Epidemiological characteristics of infected patients aged 60 years and older during the outbreak of SARS-CoV-2 Omicron variant in Sanya, Hainan in 2022 / 中国热带医学

@# or older during the outbreak epidemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant in Sanya City, Hainan Province, August-September 2022, and to provide scientific and effective basis for formulating strategies for the prevention and treatment of COVID-19 in the elderly in the future. Methods　The data of 1 785 COVID-19 cases aged ≥60 years reported from August 1 to September 8, 2022 in Sanya City, and 537 local COVID-19 inpatients aged ≥60 years treated in Sanya Central Hospital were collected and analyzed using WPS Office 2018 software for data cleaning, database assistance, and drawing, and SPSS 22.0 software was used to statistically describe and analyze the counting data. Results　A total of 1 785 local COVID-19 cases aged ≥60 years were reported in China's Disease Prevention and Control Information System, including 1 509 confirmed cases (84.54%) and 276 asymptomatic cases (15.46%). Of the confirmed cases, 1 448 were mild cases (95.96%), 40 were common cases (2.65%), 10 were severe cases (0.66%), and 11 were critical cases (0.73%), and no deaths were reported. The ratio of male to female was 0.88∶1. The youngest was 60 years old, the oldest age was 107 years old, with a median age of 67 years old. Most of them (1 559 cases, 87.34%) were non-social employed personnel. Among them, 952 (53.33%) were from Tianya District and 733 (41.06%) from Jiyang District. Among the 537 COVID-19 elderly infected patients hospitalized in Sanya Central Hospital, infected patients with underlying diseases accounted for 287 (53.45%) cases of hypertension, diabetes and other types of basic diseases (chronic kidney disease, hyperlipidemia, chronic gastritis, gastric ulcer, etc.), and there were serious infections. Conclusions　Most of the elderly infected with Omicron variants were mild cases with few symptoms, but the elderly infected with Omicron variants were difficult to recover or even worsen the condition due to old age and underlying diseases. Therefore, by analyzing the various aspects of elderly infected cases, scientific and effective basis can be provided to prevent and control the epidemic situation in the future, and reduce the occurrence of severe, critical and death cases of COVID-19 in the elderly.

Application of artificial intelligence ultrasound in breast cancer screening in Shigatse, Tibet / 中华超声影像学杂志

Objective:To explore the feasibility and clinical value of artificial intelligence-assisted breast ultrasound in screening breast cancer in Tibet.Methods:Two hundred and eighty-six women who participated in breast cancer screening in Shigatse People′s Hospital from August to September in 2021 were selected. The study included four groups. Group 1, ultrasound screening by senior breast ultrasound doctors from Shanghai; Group 2: local ultrasound doctors used intelligent-assisted ultrasound equipment for screening; Group 3: local ultrasound technicians used intelligent-assisted ultrasound equipment for screening; Group 4: ultrasound screening by local ultrasound doctors. The pathological results of screening positive cases and six-month ultrasound follow-up results of negative cases were set as the gold standard.Results:Twenty-seven lesions of 21 persons were screened positive. Pathology showed that 1 case of invasive ductal carcinoma, 1 case of severe atypical hyperplasia, 6 cases of fibroadenoma, 5 cases of breast disease, 14 cases of breast hyperplasia. Two hundred and sixty-five persons were screened negative, and the results of the six-month ultrasound follow-up were still negative. The accuracy, sensitivity, and specificity of group 2 were 0.966, 1, and 0.964 respectively; The accuracy, sensitivity, and specificity of group 3 were 0.935, 0.769, and 0.943 respectively; The accuracy, sensitivity, and specificity of group 4 were 0.860, 0.308 and 0.885 respectively. The accuracy and area under the curve of groups 2 and 3 were significantly different from that of group 4 (all P<0.001), and there was no significant difference from that of group 1 ( P=0.063, P=0.055). Conclusions:Artificial intelligence-assisted breast ultrasound screening technology can effectively improve the screening efficiency of non-breast ultrasound specialists and technicians. It is very suitable to solve the problems faced by grass-roots screening in Tibet and has great social significance and clinical value.

