nodule group(t=-3.121,P＜0.05),and the percentage of nodules with blood flow(14.89%),the percentage of aspect ratio＜1(74.47%),and the percentage of nodules with clear boundary(27.66%)in the malignant nodule group were all lower than those of the benign nodule group,with statistically significant differences(x2=25.634,5.112,12.465,P＜0.05).The ratio of lymphatic metastasis(27.66%)and that of calcification(65.96%)in the malignant nodule group were lower than those in the benign nodule group,and the differences were all statistically significant(x2=11.917,9.350,P＜0.05).The ratios of centripetal enhancement(76.60%),inhomogeneous enhancement(68.09%),low/equal enhancement(87.23%),early obvious discharge(63.83%),unclear boundary after enhancement(91.49%),and fast discharge(59.57%)in the malignant nodule group were higher than that of the benign nodule group,and the differences were statistically significant(x2=33.409,26.695,9.079,12.853,17.798,12.649,P＜0.05),respectively.The intensity and time to peak of the malignant nodule group were respectively lower and long than these of the benign nodule group,and the differences were statistically significant(t=-12.381,4.958,P＜0.05).However,the mean passage time of the two groups was not statistically significant(P＞0.05).The maximum value,minimum value and mean value of Young's modulus,the maximum value of vertical section,mean value of vertical section,maximum value of cross section,mean value of cross section in the malignant nodule group were all higher than those in the benign nodule group,and the differences were statistically significant(t=13.997,9.100,12.191,7.616,6.310,4.679,5.355,P＜0.05).The result of receiver operating characteristic(ROC)curve analysis indicated that both ultrasonography parameters and shear wave elastography(SWE)parameters had higher diagnostic value for the benign and malignant nature of thyroid nodules in patients.The area under curve(AUC)values of intensity to peak,time to peak,and the maximum value,minimum value and mean value of Young's modulus,and the maximum value of vertical section,mean value of vertical section,maximum value of cross section,mean value of cross section were respectively 0.976,0.759,0.974,0.837,0.989,0.872,0.805,0.732 and 0.749.Conclusion:Multimodal ultrasound elastography parameters has significant application value in differential diagnosis for thyroid nodules in patients with diffuse thyroid lesions.In these parameters,the diagnostic AUC values of intensity to peak,time to peak,and the maximum value and mean value of Young's modulus are higher for malignant thyroid nodules of patients,which have higher diagnostic efficiency.It can effectively help clinical doctor to accurately identify the benign and malignant nodules for patients with diffuse thyroid lesions.

Objective:To explore the application value of Superb microvascular imaging(SMI)technique in diagnosing diffuse thyroid disease with thyroid nodules,and the assessment for treatment efficacy.Methods:A total of 100 patients with diffuse thyroid disease with thyroid nodules(132 nodules),who were treated at the Baoji Hospital Affiliated to Xi'an Medical University from March 2020 to November 2024,were selected.The dual examination of SMI and conventional Color Doppler Flow Imaging(CDFI)were conducted on them.The nature of the nodules was confirmed by pathological examination.The diagnostic sensitivity,specificity and predictive value of SMI and CDFI were analyzed by using the receiver operating characteristic(ROC)curve.A series of conventional indicators,including blood flow volume,blood flow velocity,pattern of blood flow distribution,and vascular morphology,between the two imaging techniques were compared and analyzed.Results:In the 132 thyroid nodules that were detected by pathological examination,SMI identified 94 benign lesions(71.21%)and 38 malignant lesions(28.79%).The sensitivity and specificity of SMI were respectively 94.68%and 89.47%in diagnosing diffuse thyroid disease with thyroid nodules,both of them were higher than those(84.05%and 78.95%)of CDFI,and the sensitivity of SMI diagnosis was significantly higher than that of CDFI diagnosis,and the difference was statistically significant(x2=5.595,P<0.05).The nodule size as SMI diagnosis was(14.62±2.36)mm,which was significantly smaller than(16.35±4.45)mm as CDFI diagnosis,and the difference was statistically significant(x2=3.330,P<0.05).Blood flow velocity and blood flow volume of SMI diagnosis were significantly higher than those of CDFI diagnosis,and the differences were statistically significant(t=5.718,6.567,P<0.05).The detection rates of blood flow distribution mode and vascular morphology of SMI mode were significantly higher than those of CDFI mode,and the differences were statistically significant(x2=9.192,4.776,P<0.05).However,there were not statistically significant differences were observed between the two imaging techniques in terms of the shape,echo type and internal calcification of nodules(P>0.05).Conclusion:SMI technique has a significant advantage in diagnosis and assessment for diffuse thyroid disease with thyroid nodules.It can more accurately assess the hemodynamic changes of the nodules,and provide more reliable diagnostic information for clinical treatment.

