Purpose To explore the diagnostic efficiency of ultrasound(US)combined with contrast-enhanced ultrasound(CEUS)in breast lesions and to analyze the related factors affecting the diagnostic accuracy.Materials and Methods From January 2022 to February 2023,the clinical data and ultrasound images of 784 patients who underwent breast US and CEUS examination with definite pathological results were retrospectively collected in the First Medical Center of the PLA General Hospital.The diagnostic efficacy of US combined with CEUS in benign and malignant breast lesions was analyzed,respectively.The independent risk factors for diagnostic errors were analyzed via Logistic regression.Results The sensitivity,specificity and accuracy of US combined with CEUS in the diagnosis of benign and malignant breast lesions were 89.2%,84.4%and 88.7%,respectively.The area under the receiver operating characteristic curve was 0.932.The results of multivariate Logistic regression analysis showed that the diagnosis error rate increased when the lesions were non-mass type(odds ratio,OR=1.927,P=0.047),complex cystic and solid(OR=3.729,P=0.000),and high-enhanced CEUS(OR=1.937,P=0.023),while the diagnosis error rate decreased when the lesions were large(OR=0.688,P=0.004)and with US-detect suspicious lymph node(OR=0.143,P=0.011).Conclusion When the breast lesions are non-mass type,complex cystic and solid lesions and hyper-enhancement,the diagnosis error rate of US combined with CEUS increased.It is necessary to further explore the enhancement patterns of different lesions.

Purpose To explore the correlation between phosphatidylinositol 3 kinase/serine-threonine kinase(PI3K/AKT)signaling pathway and elastic characteristics of breast lesions.Materials and Methods A total of 115 breast lesions were prospectively analyzed in 114 patients who underwent surgery from May 2021 to May 2022 at Chinese PLA General Hospital.Ultrasound and shear wave elastography were performed preoperatively.Immunohistochemical staining was used to detect the expression of PI3K/AKT protein levels in the tissue specimens,and the correlation between the staining results and the elastic parameters of shear wave elastography was analyzed.Results Surgical pathology revealed benign breast lesions in 50 cases and malignant lesions in 65 cases(25 cases with axillary lymph node metastasis).The maximum modulus of elasticity(F=40.47),the average modulus of elasticity(F=45.11),the ratio of elasticity of the lesion to that of the surrounding tissue(F=48.98),the detection rate of"hard ring sign"(χ2=62.25),the expression level of PI3K/p-PI3K(F=15.19,58.95)and AKT/p-AKT(F=46.94,74.21)were found in benign and malignant lesions without axillary lymph node metastasis,malignant lesions with axillary lymph node metastasis(all P<0.05).The expression levels of PI3K/p-PI3K and AKT/p-AKT were positively correlated with the maximum elastic modulus value,the mean elastic modulus value,and the ratio of elasticity of the lesion to the surrounding tissues(r=0.475,0.475,0.451;r=0.533,0.540,0.542;r=0.371,0.402,0.445;r=0.482,0.455,0.545,all P<0.05).Conclusion The expression level of PI3K/AKT in breast lesions is correlated with elastic characteristics,suggesting that it plays an important role in the regulation of elastic characteristics of breast lesions.

Objective To evaluate the imaging features of nigrosome-1 in Parkinson's disease (PD) with a 3 T scanner by susceptibility weighted imaging (SWI),and to explore its clinical relevance.Methods Thirty-two patients with primary PD diagnosed by neurologists were collected.Healthy controls matched to their age and gender were recruited during the same period (n=20).All subjects underwent routine brain magnetic resonance imaging (MRI) and sensitive weighted imaging (SWI).The SWI images of the subjects were evaluated to evaluate nigrosome-1 by blinded investigators.Then,the correlation between imaging features and clinical data was analyzed.Results In the PD group,21 cases of bilateral "absent swallow-tail sign",five cases of bilateral "indecisive swallow-tail sign",five cases of "absent swallow-tail sign" on one side and "indecisive swallow-tail sign" on the other side,and one case of bilateral "clear swallow-tail sign" were found.The course of the "absent swallow-tail sign" group (56 (54) months) was significantly longer than the "non-absent swallow-tail sign" group (18 (18) months;U=-2.47,P=0.01).The Hoehn-Yahr stage was significantly higher in the "absent swallow-tail sign" group (2.0 (0.5)) than in the "non-absent swallow-tail sign" group (1.5 (0.5),U=-2.21,P=0.03).There was also a statistically significant difference in the Unified Parkinson's Disease Rating Scale score (24 (8),13 (14)) between the two groups (U=-2.91,P=0.01).However,there were no statistically significant differences between the two groups in the Hamilton Depression Scale score (5 (2) vs 5 (7),U=-0.10,P=0.94) and the Hamilton Anxiety Scale score (3.0 (2.5) vs 3.0 (3.0),U=-0.02,P=1.00).Conclusion The images of nigrosome-1 by SWI are closely related to the severity of the condition and motor symptoms of patients with PD,which can reflect the severity of the disease.