Assessment of different size tumor stiffness characteristic with shear wave elastography in a triple-negative human breast cancer implantation model / 中华超声影像学杂志

Objective:To investigate the stiffness characteristic of triple-negative human breast cancer at different size in a implantation nude female mice model using shear wave elastography(SWE) and to compare the clinical pathologic features of tumors with elasticity variables.Methods:Human breast cancer MDA-MB-231 cells were injected into 30 nude female mice and 27 transplanted tumors were successfully found in nude female mice. Ultrasound and SWE were longitudinally performed on maximum diameter plane of 21 tumours in 21 nude mice. The elastic parameters of maximal elasticity(Emax), mean elasticity (Emean) and standard deviation of elasticity(Esd) were recorded. The mice were divided into 3 groups according to the tumor size. They were group A with tumor size less than or equal to 5 mm, group B with tumor size greater than 5 mm and less than or equal to 10 mm, group C with tumor size larger than 10 mm and smaller than or equal to 15 mm. Compared with pathology, the relationships between Ki67 of transplanted tumor and elastic parameters were analyzed.Results:As the transplanted tumors increased, the values of Emax, Esd, Ki67 all increased. The lesions maximal size, Emax, Esd, Ki67 were significant higher in group B ( P<0.001, P=0.006, P=0.002, P=0.026) and group C ( P<0.001, P<0.001, P<0.001, P=0.028) than group A. The other parameters were not significantly different among the groups(all P>0.05). The size of transplanted tumors was significantly and positively correlated with Emax ( rs=0.673, P=0.001), Esd ( rs=0.661, P=0.001), and Ki67 ( rs=0.509, P=0.018). Conclusions:SWE Emax and Esd can reflect the tumor tissue stiffness change and biological activity during the tumor growth.

The study on solid papillary carcinoma of the breast by ultrasonography / 中华超声影像学杂志

Objective:To investigate the imaging features of breast solid papillary carcinoma(SPC) by ultrasonography.Methods:The ultrasonic images of 218 breast SPC patients confirmed by pathology in Fudan University Cancer Center from December 2012 to January 2020 were retrospectively reviewed. The manifestations were preliminarily classified into 6 types, and the ultrasonic imaging features were summarized.Results:There were 22 cases with negative ultrasound findings. The cases of solid mass, nodular with ductal dilatation, cystic-solid mass, intraductal abnormal echo, simple ductal dilation and non-ductal flaky hypoechoic area or structural disorders were 79(36.2%), 33(15.1%), 29(13.3%), 30(13.8%), 20(9.2%) and 5(2.3%), respectively, and the diagnostic rates of ultrasound were 70.9%, 24.2%, 75.9%, 20%, 0 and 0, respectively.Conclusions:The ultrasonic manifestations of breast SPC are diverse, while cystic-solid findings can be seen as a clue of breast SPC.

Predictive value of sonographic features on molecular subtypes of invasive breast carcinoma / 中华超声影像学杂志

Objective:To explore the predictive value of various specific sonographic features on molecular subtypes for invasive breast carcinoma(IBC).Methods:Sonographic and clinicopathological data were retrospectively reviewed for 500 IBC patients who accepted surgical therapy in Fudan University Shanghai Cancer Center from January 2014 to March 2016. All tumors were divided into 5 molecular subtypes. The relationships of sonographic variations associated with the molecular subtypes for IBC were analyzed by univariate and multivariate Logsitic regression analyses.Results:Specific sonographic features for triple-negative subtype included regular shape ( OR=2.06, P=0.018), no spiculated/angular margin ( OR=1.98, P=0.029), posterior acoustic enhancement ( OR=2.26, P=0.005), and no calcification ( OR=2.13, P=0.006). Specific sonographic feature for human epidermal growth factor receptor-2 positive (HER2) subtype was posterior acoustic enhancement ( OR=2.23, P=0.006). Specific sonographic features for Luminal A subtype included spiculated/angular margin ( OR=2.24, P=0.001), posterior acoustic shadow ( OR=1.84, P=0.026), and no calcification ( OR=1.89, P=0.016). There were no specific sonographic features for the Luminal B with HER2 negative subtype, while that for the Luminal B with HER2 positive subtype was calcification ( OR=3.61, P<0.001). However, when used these sonographic features to predict molecular subtypes of breast cancer, the sensitivity values were 8.4%-57.3%, and positive predictive values were 9.5%-53.3%. Conclusions:The variety of sonographic features is associated with molecular subtypes of IBC.However, due to the overlap of sonographic features between different subtypes, molecular subtypes of IBC cannot be predicted by sonographic features.

