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Objective:To explore the effect of the application of hierarchical and special quality control in the quality control management of an ultrasound department.Methods:The hierarchical and special quality control method was used to control ultrasonic reports that were related to four quality control areas: basic quality control, deep quality control, obstetrical quality control, and critical value quality control. Changes in the qualified reporting and comprehensive clinical satisfaction rates before and after the implementation of hierarchical and special quality control were examined.Results:After the implementation of hierarchical and special quality control, the qualified rates of basic quality control, deep quality control, obstetrical quality control, and critical value quality control increased significantly. The comprehensive clinical satisfaction score was (90.58±1.79) points, which was higher than before the model was applied [(80.37±2.72) points], and the difference was statistically significant ( P<0.01). Conclusion:The implementation of hierarchical and special quality control measure can effectively improve the quality of ultrasonic diagnoses and comprehensive clinical satisfaction.
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Objectives To investigate the efficacy of the shear wave velocity (SWV) based on acoustic radiation force impulse (ARFI) elastography in the differentiation of normal population with chronic kidney disease (CKD) and acute kidney injury (AKI) in middle aged and elderly patients.Methods Sixty-four middle aged and elderly patients referred to China-Japan Friendship Hospital and Zhejiang Provincial People's Hospital with AKI or CKD were enrolled in this study from February 2015 to December 2016 (kidney disease group).Among them,43 patients were CKD (CKD group),and 21 patients were AKI (AKI group,15 patients combined with prior CKD,6 patients without prior CKD).Twenty-nine middle aged and elderly healthy volunteers from China-Japan Friendship Hospital were enrolled at the same time (healthy control group).The SWV values of the renal middle pole cortex were acquired using the ARFI elastography.The differences of the kidney length,cortical thickness and SWV values among healthy control group,AKI and CKD group were compared by variance analysis.The LSD-t analysis was used for the advanced comparison between any two groups.The differences of cortical SWV values among healthy control group,AKI combined with prior CKD group,AKI without prior CKD group and CKD group were compared by variance analysis.The LSD-t analysis was used for the advanced comparison between any two groups.The receiver operating characteristic (ROC) curves of the cortical SWV values for diagnosing kidney disease was drawn.Results The mean cortical SWV values of healthy control group,AKI and CKD groups were (2.88±0.63),(2.42±0.83) and (2.06±0.72) m/s,respectively.The SWV values of AKI and CKD groups were significantly lower than that of healthy control group (t=2.158,P=0.033;t=5.234,P ＜ 0.001).The SWV values of CKD group were lower than that of AKI group,but there were no significant differences.The SWV values of AKI without previous CKD group and AKI combined with prior CKD group were (2.60±0.84) and (1.80±0.45) m/s,respectively.The SWV values of AKI combined with prior CKD group and CKD group were significant lower than that of healthy control group and AKI without prior CKD group (compared with healthy control group:t=2.916,P=0.004 and t=5.318,P ＜ 0.001;compared with AKI without prior CKD group:t=2.054,P=0.043 and t=-2.517,P=0.013).But there were no significant differences between AKI combined with prior CKD group and CKD group,so as to the AKI without prior CKD group and healthy control group.The cutoff value of cortical SWV for diagnosing kidney disease was 2.40 m/s,with an area under ROC curve was 0.767 (95％ CI 0.689-0.898,P=0.000).The sensitive and specificity were 57.1％ and 81.9％,respectively.Conclusions The SWV values of kidneys in middle aged and elderly CKD and AKI patients were significantly lower than those of apparently normal kidneys.The SWV values of AKI patients combined with prior CKD were lower than AKI patients without prior CKD.Determining cut-off SWV values based on ARFI elastography between normal and damaged renal parenchyma can help in the diagnosis of kidney disease in middle aged and elderly patients.
