ABSTRACT
Objective To explore the diagnostic value of contrast enhanced ultrasound (CEUS),elastography and their combined use in diagnosing non-mass-like lesions on breast.Methods From November 2015 to January 2017,79 nodules diagnosed by conventional ultrasound were prospectively enrolled and examined by CEUS and elastography before surgery.Multivariate logistic regression models were established for CEUS and CEUS combined with elastography to diagnose breast malignancy.The diagnostic performances of CEUS,elastography and their combined use were evaluated with the receiver operating characteristic (ROC) curve.Results The CEUS features significantly predicting malignancy were hyperenhancement,heterogeneous enhancement,visualization of penetrating vessels (P ＜ 0.01).Furthermore,the multivariate logistic regression for CEUS combined with elastography showed that heterogeneous enhancement,visualization of penetrating vessels and elasticity score were the independent predictors of breast malignancy.The area under the ROC curve of CEUS combined with elastography was (0.915 ± 0.223),which was higher than that of CEUS and elatography (0.851 ±0.029,0.790 ±0.038,P ＜0.05).Moreover,the sensitivity,and accuracy of CEUS combined with elastography were 89.1％,and 86.1％,respectively.The omission diagnostic rate of CEUS combined with elastography (8.9％) was reduced.The diagnostic accuracy of CEUS combined with elastography was significantly higher than that of CEUS and elastography.Conclusions The diagnostic value of CEUS combined with elastography was remarkably significant in the differential diagnosis of non-mass-like lesions on breast.
ABSTRACT
Objective To screen protein disulfide isomerase(PDI)inhibitors from zinc- and selenium-rich green tea and to examine the effect of PDI inhibitors on platelet aggregation. Methods Protein structure file of PDI(PDB ID:4EKZ)was downloaded from protein data bank and the current known 20 compounds in green tea were used to establish a small chemical library. The effects of 6 hit compounds by virtual screening on enzymatic activity of PDI were validated. The antiplatelet activities of the effective compounds tested on PDI enzymatic activi ty were further evaluated. Results 2 of 6 hit compounds by virtual screening ,ECG and EGCG displayed inhibitory effect on enzymatic activity of PDI. In addition ,both compounds showed the potential inhibitory effect on platelet aggregation induced by adenosine diphosphate (ADP) in vitro. Conclusion The effect of blood-activating and stasis-dissolving regulation of green tea is associated with its inhibitory effect on PDI. ECG and EGCG are major active components.
ABSTRACT
Objective To screen protein disulfide isomerase(PDI)inhibitors from zinc- and selenium-rich green tea and to examine the effect of PDI inhibitors on platelet aggregation. Methods Protein structure file of PDI(PDB ID:4EKZ)was downloaded from protein data bank and the current known 20 compounds in green tea were used to establish a small chemical library. The effects of 6 hit compounds by virtual screening on enzymatic activity of PDI were validated. The antiplatelet activities of the effective compounds tested on PDI enzymatic activi ty were further evaluated. Results 2 of 6 hit compounds by virtual screening ,ECG and EGCG displayed inhibitory effect on enzymatic activity of PDI. In addition ,both compounds showed the potential inhibitory effect on platelet aggregation induced by adenosine diphosphate (ADP) in vitro. Conclusion The effect of blood-activating and stasis-dissolving regulation of green tea is associated with its inhibitory effect on PDI. ECG and EGCG are major active components.
ABSTRACT
Objective To assess the diagnostic value of contrast enhanced ultrasound (CEUS),elastography and their combined use in diagnosing thyroid nodules of thyroid imaging reporting and data system (TI-RADS) 4. Methods From November 2011 to August 2016, 159 TI-RADS 4 nodules diagnosed by conventional ultrasound were prospectively enrolled and examined by CEUS and elastography before surgery. Multivariate logistic regression models were established for CEUS and CEUS combined with elastography to diagnose thyroid malignancy. The diagnostic performances of CEUS, elastography and their combined use were evaluated with the receiver operating characteristic (ROC) curve. The sensitivity,specificity, accuracy, positive predictive value, negative predictive value and omission diagnostic rate of CEUS, elastography and their combined use were compared by Chi-square test. Results The CEUS features significantly predicting malignancy were heterogeneous enhancement, hypoenhancement, without or incomplete ring-enhancement and later time to peak than the surrounding parenchyma (χ2=24.378, 69.194,29.434 and 7.375, all P 0.05). Conclusion The diagnostic value of CEUS combined with elastography was remarkably significant in the differential diagnosis of TI-RADS 4 nodules.
