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Objective:To evaluate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis and differential diagnosis of bladder urothelial carcinoma(BUC).Methods:A comparative analysis of 138 patients with bladder lesions (123 cases of BUC and 15 cases of other benign lesions) who were hospitalized in Union Hospital, Fujian Medical University from January 2019 to May 2021 were confirmed by pathology. All patients underwent two-dimensional ultrasound, color Doppler ultrasound, CEUS examination, the time intensity curve (TIC) of the region of interest(ROI) before operation was drawn, the ultrasound examination results with the pathological diagnosis results were compared and its diagnostic efficiency was analyzed.Results:Among the 138 cases of bladder lesions, 98 cases were single lesions and 40 cases were multiple lesions. In all single lesions, 95 cases were found by two-dimensional ultrasound and 3 cases were missed, while in all multiple lesions, 24 cases were found by two-dimensional ultrasound and 16 cases were missed, but all cases could be shown by CEUS. The sensitivity of CEUS to multiple bladder lesions was higher than that of two-dimensional ultrasound ( P<0.05). Besides, the differences between BUC and benign lesions in color blood flow distribution intensity and CEUS performance were significant (both P<0.05). Malignant lesions were mostly "less- to -rich" blood flow signals, and benign lesions were mainly "less- to- no" blood flow signals.In addition, in the CEUS examination, 83.7% (103/123) of BUC were high enhancement, and only 33.3% (5/15) of benign lesions were high enhancement. The diagnostic accuracy, specificity and negative predictive value of CEUS(89.9%, 46.7%, 53.8%) were higher than that of two-dimensional ultrasound(67.4%, 13.3%, 13.3%). The area under the curve, the rising slope and the peak intensity of BUC were all higher than those of benign lesions, and the differences were significant(all P<0.05), but none of them was independent risk factor for BUC ( P>0.05). Conclusions:CEUS can significantly improve the diagnostic sensitivity of bladder multiple lesions and help to improve the diagnostic accuracy of BUC, while the area under the curve, the rising slope and the peak intensity of TIC were not the independent risk factors for BUC.
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Background: Breathing exercise can improve the symptoms of patients with gastroesophageal reflux disease (GERD), but its specific effect and function are controversial. Aims: To evaluate the effect of breathing exercise on GERD. Methods: Randomized controlled trials (RCTs) and cohort studies on breathing exercise in treatment of patients with GERD were retrieved from PubMed, Embase, Cochrane Library, Central Database, Web of Science, AMED, CINAHL, Chinese Academic Journal Full-text Database, China Biology Medicine disc, Wanfang Data Knowledge Service Platform, and Weipu Information Chinese Journal Service Platform. The literatures were screened according to the inclusion and exclusion criteria. Meta-analysis was conducted by RevMan 5.3 software. Results: A total of 7 RCTs and 2 cohort studies involving 396 patients with GERD were included. Meta-analysis results showed that breathing exercise could relieve the short-term symptoms of patients with GERD (WMD=1.34, 95% CI: 0.99-1.70, P<0.01), improve the quality of life (WMD=2.65, 95% CI: 1.96-3.33, P<0.01), decrease the degree of depression (WMD=2.42, 95% CI: 1.41-3.42, P<0.01), reduce the long-term consumption of antacids (WMD=-34.11, 95% CI: -55.75-12.48, P<0.05), increase LES pressure (WMD=1.36, 95% CI: 0.82-1.91, P<0.01), increase tension of diaphragmatic crura (WMD=7.13, 95% CI: 6.22-8.04, P<0.01). Conclusions: Breathing exercise can relieve the symptoms of patients with GERD and enhance the effect of medical treatment to some extent.