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Objective To evaluate the diagnostic efficacy of shear wave elastography and ultrasound weighted score in differentiating benign and malignant thyroid nodules.Methods Ninety-two patients with 1 13 thyroid nodules (72 benign and 41 malignant)underwent ultrasound weighted score.The items and scores were as follow:hypoechogenicity(2),irregular margin(2),no well-defined border(1),no uniform and complete acoustic halo (1 ),microcalcification (2 ),anteroposterior to transverse diameter ratio ≥ 1 with irregular margin(6 ),nodules with cystic components which had an diameter larger than 5 mm (- 6 ), posterior enhanced echo(-2),metastasis of neck lymph nodes(6).Shear wave velocity(SWV)of thyroid nodules were measured by virtual touch tissue quantification and the mean SWV of five data was calculated. The diagnostic efficacy of shear wave elastography,ultrasound weighted score,and their combination in differentiating benign and malignant thyroid nodules were calculated by ROC curves.The diagnostic sensitivity,specificity,and accuracy of ultrasound scores,SWV,and their combination in differentiating malignant and benign thyroid nodules were compared.Results The ultrasound score cut-off for the diagnosis of malignant lesions was 4.5 with a sensitivity of 80.5%,specificity of 86.1 %,and accuracy of 84.1 %.The SWV cut-off for the diagnosis of malignant lesions was 2.55 m/s with a sensitivity of 70.7%, specificity of 88.9%,and accuracy of 82.3%.When two methods were combined,the diagnostic sensitivity, specificity,and accuracy were 95.1 %,80.6% and 85.8%,respectively.Comparing the sensitivity,specificity and accuracy of the three methods,there were no significant difference between any two methods (P >0.016 7),except that the sensitivity of combination was significantly higher than that of SWV (P <0.016 7).Conclusions Shear wave elastography and ultrasound weighted score both have high value in differentiating benign and malignant thyroid nodules.Combining two methods can not improve diagnosis value comparing with conventional ultrasonography.
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Objective To develop an apoptosis model of nucleus pulposus cells in cell culture.Methods To mimic the nutrient-deficient microenvironment of degenerative intervertebral disc,nucleus pulposus cells derived from infant SD rat disc were cultured under serum limiting conditions.Nucleus pulposus cells were cultured in culture medium contai-ning 1%, 3%, 5%, 8%and 10%fetal bovine serum( FBS) respectively to select the optimum FBA concentration.Apoptosis was assessed by flow cytometry, Western blot,cell counting kit, and immunofluorescence technique.Results The flow cy-tometry revealed that apoptosis rate of the nucleus pulposus cells increased with decreasing concentration of FBS, and 3%FBS used in the experimental group was the most effective concentration to induce apoptosis(P<0.05).Western blot dem-onstrated significantly higher expression of Bax and caspase-3 enzyme in the 3%FBS group than in the 10%FBS group, while bcl-2 activity decreased.The results of CCK-8 test indicated that the nucleus pulposus cells got slower proliferation in the medium containing 3%FBS.Immunofluoresence analysis showed that FAS expression was significantly higher in the 3%FBS group than in the 10%FBS group.Conclusions 3%FBS condition may induce apoptosis in the nucleus pulposus cells and compromise the cell function to induce intervertebral disc degeneration.The caspase family should be involved in the process.
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Objective To explore the effect of caspase-9 inhibitor on low fetal bovine serum ( FBS)-induced apop-tosis in cartilage endplate chondrocytes in SD rat vertebrae.Methods Disc cartilage endplates were obtained from 3-month old SD rats and subjected to sequential digestion to harvest chondrocytes for primary culture, and apoptosis was in-duced by 1%FBS for 48 hours.Three groups of chondrocytes were treated by 1% FBS, caspase-9 inhibitor ( Z-LEHD-FMK) and DMSO, respectively.After 48 hours, apoptosis was detected by DAPI staining and flow cytometry.The expres-sion of procaspase-9, active caspase-9 and active caspase-3 was monitored by Western blot.Results Compared with the 1%FBS group (40.8 ±0.84)%and DMSO group (40.2 ±1.56)%, the apoptosis rate of the caspase-9 inhibitor group (26.3 ±2.56)% was significantly lower (P<0.05).The expressions of active caspase-9 and active caspase-3 in the caspase-9 inhibitor group were significantly lower than those in the other two groups (P<0.05).Conclusions Caspase-9 inhibitor can inhibit low FBS-induced apoptosis in cartilage endplate chondrocytes of rat vertebrae, and might become a new drug for the treatment of disc degeneration.
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A ZnO nanofibers carrier on the Pt electrode via electrospinning technology was prepared and then the Keggin phosphotungstic acid was deposited on the ZnO/Pt electrode using electrodeposition technology. The scanning electron microscopy showed that the zinc oxide fibers presented net structure and the diameter of its fiber was about 300 nanometers. The fourier transform infrared spectroscopy confirmed that the phosphotungstic acid adhered to the fiber surface. The electrochemical property of the modified electrode showed that it exhibited rapid response, excellent sensitivity and good stability, achieving rapid and accurate determination. The electrode responded linearly to ascorbic acid ( AA) in a concentration range from 8. 8 × 10-7 to 3. 3 × 10-4 mol/L with a low detection limit of 2. 5 × 10-7 mol/L. The method is promising for the development of AA detecting instrument.
