Objective To analyze the characteristics of breast architectural distortion(AD)in mammography,MRI,and ultrasound,and to explore the value of each imaging examination in the diagnosis of AD lesions.Methods The mammography,ultrasound,and MRI data of 46 patients(48 lesions)with AD detected by mammography were analyzed retrospectively.Based on the pathological results,the imaging characteristics of benign and malignant AD were compared.Results The morphological and central density differences between benign and malignant lesions were statistically significant.There was no significant difference in microcalcification between benign and malignant AD.On 48 breast MRI,26 lesions showed mass enhancement,17 lesions showed non-mass enhancement,3 lesions showed punctate enhancement and 2 lesions showed no enhancement.There was no statistical significance in the distribution of enhancement types.The difference in time-signal intensity curve(TIC)types between benign and malignant AD was statistically significant.There was no statistical significance in ultrasound manifestation between benign and malignant AD.Using imaging findings greater than those in the breast imaging reporting and data system(BI-RADS)4 categories as a suspected malignant diagnosis,based on pathological examination results.The area under the curve(AUC)by mammography,ultrasound,and MRI was 0.582,0.426,and 0.764,respectively,showed significant differences in diagnostic efficiency.Conclusion MRI has higher sensitivity and specificity in detecting breast AD,which significantly improves the diagnosis coincidence rate of lesions,and can provide an important basis for clinicians to make decisions on surgical treatment.

Objective To investigate the effect of enhanced three-dimensional variable reversal angle fast spin-echo single breath-hold magnetic resonance cholangiopancreatography(3D SPACE BH MRCP)with high parallel acquisition factor on image quality.Methods A total of 33 patients with clinically suspected pancreatobiliary duct disease who underwent epigastric enhancement and magnetic resonance cholangiopancreatography(MRCP)examination were prospectively collected.All patients were required to acquire a single 3D SPACE BH MRCP before and after enhancement.The signal intensity of the common bile duct and background,signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and subjective scores of 3D SPACE BH MRCP before and after enhancement were recor-ded.Statistical analyses were performed using the Wilcoxon signed-rank sum test,and the Kappa test was used to assess the consis-tency of scores between the two readers.Results The difference in the common bile duct signals of 3D SPACE BH MRCP before and after enhancement was not statistically significant(Z=-1.215,P=0.224),however the background signal was decreased after enhancement with a significant difference(Z=-3.878,P＜0.001).The SNR and CNR of the images were better than those of 3D SPACE BH MRCP before enhancement(Z=-4.458,P＜0.001;Z=-4.583,P＜0.001).The subjective score of 3D SPACE BH MRCP after enhancement was better than that before enhancement,and the difference was statistically significant(Z=-2.646,P=0.008).There was a strong inter-reader agreement before and after enhancement 3D SPACE BH MRCP scores(Kappa=0.70,P＜0.01 and Kappa=0.73,P＜0.01).Conclusion The enhanced 3D SPACE BH MRCP between portal vein phase and equilibrium phase dose not affect the display of pancreaticobiliary duct,and can effectively suppress the background signal and improve the image quality of MRCP.