Objective Using MRI compatible OxyLiteTM fiber-optic microprobes to verify the reliability of detecting the oxygenation changes in rats C6 glioma by BOLD fMRI with non- hemodynamic response function (non-HRF) post-processing algorithm. Methods A total of 20 male SD rats were used to establish the subcutaneous C6 glioma model. GRE-EPI BOLD fMRI scans were performed in the tumor-bearing rats with Carbogen inhalation after anatomic scans using 1.5 T MR imaging system with
Micro-47 microscopic coil. Fiber-optic microprobes were implanted in tumor to acquire the dynamic pO2 indications during BOLD fMRI scan.“Oxy-localization map”and“oxy-amplitude map”were generated from BOLD functional image data by non-HRF post-processing algorithm analysis. A ROI about 1.5 mm on a side centered to the tip of microprobe was defined on the MRI morphological image, and then was copied onto the“oxy-localization map”and“oxy-amplitude map”to extract the values of significant re-oxygenation (T), percent BOLD signal change (ΔPSC). The mean difference of pO2(ΔpO2) measured by fiber-optic microprobes before(pO2-Air)and after (pO2-Car)Carbogen inhalation in the ROI areas was calculated. Correlation analysis was madebetween cov (T value, Δ pO2) and cov (ΔPSC value, Δ pO2). The difference between pO2-Air and pO2-Car were tested by Mann Whitney U test. Results pO2 was successfully measured and recorded from 23 points in tumor using fiber-optic microprobe during the BOLD fMRI scan. The analysis results both of physiological and functional imaging parameters were as follows: pO2-Air=2.285(19.056) mmHg,pO2-Car=14.701(48.390)mmHg,ΔpO2=8.107(33.557)mmHg,ΔPSC=0.402(2.192)%,T=2.025 (8.293). (1) 10 points were identified clearly in parenchyma area of tumor. The mean value of pO2 during air inhalation [19.462(21.511)mmHg] significantly increased after Carbogen inhalation [59.904(56.710)mmHg] (U=14.000,P=0.007). (2) 5 points were identified in tumor necrosis area. The mean value of pO2 during air inhalation [0.149(0.479)mmHg] showed no significant change comparing with Carbogen inhalation[0.273 (8.050)mmHg](U=9.000,P=0.465). (3) 8 points were identified in the boundary of tumor parenchyma and necrosis areas. Among which, 5 showed the similar pO2 change to that located in tumor necrosis area, 2 showed the similar to the tumor parenchyma. However, the pO2 showed continuously decrease after Carbogen inhalation in the last 1 point. TheΔpO2 measured from the total of 23 points correlated positively toΔPSC and T value extracted from the corresponding ROI (r=0.660,0.576,P<0.01). TheΔpO2 measured from 10 points in tumor parenchyma correlated positively to ΔPSC(r=0.717,P=0.020). Conclusion“Oxy-localization map”and“oxy-amplitude map”generated from BOLD fMRI combined with non-HRF post-processing algorithm could show reliably not only the location but also the extent where the re-oxygenation occurred within tumor.

Medical imaging is an interdisciplinary subject closely related to clinical and pathological subject. Its clinical reading skills' training has become the focus of postgraduate teaching. In the process of clinical teaching, the interactive reading mode of problem-based learning (PBL) combined with multi-disci-plinary team (MDT) was introduced into clinical reading meeting. The tutors chose the reading cases proved by pathology; designed in-depth issues step by step for execution of PBL teaching; guided postgraduates to delineate imaging signs and propose the diagnostic results, evidences and differential diagnoses according to the step from localizing to qualitative and then to pathological diagnosis;then guided postgraduates to attend in-depth case analysis of MDT and analyze the correlation or inconsistency between the imaging diagnosis and clinical and pathological diagnosis; exercise document retrieval and verbalization, multimedia design, and writing level of the records of the reading cases and papers. The interactive reading mode of PBL com-bined with MDT has achieved significant effects, which is worthy of further exploration and promotion.