Present situation of the staff of ultrasound departments in Shanghai medical institutions / 中华医院管理杂志

Objective@#To investigate the current basic situation of the staff of ultrasound departments in Shanghai′s medical institutions, for providing references in making management policy of these professionals.@*Methods@#Questionnaire surveys on human resource and service ability were made to all the ultrasound departments of medical institutions in Shanghai in December 2013 and November 2018 respectively. Data of the two surveys were compared and analyzed, and were descriptively analyzed by mean and percentage.@*Results@#The number of ultrasound professionals per 10 000 people in Shanghai was 1.04 in 2018. Tertiary hospitals had advantages in the number of the professionals, and the proportion of professional qualification, age, education background and professional title of the professionals. Compared to those data in 2013, the number of ultrasound professionals had increased 31.8% in 2018. The proportion of medical practitioners with medical imaging specialty was 95.6%(2 063/2 158), and had increased by 4.7 percent. The medical services workload of ultrasound was 19.82 million person-time, and had increased 45.8%.@*Conclusions@#Development of ultrasound departments was rapid, but the development of professionals was unbalanced with the development of medical services. It is suggested to strengthen training of ultrasound professionals and improve the system of hierarchical medical system.

Evaluation of echogenic foci pattern of papillary thyroid carcinoma solitary nodule in lateral cervical lymph node metastasis / 中华超声影像学杂志

Objective:To study the correlation between echogenic foci pattern of papillary thyroid carcinoma(PTC) solitary nodule and lateral cervical lymph node metastasis.Methods:The clinical data of 475 patients with echogenic foci in preoperative ultrasound and pathologically confirmed PTC solitary nodule from January to December 2014 in Fudan University Shanghai Cancer Center were retrospectively analyzed, which was categorized into lateral cervical lymph node metastasis group and lateral cervical lymph node non-metastasis group. Echogenic foci was classified into five types: local punctate echogenic foci, diffused punctate echogenic foci, coarse echogenic foci, mixed echogenic foci, peripheral annular and eggshell echogenic foci. The related clinical characteristics and the ultrasonic features were also involved. Chi-Square test and Logistic regression analysis were performed to analyze the correlation.Results:Age, preoperative human thyroglobulin (HTG) level, maximum diameter, location and echogenic foci pattern distributed to lateral cervical lymph node metastasis of PTC solitary nodule in 475 cases, according to univariate analysis ( P<0.05). Multivariate Logistic regression analysis showed diffused punctate echogenic foci, age≤35 years old, maximum diameter >10 mm and upper part were risk factors of lateral cervical lymph node metastasis of PTC solitary nodule. Conclusions:Diffused punctate echogenic foci in PTC solitary nodule, patients younger than 35 years old, maximum diameter larger than 1 cm and nodule location at upper part of the thyroid promote to lateral cervical lymph node metastasis.

