Objective:To investigate the clinical value of a fully autonomous ultrasound robot in splenic ultrasound imaging.Methods:A retrospective study was conducted by enrolling 56 adult volunteers from the Third Medical Center of the Chinese PLA General Hospital between February 1-8，2024 as research subjects.A senior physician sequentially performed splenic ultrasound examinations using both the fully autonomous ultrasound robot and a matched portable ultrasound device. The acquired images were randomly coded and scored via a double-blind method by 3 physicians. The differences of the image quality scores and high-quality image proportions between the two groups were compared. Examination durations were recorded and compared between the two groups.Results:Both modalities successfully acquired splenic images in all 56 volunteers. No statistically significant differences were observed in image quality scores among the 3 physicians：（3.52 ± 1.31）points vs.（3.83 ± 1.23）points，（2.77 ± 1.23）points vs.（3.17 ± 1.17）points，and（3.48 ± 0.97）points vs.（3.79 ± 0.94）points（all P>0.05）. The numbers of images scoring ≥ 3 points showed no significant differences：45（80.36%） vs. 50（89.29%），30（53.57%） vs. 38（67.86%），and 48（85.71%） vs. 52（92.86%）（all P>0.05）. The fully autonomous ultrasound robot required significantly longer examination time［（60.86 ± 50.55）s vs.（7.95 ± 4.35）s， t=6.88， P＜0.01］. Conclusions:The fully autonomous ultrasound robot demonstrates comparable image quality and clinically acceptable image proportions to conventional portable ultrasound in splenic examinations. These findings suggest its potential equivalence to operator-dependent ultrasound for splenic imaging，supporting its feasibility as an alternative ultrasound modality despite longer procedural duration.

Objective:To investigate the clinical value of a fully autonomous ultrasound robot in splenic ultrasound imaging.Methods:A retrospective study was conducted by enrolling 56 adult volunteers from the Third Medical Center of the Chinese PLA General Hospital between February 1-8，2024 as research subjects.A senior physician sequentially performed splenic ultrasound examinations using both the fully autonomous ultrasound robot and a matched portable ultrasound device. The acquired images were randomly coded and scored via a double-blind method by 3 physicians. The differences of the image quality scores and high-quality image proportions between the two groups were compared. Examination durations were recorded and compared between the two groups.Results:Both modalities successfully acquired splenic images in all 56 volunteers. No statistically significant differences were observed in image quality scores among the 3 physicians：（3.52 ± 1.31）points vs.（3.83 ± 1.23）points，（2.77 ± 1.23）points vs.（3.17 ± 1.17）points，and（3.48 ± 0.97）points vs.（3.79 ± 0.94）points（all P>0.05）. The numbers of images scoring ≥ 3 points showed no significant differences：45（80.36%） vs. 50（89.29%），30（53.57%） vs. 38（67.86%），and 48（85.71%） vs. 52（92.86%）（all P>0.05）. The fully autonomous ultrasound robot required significantly longer examination time［（60.86 ± 50.55）s vs.（7.95 ± 4.35）s， t=6.88， P＜0.01］. Conclusions:The fully autonomous ultrasound robot demonstrates comparable image quality and clinically acceptable image proportions to conventional portable ultrasound in splenic examinations. These findings suggest its potential equivalence to operator-dependent ultrasound for splenic imaging，supporting its feasibility as an alternative ultrasound modality despite longer procedural duration.