Objective:To understand the thyroid function of the physical examination population in Tangshan area, and analyze the effects of thyroid function on blood lipids, fasting blood glucose (FPG), and serum 25 hydroxyvitamin D [25(OH)D].Methods:A population from the Tangshan area who underwent physical examinations at the Kailuan General Hospital from June 2020 to June 2021 was selected as the study subjects and the levels of their thyroid serological indicators [thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (TT3), and thyroid hormone (TT4)] were tested. According to thyroid function, they were divided into normal group, hyperthyroidism group, hypothyroidism group, subclinical hyperthyroidism group, and subclinical hypothyroidism group. We compared the blood lipid indicators [triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)], FPG, and 25(OH)D levels in different subgroups, and the Pearson correlation analysis was used to investigate the correlation between TSH levels and blood lipids, FPG, and 25(OH)D levels.Results:In this study, 2 884 subjects were selected from the physical examination population in Tangshan area. The proportion of people with abnormal thyroid function was 12.03%(347/2 884), among which the proportion of subclinical thyroid function abnormal population in the total thyroid function abnormal population was 80.69%(280/347). As men age, the proportion of thyroid dysfunction in the age groups of 21-<30 years old, 30-<40 years old, 40-<50 years old, and ≥50 years old was 5.06%(4/79), 7.52%(33/439), 8.91%(53/595), and 9.95%(66/663), respectively. The proportion of thyroid dysfunction in the above age group of women was 14.02%(15/107), 15.06%(61/405), 15.47%(67/433), and 29.45%(48/163). The serum TG, TC, LDL-C, and 25(OH)D levels in the hyperthyroidism group were lower than those in the normal group, while HDL-C and FPG levels were higher than those in the normal group, with statistically significant differences (all P<0.05). The serum TG and TC in the hypothyroidism group were higher than those in the normal group, while FPG and 25(OH)D were lower than those in the normal group, with statistically significant differences (all P<0.05). TSH levels were positively correlated with TC and LDL-C, while negatively correlated with FPG and 25(OH)D (all P<0.05). Conclusions:Subclinical thyroid dysfunction is the main cause of thyroid dysfunction in the Tangshan area, and TSH levels are correlated with blood lipids, fasting blood glucose, and serum 25(OH)D levels.

Objective:To analyze locoregional recurrence (LRR) pattern of patients with pT 1-2N 1 breast cancer after modified radical mastectomy, with and without adjuvant radiotherapy (RT). Methods:A total of 5442 eligible patients with breast cancer from 12 Chinese centers were included. The LRR sites and the effect of RT at different sites on recurrence in patients with and without RT were analyzed. The Kaplan-Meier method was used to calculate the cumulative LRR rate, and the difference was compared by the log-rank test.Results:With a median follow-up time of 63.8 months for the entire cohort, 395 patients developed LRR. The chest wall and supraclavicular fossa were the most common LRR sites, regardless of RT or molecular subtypes. The 5-year chest wall recurrence rates for patients with and without chest wall irradiation were 2.5% and 3.8%( P=0.003); the 5-year supraclavicular lymph nodal recurrence rates for patients with and without supraclavicular fossa irradiation were 1.3% and 4.1%( P<0.001); the 5-year axillary recurrence-free rates for patients with and without axillary irradiation were 0.8% and 1.5%( HR=0.31, 95% CI: 0.04-2.23, P=0.219); and the 5-year internal mammary nodal recurrence-free rates for patients with and without internal mammary nodal irradiation were 0.8% and 1.5%( HR=0.45, 95% CI: 0.11-1.90, P=0.268). Conclusions:The chest wall and supraclavicular fossa are the most common LRR sites of patients with pT 1-2N 1 breast cancer after modified radical mastectomy, which is not affected by adjuvant RT or molecular subtypes. The chest wall and supraclavicular fossa irradiation significantly reduce the risk of recurrence in the corresponding area. However, axillary and internal mammary nodal irradiation has no impact on the risk of recurrence in the corresponding area.

Objective To evaluate the effect of surgery-radiotherapy interval (SRI) on clinical prognosis of locally advanced stage c Ⅱ-Ⅲ breast cancer patients treated with neoadjuvant chemtherapy and modified radical mastectomy.Methods Clinical data of 1 087 breast cancer patients treated with neoadjuvant chemotherapy and modified radical mastectomy from 11 hospitals in China were retrospectively analyzed.The optimal threshold value of SRI upon clinical prognosis was determined by maxstat method.The effect of SRI on clinical prognosis was evaluated by using multivariate Cox regression analysis and propensity score matching (PSM).Results The median follow-up time was 72.9 months.The 5-year disease-free survival (DFS) and overall survival (OS) rates were 68.1％ and 81.8％.All patients were divided into SRI ≤18 weeks (n=917) and SRI＞ 18 weeks groups (n=170).Multivariate Cox regression analysis demonstrated that hormone receptor status (P＜0.001),pathological T stage (P＜0.001),pathological N stage (P＜0.001) and SRI (P=0.023) were independent influencing factors of DFS.Hormone receptor status (P=0.013),pathological T stage (P=0.006),pathological N stage (P＜0.001),endocrine therapy (P=0.013) and SRI (P=0.001) were significantly associated with OS.After balancing the clinical and pathological factors with PSM,patients with SRI＜ 18 weeks had superior DFS and OS to those with SRI＞ 18 weeks.Conclusions SRI affects the clinical prognosis of locally advanced breast cancer patients treated with neoadjuvant chemotherapy and modified radical mastectomy.Radiotherapy should be performed within 18 weeks after mastectomy.

