Objective To observe the impact factors of the diagnostic accuracy of fine needle aspiration biopsy(FNAB)for papillary thyroid carcinoma(PTC).Methods Totally 468 patients with single PTC confirmed by postoperative pathology who underwent FNAB before surgery were enrolled.The impact of clinica,l ultrasonic and pathological features on the accuracy of FNAB diagnosis were analyzed.Results The accuracy of FNAB for diagnosing PTC was 71.37%(334/468).The maximum diameter and location of PTC were both impact factors of the diagnostic accuracy of FNAB.The maximum diameter of 0.7 cm was the optimal cutoff value of FNAB for diagnosing PTC,and the diagnostic accuracy of FNAB for PTC with the maximum diameter＜0.7 cm and those≥0.7 cm was 62.96%(119/189)and 77.06%(215/279),respectively.The diagnostic accuracy of FNAB for PTC located in the difficult and easy area of puncture was 52.53%(52/99)and 76.42%(282/369),respectively.The diagnostic accuracy of FNAB for PTC with the maximum diameter≥0.7 cm and located in the easy area,≥0.7 cm and located in the difficult area,＜0.7 cm and located in the easy area,＜0.7 cm and located in the difficult area was 80.43%(185/230),61.22%(30/49),69.78%(97/139)and 44.00%(22/50),respectively.Conclusion The maximum diameter and location of PTC were both impact factors of the diagnostic accuracy of FNAB.

Objective:To investigate the preparation of paclitaxel-loaded nanoparticles targeting liver cancer stem cells and their effects on liver cancer HepG2 cells (CD133 positive subset accounting for 8%) and Huh-7 cells (CD133 positive subset accounting for 65%).Methods:Poly (lactic-co-glycolic acid)-loaded paclitaxel nanoparticles were prepared by using emulsification-solvent evaporation method. Paclitaxel-loaded nanoparticles decorated with anti-CD133 antibody, called targeted nanoparticles, were prepared by using 1- (3-dimethylaminopropyl)-3-ethylcarbodiimide/N-hydroxysuccinimide (EDC/NHS) cross-linking method. The manifestations and physicochemical characteristics of the nanoparticles including encapsulation efficiency, loading efficiency, particle size distribution, morphology and release in vitro were studied. Liver cancer Huh-7 and HepG2 cells accompanying with paclitaxel-loaded nanoparticles or targeted nanoparticles were cocultured. The uptake and accumulation of nanoparticles by liver cancer cells were analyzed by using flow cytometry, and positive cell proportion of CD133 was also detected. Cell survival was analyzed by using plate clonogenesis assay.Results:Scan electromicroscopy result showed particle size of targeted nanoparticles was (429.26±41.53) nm with zeta potential of -11.2 mV; targeted nanoparticles were possessed with spherical morphology and higher encapsulation efficiency [(87.53±5.90) %]. Flow cytometry showed that in Huh-7 cells at 37℃, the fluorescence intensity of targeted nanoparticles group (13 397±720) was higher than that of paclitaxel-loaded nanoparticles group (6 898±604), and the difference was statistically significant ( P < 0.05); there was no statistically difference in the fluorescence intensity of HepG2 cells in paclitaxel-loaded nanoparticles group and targeted nanoparticles group at 37 ℃ (7 899±343 vs. 8 432±516, P>0.05). CD133 positive cell proportion of Huh-7 cells in targeted nanoparticles group [(15.7±2.6)%] was lower than that in paclitaxel-loaded nanoparticles group [(54.9±7.4)%], and the difference was statistically significant ( t = 7.31, P = 0.008); there was no statistical difference of HepG2 cells between the two goups ( P > 0.05). Plate clonogenesis assay showed that the cell survival rate of Huh-7 cells in targeted nanoparticles group was lower than that in paclitaxel-loaded nanoparticles group at different time points, and the difference was statistically significant ( F = 5.56, P = 0.009); but there was no statistically significant difference in HepG2 cell survival rate between the two groups ( F = 1. 19, P = 0.142). Conclusion:Prepared nanoparticles targeting liver cancer stem cells have a good inhibitory effect on liver cancer Huh-7 cells.

