Objective To design a pH-sensitive nintedanib liposomes(Nb-Lips)which targeted the acidic microenvironment of pulmonary fibrosis.The entrapment efficiency(EE%)was optimized by the formulation process.Methods Nintedanib liposomes were prepared by membrane hydration method,and the formulation of nintedanib liposomes were optimized by single factor experiments and response surface method(RSM).The particle size,polymer dispersity index(PDI),Zeta potential and encapsulation rate was investigated by dynamic light scattering technique and microcolumn centrifugation method.The release behavior of nintedanib liposomes in artificial lung fluid with pH 7.4 and artificial lung fluid with pH 5.3 was investigated by dialysis method.Nintedanib liposomes were atomized with a compressed air atomizer and its atomization stability and aerodynamic particle size were investigated.Results The particle size of nintedanib liposomes was(100.651±7.315)nm,the PDI was(0.328±0.026),the zeta potential was(21.633±2.004)mV,and the encapsulation rate was higher than 80%.Compared with nintedanib solution at pH 7.4,the total release of nintedanib liposomes in pH 5.3 artificial lung solution was 60.78%higher,and the release of nintedanib liposomes in pH 5.3 artificial lung solution was 48h delayed,which was much higher than that of nintedanib solution.The data reveals no significant differences in particle size,potential and PDI before and after atomization of nintedanib liposomes,and the encapsulation rate decreased 4.25%.The fine particle fraction of the atomized droplets was 37.49%.Conclusion The response surface method can effectively improve the encapsulation rate of nintedanib liposomes,and successfully prepare nintedanib liposomes that are sensitive to acidic environment,and can be inhaled and released slowly.

Influenza is an acute respiratory infectious disease caused by influenza virus, which can promote the adhesion and colonization of Streptococcus pneumoniae in respiratory epithelial cells, increasing the incidence of pneumococcal infections.Therefore, children should take early precautions against pneumococcal diseases during or before the influenza season.The progress in research on the epidemiology of influenza and the prevention of pneumococcal diseases in children was reviewed in this paper.

Objective To investigate the high risk factors for wheezing of low birth weight premature infants with wheezing.Methods A cohort study of 143 premature infants,whose gestation less than 37 weeks and birth weight less than 2 500 g,were collected from Neonatal Intensive Care Unit of Kunming Children's Hospital,from December 2012 to November 2013.Follow-up investigation was conducted,and those with wheezing were enrolled in the study.Many possible factors causing wheezing were analyzed,such as general conditions in the neonatal period,family conditions,and treatment.SPSS 17.0 statistical software was used to analyze the data.Single factor analysis was used by x2 test and rank sum test to evaluate the possible risk factors.Multiple factors analysis was made by Logistic regression analysis.P ＜ 0.05 was viewed as having statistical difference.Results (1) The risk factors for wheezing in the premature infants were:continuous positive airway pressure (CPAP) noninvasive ventilation (x2 =8.531,P =0.003),ventilation (x2 =4.800,P =0.028),caesarean section (x2 =6.787,P =0.009),the use of pulmonary surfactant (x2 =5.455,P =0.020),using antibiotics used at hospital (x2 =5.192,P =0.023),father smoking(x2 =5.406,P =0.020),maternal smoking (x2 =8.531,P =0.003),maternal allergic history (x2 =8.297,P =0.004),compatriot history of allergies (x2 =8.297,P =0.004) or asthma (x2 =9.774,P =0.002),family environment with dust and excitant gas (x2 =12.831,P =0.000) were the risk factors for the wheezing in the low birth weight premature infants.(2)Multi-factor classification Logistic regression analysis showed that CPAP (OR =58.414,95 ％ CI:3.317-1 028.646,P =0.005),mother smoking during pregnancy (OR =11.953,95 ％ CI:1.309-109.120,P =0.028),compatriot history of allergies (OR=135.769,95％ CI:4.914-3 751.419,P =0.004),family environment(OR =83.738,95％ CI:4.416-1 587.982,P =0.003),were independent risk factors for wheezing in low birth weight premature infants;natural labor was protective factor for wheezing in low birth weight premature infants (OR =0.045,95％ CI:0.004-0.574,P =0.017).(3)The sensitivity and specificity of risk factors were analyzed.The highest sensitivity was estimated for the father's history of allergy(83.3％).The highest specificity was estimated for the use of antibiotics at hospital (76.7％).Conclusions The study shows that CPAP noninvasive ventilation,mother smoking during pregnancy,allergy history of their brothers and sisters,family environment with dust and excitant gas are independent risk factors for wheezing in the low birth weight premature infants.There is no single risk factor with both high sensitivity and high specificity.