Objective To investigate the relationship between iodine nutritional status and thyroid hormone levels,and to provide a guideline for monitoring iodine nutrition and thyroid function.Methods A crosssectional survey was performed by randomly selecting 341 samples (health pregnant women with a first child) from the Second People's Hospital of Guiyang,Bihai Community Medical Center and Jinhuayuan Community Center from October 2015 to September 2016.Levels of serum hormones and antibodies relative to throid of pregnant women in Guanshan Lake District of Guiyang at different pregnant times,which included throid stimulating hormone (TSH),free three triiodothyronine (FT3),free thyroxine (FT4),thyroid peroxidase antibody (TPOAb),and thyroglobulin antibody (TgAb),were measured by the electrochemical luminescence method,and urinary iodine levels were measured by heat digestion.Results The median urinary iodine of pregnant women at early,middle and late stages (T1,T2 and T3 stages) were 191.8,198.9 and 214.5 μg/L,respectively.FT3 increased first and then decreased during pregnancy.Levels of FT3 in the T2 stage were significandy higher than those in T1 and T3 stages (FT3 medians at the three stages were 4.49,4.83 and 4.57 pmol/L),and the differences were statistically significant (P ＜ 0.05).FT4 levels decreased during pregnancy (FT4 medians at the three stages were 16.32,14.65 and 13.22 pmol/L),and the differences among the three groups were statistically significant (H =67.517,P ＜ 0.01).Statistically significant differences were not found in the TSH levels among the three groups ~SH medians at the three stages were 2.05,2.01 and 2.39 mU/L,H =1.297,P ＞ 0.05).The medians of TPOAb and TgAb during T2 stage (9.60 and 19.02 U/ml) were significantly lower than those of other groups (18.92 and 24.75 U/ml at stage T1,and 13.46 and 22.06 U/ml at stage T3),and the differences were statistically significant (P ＜ 0.05).TSH levels were consistent with urinary iodine levels.TSH levels in the excessive iodine group (urine iodine:250 ～ 499 μg/L,2.54 mU/L) were significantly higher than those in the adequate iodine group (urine iodine:150 ～ 249 μg/L,1.97 mU/L) and deficient iodine group (urine iodine:＜ 150 μg/L,1.91 mU/L),and the differences were statistically significant (P ＜ 0.05).No correlations were found between levels of FT3,FT4,TPOAb,TgAb and levels of the urinary iodine.There was a significant positive correlation between urinary iodine levels and TSH levels (rs =0.180,P ＜ 0.01).The incidence of abnormal thyroid function in pregnant women was 29.33％ (100/341),which was composed of clinical hypothyroidism (accounting for 0.88％,3/341),subclinical hypothyroidism (accounting for 25.51％,87/341),low T4 level (accounting for 1.76％,6/341),clinical hyperthyroidism (accounting for 0.59％,2/341),subclinical hyperthyroidism (accounting for 0.59％,2/341),and TPOAb positive and TgAb positive (accounting for 12.61％,43/341).These abnormalities occurred mainly in the T1 and T3 stages.The prevalence of subclinical hypothyroidism increased with increasing of urinary iodine level,and the difference was statistically significant (x2 =11.269,P ＜ 0.05).Conclusion There is a positive correlation between pregnancy iodine nutritional status and its TSH level,so it is important to monitor the level of urinary iodine during pregnancy and to screen the thyroid function and antibodies in the early and middle time of pregnancy.