Present situation of the staff of ultrasound departments in Shanghai medical institutions / 中华医院管理杂志

Objective:To investigate the current basic situation of the staff of ultrasound departments in Shanghai′s medical institutions, for providing references in making management policy of these professionals.Methods:Questionnaire surveys on human resource and service ability were made to all the ultrasound departments of medical institutions in Shanghai in December 2013 and November 2018 respectively. Data of the two surveys were compared and analyzed, and were descriptively analyzed by mean and percentage.Results:The number of ultrasound professionals per 10 000 people in Shanghai was 1.04 in 2018. Tertiary hospitals had advantages in the number of the professionals, and the proportion of professional qualification, age, education background and professional title of the professionals. Compared to those data in 2013, the number of ultrasound professionals had increased 31.8% in 2018. The proportion of medical practitioners with medical imaging specialty was 95.6%(2 063/2 158), and had increased by 4.7 percent. The medical services workload of ultrasound was 19.82 million person-time, and had increased 45.8%.Conclusions:Development of ultrasound departments was rapid, but the development of professionals was unbalanced with the development of medical services. It is suggested to strengthen training of ultrasound professionals and improve the system of hierarchical medical system.

Risk factors of central neck lymph node metastasis following solitary papillary thyroid carcinoma / 中华超声影像学杂志

Objective To evaluate the risk factors in terms of clinical characteristics ,serological indicators and sonographic features regarding thyroid papillary carcinoma ( PTC) for the central neck lymph node metastasis . Methods One thousand one hundred and seventy‐four patients accepted thyroid cancer surgery at Fudan University Shanghai Cancer Center from January to September 2016 were enrolled . All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy .M eanwhile ,the status of central neck lymph node metastasis was determined referring to postoperative pathology . All features of the PTC lesion in terms of clinical ,serological and sonographic features were evaluated for the association with central neck lymph node metastasis using univariate and multivariate logistic regression analysis . Meanwhile ,a nomogram model was established for the determined risk factors . Results Out of 1 174 patients ,469 patients ( 39 .9% ) presented central neck lymph node metastasis ,univariate analysis showed that age , gender , preoperative thyroglobulin ( Tg ) and thyroid peroxidase antibody ( T POAb ) , maximum diameter ,location ,close to the thyroid capsule ,AP/T R ,echo ,acoustic halo ,and presence of microcalcification were related with CLNM ( P ＜ 0 .05 ) . M ultivariate logistic regression analysis demonstrated that less than 55 years‐old , male , Tg higher than 20 eg/L , T POAb less than 1 kU/L , maximum diameter larger than 10 mm ,and presence of microcalcification were independent risk factors for CLNM . T he nomogram was established based on independent risk factors determined by the logistic regression with the AUC 0 .714 ,specificity 73 .1% ,and sensitivity 59 .7% . Conclusions For patients with single focal PTC lesion , younger age , male , higher Tg , lower T POAb , and larger lesions containing microcalcificatin on ultrasound are associated with central neck lymph node metastasis .

The association between molecular biomarkers and ultrasonographic radiomics features for triple negative invasive breast carcinoma / 中华超声影像学杂志

Objective To evaluate the association between quantitative ultrasonographic features and clinical ,pathological and immunohistochemical features of triple negative invasive breast carcinoma( TNBC) . Methods With the ethical approval , 96 patients who were pathologically confirmed as TNBC were retrospectively reviewed . All patients were sub-grouped according to age ,tumor size ,pathological grade , Ki67 expression level and human epidermal growth factor receptor 2 ( HER-2) score .Ultrasound images were segmented for the breast carcinoma mass using a phase-based active contour model . The high-throughput radiomics features were extracted based on the two-dimensional sonographic features . There were 460 features extracted from each ultrasound image . A series of computer aided algorithms including K-svd algorithm ,sparse representation ,support vector machine ( SVM ) and radial basis function were used to determine the high-throughput sonographic features that were highly correlated to clinical ,pathological and immunohistochemical features of TNBC . The performance efficacy was expressed by accuracy and area under curve ( AUC) of the ROC curve . Results The high-throughput ultrasonographic features of invasive TNBC could predict its pathological grade ,Ki67 level and HER-2 score with the accuracy 92 .2％ -96 .9％and AUC 98 .7％ -99 .9％ . There were 82 radiomics features selected for predicting the pathological grade of TNBC , the feature with the maximum weight was the elliptic-normalized eccentricity based on morphological features . There were 100 features selected for predicting the Ki67 expression level ,the feature with the maximum weight was the standard deviation of the annular region based on the boundary texture features . There were 85 features selected for the prediction of HER-2 score ,the most powerful parameter was the intensity based on NGTDM texture features . Conclusions Quantitative high-throughput ultrasonographic features are correlated with the pathological and immunohistochemical characteristics of invasive TNBC . High-throughput ultrasonographic features are valuable in predicting biological behavior of TNBC .