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OBJECTIVE@#To explore short-term clinical effect of surgical treatment for ankle fracture with complete rupture of deltoid ligament in young and middle-aged patients.@*METHODS@#From January 2016 to March 2019, 21 young and middle-aged patients with ankle joint fracture and complete rupture of the deltoid ligament were treated with internal fixation and repair of the medial deltoid ligament, including 16 males and 5 females, aged from 21 to 52 years old with an average of (38.6±7.3) years old, the time from injury to operation ranged from 1 to 7 days with an average of (3.8±1.5) days. Fracture healing time and complications were observed, changes of medial malleolus clearance before and after operation were compared, American Orthopaedic Foot and Ankle Society (AOFAS) score wasused to evaluate function of ankle joint at 18 months after operation.@*RESULTS@#Twenty-one patients were followed up from 18 to 26 months with an average of (21.7±1.2) months. The incisions were healed at stageⅠ, and fracture healing time ranged from 8 to 12 weeks with an average of (9.5±1.6) weeks. No wound infection, failure of internal fixation, and nerve injury occurred. Medial malleoius space decreased from (5.83±0.32) mm before operation to (2.69±0.25) mm after operation. Postoperative AOFAS score at 18 months was 91.43±4.14, 14 patients got excellent results, 6 good and 1 fair.@*CONCLUSION@#On the basis of stable fixation of fracture, repair of deltoid ligament could help restoring the medial anatomy of ankle joint in young and middle-aged patients, and could achieve good short term clinical effect.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Ankle Fractures , Ankle Injuries , Ankle Joint , Fracture Fixation, Internal , Ligaments , Treatment OutcomeABSTRACT
Objective:To investigate the diagnostic value of multimodal transvaginal contrast-enhanced ultrasound combined with fallopian tubal patency.Methods:From November 2017 to November 2019, 212 patients with infertility were treated in the outpatient clinic of the Union Hospital of Fujian Medical University. Multimodal contrast-enhanced ultrasonography was used to analyze the diagnostic efficiency differences of four-dimensional transvaginal contrast-enhanced hysterosalpinx (TVS 4D-HyCoSy, 4D), three-dimensional contrast-enhanced hysterosalpingography (TVS 3D-HyCoSy 3D), two-dimensional contrast-enhanced hysterosalpingography (TVS 2D-HyCoSy 2D), and transvaginal harmonic imaging (TVS harmonic imaging, HI) individually and in different combinations. The diagnostic efficiency of tubal patency was compared between the high seniority group and the low seniority group.Results:Two patients gave up the examination because of pain. A total of 420 salpingography in 210 patients were successful, of which 375 were unobstructed and 45 were blocked (13 on the right, 18 on the left, and 7 on both sides). In high seniority group and low seniority group, the diagnostic efficiencies of different mode combinations on fallopian tubal patency were significantly different ( P<0.01). There were significant differences( P<0.05) between 4D+ 3D+ 2D+ HI group and 4D+ 3D+ 2D group, 4D+ 3D+ 2D group and 4D+ 3D group, 4D+ 3D group and 4D group. There was no significant difference ( P>0.05) in the diagnostic efficiency of fallopian tubal patency between high seniority group and low seniority group. Conclusions:The diagnostic efficiency of multimodal transvaginal contrast-enhanced ultrasound combined is higher than that of single mode, and ultrasound doctors in both high and low seniority groups can effectively diagnose fallopian tubal patency, which has important clinical value in the diagnosis of fallopian tube patency.