Objective To develop and validate a nomogram model that integrates systemic inflammatory markers to predict the likelihood of pelvic lymph node metastasis(PLNM)in prostate cancer patients prior to surgery.Methods This study retrospectively analyzed the clinical data and preoperative inflammatory markers—including neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),and monocyte-to-lymphocyte ratio(MLR)—of patients diagnosed with prostate cancer.Univariate and multi-variate logistic regression analyses were conducted to identify markers that were significantly associated with PLNM.Based on the results of the multivariate analysis,a nomogram was developed and its predictive accuracy was assessed using receiver operating characteristic curves(ROC)and calibration plots.Results Among the 334 enrolled patients with prostate cancer,107 were identified with PLNM.Univariate analysis revealed statistically significant differences in free prostate-specific antigen(fPSA),Gleason score,NLR,PLR,MLR,and SII between the PLNM and non-pelvic lymph node metastasis(NPLNM)groups(P<0.05).Multivariate analysis confirmed that fPSA,Gleason score,and SII were independent predictors of PLNM(P<0.05).A nomogram incorporating these predic-tors exhibited strong discriminative ability,with an area under the ROC curve(AUC)of 0.79(95%CI:0.73～0.84).Calibration analysis further demonstrated good consistency between the predicted and observed probabilities of PLNM.Conclusions This study successfully developed a nomogram model based on systemic inflammatory markers for preoperative prediction of pelvic lymph node metastasis in prostate cancer.Owing to its user-friendly design and high predictive accuracy,this tool may serve as a valuable complementary method to conventional imaging techniques,thereby supporting personalized treatment decision-making.

Objective To investigate the effect of aerobic exercise preconditioning on cardiac function in mice bearing subcutaneous transplantable tumors and explore the potential molecular mechanisms.Methods Twenty-four 6-week-old male BALB/c mice were selected.After an acclimation period,they were randomly assigned to a control group(C),a tumor group(M)and an exercise-preconditioning plus tumor group(EM),each of eight.The EM group underwent a 4-week aerobic exercise interven-tion.Meanwhile,the C group received 0.2 ml of physiological saline injected subcutaneously on the dorsum of the proximal left hind limb,while the M and EM groups were inoculated at the same site with 0.2 ml of a CT26.WT colon carcinoma cell suspension.Three weeks after inoculation,cardiac function was assessed by transthoracic echocardiography.Hearts were then harvested for hematoxylin-eo-sin staining to evaluate cardiomyocyte cross-sectional area(CSA),while Western blot was performed to determine the expression of proteins related to myocardial protein synthesis and degradation.Results(1)Compared with group C,group M exhibited significantly lower body weight and heart weight(P<0.05),and reduced left ventricular ejection fraction(LVEF),fractional shortening(FS)and stroke vol-ume(SV)(P<0.05),as well as cardiomyocyte CSA(P<0.01)and total mTOR(P<0.01),phosphory-lated mTOR(p-mTOR)(P<0.01)and the p-mTOR/mTOR ratio(P<0.05),but a significant increase in the expression of the muscle ring finger 1(MuRF-1)and the muscle atrophy F-box(MAFbx/Atrog-in-1)(P<0.01 and P<0.05,respectively).(2)Compared with group M,group EM showed significant-ly greater heart weight(P<0.05);increased left ventricular posterior wall thickness at end-diastole(LVPWd),LVEF,FS and SV(P<0.05),as well as the larger cardiomyocyte CSA and total mTOR,p-mTOR and the p-mTOR/mTOR ratio(P<0.05),but reduced MuRF-1 and Atrogin-1 expression(P<0.05).Conclusion Four weeks of aerobic exercise preconditioning ameliorated myocardial atrophy and improved systolic cardiac function in mice bearing subcutaneously transplanted CT26 tumors.Such beneficial effects may be associated with exercise-induced down regulation of the protein degradation mediators MuRF-1 and Atrogin-1 and up regulation of total mTOR and p-mTOR.