Risk factors of predicting lateral neck lymph node metastasis following solitary papillary thyroid carcinoma / 中华超声影像学杂志

Objective@#To evaluate the risk factors in terms of clinical characteristics and sonographic features regarding solitairy thyroid papillary carcinoma (PTC) for the lateral cervical lymph node metastasis(LLNM) and then to establish nomogram model.@*Methods@#All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy in Fudan University Shanghai Cancer Center from January to September 2016. Meanwhile, the status of lateral cervical lymph node metastasis was determined referring to postoperative pathology. Clinical characteristics including gender, age, preoperative thyroid stimulating hormone (TSH), thyroglobulin (Tg), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb), central lymph node metastasis (CLNM) and sonographic features of the PTC lesion including maximum tumor diameter, location, aspect ratio, relation with thyroid capsule, echo, margin, acoustic halo, microcalcification were evaluated for the association with lateral cervical lymph node metastasis using univariate and multivariate logistic regression analyses. Then the nomogram model was established and its application value was evaluated using ROC.@*Results@#Out of 1 174 patients, 125 patients (10.6%) presented lateral neck lymph node metastasis and 10 patients presented skipping metastasis.Univariate analysis showed gender, preoperative Tg and TGAb, CLNM, maximum tumor diameter, location, close to the thyroid tumor capsule, echo, aspect ratio, acoustic halo, microcalcification were associated with LLNM(P<0.05). Binomial logistic regression analysis indicated CLNM, maximum tumor diameter of larger than 10 mm, superior or multiple location, microcalcification were independent risk factors of LLNM. The AUC of the nomogram model was 0.865, the sensitivity was 88.0%, the specificity was 75.2%, and the accuracy was 76.6%.@*Conclusions@#As for patients with single focal PTC, CLNM, larger lesions, microcalcification, superior location are associated with lateral neck lymph node metastasis. The nomogram model can be tried for clinical application.

Comparison of ultrasound radiomics with conventional imaging models: diagnosis of central cervical lymph node metastasis in papillary thyroid carcinoma / 中华超声影像学杂志

Objective@#To compare the difference of diagnostic ability between ultrasound radiomics (USR) and different conventional imaging models of central neck (Ⅵ) lymph node metastasis in papillary thyroid carcinoma (PTC).@*Methods@#A training set of 609 cases was set up. USR features were extracted and screened by USR method. A weighted formula was established to calculate the USR score of each patient by ultrasound image. The USR score of the best diagnostic ability was obtained by statistical method and set as the diagnostic criterion. A test set of 326 cases was established to compare the diagnostic ability of USR score with ultrasound (US), computed tomography (CT) and US combined CT.@*Results@#The accuracy, sensitivity, specificity, area under ROC curve and Youden index of USR score in test set were 0.804, 0.867, 0.770, 0.766, 0.533, respectively, which were significantly higher than the corresponding values of US, CT and US combined CT(all P=0.000).@*Conclusions@#USR score obtained with USR method can effectively predict lymph node metastasis in Ⅵ region of PTC. The diagnostic efficiency and clinical value of USR score were significantly higher than those of conventional medical imaging models.