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Objective:To investigate the value of three-dimensional transvaginal sonography(3D-TVS) in the diagnosis of intrauterine adhesions(IUA) and to analyze the causes of the missed diagnosis.Methods:Forty-seven patients with IUA were examined by three-dimensional transvaginal sonography(3D-TVS), 3D volume imaging (Render imaging) and tomographic ultrasound imaging(TUI imaging) in the Union Hospital of Fujian Medical University from January 2017 to July 2019. The abnormal echo data of the endometrium were recorded and analyzed, and the ultrasound diagnosis and hysteroscopic diagnosis were compared.Results:3D-TVS correctly diagnosed IUA was accurate in the 39 cases whose ultrasound imaging showed an uneven thickness of endometrial echo with the uterine cavity line having different degrees of echo continuity interruption. The diagnostic accuracy rate was 83.0%(39/47). In the Render imaging, 7 cases showed endometrial echo with honeycomb change, 28 cases showed partial echo loss with irregular low echo zone or low echo, and 4 cases showed corneal disappearance of one side. In TUI imaging, the endometrium was partly thinned in varying degrees where echo continuity was interrupted with hypoechoic band-like changes in all 39 cases. Three of the 8 missed IUA cases showed slender endometrium with filiform or membranous adhesions, and the other 5 were patients with uterine endometrial polyps.Conclusions:3D-TVS, Render imaging and TUI imaging technology can display stereo images, which contributes to the better preoperative diagnosis and postoperative follow-up. Care should be taken to avoid missed diagnosis and to improve the diagnostic accuracy for IUA by the techniques.
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Objective:To investigate the value of transrectal ultrasonography(TRUS) in the preoperative diagnosis and tumor T-staging of anorectal malignant melanoma(ARMM).Methods:The clinical and ultrasound data of 19 patients(22 lesions) with ARMM confirmed by pathology from February 2008 to Apirl 2019 in Fujian Medical University Affiliated Union Hospital were collected. TRUS was performed within one week before pathological examination. The sonographic features were summarized, ultrasonic typing was performed according to the lesion size and growth pattern, and the accuracies of preoperative ultrasound diagnosis and tumor staging were analyzed.Results:Among the 22 lesions, 63.64%(14/22) were with a distance of ≤3 cm between the anal verge and the lower margin of tumor, 68.18%(15/22) with regular shape, 81.82%(18/22) with clear boundary, and 63.64%(14/22) with Adler blood flow grading from Ⅱ to Ⅲ. The preoperative TRUS diagnostic coincidence rate was 73.68%(14/19), and the tumor T-staging accuracy was 75%(12/16), respectively.Conclusions:TRUS exhibits certain sonographic characteristics, with high preoperative diagnosis rate and tumor T-staging accuracy in anorectal malignant melanoma, which is of great guiding significance for clinical diagnosis and treatment.
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Objective@#To investigate the value of transrectal ultrasonography(TRUS) in the preoperative diagnosis and tumor T-staging of anorectal malignant melanoma(ARMM).@*Methods@#The clinical and ultrasound data of 19 patients(22 lesions) with ARMM confirmed by pathology from February 2008 to Apirl 2019 in Fujian Medical University Affiliated Union Hospital were collected. TRUS was performed within one week before pathological examination. The sonographic features were summarized, ultrasonic typing was performed according to the lesion size and growth pattern, and the accuracies of preoperative ultrasound diagnosis and tumor staging were analyzed.@*Results@#Among the 22 lesions, 63.64%(14/22) were with a distance of ≤3 cm between the anal verge and the lower margin of tumor, 68.18%(15/22) with regular shape, 81.82%(18/22) with clear boundary, and 63.64%(14/22) with Adler blood flow grading from Ⅱ to Ⅲ. The preoperative TRUS diagnostic coincidence rate was 73.68%(14/19), and the tumor T-staging accuracy was 75%(12/16), respectively.@*Conclusions@#TRUS exhibits certain sonographic characteristics, with high preoperative diagnosis rate and tumor T-staging accuracy in anorectal malignant melanoma, which is of great guiding significance for clinical diagnosis and treatment.