Objective:To explore the diagnostic value of serum soluble semaphorin 4D (sSema4D) and soluble CD40 ligand (sCD40L) in left ventricular hypertrophy (LVH) in patients with primary hypertension (EH).Methods:Eighty-four patients with EH combined with LVH admitted to Qingdao Hospital of Shandong First Medical University from December 2022 to December 2023 were prospectively selected as the study group, and 84 patients with EH and without LVH admitted to Qingdao Hospital of Shandong First Medical University during the same period were regarded as the control group. Enzyme linked immunosorbent assay was applied to detect the levels of sSema4D and sCD40L. Employing Pearson correlation coefficient, the study assessed the association between concentrations of sSema4D and sCD40L in serum and various echocardiographic measurements. A multivariate Logistic regression model was engaged to probe into the contributing factors for the development of LVH. ROC curve was plotted to analyze the diagnostic value of serum sSema4D and sCD40L for EH combined with LVH.Results:Serum sSema4D and sCD40L levels were significantly higher in the study group than in the control group: (8.56 ± 2.19) μg/L vs. (5.12 ± 1.43) μg/L, (4.02 ± 1.03) μg/L vs. (3.22 ± 0.98) μg/L, and the differences were statistically significant ( P<0.05). The duration of hypertension, LVEDD, IVSTD, LVPWT, and LVMI were significantly higher in the study group than in the control group: (7.33 ± 1.53) years vs. (4.26 ± 1.35) years, (50.28 ± 3.33) mm vs. (44.45 ± 3.76) mm, (11.64 ± 3.21) mm vs. (9.53 ± 2.89) mm, (12.45 ± 1.52) mm vs. (9.13 ± 0.98) mm, (126.11 ± 15.28) g/m 2 vs. (81.15 ± 11.31) g/m 2, and the differences were statistically significant ( P<0.05). According to Pearson correlation analysis, it was known that both serum sSema4D and sCD40L were positively correlated with LVEDD, IVSTD, LVPWT and LVMI ( r = 0.425 and 0.533, 0.612 and 0.436, 0.513 and 0.628, 0.589 and 0.618; P<0.05). Multivariate Logistic regression analysis showed that hypertension duration, LVEDD, IVSTD, LVPWT, LVMI, sSema4D, sCD40L were risk factors for LVH in EH patients ( P<0.05). According to the ROC curve, the AUC for diagnosing EH combined with LVH with serum sSema4D was 0.848, the AUC for diagnosing EH combined with LVH with serum sCD40L was 0.725, and the AUC for diagnosing EH combined with LVH with serum sCD40L was 0.888, the combination of sCD40L and sCD40L was superior to their respective individual diagnoses ( Z = 2.651 and 2.526, P<0.05). Conclusions:The serum levels of sSema4D and sCD40L in patients with EH combined with LVH are obviously elevated, which are influencing factors for the occurrence of EH combined with LVH. Combined testing of the two has high diagnostic value for EH combined with LVH.

Objective To investigate the effects of aerobic exercise and different exercise habits on skeletal muscle function and the possible molecular mechanisms in colorectal cancer-loaded mice.Methods Thirty-five 5-week-old BABL/c male mice were acclimatized to feeding for 1 week and then divided randomly into the following groups:control(D),tumor(M),exercise preconditioning(QAM),lifetime exercise(AM),and exercise(HAM)groups(n=7 mice per group).Mice in the QAM and AM groups underwent aerobic exercise regimen 1 from weeks 2～6.At week 7,mice in the experimental groups received 0.2 mL of CT26 colon cancer cell suspension subcutaneously in the dorsal aspect of the left hind limb,while control mice received 0.2 mL of saline at the corresponding site.Mice in the AM and HAM groups were subjected to aerobic exercise regimen 2 for weeks 7～9.The general status and skeletal muscle mass and function were monitored in all mice throughout the experiments.After completion of the experiment,samples were collected and the cross-sectional area of gastrocnemius muscle fibers(CSA)was measured by hematoxylin and eosin staining and expression levels of proteins related to synthesis and catabolism of the gastrocnemius muscle were analyzed by Western Blot.Results(1)The weight ratio of the gastrocnemius muscle was significantly lower in mice in the M,QAM,and HAM groups compared with group D,and was significantly higher in AM mice compared with M,QAM,and HAM mice.(2)Grip strength,endurance,skeletal muscle circumference,and CSA were significantly lower in group D mice compared with the other groups,and was most enhanced in group HAM.Endurance and CSA were consistently enhanced in groups QAM,AM,and HAM.(3)Muscle RING-finger protein-1(MuRF1)expression levels were significantly lower in groups M,QAM,AM,and HAM than in group D,significantly lower in groups AM and HAM than in group M,and significantly lower in group HAM than in group QAM.(4)Fibronectin type Ⅲ domain-containing protein 5(FNDC5)expression levels were significantly lower in group M than in groups D and QAM.(5)Peroxisome proliferator-activated receptor gamma coactivator 1-alpha expression levels were significantly lower in the QAM and HAM groups compared with group M.(6)Expression levels of phospho(p)-AMP-activated protein kinase(AMPK)/AMPK and p-AMPK were significantly higher in group QAM than in groups D and M,p-AMPK expression significantly lower in groups AM and HAM was than in group QAM,and AMPK expression was significantly lower in groups QAM,AM,and HAM than in group D.Conclusions Exercise preconditioning and continuous aerobic exercise can improve skeletal muscle mass and function in CT26 colon cancer-loaded mice by activating AMPK phosphorylation to stimulate skeletal muscle secretion of FNDC5,thereby regulating the expression of MuRF1 protein.