Objective:To investigate the value of ultrasound and Ki-67 for early predicting pathological complete response (pCR) of triple negative breast cancer(TNBC) after neoadjuvant chemotherapy (NAC).Methods:Retrospective analysis was performed in 190 patients with TNBC who underwent surgery after NAC treatment at the Cancer Hospital of Fudan University from January 2019 to December 2022. All patients underwent ultrasound examination before and after 2 and 4 cycles of NAC treatment. According to the operation pathological results after NAC, the patients were divided into pCR group and non-pCR group. The differences in ultrasound and Ki-67 parameters were compared between the pCR and non-pCR groups, and binary Logistic regression analysis was performed to determine the independent predictors for pCR. The ROC curve was plotted to evaluate the diagnostic efficacy.Results:Tumor maximum diameter, relative change rates of tumor maximum diameter after 2-cycle and 4-cycle NAC (ΔD2, ΔD4), relative change rate of lymph node short diameter after 2-cycle NAC (ΔS2), T-stage, N-stage and Ki-67 showed statistically significant differences between the pCR group and the non-pCR group (all P<0.05). Logistic regression analysis showed that ΔD4, T-stage, N-stage and Ki-67 were independent predictors for pCR ( OR=1.029, P=0.011; OR=0.300, P=0.009; OR=0.653, P=0.048; OR=1.028, P=0.001). The area under the curve (AUC) of pCR was 0.804 (95% CI=0.742-0.866), the sensitivity and specificity were 67.5% and 83.2% respectively. Conclusions:The combination parameters of ΔD4, T-stage, N-stage and Ki-67 have certain clinical value for predicting pCR of TNBC.

Objective:To observe the effect of exercise preconditioning with different intensities and durations on early kidney injury indicators in rats by constructing a rat model of kidney injury induced by one-off high intensive and exhaustive military training, and to provide guidance on implementing scientific training plans.Methods:A total of 70 male Sprague Dawley (SD) rats were divided into seven groups with 10 rats in each group according to the random number table method, namely, model group with kidney injury induced by one-off high-intensive military training (M group), low-intensive and short-term exercise preconditioning group (LS group), low-intensive and long-term exercise preconditioning group (LL group), medium-intensive and short-term exercise preconditioning group (MS group), medium-intensive and long-term exercise preconditioning group (ML group), high-intensive and short-term exercise preconditioning group (HS group), and high-intensive and long-term exercise preconditioning group (HL group). After treadmill exercise preconditioning in different modes, the rats were trained as the kidney injury model group receiving one-off high intensive and exhaustive military training. The behavioral characteristics of rats after each training and when they were trained to exhaustion, the time to exhaustion, the levels of blood urea nitrogen (Bun), serum creatinine (SCr), cystatin C (Cys-C), kidney injury molecule-1(KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL), the activities of Na + K + -ATPase in kidney tissues, the levels of total superoxide dismutase (SOD), and malondialdehyde (MDA), and the semi-quantitative scores of renal tubules were observed. Results:The rats in the HL group had indifferent expressions, slow responses, glossless fur, and weak responses for evading capture, while the rats in other groups had glossy fur and were alert to surrounding stimuli. In terms of the length of the time to exhaustion, the groups were ranked as ML>HS>MS>LL>LS>M>HL. There was no statistically significant difference in the time to exhaustion between the LS group and the M group ( P>0.05); but there were statistically significant differences in the time to exhaustion among other groups, and the time to exhaustion in the HL group was significantly shorter than those in other groups ( P<0.05). In terms of serum Bun, SCr, Cys-C, KIM-1, and NGAL levels, there was no statistically significant difference between the LS group and the M group ( P>0.05), but there were statistically significant differences among other groups ( P<0.05). In terms of the expressions of Na + , K + -ATPase activities and total SOD activity in renal tissues of rats, the groups were ranked as ML>HS>MS>LL>M>LS>HL. In terms of the expressions of Na + , K + -ATPase activities and total SOD activity in renal tissue of rats, there was no significant difference between the M group and the LS group ( P>0.05), but there were statistically significant differences among other groups ( P<0.05). The MDA levels from low to high were ranked as ML0.05), but there were statistically significant differences among other groups ( P<0.05). The renal tubules scores from low to high were ranked as ML