Comparison of ultrasound radiomics with conventional imaging models :diagnosis of central cervical lymph node metastasis in papillary thyroid carcinoma / 中华超声影像学杂志

Objective To compare the difference of diagnostic ability between ultrasound radiomics ( USR) and different conventional imaging models of central neck ( Ⅵ ) lymph node metastasis in papillary thyroid carcinoma ( PTC) . Methods A training set of 609 cases was set up . USR features were extracted and screened by USR method . A weighted formula was established to calculate the USR score of each patient by ultrasound image . T he USR score of the best diagnostic ability was obtained by statistical method and set as the diagnostic criterion . A test set of 326 cases was established to compare the diagnostic ability of USR score with ultrasound ( US ) ,computed tomography ( CT ) and US combined CT . Results T he accuracy ,sensitivity ,specificity ,area under ROC curve and Youden index of USR score in test set were 0 .804 ,0 .867 ,0 .770 ,0 .766 ,0 .533 ,respectively ,which were significantly higher than the corresponding values of US ,CT and US combined CT ( all P ＝ 0 .000 ) . Conclusions USR score obtained with USR method can effectively predict lymph node metastasis in Ⅵ region of PTC . T he diagnostic efficiency and clinical value of USR score were significantly higher than those of conventional medical imaging models .

Risk factors of predicting lateral neck lymph node metastasis following solitary papillary thyroid carcinoma / 中华超声影像学杂志

Objective To evaluate the risk factors in terms of clinical characteristics and sonographic features regarding solitairy thyroid papillary carcinoma (PTC) for the lateral cervical lymph node metastasis (LLNM) and then to establish nomogram model.Methods All patients were confirmed to be solitary PTC in paraffin wax pathology after thyroidectomy in Fudan University Shanghai Cancer Center from January to September 2016.Meanwhile,the status of lateral cervical lymph node metastasis was determined referring to postoperative pathology.Clinical characteristics including gender,age,preoperative thyroid stimulating hormone (TSH),thyroglobulin (Tg),thyroglobulin antibody (TGAb),thyroid peroxidase antibody (TPOAb),central lymph node metastasis (CLNM) and sonographic features of the PTC lesion including maximum tumor diameter,location,aspect ratio,relation with thyroid capsule,echo,margin,acoustic halo,microcalcification were evaluated for the association with lateral cervical lymph node metastasis using univariate and multivariate logistic regression analyses.Then the nomogram model was established and its application value was evaluated using ROC.Results Out of 1 174 patients,125 patients (10.6％) presented lateral neck lymph node metastasis and 10 patients presented skipping metastasis.Univariate analysis showed gender,preoperative Tg and TGAb,CLNM,maximum tumor diameter,location,close to the thyroid tumor capsule,echo,aspect ratio,acoustic halo,microcalcification were associated with LLNM (P ＜0.05).Binomial logistic regression analysis indicated CLNM,maximum tumor diameter of larger than 10 mm,superior or multiple location,microcalcification were independent risk factors of LLNM.The AUC of the nomogram model was 0.865,the sensitivity was 88.0％,the specificity was 75.2％,and the accuracy was 76.6％.Conclusions As for patients with single focal PTC,CLNM,larger lesions,microcalcification,superior location are associated with lateral neck lymph node metastasis.The nomogram model can be tried for clinical application.

Ultrasonographic features of different pathological types of breast phyllodes tumors / 中华超声影像学杂志

Objective To investigate the ultrasonographic features of different pathological types of phyllodes tumors ( PT ) of breast . Methods T he clinical manifestations and sonographic findings were analyzed retrospectively in 132 patients with 136 different subtype PT s . Ultrasonographic features of benign ,borderline and malignant types were compared . Results All the lesions were classified into benign ( 46/136 ,33 .8% ) ,borderline ( 62/136 ,45 .6% ) and malignant ( 28/136 ,20 .6% ) . On sonography ,most tumors were show n as oval or lobulated ( 77 .9% ) ,well‐defined margins ( 70 .6% ) ,and posterior echo enhancement ( 72 .1% ) . Cystic areas were observed in 36 lesions ( 26 .5% ) . No significant difference was observed in age ,lesion shape ,echo patterns ,posterior acoustic features or cystic area ( P ＞ 0 .05 ) . Large size ,indistinct margins and grade Ⅱ － Ⅲ vascularity were more frequent in borderline and malignant tumors ( P ＝0 .002 , P ＝0 .028 , P ＜0 .001 ,respectively ) . Conclusions Phyllodes tumors of breast have certain characteristics on ultrasonography .Large size ,unclear margins and rich blood flow signals may indicate malignancy .

