Objective:To explore the value of contrast-enhanced ultrasound (CEUS) combined with Ovarian-Adnexal Reporting and Data System (O-RADS US) risk stratification and management system in differential diagnosis of ovarian-adnexal mass.Methods:Fifty-six patients with ovarian-adnexal mass who received transabdominal transvaginal ultrasound and CEUS in the Third People′s Hospital of Longgang District from September 2018 to January 2021 were enrolled. The images were classified by O-RADS US and diagnosed by CEUS by experienced and senior radiologist. On the basis of O-RADS US classification, the enhancement time, enhancement level and enhancement mode of CEUS were combined to upgrade or degrade the classification results of O-RADS US. The diagnostic accuracy was assessed using ROC curve analysis, the area under the ROC curve (AUC) was calculated. The reproducibility of O-RADS US was assessed by another senior radiologist.Results:The AUC of O-RADS US for diagnosing benign and malignant ovarian-adnexal masses was 0.844(0.722, 0.927), the AUC of CEUS was 0.833(0.710, 0.920), the AUC of O-RADS US combined with CEUS was 0.940(0.842, 0.986) (compared with O-RADS US, P=0.020; compared with CEUS, P=0.031). The intra-class correlation coefficient (ICC) was 0.897(0.824, 0.940) for O-RADS US. Conclusions:CEUS combined with O-RADS US classification can effectively improve the diagnostic efficiency for benign and malignant ovarian-adnexal masses.

Objective:To investigate whether the bladder neck descent and the area of levator ani hiatus obtained on the maximum Valsalva were consistent at the lithotomy position and separating-legs-holding-knees position.Methods:Forty four subjects who underwent perineal pelvic floor four-dimensional ultrasound at 6-8 weeks postpartum in Third Hospital of Longgang Shenzhen from November 2019 to January 2020 were enrolled in this study. All subjects were able to effectively complete the maximum Valsalva maneuver both at the lithotomy position and the separating-legs-holding-knees position. The bladder neck descent and hiatus area of the levator Ani on the maximum Valsalva at these two positions were measured and compared.Results:The bladder neck descent at the separating-legs-holding-knees position was higher than that at the lithotomy position [(41.06±8.25)mm vs (39.96±8.10)mm; t=-2.965, P=0.005], and the hiatus area of levator Ani at the separating-legs-holding-knees position was larger than that at the lithotomy position[(27.55±4.90)cm 2 vs (26.32±4.76)cm 2; t=-3.820, P<0.001]. Conclusions:The bladder neck descent and the area of levator Ani hiatus on the maximum Valsalva at separating-legs- holding-knees position are larger than those on the maximum Valsalva at the lithotomy position.

Objective To observe the clinic effects and safety of thoracic dorsal root ganglion(DRG) pulsed radiofrequency in treating post-thoracotomy pain syndrome(PTPS). Methods 47 PTPS patients were treated with thoracic DRG pulsed radiofrequency. VAS, Oxycodone dosage, medicine side effects before and after operation were recorded. Results The VAS before operation and 1 d, 15 d, 1 m, 3 m, 6 m, 12 m after operation were 6. 3 ±2. 4, 4. 1 ±1. 8, 3. 2 ±1. 3, 2. 5 ±1. 5, 2. 1 ±0. 9, 2. 0 ±0. 8 and 2. 2 ±1. 1 respectively. The oxycodone dosage were (28. 5 ±10. 2)mg, (12. 3 ±5. 7)mg, (8. 3 ±3. 8)mg, (7. 6 ± 3. 1) mg, (7. 0 ± 3. 4) mg, (6. 6 ± 2. 7) mg and (7. 2 ± 3. 2) mg respectively. The difference was significant compared with the preoperative (P＜0. 05). No serious complications occurred. Conclusion Thoracic DRG pulsed radiofrequency was a safe and effective method in treating PTPS.

BACKGROUND: Cells in contact with nanomaterials can induce oxidative stress, allergic reactions, and then produce cytotoxicity and genotoxicity. Therefore, studies on nano toxicology have attracted more and more attention.OBJECTIVE: To comparatively evaluate the cytocompatibility of Pluronic (P85, F127, F87) tri-block copolymer nanoparticles modified with folic acid (FA) and polylactic acid (PLA).METHODS: Pluronic (P85, F127, F87) tri-block copolymer nanoparticles were modified with FA and PLA to synthesize a variety of amphiphilic block copolymers, including PLA-P85-PLA, FA-P85-PLA, PLA-F127-PLA, FA-F127-PLA,PLA-F87-PLA and FA-F87-PLA. The cytotoxicity of these synthesized nanoparticles was analyzed by cell morphology,cell metabolic activity and cell membrane effects in HepG-2 cells.RESULTS AND CONCLUSION: The relative growth rate of HepG-2 cells had no significant differences under 24-hour induction of various concentrations (5, 10, 20, 50, 100 mg/L) of unmodified P85, F127, and F87 nanoparticles (P > 0.05).The growth and proliferation of cells under the low concentrations (5, 10, 20, 50 mg/L) were enhanced. P85 NPs and F87 NPs could significantly inhibit cell viability at dose of 400 mg/L. In contrast, there were no significant differences towards P85, F127 and F87 nanoparticles (5, 10, 20, 50, 100, 200, 400 mg/L) modified with FA and PLA when compared with the control group (P > 0.05). These findings indicate that the modification of FA and PLA can improve the cytocompatibility of Pluronic (P85, F127, F87) tri-block copolymers, and therefore, PLA-Pluronic-PLA and FA-Pluronic-PLA nanoparticles are both good candidates for drug vectors.

