Exploration on an ultrasonographic imaging reporting and data system in malignancy grading of thyroid nodules / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the values of ultrasonographic features in differentially diagnosing benign and malignant thyroid nodules, and attempt to establish a quantitative ultrasound classification system.</p><p><b>METHODS</b>We retrospectively analyzed 20 ultrasound features of 926 thyroid nodules in 527 patients. Using logistic regression analysis, we obtained the probability function for predicting the malignancy in thyroid nodules and established a preliminary ultrasound classification system.</p><p><b>RESULTS</b>The ages of patients with thyroid nodules was older than that of the patients with thyroid carcinoma (t = 6.496, P < 0.001). The correctness rate of ultrasonic diagnosis was 80.1%. The logistic multivariate regression analysis showed that among all ultrasonographic features, aspect ratio ≥ 1, obscure boundary, irregular margin, significant internal hypoecho, internal hypoecho, internal micro-calcifications, posterior echo attenuation, thyroid capsule invasion, abnormal adjacent lymph nodes, and ultrasonic elastography 5-point evaluation scores > 3 were contributing factors for thyroid carcinoma. The equation was P (us) = 1 /[1+e(-)Z], where z is the logit of malignant thyroid nodule, and taking P (us) > 0.50 as boundary value, the prediction accuracy rate was 84.1%. Using this model, 92.2% of the thyroid nodules were predicted as nodular goiter, and 69.4% of the thyroid carcinomas were correctly predicted. P (us) was stratified into four levels: Level 1: 0-16% malignancy; Level 2: 17%-50% malignancy; Level 3: 51%-70% malignancy; and level 4: 71%-100% malignancy.</p><p><b>CONCLUSIONS</b>The quantitative thyroid imaging reporting and data system developed in this study makes ultrasound reports more objective, normalized and standardized. It can be used to evaluate the malignancy risk of thyroid nodules and help to make right decision in clinics.</p>

Aortic elastic properties and its clinical significance in intracranial aneurysms / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the aortic elastic properties and its clinical significance in intracranial aneurysms (IAs).</p><p><b>METHODS</b>One hundred and seven IAs patients (57 with hypertension) and 108 healthy subjects were recruited. The internal aortic diameters in systole and diastole were measured by the M-mode echocardiography, the aortic elasticity indexes were calculated and compared.</p><p><b>RESULTS</b>The aortic distensibility (DIS) was lower and the aortic stiffness index (SI) was higher in IAs patients than those in controls (both P <0.001). DIS was lower and SI was higher in IAs patients with hypertension (IAs-HP) than those in IAs with no hypertension (P <0.001). Similar results were obtained when the aortic elasticity index were adjusted for body surface area and body mass index.</p><p><b>CONCLUSION</b>Abnormal aortic elasticity is a common finding in IAs patients and hypertension is closely related to the severity of aortic elasticity.</p>

Tissue Doppler imaging study of right ventricular myocardial systolic activation in subjects with pulmonary arterial hypertension / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Tissue Doppler imaging (TDI) has provided an objective means to quantify global and regional left ventricular (LV) and right ventricular (RV) function with improved accuracy and greater reproducibility than conventional echocardiography. This study was conducted to assess RV myocardial systolic activation by TDI in subjects with pulmonary arterial hypertension (PAH).</p><p><b>METHODS</b>A total of 30 patients with PAH and 30 healthy volunteers, all comparable in age and sex, underwent standard Doppler echo and TDI. Using pulsed Doppler echocardiography combined with TDI, the following regional parameters were evaluated in three different myocardial segments (RV basal lateral wall, basal septal, and LV basal lateral) on apical 4-chamber view: systolic (Sm), early- and late-diastolic (Em and Am) peak velocities. RV myocardial systolic activation delay was defined as the difference in time to peak TDI systolic velocities between the RV basal lateral wall and basal septal. In addition, RV end-diastolic and end-systolic areas were measured to calculate RV fractional area change from the same apical 4-chamber view.</p><p><b>RESULTS</b>Compared with the control group, patients with PAH showed increased RA and RV end-diastolic diameter (RA: (4.5 +/- 1.2) cm vs (3.0 +/- 0.8) cm, P < 0.05 and RV: (4.8 +/- 1.9) cm vs (3.4 +/- 0.5) cm, P < 0.05) and reduced RV fractional area change; (35 +/- 14)% vs (56 +/- 9)%, P < 0.05. These PAH patients showed lower myocardial peak velocities and a significant activation delay compared with controls (P < 0.05). Moreover, a strong correlation between RV myocardial systolic activation delay and RV fractional area change was shown in patients with pulmonary arterial hypertension (r = -0.82).</p><p><b>CONCLUSIONS</b>In PAH, RV myocardial systolic activation was markedly delayed, which was directly related to the RV fractional area change. RV myocardial systolic activation delay assessed by TDI could offer a unique approach to predict RV dysfunction.</p>

The epidemiological study on human immunodeficiency virus infection among paid blood donors living in Shandong provincial China Comprehensive Response Project Areas / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the current epidemic situation and high risk factors of human immunodeficiency virus (HIV) infection among paid blood donors living in Shandong provincial China Comprehensive Response (CARES) Project Areas.</p><p><b>METHODS</b>All residents between 20 to 60 years old were selected from one or several counties in August 2003.</p><p><b>RESULTS</b>There were 19 HIV(+) infections among 661 subjects interviewed. HIV prevalence rate among paid blood donors was higher (3.98%) than that of others (0.48%) while HIV prevalence rate was higher in plasma donors (7.24%) than that in both plasma and full blood donors (2.90%). There was no infections identified in full blood donors. Donors who donated blood during 1994 - 1995 had a higher prevalence rate (7.07%) than those who started donation after 1995 and those began donation before 1993 (0.99%). The rate of condom use was lower among paid blood donors (13.72%) than that of others. There was a lower rate of voluntary HIV testing among paid blood donors than that of others.</p><p><b>CONCLUSION</b>The main high risk population of HIV infection were paid donors in CARES Project Areas, whose risk factor was plasma donation and were infected mainly before 1995. Both the rate of condom use and HIV testing were all very low, indicating that they knew little on HIV/AIDS and paid less attention to self-proctection. It is necessary to enhance HIV/AIDS health education and behavior intervention on paid blood donors.</p>

Assessment of myocardial ischemia and infarction by intravenous myocardial contrast echocardiography with perfluorocarbon microbubbles / 浙江大学学报·医学版

OBJECTIVE: To assess the value of myocardial contrast echocardiography (MCE) with intermittent second harmonic technique and perfluorocarbon microbubbles in identifying myocardial ischemia and infarction. METHODS: Open-chest dogs were performed by intravenous MCE with perfluorocarbon microbubbles after 3 h of left anterior descending coronary artery (LAD) occlusion. The parameters of time-intensity curve were measured and compared between the normal and ischemic myocardial area at short-axis view of left ventricule midpapillary muscle level. The infarct size assessed by MCE was compared with the gross pathologic specimen stained with triphenyltetrazolium chloride (TTC). RESULTS: The peak intensity (PI), T1/2, and area under curve (AUC) in the ischemic area were significantly different versus the normal area 13.5+/-1.9 compared with 22.5+/-2.4; 16.6+/-0.9 compared with 9.7+/-0.5; 231.6+/-14.9 compared with 405.6+/-12.3 P<0.02). The percents of the no flow area determined by MCE had correlation with those by TTC stain(r=0.89, P=0.01). CONCLUSION: Intermittent second harmonic MCE using intravenous injection of perfluorocarbon microbubbles could assess myocardial perfusion, diagnose ischemia, and define myocardial infarct size.