Comparison of ultrasonography and ultrasound-guided diffuse optical tomography in assessing treatment response of breast cancer to neoadjuvant chemotherapy / 中华超声影像学杂志

Objective To investigate the clinical value of conventional ultrasonographic ( US),US-guided diffuse optical tomography ( US-guided DOT ) and both combined to assess treatment response of breast cancer to neoadjuvant chemotherapy( NAC). Methods Eighty-eight breast cancer patients,totally 93 lesions were included in the study. Pre-and post-last chemotherapy,size,and total hemoglobin concentration ( THC) of each lesion were measured by conventional US and US-guided DOT before biopsy,the change of lesion Size( ΔSize) and the change of THC( ΔTHC) were calculated respectively.Based on the guidelines to evaluate the response to treatment in solid tumors,the responses to NAC were classified into complete response, partial response, static disease, progressive disease groups. The histological response to chemotherapy were categorised as partial pathological response and complete pathological response using Miller and Payne system. Results Of 93 breast cancers,the overall response rate was 81.7%,the cPR rate was 24.7%. According to ROC curve analysis,when ΔSize 42.6% and ΔTHC 23.9% as cutoff values to evaluate the complete response and partial response,the area under the curve ( AUC ) were 0.666 and 0.751,respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.680 and 0.737 respectively.When ΔSize 64.5% and ΔTHC 27.2% as cutoff values to evaluate complete pathologial response,the AUC were 0.690 and 0.728 respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.693 and 0.726 respectively. Conclusions US-guided DOT and US can be used to predict breast cancers response to NAC,US and US-guided DOT combined in parallel and in series can not improve response prediction comparing with US or US-guided DOT alone.

Preoperative ultrasonography of thyroid cancers:is it overdiagnosis or underdiagnosis? / 中华超声影像学杂志

Objective To investigate the accuracy and missed diagnosis rate of preoperative ultrasound in the diagnosis of thyroid carcinoma . Methods With the method of natural language recognition ,816 solitary thyroid nodules which received thyroidectomy were enrolled for the analysis of preoperative ultrasound examination and post-operative pathology results . The accuracy and the rate of missed diagnosis of ultrasonography for the diagnosis of thyroid carcinoma and lymph node metastasis were evaluated with the pathological results as the gold standard . Results There were 783 ( 96 .0％ ) malignant thyroid tumors ,6 ( 0 .7％ ) follicular tumor with uncertain malignant potential ,and 27 ( 3 .3％ ) benign thyroid tumors . Ultrasonography yielded an accuracy of 96 .1％ in the differential diagnosis between benign and malignant thyroid nodules and an accuracy of 94 .5％ in the quantification of nodule numbers . 5 .5％ of solitary nodules reported by ultrasound were proved to be 2 or more malignant nodules after the surgery . Regarding the diagnosis of central lymph node ,the preoperative ultrasound yielded an accuracy of 73 .0％and a misdiagnosis rate of 38 .7％ . For the lateral neck lymph node ,the accuracy was 88 .3％ ,and the misdiagnosis rate was 3 .4％ . Conclusions Natural language recognition method can assist clinical research . Ultrasonography is valuable in the diagnosis of thyroid carcinomas and neck lymph nodes . However , ultrasonography has a certain rate of misdiagnosis for the quantification of nodule numbers ,and for the diagnosis of lymph nodes in central and lateral necks .

Ultrasound-guided diffuse optical tomography(DOT) differences and clinical characteristics of T1-T3 breast carcinoma / 中华超声影像学杂志

