Discussion on the Inhibitory Mechanism of Lanthanum Chloride on Vascular Smooth Muscle Cell Calcification Induced by High Phosphorus Based on NF-κB Signaling Pathway / 中国药房

OBJECTIVE：To discuss the inhibitory effect of lanthanum chloride on the calcification of vascular smooth muscle cells（VSMCs）induced by high phosphorus and its mechanism. METHODS ：On the basis of screening the action concentration and time of lanthanum chloride by MTT method ，human VSMCs were divided into control group （1 mmol/L phosphorus solution ）， lanthanum chloride high concentration control group （1 mmol/L phosphorus solution+ 60 μmol/L lanthanum chloride），model group （3 mmol/L phosphorus solution ），sodium chloride group （3 mmol/L phosphorus solution+ 180 μmol/L sodium chloride），nuclear factor κB（NF-κB）signaling pathway agonist+lanthanum chloride group （3 mmol/L phosphorus solution+ 1 μg/mL lipopolysaccharide+ 60 μmol/L lanthanum chloride），positive control group （3 mmol/L phosphorus solution+ 100 μmol/L sodium pyrophosphate），and lanthanum chloride low ，medium，and high concentration groups （3 mmol/L phosphorus solution+ 15，30，60 μmol/L lanthanum chloride）. Alizarin red S staining and Von Kossa staining were used to detect cell calcification in each group after treated with phosphorus solution for 6 d and relevant medicine for 2 d. Western blot assay was used to detect the protein expression of TNF-α receptor associated protein 6（TRAF6），nuclear factor κB inhibitor protein α（IκBα），NF-κB p65，bone morphogenetic protein 2 （BMP-2），smooth muscle 22 α（SM22α）and Runt related transcription factor 2（Runx2）. Real-time fluorescence quantitative polymerase chain reaction was used to detect mRNA expression of TRAF 6，IκBα，BMP-2，SM22α and Runx2. RESULTS ： Compared with control group ，no cell calcification was observed in the lanthanum chloride high concentration control group ，while obvious cell calcification and significant increase of OD value were observed in model group and sodium chloride group （P＜ 0.01）；protein and mRNA expression of TRAF 6 and BMP- 2 in cytoplasm as well as mRNA expression of Runx 2，protein expression of NF-κB p65 and Runx 2 in nucleus were significantly increased （P＜0.01）；protein and mRNA expression of IκBα and SM22α as well as protein expression of NF-κB p65 in cytoplasm were significantly decreased （P＜0.01）. Compared with model group，cell calcification was significantly improved in lanthanum chloride groups and positive control group ，while OD values were significantly reduced ；the expression levels of the above-mentioned protein and mRNA were reversed to varying degrees （P＜0.05 or P＜0.01）. Compared with lanthanum chloride high concentration group ，obvious cell calcification was observed in NF-κB signaling pathway agonist + lanthanum chloride group ，and OD value was significantly increased ；the above indexes were significantly reversed in cytoplasm and nucleus （P＜0.05 or P＜0.01）. CONCLUSIONS ：Lanthanum chloride can inhibit the calcification of VSMCs induced by high phosphorus ，and its mechanism may be related to the inhibition of NF-κB signaling pathway activation.

Quantitative evaluation of fibrosis by geometrical characteristics of hepatic capsule based on ultrasonic images:an experimental study / 中华超声影像学杂志

Objective To explore the feasibility of quantitative evaluation in fibrosis by geometrical characteristics of hepatic capsule based on computer technology . Methods Fifty-nine rabbits models of fibrosis were established and then were divided into four groups according to the results of pathologic examination:S0-S1 ,S2 ,S3 and S4 groups . Two-dimensional high-frequency ultrasound images of hepatic capsule of the rabbits were collected at 6th week ,12th week and 18th week . All the images were collected to obtain the contour line of the capsule and its shape control points by combining manual monitoring and gradient optimization methods . Subsequently ,the mean value and variance of angles between adjacent seed points and the number of continuous segments of the contour line ,were extracted to evaluate the smoothness and continuity of the contour line of the hepatic capsule . Results With aggravating fibrosis ,the mean value and variance of the angles were gradually increased ,and the differences between S0-S1 and other 3 groups were all statistically significant( P <0 .05) . Similarly ,the number of segments required to make the sum of lengths of continuous segments reach up to 80％ of the total width of the imaging section was gradually increased . The differences between S0-S1 and S4 group( P =0 .025) ,S2 and S4 group( P =0 .004) were also statistically significant . Conclusions Analysis of geometrical characteristics of the hepatic capsule partially indicates the presence of early-stage fibrosis ,and is expected to provide a quantitative method for non-invasive assessment of fibrosis .