ObjectiveTo discusses the MSCT multiplanar reconstruction manifestation (MPR) of localized fat collection adjaction to subdiaphragmatic inferior vena cava (IVCfat).MethodsThe thoracic and abdominal MSCT scan data of 8246 patients were browsed,45 patients with presumed IVCfat on axial CT scans were further studied prospectively with MSCT MPR.The predisposing position of IVCfat and its relationship with IVC were observed.It was divided into two kinds of intraluminal type and extraluminal type according to the angle of IVCfat with respect of the wall of IVC.The other 50 patients without IVCfat were randomly selected as the control group.The sagittal inclination angle (SIA) and diameter ratio (DR) between supra- and sub-diaphragmatic IVC between the two groups were compared by using t test.Results The detection rate was 0.55％ (45/8246).Of which hepatic vein lacuna 8 patients,subdiaphragmatic gap medial to IVC 28 patients and IVC groove 9 patients.The shape of IVCfat showed mainly for the round,oval and crescents on axial CT scans,of 15 patients intraluminal type,4 showed target signs .The shape of IVCfat showed mainly for half-moon at MPR.The SIA and DR at IVCfat group were 21.62° ± 8.42°and 2.01 ±0.84 respectively,at control group were 16.75° ±7.82°(t =1.594,P ＞0.05) and 1.31 ±0.28(t =2.341,P ＜ 0.05 ) respectively.ConclusionThe round,oval or half of limited fat density shadow adjaction to subdiaphragmatic inferior vena cava which similar to in the lumen is the characteristic performance of IVCfat,it may be an anatomical variation.

Medical imaging involves not only the multidisciplinary knowledge,but also the concurrent updating of the knowledge system related to the imaging technology development.In this case,it's an important issue how to guarantee the teaching quality of the medical imaging postgraduate education effectively and cultivate the professsionals with higher comprehensive quality in the limited teaching time available.Thus the implementation as well as the teaching effects of the reading report in the promotion of medical imaging postgraduates' research ability and comprehensive quality is needed to be discussed from the accumulation and update of knowledge system.

Objective To monitor epidemiological distribution and antibiotic resistance of bacteria isolated from cerebral spinal fluid in neurosurgically treated patients. Methods Bacteria isolated from cerebral spinal fluid specimens and antibiotic resistance identification results of patients admitted into our department from January 2003 to December 2007 were collected to analyze distribution and antibiotic resistance of the pathogens. Results Of 437 isolates, Gram-positive bacilli and Gram-negative bacilli accounted for 73.5% (321 isolates) and 26.5% ( 116 isolates), respectively. The first five most fre-quently isolated pathogens were staphylococcus epidermidis (55.6%), staphylococcus aurens (15. 3% ), enterobacter (6.6%), aeinetobacter (5.3%) and pseudomonas aeruginosa (3.0%). The anti-bacterials with highest susceptibility to Gram-negative bacilli were imipenem ( 83.9% ), amikacin ( 68. 8% ), ciprofloxacin and tobramycin (67.4%), cefepime (61.3%) and ceftazidime (69.2%). The other antibacterials had susceptibility of less than 60%. Conclusions The prevailing pathogens in post-operative intracranial infection are Gram-pnsitive bacilli, especially staphylococcus epidermidis and staphylococcus anreu. Data collected in present study may provide valuable information for prophylactic and empirical antibiotic use in post-operative intracranial infection.

the incidence of the complication.

Objective:There is a large of population of macrophages resident in the testicular interstitial tissue under normal conditions and they are increased during inflammation.The mechanisms involved are unclear.This study focused on the expression of monocyte chenoattractant protein-1 (MCP-1) in the mouse testis before and after an intraperitoneal injection of LPS.Methods:The expression of MCP-1 in testis was detected by using reverse transcription-polymerase chain reaction and Western blot,the immunofluorescent technique was used to detect the localization of MCP-1 protein in testis.Results:In the normal testis,the expression of MCP-1 mRNA and protein was detectable by RT-PCR and immunofluorescent technique,respectively.The level of testicular MCP-1 mRNA increased dramatically at 3-24 h after LPS treatment,the level of MCP-1 protein increased at 12 h after LPS treatment.The MCP-1 was localized in the testicular interstitial tissue.Conclusion:MCP-1 may play a role in maintaining the resident macrophage population in normal testis and regulating monocyte and macrophage influx in inflammatory testis.