Objective:To explore application value of a constructed predictive model of quantitative parameters of contrast-enhanced ultrasound(CEUS)combined with immunohistochemical indicators in assessing the curative efficacy of neoadjuvant chemotherapy(NAC)for breast cancer,so as to provide objective basis for clinically individual treatment decisions.Methods:The CEUS quantitative parameters were used to combine with immunohistochemical indicators to construct predictive model,and this study adopted prospective cohort design.A total of 93 patients who were preliminarily diagnosed as breast cancer at Affiliated Hospital of Jiangnan University during June 2022 and June 2023 were included in this study.According to the pathologically relieve condition,they were divided into significant response group(41 cases)and non-significant response group(52 cases).All of them received NAC with docetaxel/doxorubicin/cyclophosphamide(TAC).Before treatment,the peak intensity(PI),time-to-peak(TTP),and wash-in rate(WIR)of them were obtained through CEUS,and all of patients underwent immunohistochemical examination to detect the expressions of immunohistochemical indicators included estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER2)and Ki-67 proliferation index.The Miller-Payne grade G4-G5 was used as the standard of pathological complete response(pCR).Multivariate logistic regression was adopted to screen independent predictors,and construct a jointly predictive model,and verify effectiveness by Bootstrap resampling method.Results:The PI value of significant response group was(22.7±4.1)dB,which was significantly higher than(18.3±3.6)dB of non-significant response group,and the difference was significant(t=5.437,P<0.001).The TTP of significant response group was(14.2±2.8)s,which was shorter than(18.6±3.1)s of non-significant response group,and the difference was significant(t=7.152,P<0.05).The wash-in rate(WIR)of significant response group was(1.61±0.43)dB/s,which was significantly higher than(0.98±0.37)dB/s of non-significant response group,and the difference was significant(t=7.893,P<0.001).In the immunohistochemical indicators,the positive HER2 and high Ki-67 expression significantly correlated with pathological response.In the results of positive HER2,there were 17 cases(41.5%)in 41 patients of significant response group,and there were 9 cases(17.3%)in non-significant response group,and the positive HER2 of significant response group was higher than that of non-significant response group,and the difference was significant(x2=7.326,P<0.05).For patients whose Ki-67 were larger or equal to 20%,the positive rate of significant response group was 75.6%(31 cases),which was higher than 57.7%(30 cases)of non-significant response group.For patients whose Ki-67 were less than 20%,the positive rate of significant response group was 24.4%(10 cases),which was significantly higher than 42.3%(22 cases)of non-significant response group,and the difference was significant(x2=3.921,P<0.05).Multivariate analysis indicated that TTP≤15 s,WIR≥1.5 dB/s,and positive HER2 were respectively independent predictors(OR=4.23,3.76,2.91,P<0.05).The area under curve(AUC)value of receiver operating characteristic(ROC)curve of joint model was 0.89(95%CI:0.83-0.95),and the sensitivity and specificity of that were respectively 92.7%and 80.8%,which were significantly better than each single parameter.Decision curve analysis indicated that the net benefit value of joint model increased by 21.3%-28.6%than conventional strategy when threshold probabilities was 15%-60%.Conclusion:CEUS quantitative parameters(TTP,WIR)that combine with HER2 status can construct predictive model with high-precision and low-cost for NAC curative efficacy,which synergistic effect in dynamic perfusion assessment and molecularly pathological characteristic can provide new paradigm for precision treatment in breast cancer.This mode has excellent clinical applicability,and can effectively identify chemosensitive populations and optimize decision-making process of treatment.

Objective:To explore application value of a constructed predictive model of quantitative parameters of contrast-enhanced ultrasound(CEUS)combined with immunohistochemical indicators in assessing the curative efficacy of neoadjuvant chemotherapy(NAC)for breast cancer,so as to provide objective basis for clinically individual treatment decisions.Methods:The CEUS quantitative parameters were used to combine with immunohistochemical indicators to construct predictive model,and this study adopted prospective cohort design.A total of 93 patients who were preliminarily diagnosed as breast cancer at Affiliated Hospital of Jiangnan University during June 2022 and June 2023 were included in this study.According to the pathologically relieve condition,they were divided into significant response group(41 cases)and non-significant response group(52 cases).All of them received NAC with docetaxel/doxorubicin/cyclophosphamide(TAC).Before treatment,the peak intensity(PI),time-to-peak(TTP),and wash-in rate(WIR)of them were obtained through CEUS,and all of patients underwent immunohistochemical examination to detect the expressions of immunohistochemical indicators included estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER2)and Ki-67 proliferation index.The Miller-Payne grade G4-G5 was used as the standard of pathological complete response(pCR).Multivariate logistic regression was adopted to screen independent predictors,and construct a jointly predictive model,and verify effectiveness by Bootstrap resampling method.Results:The PI value of significant response group was(22.7±4.1)dB,which was significantly higher than(18.3±3.6)dB of non-significant response group,and the difference was significant(t=5.437,P<0.001).The TTP of significant response group was(14.2±2.8)s,which was shorter than(18.6±3.1)s of non-significant response group,and the difference was significant(t=7.152,P<0.05).The wash-in rate(WIR)of significant response group was(1.61±0.43)dB/s,which was significantly higher than(0.98±0.37)dB/s of non-significant response group,and the difference was significant(t=7.893,P<0.001).In the immunohistochemical indicators,the positive HER2 and high Ki-67 expression significantly correlated with pathological response.In the results of positive HER2,there were 17 cases(41.5%)in 41 patients of significant response group,and there were 9 cases(17.3%)in non-significant response group,and the positive HER2 of significant response group was higher than that of non-significant response group,and the difference was significant(x2=7.326,P<0.05).For patients whose Ki-67 were larger or equal to 20%,the positive rate of significant response group was 75.6%(31 cases),which was higher than 57.7%(30 cases)of non-significant response group.For patients whose Ki-67 were less than 20%,the positive rate of significant response group was 24.4%(10 cases),which was significantly higher than 42.3%(22 cases)of non-significant response group,and the difference was significant(x2=3.921,P<0.05).Multivariate analysis indicated that TTP≤15 s,WIR≥1.5 dB/s,and positive HER2 were respectively independent predictors(OR=4.23,3.76,2.91,P<0.05).The area under curve(AUC)value of receiver operating characteristic(ROC)curve of joint model was 0.89(95%CI:0.83-0.95),and the sensitivity and specificity of that were respectively 92.7%and 80.8%,which were significantly better than each single parameter.Decision curve analysis indicated that the net benefit value of joint model increased by 21.3%-28.6%than conventional strategy when threshold probabilities was 15%-60%.Conclusion:CEUS quantitative parameters(TTP,WIR)that combine with HER2 status can construct predictive model with high-precision and low-cost for NAC curative efficacy,which synergistic effect in dynamic perfusion assessment and molecularly pathological characteristic can provide new paradigm for precision treatment in breast cancer.This mode has excellent clinical applicability,and can effectively identify chemosensitive populations and optimize decision-making process of treatment.