Objective To explore the ultrasound-guided diffuse optical tomography (DOT) distribution difference and clinical characteristics of T 1-T3 breast carcinoma. Methods Four hundred and forty-seven breast cancer patients with 455 breast lesions were enrolled.The lesion maximal diameter and total hemoglobin concentration(THC) were obtained by ultrasound-guided DOT before breast surgery biopsy.The patients age,body mass index(BMI),and the distances from lesion to skin and nipple were measured,lymph node status were also assessed.According to the 7th Edition of the AJCC Cancer Staging, all tumors were divided into T1( ≤ 2 cm),T2(2 cm < lesion ≤ 5 cm),and T3( > 5 cm) three groups according to maximum diameter on ultrasound.Results Out of 455 breast cancer lesions,148 lesions were stage T1,251 lesions were stage T2,56 lesions were T3.The age,lesion size,lesion THC and the distances between lesions and nipples of breast cancer patients were found that there were significant differences among T1,T2 and T3(all P = 0.000). With T stages increasing,the age of breast cancers patients decreased,the distance between lesions and nipples decreased,the THC increased.THC of breast cancer T 2 [(221.0 ± 56.0)μmol/L] and T3[(233.1 ± 54.0)μmol/L] were significant higher than that of T1 [(181.6 ± 70.4)μmol/L](all P = 0.000).There were all no significant difference for BMI and the distancefrom lesion to skin among different stages T( P > 0.05).With T stages increasing,the ratio of lymph node metastasis increased(T1 26.4%,T2 49.8%,T3 55.4%; P =0.000).Conclusions With breast cancer T stages increasing,T HC increases,the age of the patients decreases,lymph node metastasis rate increases.

Comparative study of the diagnostic value of ultrasonography and MRI in mucinous adenocarcinoma of breast / 中华超声影像学杂志

Objective@#To investigate ultrasonographic and magnetic resonance imaging features of pure mucinous adenocarcinoma of breast, and to discuss the diagnose value.@*Methods@#Eighty-eight patients with 92 breast lesions of pure mucinous adenocarcinoma had undergone ultrasonography and MRI. The imaging features were reviewed and the diagnostic values were compared between the two imaging examinations.@*Results@#On ultrasonography, tumors were mostly showed well-defined margins (77.2%), lobulated shape (60.9%), hypoechoic (51.1%), heterogeneous texture (63.0%), posterior echo enhancement (82.6%). Color Doppler imaging showed vascularity in 75% of these lesions.On magnetic resonance imaging, most tumors showed circumscribed mass with lobulated shape. Sixty-four lesions (69.6%) showed hypointensity on T1-wighted images.Hyperintensity and strongly hyperintensity on T2-weighted images were identified in 71 cases and 21 cases, respectively. After contrast, 54 cases showed rim enhancement and the other 38 cases showed heterogeneous enhancement. There was no significant difference in diagnostic accuracy between ultrasonography and MRI (72.8% vs 77.2%, P=0.481). Combined the two imaging examinations, the diagnostic accuracy was higher than that of ultrasonography (84.8% vs 72.8%, P=0.001) and MRI (84.8% vs 77.2%, P=0.016).@*Conclusions@#Pure mucinous adenocarcinoma of breast has some typical characteristics in ultrasonography and MRI, combination of the two imaging examinations can improve the diagnostic accuracy.

Correlation between echocardiography report narratives and the risk level of congenital heart disease in children / 复旦学报（医学版）

Objective To analyze the correlation between echocardiography report narratives and the risk level of congenital heart disease in children,and to validate the feasibility and value of employing text mining technique in such task.Methods Echocardiography reports were retrospectively analyzed for 1 042 children with congenital heart disease.We adopted natural language processing (NLP) technique to generate features from the clinical narratives for machine learning algorithms.Decision trees were trained to predict the risk level of patients.Model performance was evaluated by means of classification accuracy and normalized mean absolute error (NMAE),which were averaged among 50 rounds of stratified 10-fold cross validation.By analyzing branches of the decision tree,we formulated the possible decision path of a clinician and identifyied the key information in the clinical narratives.Results Compared with the auto-generated 3-grams,the selected features yielded a better performance.After feature selection,the predict accuracy was improved from 32.82％ to 48.57％,while the NMAE reduced from 0.33 to 0.25.Conclusions Based on echocardiography report narratives,the risk levels of congenital heart disease in children can be evaluated by our model with an accuracy level of 75 ％.Echocardiographic terms that describe the lesion provide significant information to support the clinical decision making.