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Poly(3-hydroxybutyrate-co-lactate) [P(3HB-co-LA)] belongs to the polyhydroxyalkanoates (PHA) family and possesses promising properties including biocompatibility and biodegradability. In this study, we directly synthesized P(3HB-co-LA) with glucose by introducing the β-ketothiolase and acetoacetyl-CoA reductase from Ralstonia eutropha, the engineered propionate CoA transferase from Clostridium propionicum and the engineered polyhydroxyalkanoate synthase from Pseudomonas fluorescens strain 2P24 into Escherichia coli. The polymer content was 83.9% (W/W), and the molar percentage of lactate reached 1.6%. On this basis, in order to accumulate lactate, we reduced the activity of respiratory chain by deleting the ubiX gene, which is involved in the synthesis of coenzyme Q8. Moreover, we removed the dld gene to avoid the conversion of lactate to pyruvate during the fermentation. With these manipulations, the molar percentage of lactate in the polymer was improved to 14.1%, with an 81.7% (W/W) of polymer content. The test results indicated that the strategy of reducing the activity of respiratory chain effectively increased the lactate units in the polymer, and it contributed a new approach to change the content of monomer components in the polymer.
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3-Hydroxybutyric Acid , Electron Transport , Escherichia coli , Lactic Acid , Metabolic Engineering , PolyestersABSTRACT
Objective@#To explore the risk factors of predicting white matter hyperintensities progression based on radiomics of MRI of whole-brain white matter.@*Methods@#The imaging and clinical data of 152 patients with white matter hyperintensities admitted to Zhejiang People′s Hospital from March 2014 to October 2018 were retrospectively analyzed. The whole brain white matter on baseline T1WI images of each patient were segmented by SPM12 software package, and images of white matter were imported into AK software for texture feature extraction and dimensionality reduction. At last, least absolute shrinkage and selection operator(LASSO) was used to calculate the score of radiomics signature of each patient. According to the improved Fazekas scale, patients with WMH progression were divided into three groups: any white matter hyperintensities (AWMH), periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH). Statistical differences of clinical factors and radiomics signature between WMH progression subgroups and non-progression subgroups were compared with independent sample t test or Mann-Whitney U test, and Univariate logistic regression was used to select independent clinical risk factors and multivariate logistic regression along with imaging omics tags were used to construct predictive models, which was evaluated by ROC curve. And the correlation between the clinical indicators of independent risk factors and the texture feature of radiomics signature was analyzed.@*Results@#The efficacy of the model for the detection for AWMH progression, PWMH progression and DWMH progression was 0.818,0.778 and 0.824, respectively. Age is an independent risk factor for AWMH progression and DWMH progression[OR(95%CI), 4.776(2.152-10.601) vs. 3.851(1.101-8.245); P<0.05]. BMI is an independent risk factor for DWMH[OR(95%CI), 3.004(1.204-7.370); P<0.05], and hyperlipidemia is an independent risk factor for AWMH and PWMH[OR(95%CI), 4.062(1.834-8.998) vs. 3.549(1.666-7.563); P<0.05]. In AWMH subgroup, Surface Area was negatively correlated with age and low density lipoprotein(LDL) (r=-0.401, -0.312), and Inverse Difference Moment_ALLDirection_offset 1_SD was negatively correlated with age(r=-0.412). In PWMH subgroup, Compactness 1 was negatively correlated with LDL(r=-0.198), and Inverse Difference Moment_angle 0_offset 7 was positively correlated with LDL(r=0.252). In DWMH subgroup, LongRunEmphasis_ALLDirection_offset 7 was negatively correlated with age(r=-0.322), and GLCMEntropy_angle0_offset 4 was negatively correlated with age(r=-0.278). GLCMEntropy_AllDirection_offset4 was negatively correlated with body mass index(r=-0.514).@*Conclusion@#Radiomics based on whole-brain white matter MR imaging can predict WMH progression and identify the risk factors in high-risk populations, thus providing early additional information to conventional magnetic resonance imaging to predict WMH progression.