Objective:To observe the effect of exercise preconditioning with different intensities and durations on early kidney injury indicators in rats by constructing a rat model of kidney injury induced by one-off high intensive and exhaustive military training, and to provide guidance on implementing scientific training plans.Methods:A total of 70 male Sprague Dawley (SD) rats were divided into seven groups with 10 rats in each group according to the random number table method, namely, model group with kidney injury induced by one-off high-intensive military training (M group), low-intensive and short-term exercise preconditioning group (LS group), low-intensive and long-term exercise preconditioning group (LL group), medium-intensive and short-term exercise preconditioning group (MS group), medium-intensive and long-term exercise preconditioning group (ML group), high-intensive and short-term exercise preconditioning group (HS group), and high-intensive and long-term exercise preconditioning group (HL group). After treadmill exercise preconditioning in different modes, the rats were trained as the kidney injury model group receiving one-off high intensive and exhaustive military training. The behavioral characteristics of rats after each training and when they were trained to exhaustion, the time to exhaustion, the levels of blood urea nitrogen (Bun), serum creatinine (SCr), cystatin C (Cys-C), kidney injury molecule-1(KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL), the activities of Na + K + -ATPase in kidney tissues, the levels of total superoxide dismutase (SOD), and malondialdehyde (MDA), and the semi-quantitative scores of renal tubules were observed. Results:The rats in the HL group had indifferent expressions, slow responses, glossless fur, and weak responses for evading capture, while the rats in other groups had glossy fur and were alert to surrounding stimuli. In terms of the length of the time to exhaustion, the groups were ranked as ML>HS>MS>LL>LS>M>HL. There was no statistically significant difference in the time to exhaustion between the LS group and the M group ( P>0.05); but there were statistically significant differences in the time to exhaustion among other groups, and the time to exhaustion in the HL group was significantly shorter than those in other groups ( P<0.05). In terms of serum Bun, SCr, Cys-C, KIM-1, and NGAL levels, there was no statistically significant difference between the LS group and the M group ( P>0.05), but there were statistically significant differences among other groups ( P<0.05). In terms of the expressions of Na + , K + -ATPase activities and total SOD activity in renal tissues of rats, the groups were ranked as ML>HS>MS>LL>M>LS>HL. In terms of the expressions of Na + , K + -ATPase activities and total SOD activity in renal tissue of rats, there was no significant difference between the M group and the LS group ( P>0.05), but there were statistically significant differences among other groups ( P<0.05). The MDA levels from low to high were ranked as ML0.05), but there were statistically significant differences among other groups ( P<0.05). The renal tubules scores from low to high were ranked as ML

ObjectiveTo investigate the effect of direct-acting antiviral (DAA) on the recurrence of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) after curative treatment. MethodsPubMed, Web of Science, Cochrane Library, CNKI, CBM, Wanfang Data, and VIP were searched for the clinical studies of DAA and the recurrence of HCV-related HCC published up to April 2020. Stata 14.0 software was used to perform the meta-analysis. The Cochran Q test was used to evaluate heterogeneity between studies; the fixed effects model was used for non-heterogeneous data, and the random effects model was used for heterogeneous data. The Egger regression method or the Begg rank correlation method was used to evaluate the presence or absence of publication bias. ResultsA total of 10 articles (11 studies) were included in our study, among which 8 articles (9 studies) compared the effect of DAA versus the absence of anti-HCV therapy on the recurrence of HCC after curative treatment. There were 991 patients in DAA group and 808 patients in untreated group. The results of the meta-analysis showed that DAA reduced the recurrence rate of HCC after curative treatment in patients with HCV infection (hazard ratio ［HR］=0.42, 95% confidence interval ［CI］: 0.28?0.36, P＜0.001). Three articles compared the effect of DAA versus interferon for the treatment of hepatitis C on the recurrence of HCC after curative treatment, with 267 patients in DAA group and 212 in interferon group, and the results of the meta-analysis showed that DAA and interferon had a similar effect on the recurrence rate of HCV-related HCC (HR=0.85, 95% CI: 0.64-1.15, P=0.298). ConclusionBoth interferon and DAA can significantly reduce the recurrence risk of HCV-related HCC after curative treatment, with no significant difference between them.