Objective To investigate the value of the automated breast volume scanning (ABVS) combined with virtual touch tissue imaging quantification (VTIQ) in the differential diagnosis of benign and malignant breast lesion.Methods Five hundred and seven patients with a total of 675 breast nodules were detected using ABVS and VTIQ technique.Of them,coronal plane imaging,SWVmax,SWVmin,and SWVmean (in m/s) for each nodule was acquired three days before operation or core needle biopsy.According to pathological results,the receiver operating characteristic (ROC) curve analysis was performed to evaluate the utility of the ABVS alone (retraction phenomenon on coronal plane),VTIQ alone and their combination in the diagnosis of breast lesions.Results Among all nodules,504 lesions were benign,and 171 were malignant.The rate of retraction phenomenon on coronal plane in malignant lesions was significantly higher than that in benign lesions (x2=279.89,P ＜ 0.001).The value of SWVmax,SWVmin,SWVmean (6.79± 1.71 m/s,5.03 ± 1.24 m/s,5.74± 1.36 m/s) in malignant nodules were higher than that of benign nodules [(3.41 ±1.51) m/s,(2.46± 0.87) m/s,(2.65 ± 1.23) m/s],the differences were statistically significant (t=32.43,33.85,26.77,all P ＜ 0.001).The AUC of malignant nodules for SWV (maximum,minimum,and average) were 0.922,0.934 and 0.937,respectively.With cut-off value of 4.045 m/s,SWVmean showed the best diagnostic performance.The sensitivity,specificity and accuracy of the retraction phenomenon on coronal plane,SWVmean and their combination in diagnosing malignant breast lesion were (39.65％,94.39％,95.78％),(97.50％,94.39％,95.53％) and (82.84％,93.51％,94.25％),respectively.And the SWVmean showed significant higher sensitivity than that of retraction phenomenon.The diagnostic capacity significantly improved when the two approaches were combined.Conclusion Both the retraction phenomenon on coronal plane and VTIQ had high diagnostic value,combining the two methods can improve the differential diagnosis ability for breast lesions.

Objective To evaluate the practical value of the method of contrast enhanced ultrasoundguided reduced-fine needle aspiration (CEUS-FNA) in decreasing the complications of prostate nodule puncture.Methods Nine hundred patients with suspected prostate cancer(PCa) who underwent traditional 10-point blind transperineal prostate nodule puncture(n =548) or CEUS-FNA(n =352) were collected retrospectively and classfied into normal group or CEUS group,respectively.The ratio of prostate cancer diagnosis,number of punctur and compliations were observed in both groups.Results Altogether 362 PCa were diagnosed from 900 patients.Among these cases the diagnosis ratio of normal group was 38.0％ (208/548) and that of CEUS group was 43.8 ％ (154/352).There was no significant difference in diagnosis ratio between two groups (x2 =2.992,P =0.084).The puncture number of normal group were more than that of CEUS group(P ＜0.01).There were 134 cases occurred infection and other complications in tradition group and 56 cases in CEUS group.The complication rate in normal group was higher than that in CEUS group (24.5 ％ vs 15.9 ％),with significant differences between the two groups (x2 =9.393,P =0.002).Conclusions CEUS-FNA could reduce puncture number,but not decrease the PCa diagnsis rate.And also that could reduce the complication rate of prostate puncture.