Objective:To investigate the factors affecting the prognosis of sudden sensorineural hearing loss (SSNHL), so as to guide the comprehensive treatment combined with hyperbaric oxygen (HBO) on SSNHL.Methods:A retrospective analysis was conducted on 112 patients (115 ears) with SSNHL who were admitted to the Department of Hyperbaric Medicine of Beijing Chao-yang Hospital from June 2018 to September 2021. They were divided into effective group (cured + markedly effective + effective) and ineffective group. The factors, i. e., head magnetic resonance angiography (MRA) and neck vascular ultrasound, were compared between the two groups, and then binary logistic regression analysis was performed.Results:There were 45 cases (46 ears) in the effective group, 67 cases (69 ears) in the ineffective group, and the effective rate was 40.0%. After two courses of HBO treatment, ultrasound-assisted examination was performed. Internal carotid artery plaques were found in 53 cases and vertebral artery plaques were found in 12 cases. Head MRI showed white matter lesions (WMLs) in 53 cases and MRA showed intracranial vascular stenosis in 26 cases. Types of hearing loss curves: 12 cases (12 ears) were hearing loss in low tone frequencies, 16 cases (16 ears) were hearing loss in high tone frequencies; 44 cases (45 ears) were hearing loss in all tone frequencies; and 40 cases (42 ears) were total deafness. Hearing loss degree: 22 cases (22 ears) were mild, 29 cases (30 ears) were moderate, 17 cases (17 ears) were severe, and 44 cases (46 ears) were extremely severe. The time from onset to first treatment, the type of hearing loss, and the degree of hearing loss between the two groups were significantly different ( P<0.01). Logistic regression analysis showed that the type of hearing loss and the time from onset to first treatment were correlated with the prognosis of SSNHL ( P<0.01). Conclusion:The prognosis of SSNHL with early HBO intervention was better, while the prognosis of SSNHL patients with intracranial vascular stenosis was poor. The SSNHL patients with abnormal head MRA results need more attention.

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by 2019 novel Coronavirus (2019-nCoV). At present, the most used method to diagnose 2019-nCoV is nucleic acid test. Suspected cases underwent real-time fluorescent RT-PCR examination, and those who were 2019-nCoV nucleic acid positive were confirmed cases. However, in the process of nucleic acid test, factors such as specimen quality, specimen transportation and storage conditions, detection reagents and methods may cause false negative or false positive results. This article reviews the factors that may affect the results of 2019-nCoV nucleic acid test, and provides a basis for the diagnosis of suspected COVID-19 cases.

Objective:To investigate the factors affecting the prognosis of sudden sensorineural hearing loss (SSNHL), so as to guide the comprehensive treatment combined with hyperbaric oxygen (HBO) on SSNHL.Methods:A retrospective analysis was conducted on 112 patients (115 ears) with SSNHL who were admitted to the Department of Hyperbaric Medicine of Beijing Chao-yang Hospital from June 2018 to September 2021. They were divided into effective group (cured + markedly effective + effective) and ineffective group. The factors, i. e., head magnetic resonance angiography (MRA) and neck vascular ultrasound, were compared between the two groups, and then binary logistic regression analysis was performed.Results:There were 45 cases (46 ears) in the effective group, 67 cases (69 ears) in the ineffective group, and the effective rate was 40.0%. After two courses of HBO treatment, ultrasound-assisted examination was performed. Internal carotid artery plaques were found in 53 cases and vertebral artery plaques were found in 12 cases. Head MRI showed white matter lesions (WMLs) in 53 cases and MRA showed intracranial vascular stenosis in 26 cases. Types of hearing loss curves: 12 cases (12 ears) were hearing loss in low tone frequencies, 16 cases (16 ears) were hearing loss in high tone frequencies; 44 cases (45 ears) were hearing loss in all tone frequencies; and 40 cases (42 ears) were total deafness. Hearing loss degree: 22 cases (22 ears) were mild, 29 cases (30 ears) were moderate, 17 cases (17 ears) were severe, and 44 cases (46 ears) were extremely severe. The time from onset to first treatment, the type of hearing loss, and the degree of hearing loss between the two groups were significantly different ( P<0.01). Logistic regression analysis showed that the type of hearing loss and the time from onset to first treatment were correlated with the prognosis of SSNHL ( P<0.01). Conclusion:The prognosis of SSNHL with early HBO intervention was better, while the prognosis of SSNHL patients with intracranial vascular stenosis was poor. The SSNHL patients with abnormal head MRA results need more attention.