Objective To explore the clinical and ultrasonographic characteristics leading to non-diagnostic results after ultrasound-guided fine-needle aspiration ( US-FNA) in patients with thyroid nodules . Methods One thousand and thirty-four thyroid nodules of 1009 patients who underwent US-FNA from June 2013 to September 2015 in Fudan University Shanghai Cancer Center were included in this study . The ultrasonographic characteristics , cytological and histological diagnosis were collectecl . Univariate and multivariate logistic methods were applied to analyze the factors bringing about non-diagnostic results . Results Of the 1034 nodules ,174 ( 16 .8％ ) had non-diagnostic results and 860 ( 83 .2％ ) had diagnostic results . Age ,echogenicity ,anteroposterior/transverse diameter ratio ( AT ) ,calcification ,margin and depth were associated with nondiagnostic results . Age ≥45 years ,the largest diameter ≤10 mm ,AT <1 ,located at the middle 1/3 and dorsal 1/3 in the cross section of nodules , macrocalcification were proved as independent influencing factors for non-diagnostic results of FNA . Conclusions Age≥45 years ,the largest diameter ≤10 mm ,AT < 1 ,located at the middle 1/3 and dorsal 1/3 in the cross section of nodules , macrocalcification are independent influencing factors of non-diagnostic results . As a result ,for nodules with the characteristics above it may recommend follow up instead of FNA . During follow-up ,it may recommend surgery if the nodule has progressed .

Objective To study the characteristics of the sciatic nerve injuries inflicted by highvelocity triangle fragments in swine.Methods According to the injury position,14 swines weighing (34.29±5.2)kg were divided into two groups.All swines were shot by 0.37 g triangle fragments at (773.1±12.4)m/s aimed at the midpoint of the lateral body surface projection of the right sciatic nerve in Group A(n=7)and at 2 cm aside from sciatic nerve in Group B(n=7).The entrance,exit and length of wound tract,distance between nerve and wound tract were detected,and the pathology of sciatic nerve and wound tract at 48 hours after injury were observed under light microscope and electron microscope.Results The course of the fragments was deviated to different extent.Six sciatic nerves were in primary wound tract,four of which were lacerated and ruptured at different degrees.The light microscope showed pathological changes including severe hemorrhage and edema,leukocytic infiltration,neurotmesis,axonotmesis and light myelin coloration;while electron microscope showed severe degeneration of myelin sheath and neuraxon distortion.Six nerves(one in Group A and five in Group B)were in the concussion zone,with the distance between sciatic nerve and primary wound tract for(2.07±0.45)cm.Hyporrhea and hyperemia under perilemma and perineurium,partial nerve fiber disrupt and axonotmesis were observed by light microscope and partly myelin sheath delamination by electron microscope.Two nerves (one in Group A and another in Group B)were in the contusion zone,with moderate pathological changes.Conclusions The track of high velocity triangle fragments is unstable in the tissues.High disrupt rate,severe and wide extent lesion,early Wallerian degeneration are the main characteristics of direct injuries of swine's sciatic nerves.Indirect injuries can induce pathologic changes too,for which the lesion severity is related to the distance between nerves and primary wound tract.

Objective To assess the value and safety of SonoVue in ultrasonic diagnosis of abdominal diseases. Methods A total of 204 patients (149 male, 55 female) with abdominal examination of contrast-enhanced ultrasonography (CEUS) with SonoVue from August 2007 to February 2009 were reviewed. Results Definitive diagnosis were obtained 215 times in 204 patients (233 times) with abdominal CEUS. The diagnostic accuracy of CEUS was 92.27%, significant higher than that of conventional ultrasonography (62.23%). Anaphylactic shock happened 1 time (0.43%) in 1 patient. Conclusion CEUS with SonoVue can provide a high diagnostic accuracy with relatively safety of the possibility of serious adverse event.

Objective To evaluate the diagnostic advantages of contrast-enhanced ultrasonography in experimental abdominal blunt trauma in comparison of routine ultrasonogrphy. Methods Liver, spleen and kidney blunt trauma models were established in 10 canines and 12 rabbits. Both routine ultrasonography and contrast-enhanced ultrasonography were performed to identify the possible injury. Accuracy of the two ultrasonic technologies was compared in diagnosing each kind of organ and various injury degrees. Results Fifty-six trauma models including 22 livers, 14 spleens and 20 kidneys were established. There was significant difference between two ultrasonic methods in diagnosing liver, spleen and kidney injury (P<0.01);and contrast-enhanced ultrasonogarphy had particular advantage in detecting minor injuries of Ⅰ-Ⅱ scale (P<0.01). Conclusion Contrast-enhanced ultrasonography greatly enhances diagnostic accuracy of blunt abdominal solid organ trauma, especially in minor injuries.