ABSTRACT
Objective To evaluate the diagnostic value of gray-scale ultrasonography (GSU) combined with contrast-enhanced ultrasonography (CEUS) and real-time elastography imaging (EI) in solid thyroid nodules.Methods A total of 124 solid nodules were collected from Xuanwu Hospital of Capital Medical University from September 2011 to November 2014, including 49 benign nodules and 75 malignant nodules conifrmed by surgical pathology. The data of multimodal imaging were retrospectively analyzed and compared with the pathological results. The parameters among the groups were compared byχ2 test. Four diagnostic models including the statistically signiifcant independent variables were established accord to different combinations of routine ultrasound examination. The binary Logistic regression equation using the pathological results as the dependent variable Y and the ultrasound features of thyroid nodules as independent variableX was established for calculating the area under the receiver operator curve (ROC) and multiple regression analysis furthermore.Results There were statistically significant differences in aspect ratio, margin condition, echo type, CEUS features, elastic imaging score and elastic strain rate of benign and malignant thyroid nodules(χ2=13.966, 7.106, 24.215, 17.250 and 27.158,P<0.05).The four Logistic regression models were statistically signiifcant (χ2=5.37, 5.37, 8.155, 8.155, allP<0.05). By using modelⅠ,Ⅱ,Ⅲ andⅣ, the diagnostic sensitivity, speciifcity and accuracy of malignant nodules were (73.8%, 75.9%, 79.7%, 83.3%), (67.5%, 70.7%, 85.2%, 86.7%), and (71.8%, 74.2% 81.8%, 84.4%) respectively. The area under the ROC of logistic equation predicted values were (0.778, 0.809, 0.875 and 0.898, allP<0.01). Multivariate categorical analysis showed that aspect ratio, margin condition and the elastic strain rate ratio (χ2=13.73, 7.541 and 11.461, allP<0.05) of thyroid nodules were effective diagnostic indicators. Conclusions Our study indicated that CEUS and EI could be helpful modality for GSU to improve the diagnostic accuracy of thyroid nodules. The combined application of multi mode ultrasound examination has a high diagnostic value.
ABSTRACT
Objective To compare the value of transrectal real -time elastography ( TRTE) with dynamic contrast material -en-hanced magnetic resonance imaging (DCE-MRI) for prostate cancer detection.Methods A total of 60 men (mean age 71years, range 43 to 83) with serum PSA levels of greater than 4.0ng/ml were assessed using gray -scale transrectal ultrasound (TRUS), transrectal real-time elastography ( TRTE ) and dynamic contrast material -enhanced magnetic resonance imaging ( DCE -MRI ) .Subsequently , these patients underwent systematic sextant transrectal biopsy and additional biopsies for positive sites on gray -scale TRUS, TRTE and DCE-MRI.The cancer detection rates of the 3 techniques were compared .Results Cancer was detected in 23 of the 60 patients (23/60,38.3%).TRTE and DCE-MRI had a higher sensitivity, specificity and accuracy of 73.9%,78.3%,87.0%,80.1%,75.1%, 89.2%,78.3%,76.7%,88.3%respectively.TRTE and DCE-MRI guided targeted biopsy improve the positive detection rate of pros-tate cancer, compared with TRUS (P<0.05).Conclusion TRTE and DCE-MRI can improve the detection rate of the increase of ser-um PSA in patients with prostate cancer , so as to improve the positive rate of prostate biopsy diagnosis ,provide strong support for clinical diagnosis
ABSTRACT
BACKGROUND:As a new kind of bone repair material, NovaBone has a unique biological activity and good biocompatibility. It has a good binding role in the clinical repair of bone defects, so as to effectively promote the bonding of soft tissue and bone tissue. OBJECTIVE: To explore the clinical effect of NovaBone in the repair of bone defects due to limb fractures. METHODS: Sixty-seven patients with bone defects due to limb fractures were enroled, 37 males and 30 females, aged 17-81 years. Al the patients underwent NovaBone repair. Three days after repair, routine blood test, heart and kidney function, serum complement C3, complement C4, immunoglobulin G, immunoglobulin A, immunoglobulin M were detected; 12 months after repair, X-ray observation was performed for bone graft fusion effect. RESULTS AND CONCLUSION:Al patients presented with stage I healing, and there was no incision infection, rejection or non-specific inflammation. Patients felt no discomfort or developed symptoms in the bone graft region. Laboratory indexes showed no abnormity. At 12 months after treatment, bony union was seen in al patients, and there was 1 case of nonunion, 1 case of possible nonunion, 2 cases of uncertain nonunion, 33 cases of possible union, 30 cases of strong union, with a bone fusion rate of 94%. These findings suggest that NovaBone materials for repair of bone defect due to limb fractures have good biocompatibility and obtain good clinical effect.