Objective: To investigate the characterization of doxorubicin (DOX) coupling segmented copolymer nanomicelles with dual effects of passive and active targeting to liver cancer and its antineoplastic function in vitro. Methods: DOX was covalently conjugated to a terminal hydroxyl group of poly lactic-co-glycolic acid-poly ethylene glycol (PLGA-PEG) diblock copolymer to form DOX-PLGA-PEG. The formation of amido bond was determined by using fourier transform infrared spectroscopy (FTIR) and magnetic resonance method. Amphiphatic diblock copolymer DOX-PLGA-PEG could self-assemble to form nanomicelles in an aqueous phase by dialysis method. The DOX-PLGA-PEG targeted micelles decorated with liver cancer HAb18 F (ab')₂ specific antibody were prepared by using physical bonding method. The size and the scattering scope of nanomicelles was determined by using granulometer and dynamic light scattering (DLS). Micelle morphology was examined by using scanning electron microscopy (SEM). The drug loading rate and entrapment rate of DOX-PLGA-PEG micelles or targeted micelles were measured by using ultraviolet spectrophotometry method, and stimulated release in vitro experiment was done. After administration of 2 mg/ml DOX-PLGA-PEG or targeted micelles, cell morphology change of liver cancer HepG2 and Huh7 was observed by using the phase-contrast photomicrography. After administration of 1 mg/ml DOX-PLGA-PEG or targeted micelles, cell survival was analyzed by using plate clone formation assay. Results: The spectrum peak was around 1 575 cm^-1 under the observation of FTIR, which was accord with the location of the peak of amido bond. Activating with p-nitrophenyl chloroformate, DOX was covalently conjugated to PLGA-PEG to produce DOX-PLGA-PEG via a carbamate linkage between the primary amine group in DOX and the terminal hydroxyl group in PLGA-PEG. DLS measurements showed that the diameter of DOX-PLGA-PEG micelles and targeted micelles was (55.0±6.3) nm and (87.6±9.3) nm, respectively, and polydispersity index was 0.098 and 0.142, respectively. SEM micrographs revealed that these nanomicelles had a spherical morphology and relatively smooth surface. Drug loading rate of DOX-PLGA-PEG micelles and targeted micelles was (2.4±0.2)% and (2.2±1.9)%, and the entrapment rate was (91.7±5.3)% and (87.5±4.8)%, respectively. The drug release curve in vitro of DOX-PLGA-PEG micelles and targeted micelles exhibited a biphasic pattern characterized by a fast initial release, followed by a slower and continuous release. The amount of the drug release rate was about 30% within 5 d, and 25% within 6 h. After 2 mg/ml DOX-PLGA-PEG micelles and targeted micelles, the cell morphology of liver cancer HepG2 and Huh7 had the impaired change, and the part of the cells were dead, the clonality decreased. The effect of targeted micelles was more significant compared with DOX-PLGA-PEG micelles. After DOX-PLGA-PEG micelles and targeted micelles, the survival rates of HepG2 and Huh7 cells were decreased with time, and the effect of targeted micelles was more effective compared with DOX-PLGA-PEG micelles (all P < 0.05). The 50% effective inhibition of the targeted micelles and DOX-PLGA-PEG micelles was obtained in 2.4 d and 5.5 d, respectively for Huh7 cells. At these time points, DOX concentration was 1.15 μg/ml and 1.24 μg/ml, respectively. The 50% effective inhibition of targeted micelles and DOX-PLGA-PEG micelles was obtained in 3.3 d and 7.4 d, respectively for HepG2 cells. At these time points, DOX concentration was 1.20 μg/ml and 1.31 μg/ml. Conclusion DOX nanomicelles with dual effects of passive and active targeting can release a large number of active drugs in vitro, which plays an obvious inhibitory role in the cell proliferation of liver cancer HepG2 and Huh7 cells.

Objective To investigate the indications and complications of onlay island flap urethroplasty in hypospadias.Methods Retrospective analysis 51 cases who received the onlay urethroplasty from Mar.2005 to Sep.2012 at the First Affiliated Hospital of Guangxi Medical University.Their ages were from 2 years to 12 years,the median age was 4 years and 3 months.Forty-three cases received the operation for the first time,8 cases were re-operation.The prepuce island flaps were implemented in all cases.Factors which contributed to the successful operation ratio were compared,such as the levels of penile curvature,the lengths of urethral defects,first operation or reoperation,the size of glans.Results The operation achievement ratio was 82.4％ (42/51 cases).There were 7 cases urethrocutaneous fistula(6 cases were then cured by reoperation,1 case healed naturally).One case had urinary meatus had retraction.There was another case with persisting penile curvature.Some differences in factors had no statistical significance,such as the levels of penile curvature,the lengths of urethral defects,first operation or reoperation (x2 =0.249,0.287,1.208 ; all P ＞ 0.05).The difference in glans size had statistical significance (x2 =3.393,P ＜ 0.05).Conclusions Onlay urethroplasty was suitable for the cases of coronary sulcus of penis and extremitas anterior penis,but for proximal cases,this therapy must be applied very carefully because of persisting penile curvature.For some reconstruction cases,Onlay urethroplasty was suitable,but the island flap must be designed flexibly.Urethrocutaneous fistula was the most complication,especially in some small flat glans.