Objective To explore the roles of spinal microglial Src-family kinases (SFKs) in diabetic neuropathic pain. Methods Male Sprague-Dawley rats, weighing 200 ~ 220 g, were used in the experiments. The level of p-SFKs in spinal dorsal horn was detected by single immunofluorescence staining on day 7th , 14th and 28th after intraperitoneally injection of Streptozotocin (STZ) and its location was detected by double immunofluorescence staining. The changes of 50% paw-withdrawal thresholds of rat were detected by behavioral tests when PP2 , a specific inhibitor of SFKs , was intrathecally administered before intraperitoneally injection of STZ. Results Compared with vehicle group, the blood glucose level increased on day 1 (P < 0.001) and the hyperglycemia persisted at least for 28 days (P < 0.001) after intraperitoneally administered of STZ (50 mg/kg). Paw-withdrawal threshold (PWT) decreased gradually from day 1 (P < 0.05) and reached the minimum on day 28 (P < 0.001) after STZ administration. Meanwhile, the expression of p-SFKs in spinal dorsal horn markedly increased on day 7 (P < 0.01), day 14 (P < 0.01) and day 28 (P < 0.01). The p-SFKs was mainly co-localized only with microglia , but not with neurons or with astrocytes. Intrathecally administered of PP2 before STZ reversed STZ-induced mechanical hyperalgesia. Conclusion Microglial SFKs in spinal dorsal horn maybe play a pivotal role in diabetic neuropathic pain.

AIM:To investigate the effects of P2X4 receptor on peri-sciatic administration of recombinant rat TNF-α(rrTNF)-induced mechanical allodynia.METHODS:Male Sprague-Dawley rats (180~200 g) were used in the experiments.The levels of P2X4 receptor on day 3, day 7 and day 14 after peri-sciatic administration of rrTNF were exam-ined by Western blot, and the location of P2X4 receptor in the spinal dorsal horn was observed by double immunofluores-cence staining.The changes of 50%paw-withdrawal thresholds of the rat were detected by behavioral test, and the level of TNF-αin the spinal dorsal horn was also examined by Western blot when TNP-ATP was intrathecally injected before the ad-ministration of rrTNF.RESULTS:Compared with control group, the expression of P2X4 receptor in the spinal dorsal horn on the ipsilateral side significantly increased on day 3, day 7 and day 14 (P<0.01) after rrTNF (100 ng/L) administra-tion.P2X4 receptor was co-localized only with microglia, but not with neurons or astrocytes.Intrathecal injection of TNP-ATP before rrTNF administration prevented mechanical allodynia induced by rrTNF and inhibited the upregulation of TNF-αin the spinal dorsal horn.CONCLUSION:P2X4 receptors in microglia may be involved in rrTNF-induced mechanical allodynia by the upregulation of TNF-αin the spinal dorsal horn.

Objective To investigate the clinical value of 18F-FDG PET/CT in staging,therapeutic response evaluation,relapse early detection and prognostic prediction of follicular lymphoma (FL).Methods Twenty-eight patients (12 males,16 females; average age 57 (36-82) years) with pathologically confirmed FL from December 2005 to January 2013 were enrolled.All patients underwent 18F-FDG PET/CT before treatment.The SUVmax of different staging groups,different pathological grade groups (high:3a+3b; low:1+2) was compared.Seventeen of 28 patients underwent PET/CT after chemotherapy and received phone follow-up (10-88 months) to monitor the progress of treatment.Survival difference was analyzed.Mann-Whitney u test,Wilcoxon signed-rank test and Kaplan-Meier survival analysis were used for data analysis.Results (1) The initial clinical staging without 18F-FDG PET/CT based on Ann Arbor standard changed in 4 cases (up-staging in 3 cases,down-staging in 1 case) after the PET/CT scan.The 18F-FDG uptake (SUVmax) in patients of stage Ⅰ/Ⅱ and stage Ⅲ/Ⅳ was 10.1±3.2 and 11.5±4.9,respectively (Z=-0.619,P＞0.05).The SUVmax in patients of the low grade group (6.9±3.6,n=15) was significantly lower than that of the high grade group (12.4±5.6,n=13) (Z=-3.706,P＜0.01).(2) 17 patients underwent PET/CT scan both before and after chemotherapy,the pre-treatment SUVmax and post-treatment SUVmax were significantly different in CR+PR group (10.8±5.1 vs 3.4±2.3; Z=-2.312,P＜0.05),while there was no significant difference in SD+PD group (11.2±6.9 vs 7.8±3.3; Z=-1.153,P＞0.05).There was a significant difference in the median progress-free survival time between the CR+PR group and the SD+PD group (48 months vs 26 months; x2 =4.207,P＜0.05).Conclusion 18F-FDG PET/CT has an advantage in clinical staging,therapeutic evaluation,relapse monitoring and prognosis predicting of FL.