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One of the major complications of diabetes is blood vessel disease, termed angiopathy, which is characterized by abnormal angiogenesis. The objective of this study was to discuss the characteristics of lower limb vascular angiopathy and plaque formation in type 2 diabetes patients and finding its relevance to the carotid atherosclerotic plaque formation, thus directing the clinical diagnosis and treatment. The ultrasonography was used to monitor the patients with carotid artery and lower limb artery. Compared with the control group, decreased blood flow to lower limb and lower limb angiopathy occurred more obviously in dorsal artery of foot than in popliteal artery. The study revealed that the detection rate of the prevalence of carotid atherosclerosis plaque and lower limb arterial plaque and the combination of plaque both carotid and lower limb arteries in diabetic patients was 369:342:296 [about 1.25:1.15:1] and that the prevalence of carotid plaque and lower limb arterial plaque in all subjects with plaque was 71.3%. The risk of plaque formation also had positive correlation with patient's age. Color Doppler ultrasound had a clinical significance in the early diagnosis and curative effect observation in type 2 diabetes with lower limb angiopathy. The risk of simultaneous plaque formation in both carotid artery and lower extremity artery was greater in type 2 diabetes than that of control subjects, but they were not necessarily to occur simultaneously. The symptoms were inconspicuous in the early course of diabetes. The application of ultrasound monitoring in patients with carotid artery and lower limb artery might play a role in early warning, delaying the occurrence of macrovascular diseases, and slowing down the development of macroangiopathy such as cerebral infarction and diabetic foot and so on, thus providing a significant basis for clinical diagnosis and treatment
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Objective To discuss the diagnostic value of distal subclavian artery flow velocity tracing for proximal segment severe stenosis.Methods 56 cases with 112 subclavian arteries were examed by ultrasonography and multidetector CT angiography respectively,then the flow velocity tracing of distal subclavian arteries had been compared with CT results.Results In all 112 subclavian arteries,there were 37without proximal segment stenosis,32 with mild stenosis,12 with moderate stenosis,and 31 with severe stenosis.Innominate arteries and other parts of subclavian arteries had no stenosis.In diagnosis of subclavian artery proximal severe stenosis using single phase single peak waveform,the sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio were 83.9 ％,96.3 ％,22.7,0.063 respectively.The sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio were 100 ％,93.8 ％,16.1,0 respectively,in terms of diagnosis by application of acceleration time ≥0.11s.Conclusions The statistics of acceleration time ≥0.11 s and single phase single peak waveform have high application value in diagnosis of subclavian artery severe stenosis respectively.
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BACKGROUND:Previous studies have shown that chitosan can promote the repair of peripheral nerve injury and methylprednisolone can improve the microenvironment around nerve injuries, which are commonly used in clinical treatment of acute central nervous system injury. OBJECTIVE:To observe the effects of modified chitosan and methylprednisolone combination on repair of sciatic nerve injury in rats. METHODS:The rat sciatic nerve was transected and microscopical y anastomosed immediately. Then, modified chitosan, methylprednisolone, methylprednisolone+modified chitosan, and saline were injected respectively around the anastomosis site, compared with the sham surgery group. RESULTS AND CONCLUSION:Compared with other groups, the combination group showed shorter claw extending reflex recovery time (P<0.05). Significant differences were found between the combination group and other groups in nerve conduction velocity, the remnant rate of gastrocnemius wet weight, the diameter and section area of gastrocnemius cells (P<0.05). The nerve fibers through the anastomotic site were significantly increased, with consistent thickness and arrangement and less neurodegeneration when observed 12 weeks after operation. In conclusion, the modified chitosan combined with methylprednisolone could significantly promote the sciatic nerve repair.
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Objective To investigate the correlation between shear wave velocity and tissue fibrosis score in thyroid space-occupying lesions.Methods The shear wave velocity of 55 thyroid space-occupying lesions was examined by virtual touch tissue quantification.The shear wave velocity of different solid parts of the lesions was detected for several times and 15 data were genarated.Then maximum and minimum value were removed.The maximum (Vmax),minimum (Vmin),mean (Vm) of shear wave velocity were calculated with the rest of 13 data.Meantime the fibrosis degree of these pathological lesions were scored by using optical micorscope.The maximum (Fmax),minimum (Fmin) and mean (Fm) fibrosis degree were calculated with these scores.Then the difference between Fmax,Fmin and Fm value of benign lesions and malignant lesions was analyzed.The linear correlation between Fmax and Vmax,Fmin and Vmin,Fm and Vm was also analysed.Results In the 55 lesions,30 lesions were benign and the rest was malignant.The Fmax,Fmin,Fm of benign lesions were 1.38 ± 1.44,0.68 ± 0.25,0.91 ± 0.73 respectively; the corresponding value of malignant lesions were 5.00 ± 1.91,3.52 ± 1.82,4.08 ± 1.75 respectively.There was significant difference between the benign group and malignant group (t test,P ＜0.01).There were linear correlation between Fmax and Vmax,Fmin and Vmin,Fm and Vm and the Pearson correlation coefficients were 0.504,0.284,0.453 respectively.Conclusions The shear wave velocity and fibrosis degree of thyroid lesions has linear relationship.The heavier the degree of fibrosis is,the faster the shear wave velocity would be.