ABSTRACT
ObjectiveTo study the utility of multi-modal guiding in transrectal ultrasound-guided prostate biopsies.MethodsA total of 115 consecutive patients suspicious for prostate cancer due to elevated serum prostate specific antigen level were enrolled in this prospective study. All patients underwent transrectal ultrasound (TRUS), transrectal real-time elastography (TRTE) and contrast-enhanced transrectal ultrasound (CETRUS). Both positive sites on above imaging studies and 6 core-systematic biopsy sites were included in transrectal biopsy. The impact of targeted biopsies on the prostate cancer detection rate was analyzed in comparison with prostate biopsy pathology.Results The overall prostate cancer detection rate was 55% (63/115). TRTE and CETRUS had a higher sensitivity, specificity and accuracy of 71% (45/63), 81% (42/52), 76% (87/115), and 65% (41/63), 83% (43/52), 73% (84/115), respectively. Compared with TRUS, TRTE and CETRUS guided targeted biopsy improve the sensitivity of prostate cancer (χ2=14.950, 10.754,P=0.002, 0.013), specificity (χ2=0.256, 20.021,P=0.006, 0.009), accuracy (χ2=5.735,10.361, P=0.020, 0.011). Targeted biopsy could improve the detection rate of prostate cancer (χ2=9.021, 23.176,P=0.042, 0.000). On the operating characteristic (ROC) curve of TRTE, the area under the curve was 0.834 with a 95% confidence interval of 0.742-0.926.ConclusionCombined with the application of new technology of ultrasound to improve positive rate of prostate cancer, improving the multi-mode ultrasound-guided prostate biopsy positive rate, and has important clinical significance for early screening and diagnosis of prostate cancer.
ABSTRACT
Objective To determine the rate of hemorrhagic complications and the possible risk factors in transrectal ultrasound(TRUS)guided prostate biopsies.Methods TRUS guided prostate biopsies were carried out in 252 patients.Chi-aquare test,t test,conditional Logistic regression were used to comparatively analyze the risk factors(age,presence of prostate cancer,the volume of prostate,arterial hypertension,diabetes mellitus,use of acetylsalicylic acid and anticoagulant,number of samples)between hemorrhagic patients and non-hemorrhagic groups.Results Hematuria was the most frequent sing in all complications,corresponding to 19.1% of the cases.According to the general feature analysis between two groups,age and the volume of the prostate were significant different.Multiple factor Loigistic regression analysis showed that patients with or without hemorrhagic complications were significant differences in age(OR=0.97,95% CI:0.942～1.000)and the volume of the prostate(OR=0.989,95% CI:0.9790～0.999).Patients with or without hematuria were significant differences in presence of prostate cancer(OR=0.479,95% CI:0.236～0.975),the volume of the prostate(OR=0.987,95% CI:0.976～0.999)and use of acetylsalicylic acid and anticoagulant(OR=3.589,95% CI:1.133～11.366).Conclusions TRUS guided prostate biopsy is a safe and effective procedure.Age and the volume of prostate are influencing factors for hemorrhagic complications.Presence of prostate cancer and the volume of prostate are influencing factors for hematuria.Use of acetylsalicylic acid and anticoagulant are risk factors for hematuria after biopsy.
ABSTRACT
Objective To evaluate the clinical value of transrectal ultrasound(TRUS)guided biopsies of the prostate cancer(PCA)with serum prostate specific antigen(PSA)level less than 4 μg/L.Methods Fifty-nine patients suspected PCA were underwent TRUS guided-biopsy.The ultrasonographic features of lesions and prostate gland were observed.The PSA,PSA density(PSAD),F/T(free/total PSA ratio),prostatic volume(PV)were compared between PCA group and non-PCA group,and further analyzed the sensitivity and specificity of PSAD and F/T at different thresholds for PCA diagnosis.Results In 59 patients,16 were proved to be cancer by pathological examination,the positive detection rate was 27%.In these 16 patients,12 had lesions on ultrasound,which locatqed in outer gland.The rich vascularity was observed in PCA more than in benign and precancerous lesion.There were statistical significant differences in PSA,PSAD,F/T,PV between PCA and non-PCA groups.When selecting threshold of PSAD and F/T were 0.09 and 0.20,respectively,there were the highest diagnostic specificity and sensitivity.The diagnostic specificity and sensitivity of PSAD were higher than those of F/T.Conclusions TRUS guided biopsies of the prostate is one of the most efficient methods for detection of PCA with PSA level less than 4μg/L.Combining TRUS features with PSA parameters can further increase positive detection rate of PCA.
ABSTRACT
OBJECTIVE:To establish the quality standard of Welie capsule METHO DS :Fritillary bulb,rhizoma corydalis and magnolia bark in the capsule were ident ified with TLC;the contents of berberine hydrochloride was determined with TLC scanning RESULTS:Fritillary bulb,magnolia bark and rhizoma corydalis could be tested out in TLC chromatogram;berberine hydrochloride appeared good linear re lationship in the range of 0 1～1 0?g,r=0 9 991;and the average recovery w as 97 84%,RSD=2 86%(n=5) CONCLUSION:This method can be used to control the quality of Weile capsule