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OBJECTIVE: To explore the guiding significance of artificial intelligence for clinical practice of breast cancer after operation,and to evaluate the concordance of the Watson for oncology(WFO)with the breast cancer treatment guidelines of NCCN and Chinese Anti-Cancer Association.METHODS: A total of 100 patients who were diagnosed as breast cancer after accepting surgical operations from January 2016 to December 2017 in China-Japan Union Hospital of Jilin University were enrolled.The expressions of ER,PR,Her-2 and Ki-67 protein in cancer tissues after operation were detected by using immunohistochemitry,and inputed the clinical cases information of these 100 patients into the WFO system.Finally,the treatment recommendations were compared with the breast cancer treatment guidelinesof NCCN and the China Anticancer Association.The Kappa test was used to determine the concordance.RESULTS: There were 64 cases(64%)of all 100 patients with the same treatment plans,the clinical stage Ⅱ(42/44 cases,95.5%)to Ⅲ(15/16 cases,93.6%)and triple negative breast cancer(7/8 cases,87.5%)treatment showed a higher concordance(Kappa value ≥ 0.75);The age≥ 41 years old,Luminal A of the immunophenotype and pathological grade Ⅲ also had a certain concordance,and the concordance of 41-55 years old were average,but it is not ideal of the cases that older than 55 years old or the pathological grade Ⅲ;On the contrary,the treatment recommendations of clinical stage Ⅰ(7/40 cases,17.5%),especially for both the lymph node metastasis negative were very inconsistency(Kappa value <0).But there was no statistical significance in the cases of the age ≤ 41 years old,pathological gradeⅠto Ⅱ,Luminal B and HER-2 type of immunophenotype.CONCLUSION: WFO in the patients of clinical stageⅡ to Ⅲ and triple negative breast cancer(P<0.05)has a certain reference value in the afore-mentioned situations;And WFO could be considering in the cases of age ≥ 41 years of age or older,Luminal A of immunophenotype and pathological grade Ⅲ;In contrast,for clinical stage Ⅰ of early breast cancer patients,WFO is not recommended.WFO could offer some reasonable treatment recommendations in partial patients with artificial intelligent computer system,and it may provide clinical decisionsupport for clinicians,and it has some guiding significance in breast cancer postoperative clinical practice,clinical learning and research.
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To discuss the value of color Doppler ultrasonography in the diagnosis and differential diagnosis of ureteral polyps ( U P) . Methods Ninety‐five cases with pathologically proven U P and 104 cases with pathological confirmed urinary tract urothelial carcinoma ( U T UC) were enrolled in the study . T heir positive rate of color Doppler ultrasonography exam preoperatively were retrospectively analyzed and compared with pathological findings . Results Compared with pathological diagnosis , the accordance rate of color Doppler ultrasonography localization were 82 .1% ( 78/95) and 80 .8% ( 84/104) for U P and U T UC respectively ,the accordance rate of qualitative diagnosis were 69 .2% ( 54/78 ) and 90 .5%( 76/84) . Color Doppler ultrasonographic features of U P displayed a clear demarcation between the pipe wall of ureter and surrounding tissue .However ,such clear demarcation could not be found in U T UC . T he accordance rate between two groups has statistically significant difference ( P ＝0 .000 6 ) . Color Doppler ultrasonographic image showed no blood flow in the ureteral polyps ,while mainly minor or medium amount of blood stream signals were found in most tumors of U T UC . According to Adler blood flow grading and the blood flow detective rate ,the two groups demonstrated statistically significant difference ( P ＜0 .05 ) . Conclusions With high resolution color Doppler ultrasonography and flexible operation technique ,it can clearly observe the internal structure of ureter at obstruction end as well as boundary conditions of peripheral tissue ,w hich will play a profound role in preoperative diagnosis and differential diagnosis of U P .