Objective To select sonogram features for the differential diagnosis of benign and malignant thyroid small nodules by Logistics regression analysis,and to contribute the binary Logistic regression model of sonogram features as independent variable and evaluate the value of conventional ultrasonography and ultrasound elastography (UE) in the differential diagnosis of benign and malignant thyroid small nodules.Methods 166 thyroid nodules (≤ 10 mm) in 140 patients were reviewed and analyzed by 2D ultrasound,color Doppler flow imaging and UE.A Logistic model was obtained based on pathology as golden diagnosis criteria.The odds ratio of variables in the equation were compared to assess various variables,especially the efficacy of elastography in the diagnosis.Results Four statistically significant features were finally entering the Logistic stepwise regression model,including shape,calcification,the internal component of nodules and elasticity score.And the odds ratio of the elasticity score was higher than other features.Conclusions The analysis of binary Logistic regression can select the valuable variables for the diagnosis of pathological nature of thyroid small nodules.UE has much more dominances than other features.The combinated application of UE and 2D ultrasonic features plays a great clinical role in the final diagnosis of thyroid small nodules.

Objective To create a large samples digital database of breast ultrasound imaging (DDBUI),which is open and can be used for scientific research,clinical training and diagnose in order to improve early diagnostic rate of breast cancer by using the database.Methods The database applies structured query language (SQL) to record the integrated resources of patients with breast masses and utilizes Brower/Server (B/S) technology to achieve universal data access.Results The database consists of 853 cases and 5780 images.So far,researchers in home and abroad have done many researches with the images in DDBUI.For example,the speckle reduction,enhancement,segmentation and classification algorithms for computer aided diagnosis (CAD).The database provides a complete shared operation platform for clinical diagnosis and teaching.Conclusions The first public database of breast ultrasound images is created which provides comprehensive information for the development and verification different CAD algorithms,and is helpful for researches,ultrasound diagnosis learning,and improving the breast cancer diagnosis.

Objective To evaluate left ventricular myocardial function of rabbit after ischemiareperfusion using speckle tracking imaging (STI),and to explore the myocardial protect effects of ischemia postconditioning (I-PostC) on reperfusion injury.Methods 24 Japanese rabbits were divided into ischemiareperfusion group (group Ⅰ) and I-PostC group (group Ⅱ) randomly.The characteristic changes of left ventricular global and regional myocardial strain and twist function of two groups were evaluated quantitatively by STI and compared with pathological results.Results ① Global longitudinal systolic strain rate(GLSrsys),global longitudinal systolic strain (GLSsys) and global longitudinal peak strain(GLSp) decreased in both groups,longitudinal systolic strain rate(SrLsys),longitudinal systolic strain(SLsys) and longitudinal peak strain(SLp) in the lateral wall of left ventricle decreased significantly and negative peak of SrLivr and PSI increased after the left ventricular branch of coronary artery was occluded;The values of Ptw and untwR of left ventricle were smaller.② After the artery was released,GLSp recovered in group Ⅱ,which was not seen in group Ⅰ.The values of SrLsys,SLsys and SLp increased significantly and negative peak of SrLivr and PSI decreased in group Ⅱ.However,only Slsys and SLp rebounded in group Ⅰ.Between the 2 groups,SrLsys andSLp in group Ⅱ were higher than that of group Ⅰ (P＜0.05 or 0.01),and SrLivr was lower compared with group Ⅰ (P ＜0.05).In group Ⅱ,Ptw and untwR changed back to a normal range (P ＜0.05 or 0.01),and no index has changed in group Ⅰ ;Between the 2 groups,Ptw and untwR in group Ⅱ were higher than that of group Ⅰ (P ＜0.05).③ The sensitivity and specificity of GLSrsys,GLSsys,SrLsys,SLsys and Ptw to detect rabbit myocardial infarction were 81.3 ％ and 75.0 ％,62.5 ％ and 81.2％,87.5％ and 87.5％,93.8％ and 75.0％,81.3％ and 68.7％ respectively.Conclusions STI may provide a promising approach to evaluate the global and regional myocardial function.It also can observe the protect effects of I-PostC on myocardial reperfusion injury accurately.