Objective To investigate perioperative nursing of new generation optical coherence tomography (OCT) in the diagnosis of percutaneous coronary intervention (PCI).Methods Nursing methods and clinical data of 42 patients who received OCT during PCI were retrospectively summarized.Results After OCT,the incidence rate of blood vessel complications such as coronary artery spasm,slow coronary blood flow were 7.1％.All the complications were relieved after intracoronary nitroglycerin injection,and no chest pain and ECG changes were observed.No complications such as acute heart failure,malignant arrhythmia,and coronary artery dissection were seen,and no contrast nephropathy after surgery was observed after reasonable hydration and nursing cooperation.Conclusion The new generation OCT can accurately determinate the characteristics of coronary artery lesions without blocking coronary flow,and the skilled coordination and strict observation of perioperative nursing are important factors for OCT examination.

Objective To investigate perioperative nursing of new generation optical coherence tomography (OCT) in the diagnosis of percutaneous coronary intervention (PCI).Methods Nursing methods and clinical data of 42 patients who received OCT during PCI were retrospectively summarized.Results After OCT,the incidence rate of blood vessel complications such as coronary artery spasm,slow coronary blood flow were 7.1％.All the complications were relieved after intracoronary nitroglycerin injection,and no chest pain and ECG changes were observed.No complications such as acute heart failure,malignant arrhythmia,and coronary artery dissection were seen,and no contrast nephropathy after surgery was observed after reasonable hydration and nursing cooperation.Conclusion The new generation OCT can accurately determinate the characteristics of coronary artery lesions without blocking coronary flow,and the skilled coordination and strict observation of perioperative nursing are important factors for OCT examination.

Objective To investigate the changes of serum thyroid peroxidase(TPOAb)and thyroglobulin antibody(TGAb)and their relationship with thyroid function in pregnant women during different gestation period Methods Totally 341 cases of primiparae were selected from October 2015 to September 2016 and levels of se-rum thyrotropin(TSH),free triiodothyronine(FT3),free thyroxine(FT4),thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TgAb)were measured by electrochemiluminescence. Results The prevalence of thy-roid dysfunction and positive serum thyroid autoantibodies were 13.2%and 12.61%respectively,which mainly oc-curred in early and middle pregnancy. Thyroid dysfunction in subjects included hypothyroidism(0.59%),subclini-cal hypothyroidism(7.92%),low T4 hyperlipidemia(3.23%),hyperthyroidism(0.88%)and subclinical hyper-thyroidism(0.59%). The positive rate of TPOAb was significantly higher than that of TgAb(10.85% vs. 4.99%, P<0.01). The positive rate of TPOAb in women with thyroid disfunction was significantly higher than that in those with normal thyroid function(44.44%vs. 5.74%,P<0.01). TSH level of TPOAb positive subjects was higher than that of TPOAb negative ones(P<0.05,P<0.01);TSH level of TPOAb positive subjects with thyroid dysfunction were significantly higher than those of TPOAb negative subjects and TPOAb positive pregnant women but with nor-mal thyroid function(P < 0.01). The hypothyroidism prevalence rate of TPOAb positive subjects was significantly higher than that of TPOAb negative subjects in early and middle stage of pregnancy (P < 0.01). The prevalence rates of subclinical hypothyroidism ,low T4 hyperlipidemia and clinical hypothyroidism were significantly higher in TPOAb positive pregnant women(29.17%,20.83% and 8.33%)than those in TPOAb negative pregnant women (P < 0.01). Conclusions Thyroid dysfunction is closely related to positive status of TPOAb and TgAb in pregnancy,which could influence the outcome of pregnancy and the development of offspring. Since levels of TSH, FT3 and FT4 could not fully reveal thyroid function ,it is necessary to monitor the status of TPOAb and TgAb as early as possible for the early diagnosis and treatment of thyroid disease in pregnancy.