Background and purpose:At present, color Doppler ultrasound scoring and radionuclide imaging are two important imaging methods for diagnosing thyroid nodules, but their checking principle is different. Which method is better? Or combining them will be the best method for diagnosing thyroid nodules? This study aimed to compare the value of99mTcO4- combined with99mTc-methoxyisobutylisonitrile (MIBI) imaging, ultrasound scoring method and ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging in diagnosis of thyroid nodules.Methods:The results of ultrasound scoring method and99mTcO4- combined with99mTc-MIBI imaging were compared in 50 patients with 54 thyroid nodules, and then compared with pathological findings. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the methods were calculated.Results:A total of 54 thyroid nodules were found pathologically including 20 malignant and 34 benign nodules. The sensitivity, specificity, accuracy, PPV and NPV of99mTcO4- combined with99mTc-MIBI imaging were 80.00% (16/20), 70.59% (24/34), 74.07% (40/54), 61.54% (16/26), 85.71% (24/28), re-spectively. Those of ultrasound scoring method were 80.00% (16/20), 88.24% (30/34), 85.16% (46/54), 80.00% (16/20), 88.24% (30/34), respectively. And those of ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging were 100.00% (20/20), 64.71% (22/34), 77.78% (42/54), 62.50% (20/32), 100.00% (22/22), respectively. The sensitivity of ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging was higher than ultrasound scoring method or99mTcO4-+99mTc-MIBI imaging along (100.00%vs 80.00%, 100.00%vs 80.00%,χ2 value was 4.444 4 and 4.444 4,P value was 0.035 0 and 0.035 0, respectively). The specificity of ultrasound scoring method was higher than those of two methods combined together (88.24%vs 64.71%,χ2 value was 5.230 8,P value was 0.022 2). However, no factorial negative thyroid nodule was found by ul-trasound scoring method+99mTcO4-+99mTc-MIBI imaging.Conclusion:Ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging can offer comprehensive diagnosis of thyroid nodules from their structure and function to avoid missed diagnosis.

Objective To evaluate the value of automated breast volume scanner (ABVS) and conventional ultrasound in differentiation of benign and malignant breast imaging reporting and data system (BI-RADS) 4 breast lesions. Methods Totally 239 breast lesions from 217 patients, with diagnosing of BI-RADS 4 by conventional ultrasound and automatically breast volume imaging, were analyzed retrospectively, using postoperative pathology as golden standard. The sensitivity, specificity, accuracy and area under the curve of ABVS and conventional ultrasound were calculated separately. Results There were 154 benign breast lesions, 83 malignant lesions and 2 borderline lesions. The statistical analysis results of ABVS and conventional ultrasound were 96.10% and 91.80% in sensitivity, 84.30% and 80.20% in specificity,89.30% and 84.10% in accuracy, and 0.952 and 0.833 in area under the curve. Therefore, ABVS was superior to the conventional ultrasound. Conclusion Compared with conventional ultrasound, ABVS could improve the diagnostic efficacy for BI-RADS 4 breast lesions in the aspects of sensitivity, specificity, accuracy, which was useful in detection of small and atypical breast cancer and could be used as a noninvasive and reliable complement for conventional ultrasound.

Objective To discuss the predictive value of multiple ultrasonic features combination in diagnosis of thyroid papillary carcinoma (PTC) more than 1.0 cm in diameter. Methods The ultrasonic features of 258 PTC nodules from 251 patients and 207 nodular goiter (NG) nodules from 190 patients in the First People′s Hospital of Hangzhou were retrospectively analyzed. All the nodules were confirmed by pathological examination after surgery. The ultrasonic features included the shape of nodules, internal echo,anteroposterior/transverse diameter ratio (A/T), and microcalcification. The χ2 test was used to analyze the differences of ultrasonic features between PTC and NG. Multi-variate analyses (Logistic regression) was used to analyze the predictive risk ultrasonic features of PTC. The sensitivity and specificity of ultrasonic features were analyzed based on the gold standard of pathological results. Results There were significantly differences between 258 PTC nodules and 207 NG nodules in irregular shape, hypoechogenicity,A/T > 1 and microcalcification (χ2 values were 121.511, 105.411, 41.483, 121.072, all P < 0.01). The results of Logistic regression showed that irregular shape, hypoechogenicity, A/T>1 and microcalcification were risk ultrasonic features of PTC. And their OR values were 5.013 (95%CI 2.919-8.610), 5.811 (95%CI 3.411-9.901), 15.399 (95%CI 7.576-31.301), 4.141 (95%CI 1.687-10.164) respectively. The sensitivity and specificity of single ultrasonic feature were 26.0%-79.5% and 71.5%-96.1%; the sensitivity and specificity of two ultrasonographic features combination were 11.2%-57.0% and 92.3%-99.0%; and the sensitivity and specificity of three or four ultrasonographic features combination were 8.1%-31.8% and 99.0%-99.5%.Conclusions Irregular shape, hypoechogenicity, A/T> 1 and microcalcification of thyroid neoplasm are important ultrasonic features of PTC. Although the sensitivity of single ultrasonic feature in diagnosing PTC is higher than that of multiple features combination, it has a lower specificity. Therefore, combination of multiple ultrasonographic features can improve the specificity in diagnosing PTC and reduce the misdiagnosis of PTC.