Objective To investigate the left ventricular(LV) systolic hemodynamics and the distribution of blood flow in patients with hypertrophic cardiomyopathy(HCM) by vector flow mapping(VFM).MethodsThirty-five random non-obstructive HCM patients(case group) and forty healthy volunteers (control group) were enrolled.Peak systolic velocity (Vs),peak systolic flow (Fs) and total systolic negative flow (SQ-) of two groups were compared.Velocity vector,streamline and vortex distribution of two groups were observed.Results Vs,Fs,SQ- of the control group and Vs,Fs of the case group all showed a decreasing trend from the basal segments to the apical segment(P<0.05).SQ- of the case group lost this decreasing tendency.Vs,Fs of all segments and SQ- of the middle and apical segment of the case group were higher than those of the control group.SQ- of the basal segment of the case group were significantly lower than that of the control group(P＜0.01).Distribution of blood flow:The velocity of blood flow was faster in the case group than that in the control group and the direction was disordered.The streamlines of the case group were discontinuous,and vortexes in the case group were more than that in the control group.Conclusions VFM technology could quantitatively evaluate LV systolic hemodynamics in patients with HCM,and can clearly show the distribution of blood flow.

Objective To summarize the characters of the elastograms of different pathological nodules, and to observe the value of elastography in differentiating benign from malignant thyroid solid nodules. Methods One hundred and sixteen patients with thyroid nodules were enrolled in the study and 122 nodules were detected in total. All of them were examined by elastography and conventional ultrasound. Five sonographers were invited to evaluate the nodules double blinded basing on the images and the four-point system proposed by Fukunari. The interobserver agreement was evaluated by Kappa coefficient. Diagnostic performances of the five readers were compared by the ROC curves. Distributions of elastography scores of different pathological nodules were compared by one-way ANOVA. Results Interobserver agreements on scoring the nodules were moderate. Mean value of benign nodules was obvious lower than that of the malignant ones. The mean score of nodular goiters was 2.67 ± 0.89, range from 1 to 3. Most of the adenomas got score of 2, but the score of thyroiditis was quite high. No significant differences were found between the comparison of thyroiditis and thyroid cancers. Areas under the ROC curve (AUC) of the five readers were 0.82,0.81,0.79,0.73 and 0.83 respectively. When 3.5 was choosen as the cut-off point, the sensitivity of elastography was 82.4%, and specificity was 71.6%. Conclusions Elastography was really a useful technique for it can provide a new index for the differential diagnosis of thyroid nodules. However, the 4-point score system is not comprehensive enough.

Objective To summarize the characteristics of common carotid arterial wave intensity (WI) in healthy volunteers and offer the normal reference values of WI. Methods Common carotid arteries (CCA) in 525 healthy volunteers were examined using Aloka Prosound α10 equipped with wave intensity software. The volunteers were divided into six group according to age,group A,＜20 years old;group B,20 - 29 years old;group C,30 - 39 years old;group D,40 - 49 years old;group E,50 - 59 years old and group F,≥60 years old. Carotid arterial wave intensity in normal subjects had two positive peaks, the first peak,W1 ,and the second peak, W2. Between the two positive peaks, a negative area (NA), the time interval between the R-wave of ECG and the first peak(R-W1 ) and that between the first and second peaks (W1-W2) were observed. Results ① 1050 common carotid arteries in 525 volunteers were studied. The mean values of W1,W2,NA,R-W1,and W1-W2 were (8332±4796) mmHg · m-1 · s-3,(1853±1143)mmHg · m-1 · s-3,(38 ± 26) mmHg · m-1 · s-2, (102 ± 19)ms and (266 ± 42)ms,respectively. ②These values were no significant between the left and right CCA in same group. W1 and NA were correlated with age ( r = - 0. 204 and r = -0.301, P ＜0. 001). W1 and NA in group A and B were significant increased than those in other groups( P ＜0. 05 or P ＜0. 001 ). ③There were statistical significances in W1 and W1-W2 of CCA between male and female. ④There were no statistical significances in all values in common carotid arteries of both sides (P ＞0. 05). ConclusionsWI technique is useful for evaluating the dynamic behavior of the heart and the vascular system and their interaction. W1 is very sensitive to the changes in the working condition of the cardiovascular system.