Multimodal ultrasonographic characteristics of primary thyroid lymphomas / 中华医学超声杂志（电子版）

Objective To summarize the multimodal ultrasonographic characteristics primary thyroid lymphoma (PTLs), and to discuss the diagnosis and differential diagnosis of PTLs. Methods Multimodal ultrasonographic charactericsits of six cases of PTLs were analyzed retrospectively. All of the patients were examined by the conventional two-dimensional ultrasound (2DUS), color Doppler flow imaging (CDFI), contrast-enhanced ultrasound (CEUS), three-dimensional ultrasound (3DUS) reconstruction and elastography imaging (EI) from October 2011 to February 2016 in Changzheng Hospital, affiliated to Secondary Military Medical University. All diagnoses were confirmed by ultrasound-guided percutaneous biopsy.Results (1) 2DUS: six cases of PTLs without capsule were observed as diffusely enlargement type (two cases), unilateral nodular type (one case, on left lobe),and bilateral multiple nodular type (the other three cases). The margin of the multiple nodules were not clear, and some nodules were fused with each other.There were four cases of heterogeneous (extremely) hypoechogenicity and two cases of mixed echogenicity, All of the lesions were characterized by various striped and reticular hyperechogenicity interiorly on ultrasonograms, and only one case showed slightly posterior enhancement. Except one case, multiple cervical lymphnodes hyperplasia were identified on neck regionⅡ-Ⅴin five cases. (2) CDFI and CEUS:CDFI showed abundant blood flow signals in the PTLs nodules peripherally and internally. The striped blood flow was observed in the lesions, and spectrum showed as artery and veins. The plentiful vascular tree was also found in the enlarged lymphnodes. By using high frequency CEUS, six cases of the PTLs demonstrated diffuse and heterogeneous enhancement significantly, including little necrosis area without prominent contrast agent filling in two cases. (3) 3DUS reconstruction: Various striped and reticular hyperechoic features were found on the surface of six cases of PTL nodules. (4) EI: All lesions were soft in six cases. The ratio of elastic strain rate was 1.28-1.96, average (1.82±0.29).Conclusion The ultrasonographic features of PTLs are of certain characteristics, and multiple modes of ultrasound examination can help to grasp the comprehensive imaging informations of PTLs, which should be encouraged positively to facilitate the early detection, early diagnosis and early treatment for PTLs.

Analysis of the impact of ultrasographer′s experience in diagnosing porcine striped muscle injury from thermal and chemical factors / 中华医学超声杂志（电子版）

Objective To investigate the ultrasonic and pathological features of porcine striped muscle injury from thermal and chemical factors respectively, and to analyze the limitation of ultrasound diagnosis given by doctors with different skill levels. Methods An experimental study using fresh porcine striped muscle in vitro was designed, where the injury were caused by microwave ablation (2 450 MHz) and Anhydrous acetic acid (99.8%) injection separately. Blind to pathologic results, the two-dimensiona sonograms taken from each model were analyzed by sonographers with different skill levels independently. Finally, the diagnoses were evaluated and compared among them. Results Two-dimensional sonograms showed distinct changes of the textures in both injury models, which was characterized as the disappearance of regular tissue structure. However, the corresponding histopathology revealed obvious differences between the two interventions on ultrasonograms. There was no statistical difference between chief physician and attending doctor (both of them had over 5-year experiences on skeletal muscle ultrasound ) in identifying the ultrasonic features of boundary, shape and muscle texture (Kappa=0.933, 0.845, 0.789;Kappa=0.790, 0.935, 0.865, all P<0.05). Compared with residents′diagnosis, there were signiifcant differences in identifying the ultrasonic features of echo level and muscle texture in both injury models:Echo level in thermal injury group:chief physician vs residents, Kappa=0.323;attending doctor vs residents, Kappa=0.297. Texture feature in thermal injury group:chief physician vs residents, Kappa=0.259;attending doctor vs residents, Kappa=0.112. Texture feature in chemical injury group:chief physician vsresidents, Kappa=0.253;attending doctor vs residents, Kappa=0.070. Conclusions Microwave ablation and Anhydrous acetic acid can cause different histopathologic changes in correspondence with various features on two-dimensional sonograms. But ultrasonographers with different skill levels leads to signiifcant variations in identiifcation and qualitative diagnosis, which is impossible to be quantitatively analyzed. Chief physician and attending doctor can draw a consistent conclusion and demonstrate the ultrasounic characteristics in porcine striped muscle injury model from thermal or chemical factors.

Ultrasound-guided percutaneous lauromacrogol injection therapy for simple hepatic or renal cysts / 中华超声影像学杂志

Objective To make a comparative assessment on both the therapeutic effects and side effects between percutaenous lauromacrogol injection therapy(PLIT) and percutaenous ethanol injection therapy(PEIT) for simple hepatic or renal cyst.Methods In group A,55 patients with simple hepatic or renal cysts underwent ultrasound-guided aspiration and successive PLIT.The intra-operative side effects were investigated and the therapeutic effects assessment by using ultrasonography was conducted 3 months after the treatment.In group B,60 patients with simple hepatic or renal cysts had received ultrasound-guided aspiration and PEIT sometime before.The intra-operative side effects and therapeutic effects on the thirdmonth ultrasonography were independently reviewed according to their case records.Results In group A,3 patients(5.5 ％) expressed slight discomfort but not pain while receiving lauromacrogol injection.Follow-up ultrasound examination at the end of third month demonstrated the cysts in 43 patients completely regressed,while cysts in rest 12 patients shrank over 50 ％ in size,showing the overall response rate(ORR) and completely cure rate(CCR) were 100％ (55/55) and 78.2％ (43/55) for PLIT respectively.In group B,12 patients(20％) suffered from slight to moderate irritating pain or drunk performance.The third-month ultrasound examination disclosed that cysts in 47 patients completely vanished,and cysts in the other 13patients shrank more than a half,indicating the ORR and CCR were 100％ (60/60) and 78.3 ％ (47/60) for PEIT respectively.Conclusions Although their therapeutic efficacy are perfectly similar,PLIT is much more superior to PEIT in term of less and minor side effects.