ObjectiveTo investigate the value of the automated breast volume scanner (ABVS) in the diagnosis of ductal carcinomain situ(DCIS).MethodsSixty-seven patients who were diagnosed as DCIS by histopathology from December, 2010 to December, 2012 were retrospectively analyzed. Their image results and detection rates of mammography, conventional ultrasound and ABVS were analyzed and compared by Nonparametric Cochran'sQ test, and the further comparison were performed between groups by McNemar test.ResultsThe cases diagnosed as mass (with or without microcalcifications) by mammography, conventional ultrasound and ABVS were 13 (19%), 22 (33%) and 25 (37%), respectively. The detection rates of conventional ultrasound and ABVS were higher than mammography, and the differences were statistically significant (χ2=7.11, 10.08, bothP<0.05). However, the detection rate of mass between conventional ultrasound and ABVS were not statistically different (P>0.05). The cases diagnosed as simple microcalcification or associated with microcalcification by mammography, conventional ultrasound and ABVS were 42 (63%), 30 (45%) and 39 (58%), respectively. The detection rates of simple microcalcification or associated with microcalcifications by mammography and ABVS were higher than conventional ultrasound, and the differences were statistically significant (χ2=8.64, 5.82, bothP<0.05). However, the detection rate of simple microcalcification or associated with microcalcifications between conventional ultrasound and ABVS were not statistically different (P>0.05). The detection rates of DCIS by mammography, conventional ultrasound and ABVS were 84%, 70% and 91%. The detection rates of DCIS by mammography and ABVS were higher than conventional ultrasound, and the differences were statistically significant. But the rate between mammography and ABVS showed no statistical significance.ConclusionsABVS can improve the ultronic detection rate of breast DCIS. Its detection rate is similar with mammography performance.

Objective To analyze sonographic characteristics of the automated breast volume scanner (ABVS) in non-mass-like breast carcinoma.Methods 49 patients with non-mass-like breast carcinoma were confirmed by pathology after operation.All of the patients underwent ABVS,the sonographic characteristics of internal echo and microcalcifications in the lesions,the retraction phenomenon in coronal plane and surrounding change were analyzed.All the lesions were assessed by breast imaging reporting and data system (BI-RADS).Results In 49 patients with non-mass-like breast carcinoma,27(55.10％) cases were ductal carcinoma in situ,21 (42.86％) cases were infitrating ductal carcinoma,and 1 (2.04％) case were infitrating lobular carcinoma.The findings of ABVS:43 (87.76 ％) lesions appeared as segmental hypoechoic areas,41 (83.67％) lesions appeared as scattered or clustered microcalcifications,6(12.24％) lesions appeared as the retraction phenomenon in coronal plane,and 1 (2.04％) lesion appeared as pachyderma and subcutaneous dropsy.Microcalcifications in ductal carcinoma in situ appeared more than that in infitrating ductal carcinoma (85.19 ％ vs 80.95 ％,P =0.715) ;the retraction phenomenon in coronal plane of infitrating ductal carcinoma were higher than that of ductal carcinoma in situ(19.05％ vs 7.41％,P =0.383),but there were no significant difference in those between ductal carcinoma in situ with infitrating ductal carcinoma(P ＞0.05).All the cases were assessed according to BI-RADS,including 4a-5 category 44 cases,0-2 category 5 cases.The coincidence rate in diagnosis of ABVS were 89.80％.Conclusions The ABVS features of non-mass-like breast carcinoma are characteristic.Segmental hypoechoic areas,microcalcifications and the retraction phenomenon in coronal plane are important for the diagnosis of non-mass-like breast carcinoma,ABVS can improve the detect ability and decrease the missed diagnosis of non-mass-like breast carcinoma.