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Objective To compare the image features of magnetic resonance imaging (MRI) and ultrasound (US) for papillary thyroid carcinoma(PTC).Methods From January 2015 to April 2016,86 consecutive patients underwent surgery and pathologically confirmed PTCs in the People 's Hospital Affiliated to Jiangsu University were selected.All patients received neck US and MRI examination before thyroid surgery .For each case,the US and MRI features emphasized included the echogenic /signal,margin,shape,anteroposterior to transverse diameter ratio (A/T), microcalcifications and lymph node metastasis .Statistical analysis was performed using the χ2 test.Results In the comparison of US and MRI features,A/T≥1(41.9％in US and 62.8％in MRI) and lymph node metastasis(88.0％in MRI;56.0％in US) demonstrated statistically significant differences (χ2 =7.551,P=0.009;χ2 =6.349,P=0.025),and no significant differences were observed in the margin ,shape(P=0.724,P=0.316).Conclusion The MRI features of PTCs included A/T and lymph node metastasis was superior to US .
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Objective To investigate the distribution of pathogens and their drug resistance in elderly patients with community-acquired pneumonia. Methods A total of 222 elderly patients with community-acquired pneumonia admitted to our hospital from February 2017 to January 2018 were enrolled in this study.Lower respiratory tract secretions or morning sputum were collected by using the sterile culture method. According to the clinical microbiological examination procedures ,pathogenic bacteria were cultured and identified. The pathogenic bacteria strains and the drug resistance were analyzed. Results The bacteria examination rate of the patients was 100.0% (222/222 patients) , and the rate of positive cultures was 64.9% (144/222 ).216 strains of pathogenic bacteria were identified ,and 75 strains(34.7% )were Gram-positive bacteria ,of which the most common pathogenic bacteria were Staphylococcus aureus ,Streptococcus pneumoniae and Staphylococcus epidermidis. And 127 strains(58.8% )were Gram-negative bacteria ,of which the most common pathogenic bacteria were Klebsiella pneumoniae ,patina Pseudomonas ,Escherichia coli ,Stenotrophomonas maltophilia and Haemophilus influenza. The drug susceptibility test showed that Gram-positive bacteria were sensitive to nitrofurantoin ,cotrimoxazole ,vancomycin and teicoplanin ,and Gram-negative bacteria were sensitive to piperacillin ,tazobactam ,cefepime ,amikacin ,levofloxacin and imipenem cilastatin. Conclusions The pathogenic bacteria are mainly Gram-negative bacteria in the elderly patients with community-acquired pneumonia ,but the majority of pathogenic bacteria have higher resistance to antibacterial drugs. The analyses of distribution of pathogens and their drug resistance are of great significance for the reasonable selection of antimicrobial agents and for the obvious decrease of lung infection and mortality rate.
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Objective To evaluate the diagnostic performance of preoperative multi b values of DWI and ADC for the prediction of extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC).Methods Between January 2013 and February 2017,MR images including dynamic contrast-enhanced MR imaging (DCE-MRI) and DWI images of 81 patients diagnosed as papillary thyroid carcinoma in the Affiliated Renmin Hospital of Jiangsu University were retrospectively analyzed.ADC values were measured on solid regions of tumors.The differences of ADC were compared between tumors with total ETE(minimal ETE,extensive ETE) and without ETE by independent-samples t test.Results When b=500 s/mm2,ADC values of PTCs with ETE[(1.27±0.17)× 10-3mm2/s]were significantly lower than those from PTCs without ETE [(2.12±0.72)× 10-3mm2/s,(t=9.126,P=0.000)].ADC values of PTCs with extensive ETE[(1.23±0.17)× 10-3mm2/s] were significantly lower than those from PTCs with minimal ETE[(1.29±0.16)× 10-3mm2/s,(t=1.467,P=0.147)].When b=500 s/mm2,the cutoff value of ADC to discriminate PTCs with and without ETE was 1.530×10-3 mm2/s with a sensitivity of 69.0％,specificity of 93.7％,positive predictive value of 77.6％,negative predictive of 77.5％ and ROC curve area of 0.887.Conclusion ADC values of the solid tumor tissue of PTC with ETE are significantly lower than those of PTC without ETE.DWI may be helpful in the determination of thyroid papillary carcinoma ETE.
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Objective To evaluate the diagnostic value of preoperative ultrasonography(US)and magnetic resonance imaging (MRI) for the extrathyroidal extension (ETE) in patients with papillary thyroid carcinoma(PTC).Methods The clinical data of 90 patients with PTC from January 2013 to June 2016 were analyzed retrospectively,and all patients were examined by US and MRI before operation.The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of minimal ETE, extensive ETE and ETE (minimal ETE + extensive ETS) were compared between UC and MRI.Results The diagnostic minimal ETE sensitivity of UC was significantly higher than that of MRI (81.9% vs.60.0%), and there was statistical difference (P<0.05).The diagnostic extensive ETE specificity of MRI was significantly higher than that of UC(80.9% vs.63.5%),and there was statistical difference (P<0.01).The diagnostic ETE sensitivity and NPV of UC were significantly higher than those of MRI(97.4% vs.88.3% and 80.0% vs.50.0%),and there were statistical differences (P<0.05 or <0.01).Conclusions US has a higher sensitivity, compared with MRI for diagnostic minimal ETE.MRI has a higher specificity for diagnostic extensive ETE,compared with US.And US has a higher sensitivity and NPV for diagnostic ETE,compared with MRI.
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Objective To Study the application of ultrasound mediated drug-loading ultrasound contrast agents in auxiliary cancer chemotherapy.Methods Carrying paclitaxel (PTX) hollow periodic mesoporous organosilicas(HPMOs) were prepared by Structural differences selective etching method.The drug release kinetics of ultrasound mediated in vitro were evaluated at different time points of ultrasound radiation to PTX-HPMOs.The cell survival were evaluated by CCK8 experiment.Results ① The drug loading of PTX-HPMOs was 91 mg/g.②The achieved HMONs showed the high stability and excellent contrast enhancement for ultrasound imaging both in vitro.HPMOs showed the same good effect of contrastenhanced ultrasound imaging as SonoVue.③Drug-loaded HMONs exhibit ultrasound-responsive drug release performance.The ultrasonic stimulation can increase the release of 18 ％ of PTX each time.④ After ultrasonic stimulation,PTX-HPMOs showed good antitumor effect in vitro.Conclusions The new type of drug loading ultrasound contrast agents show good ultrasonic imaging and can help the cancer chemotherapy at the same time.
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This paper summarizes the new progress of the research of the targeted microbubble ultrasound contrast agents and ultrasound molecular imaging in tumor angiogenesis.There are two constructing methods of targeted microbubble ultrasound contrast agents.Targeted new blood vessels microbubble unltrasound contrast agents are mainly divided into the connection of alpha(V)beta3 antibody,αVβ3 integration antibody and connecting VEGFR2.The quantitative analysis of targeted microbubble adhering to tumor target and the evaluation of the correlation between targeted microbubble adhering to tumor neovascular endothelial cell and tumor local pathological microvessel density suggest that ultrasound molecular imaging can be noninvasive,quick,repeated,dynamic and quantitative evaluate tumor angiogenesis and indirectly reflect the malignant tumor tissue proliferation activity and its biological characteristics.