Objective To develop and validate a nomogram model that integrates systemic inflammatory markers to predict the likelihood of pelvic lymph node metastasis(PLNM)in prostate cancer patients prior to surgery.Methods This study retrospectively analyzed the clinical data and preoperative inflammatory markers—including neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),and monocyte-to-lymphocyte ratio(MLR)—of patients diagnosed with prostate cancer.Univariate and multi-variate logistic regression analyses were conducted to identify markers that were significantly associated with PLNM.Based on the results of the multivariate analysis,a nomogram was developed and its predictive accuracy was assessed using receiver operating characteristic curves(ROC)and calibration plots.Results Among the 334 enrolled patients with prostate cancer,107 were identified with PLNM.Univariate analysis revealed statistically significant differences in free prostate-specific antigen(fPSA),Gleason score,NLR,PLR,MLR,and SII between the PLNM and non-pelvic lymph node metastasis(NPLNM)groups(P<0.05).Multivariate analysis confirmed that fPSA,Gleason score,and SII were independent predictors of PLNM(P<0.05).A nomogram incorporating these predic-tors exhibited strong discriminative ability,with an area under the ROC curve(AUC)of 0.79(95%CI:0.73～0.84).Calibration analysis further demonstrated good consistency between the predicted and observed probabilities of PLNM.Conclusions This study successfully developed a nomogram model based on systemic inflammatory markers for preoperative prediction of pelvic lymph node metastasis in prostate cancer.Owing to its user-friendly design and high predictive accuracy,this tool may serve as a valuable complementary method to conventional imaging techniques,thereby supporting personalized treatment decision-making.

Objective To investigate the effects of aerobic exercise and different exercise habits on skeletal muscle function and the possible molecular mechanisms in colorectal cancer-loaded mice.Methods Thirty-five 5-week-old BABL/c male mice were acclimatized to feeding for 1 week and then divided randomly into the following groups:control(D),tumor(M),exercise preconditioning(QAM),lifetime exercise(AM),and exercise(HAM)groups(n=7 mice per group).Mice in the QAM and AM groups underwent aerobic exercise regimen 1 from weeks 2～6.At week 7,mice in the experimental groups received 0.2 mL of CT26 colon cancer cell suspension subcutaneously in the dorsal aspect of the left hind limb,while control mice received 0.2 mL of saline at the corresponding site.Mice in the AM and HAM groups were subjected to aerobic exercise regimen 2 for weeks 7～9.The general status and skeletal muscle mass and function were monitored in all mice throughout the experiments.After completion of the experiment,samples were collected and the cross-sectional area of gastrocnemius muscle fibers(CSA)was measured by hematoxylin and eosin staining and expression levels of proteins related to synthesis and catabolism of the gastrocnemius muscle were analyzed by Western Blot.Results(1)The weight ratio of the gastrocnemius muscle was significantly lower in mice in the M,QAM,and HAM groups compared with group D,and was significantly higher in AM mice compared with M,QAM,and HAM mice.(2)Grip strength,endurance,skeletal muscle circumference,and CSA were significantly lower in group D mice compared with the other groups,and was most enhanced in group HAM.Endurance and CSA were consistently enhanced in groups QAM,AM,and HAM.(3)Muscle RING-finger protein-1(MuRF1)expression levels were significantly lower in groups M,QAM,AM,and HAM than in group D,significantly lower in groups AM and HAM than in group M,and significantly lower in group HAM than in group QAM.(4)Fibronectin type Ⅲ domain-containing protein 5(FNDC5)expression levels were significantly lower in group M than in groups D and QAM.(5)Peroxisome proliferator-activated receptor gamma coactivator 1-alpha expression levels were significantly lower in the QAM and HAM groups compared with group M.(6)Expression levels of phospho(p)-AMP-activated protein kinase(AMPK)/AMPK and p-AMPK were significantly higher in group QAM than in groups D and M,p-AMPK expression significantly lower in groups AM and HAM was than in group QAM,and AMPK expression was significantly lower in groups QAM,AM,and HAM than in group D.Conclusions Exercise preconditioning and continuous aerobic exercise can improve skeletal muscle mass and function in CT26 colon cancer-loaded mice by activating AMPK phosphorylation to stimulate skeletal muscle secretion of FNDC5,thereby regulating the expression of MuRF1 protein.