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Objective To study the diagnostic value of relative parameters and time-relative-intensity curve(TRIC) in malignant and benign liver tumors with contrast-enhanced ultrasound(CEUS). Methods Fifty-nine focal liver lesions were examined with CEUS and drawed time-intensity curve(TIC) with QLAB software. The relative parameters of malignant and benign liver tumors were calculated and analysed. The relative intensity equaled the echo intensity of lesion substracted the encho intensity of liver. TRIC were drawed with time as abscissa and relative intensity as the ordinate. The types of TIRC were analysed comparatively in different groups (benign and malignant). Results There were significant differences in relative peak time, relative peak intensity, relative enhancement time and relative decline slope between malignant and benign lesions( P ＜0. 05). TRIC appeared quick-ascending and quick-descending types in the malignant lesions,the decline curve of TRIC droped down to 0 dB at (28.24 ± 8. 14)s and down to lowest - 8 dB continually, meanwhile fluctuated slightly. While TRIC appeared slow-ascending and slow-descending types in the benign lesions, the decline curve of TRIC droped down to the lowest 4 dB continually, meanwhile fluctuated slightly. Conclusions The relative parameters and TRIC are new quantitative indicators of CEUS for diagnosis of malignant and benign liver tumors.
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This paper briefly reviews the latest progress in the analyses of the technologies for artificial hip joints; and in the researches directed to the features of UHMWPE debris obtained from all kinds of experimental conditions, to the wear process and wear mechanism, and to the factors which influence the wear mechanism. Furthermore, the signification of debris atlas was illustrated. Finally, future directions to be furthered were considered and envisaged. It is suggested that emphases be laid on the relationship between the UHMWPE debris feature and the wear mechanism, and be laid synergistic effects of biochemical environment and loading environment so as to establish the predictive wear models of artificial hip joints.
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Humans , Arthroplasty, Replacement, Hip , Equipment Failure Analysis , Methods , Foreign Bodies , Particle Size , Polyethylenes , Prosthesis FailureABSTRACT
Objective To investigate the impact of aging and weight bearing on cartilage endplate morphology and chondrocyte apoptosis in rats. Methods The bipedal rat model (n=45) was developed by forelimb amputation and special breeding methods. The normal rats of the same age served as the control group (n=40). When the rats became 3, 6, 9, and 12 months old, 8 rats randomly selected from each group were sacrificed and paraffin-embedded mid-sagittal sections of the L4-5 spine were obtained. Sections were stained with hematoxylin and eosin and the TUNEL procedure was performed. The numbers of apoptotic cells and viable cells in the cartilage endplates of the intervertebral discs were counted, the thickness of the cartilage endplate was measured and the degree of impairment of the cartilage endplate was evaluated. Results Apoptosis first appeared in the cartilage endplate, then increased with aging and resulted in a remarkable decrease in cell density. The apoptotic rate of chondrocytes within the cartilage endplate of the bipedal rat model group was significantly higher than the control group at the 6-month time point. A statistically significant difference was observed in the bipedal rat model group between the 6-month time point and 9-month time point (P<0.05). Correlation analyses indicated that there was a highly negative correlation between the number of the viable cells of the cartilage endplate and the degree of the cartilage endplate degeneration (r=-0.97, P<0.05). Compared with the naturally aged group, the bipedal rat model group experienced more severe degeneration in the structure of the cartilage endplate, more obvious thickening of the cartilage endplate's calcified layer, and more defects in the structure of the cartilage. Conclusions Besides aging, weight bearing is probably a key factor of the increase of chondrocyte apoptosis and the degeneration of vertebral cartilage endplate.
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Aim To evaluate the short-term biocompatibility of a newkind of prosthetic nucleus-Evergel, which is made from the modifiedpolyvinyl alcohol hydrogel. Methods According to China national standardGB/T16886 documents, the toxicity of Evergel prosthetic nucleus materialwas investigated by the cytotoxicity test, sensitization test, haemolysis test,Ames test, mice marrow micronucleus test and chromosome aberration test ofmammalian cell in vitro. Results This material had no cytoxicity, no sen-sitivity, no obvious haemolysis, and no mutagencity in Ames test, micemarrow micronucleus test and chromosome aberration test of mammalian cellin vitro. Conclusion The Evergel prosthetic nucleus has a good biocom-patibility and can be used clinically.