Objective To evaluate the clinical value of 18F-FDG PET-CT in monitoring response to therapy in patients with follicular lymphoma (FL) staging Ⅲ-Ⅳ.Methods The clinical data of 20 patients with FL were analyzed retrospectively.All patients underwent PET-CT at three times:baseline,after 3-4 cycles of chemotherapy,and end of treatment.Kaplan-Meier method was used to analyze the survival of patients.Results 14 patients achieved CR at the interim PET-CT,all patients achieved CR at post therapy PET-CT:all patients were alive with no evidence of disease in the follow-up.2 patiens achieved PR at the interim PET-CT,and 1 patient achieved CR,and 1 patient was PD,at post therapy PET-CT,all patients were relapsed in the follow-up.4 patients achieved PD,and all patients were changed the chemotherapy plan.At post therapy PET-CT,2 patients achieved CR,1 patient achieved PR,and 1 patient was PD,1 patient was no evidence of disease,2 patients were relapsed,and another was died in the follow-up.The negative predictive values (NPV) of the interim and the post therapy PET-CT were 100 ％ (14/14),88.2 ％ (15/17) respectively.The interim PET-CT was no significantly correlated with PFS (P =0.135),while the post therapy PET-CT was significantly correlated with PFS (P =0.0006).Conclusion 18F-FDG PET-CT is useful to monitor response to chemotherapy in patients with FL staging Ⅲ-Ⅳ,and set personalized treatment plan.

Objective To assess the value of CT or PET-CT with fluorine-18-labeled fluorodeoxyglucose (FDG) for the diagnosis of pulmonary mucosa-associated lymphoid tissue (MALT) type lymphoma. Methods The CT or FDG PET-CT findings in 14 patients with pathologically proved pulmonary MALT lymphoma were retrospectively analyzed. Results Lung lesions were unilateral in 7 patients and bilateral in 7 patients. Lesions presented as a single mass in 3 patients, as a single consolidation in 3 patients, as a nodule in 1 patient, as multiple nodules in 1 patient, as multiple patchy consolidations in 4 patients, as a mass with multiple nodules and patchy consolidations in 1 patients, as diffuse interstitial change in 1 patients. Air bronchogram was found in 9 patients and CT angiogram sign in 5 patients. On PET-CT, lesions showed heterogeneous FDG uptake in 2 patients, maximum standard uptake value was higher than 2. 5. Conclusion Imaging characteristics of pulmonary MALT lymphoma are single or multiple nodules or consolidations with air bronchogram on CT, and heterogeneous high FDG uptake on PET-CT.

Objective To evaluate the applied value of multislice CT (MSCT) in the selection of living donor kidneys and excision methods.Methods Ninety living renal donors underwent MSCT assessment.The nonenhanced,arterial,venous and excretory phase examinations were performed.Using maximum intensity projection and volume rendering techniques for vascular imaging,two blinded radiologists independently analyzed and evaluated all MSCT images.According to the CT reconstructive images,radiologists and physicians selected the left renal or the right renal donors,and chose laparoscopic or open live donor nephrectomy.Results On the 90 cases of donors,78 donors underwent nephrectomy in the left kidney.Seventy-one left kidney donors having no significant variation received the routine laparoscopic live donor nephrectomy.Seven left kidney donors on both sides had relatively obvious anatomical variations such as accessory renal artery,multi-branch renal vein and renal vein in the back of the abdominal aorta,and they were subjected to the left kidney open donor nephre.ctomy.Other 12 donors having significant variation in the left kidney were given nephrectomy in the right kidney,and all of them received hand-assisted laparoscopic live donor nephrectomy.All intraoperative records of urine collection system and renal vascular anatomy were consistent with the preoperative evaluation of MSCT,and the accuracy was 100 ％.Two imaging experts in the evaluation of renal artery,renal vein and urine collection system showed good consistency.Nephrectomy was successfully performed on 90 cases of donors,and.postoperative recipients had no renal vein thrombosis and other vascular complications.Conclusion MSCT can provide accurate and valuable information for the selection of living donor kidneys and excision methods as a “one-stop” technique for the preoperative evaluation of living renal donors.