Objective:To analyze the value advantages of multimodal ultrasound in the diagnosis of benign and malignant nodules of 4a grade of nodules of Chinese thyroid imaging reporting and data system (C-TIRADS) of diffuse thyroid nodules. Methods:A total of 227 diffuse thyroid nodules (116 malignant nodules and 111 benign nodules) from 219 patients who admitted to Baoji Hospital Affiliated to Xi'an Medical University between January 2020 to December 2023 were retrospectively selected. Two-dimensional ultrasound and multimodal ultrasound were used to diagnose diffuse thyroid nodules,and to perform data analysis. There were 49 males and 170 females,ranging in age from 24 to 72 years old,whose average age was 52.31±10.08 years. The result of pathological diagnosis was used as the "gold standard",and the results of pathological diagnosis and the parameters of multimodal ultrasound for diffuse thyroid nodules were compared. The diagnostic efficiency of the results of multimodal ultrasound and two-dimensional ultrasound for diffuse thyroid nodules was compared and analyzed. Results:As the results of pathological diagnosis,the scores of contrast-enhanced ultrasound,micro blood flow imaging,elastography and malignant risk score of multimodal ultrasound technique of malignant diffuse thyroid nodules were significantly higher than those of benign nodules (Z=-4.258,-5.007,-5.631,P<0.05),respectively. The sensitivity (92.24％) and specificity (92.79％) of multimodal ultrasound were significantly higher than those (75.00％ and 83.78％) of two-dimensional ultrasound (x2=12.588,4.356,P<0.05),respectively. The positively predictive values (93.04％) and negatively predictive values (91.96％) of multimodal ultrasound were significantly higher than those (82.86％ and 76.23％) of two-dimensional ultrasound (x2=5.465,10.629,P<0.05),respectively. Conclusion:For the judgment of benign and malignant nodules of C-TIRADS 4a in the background of diffuse thyroid nodules,the application of multimodal ultrasound technique,especially the combined use of contrast-enhanced ultrasound,elastography and micro blood flow imaging,can greatly improve the accuracy of ultrasonic diagnosis of these diseases.

Objective To investigate the effect of aerobic exercise preconditioning on cardiac function in mice bearing subcutaneous transplantable tumors and explore the potential molecular mechanisms.Methods Twenty-four 6-week-old male BALB/c mice were selected.After an acclimation period,they were randomly assigned to a control group(C),a tumor group(M)and an exercise-preconditioning plus tumor group(EM),each of eight.The EM group underwent a 4-week aerobic exercise interven-tion.Meanwhile,the C group received 0.2 ml of physiological saline injected subcutaneously on the dorsum of the proximal left hind limb,while the M and EM groups were inoculated at the same site with 0.2 ml of a CT26.WT colon carcinoma cell suspension.Three weeks after inoculation,cardiac function was assessed by transthoracic echocardiography.Hearts were then harvested for hematoxylin-eo-sin staining to evaluate cardiomyocyte cross-sectional area(CSA),while Western blot was performed to determine the expression of proteins related to myocardial protein synthesis and degradation.Results(1)Compared with group C,group M exhibited significantly lower body weight and heart weight(P<0.05),and reduced left ventricular ejection fraction(LVEF),fractional shortening(FS)and stroke vol-ume(SV)(P<0.05),as well as cardiomyocyte CSA(P<0.01)and total mTOR(P<0.01),phosphory-lated mTOR(p-mTOR)(P<0.01)and the p-mTOR/mTOR ratio(P<0.05),but a significant increase in the expression of the muscle ring finger 1(MuRF-1)and the muscle atrophy F-box(MAFbx/Atrog-in-1)(P<0.01 and P<0.05,respectively).(2)Compared with group M,group EM showed significant-ly greater heart weight(P<0.05);increased left ventricular posterior wall thickness at end-diastole(LVPWd),LVEF,FS and SV(P<0.05),as well as the larger cardiomyocyte CSA and total mTOR,p-mTOR and the p-mTOR/mTOR ratio(P<0.05),but reduced MuRF-1 and Atrogin-1 expression(P<0.05).Conclusion Four weeks of aerobic exercise preconditioning ameliorated myocardial atrophy and improved systolic cardiac function in mice bearing subcutaneously transplanted CT26 tumors.Such beneficial effects may be associated with exercise-induced down regulation of the protein degradation mediators MuRF-1 and Atrogin-1 and up regulation of total mTOR and p-mTOR.