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Objective To investigate the value of high frequency ultrasound combined with color Doppler flow imaging in diagnosis and classification of trauma of penis on the clinical treatment . Methods T he sonographic features of 48 cases with penile trauma were analyzed and compared with treatment outcomes . Results T he ultrasonic findings of penile trauma ranged from penis contusion to penis fracture . According to the sonographic features ,the trauma of penis was grouped as follow s :Type 1 ,penis bruise ( 7 cases) presented with images of continuous penis skin and tunica albuginea ,inhomogeneous echoes of subcutaneous tissue . Type 2 ,corpora cavernosa bruise ( 4 cases ) showed images of continuous tunica albuginea ,inhomogeneous internal echoes of corpora cavernosa without abnormal flow signal . T he corpora cavernosa swelling into honeycomb‐like ,anechoic area of cavernosa with high‐speed artery Doppler signals w hen accompanied by cavernous artery injury . Four cases were treated conservatively . Type 3 ,the skin and subcutaneous tissue contusion ( 6 cases) manifested images of incontinuous and inhomogeneous echoes of skin and subcutaneous tissue but homogeneous echoes of corpora cavernosa and tunica albuginea . Six cases of patients underwent debridement and sutured by local anesthesia . Type 4 ,rupture of tunica albuginea( 26 cases) revealed images of incontinuous and irregular local tunica albuginea ,a hematoma seen between the tunica albuginea and subcutaneous tissue . Type 5 , penile fracture ( 5 cases ) revealed mostly or fully disconnected skin and corpora cavernosa ,tearing of blood vessels . T he patients of type 4 and 5 were all treated surgically . Conclusions Color Doppler ultrasonography could provide accurate assessment and classification for trauma of penis ,w hich is helpful to offer a reliable basis for clinical treatment scheme .
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Objective To investigate the distribution of alleles in 19 autosomal short tandem repeat (STR) loci in Jiangsu Han population.Methods Goldeneye20A kit was used to detect 9 025 samples.Genetic analysis was performed on typing data of 19 autosomal STR loci, and genetic distance with other 17 populations was analyzed.Results All the 19 autosomal STR loci were consistent with the Hardy-Weinberg equilibrium (P＞0.05), with the heterozygosity 0.616 1-0.916 3, probability of match 0.012 8-0.202 6, discrimination power 0.797 4-0.987 2, probability of paternity exclusion 0.310 8-0.828 8, and polymorphic information content 0.561 7-0.913 6.The cumulative discrimination power and cumulative probability of exclusion were 0.999 999 999 999 999 998 434 1 and 0.999 999 989, respectively.The Jiangsu Han population had close genetic distances with the Han population in Tianjin, Hunan and Jilin, and significant difference with Han population in Aletai region in Xinjiang (P＜0.05).Conclusion The STR allele polymorphism data and population genetic parameters of Jiangsu Han population can provide data support for the forensic application of these STR loci in Jiangsu Han population.
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Objective:In this study,through the description of understanding,behavior,evaluation about med-ical alliances,we explore the problems and made recommendations to medical alliances. Methods: A questionnaire survey was conducted on 556 medical staff in 18 medical alliances in Beijing. We used descriptive statistical methods to analyze the situation of cognition and so on. And we compared medical staff evaluation of medical alliances be-tween core hospital and cooperative hospital. Results: Only 5.40 % of medical staff are totally unaware of the medical alliances policy. 38.73 % of the doctors don't conduct two-way referral. 55.69 % of the doctors in the core hospital don't come to the cooperative hospital. 71.40 % of the medical staff think that the operation of the medical alliances is good. There are big differences in the distribution of overall evaluation between core hospital medical staff and cooperative hospital medical staff by rank sum test. Conclusion: The understanding of medical alliances and the evaluation of activities are better. However, the two-way referral effect is not obvious and some specific activities are not ideal.
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Objective:This article analyzes the cognition and satisfaction evaluation of patients in medical alli-ance. Under the medical alliance mode,the present study tries to explore the choice of medical treatment of patients, the first diagnosis of primary health care institutions and its influencing factors, in order to provide reference for the construction of medical alliance. Methods:With the help of stratified sampling method,eighteen (18) medical alli-ances were selected from 16 districts and counties in Beijing. The survey questionnaire was designed to be used as the tool for data collection. A total of 1 280 patients in medical alliance participated in this study. The Chi-square Test and binary logistic regression model were used for statistical analysis. Results:59.12% of patients understand the medical association and related policies. 39.12% of the patients are satisfied with the medical association,51.44% of patients are willing to take first diagnosis at primary health care institutions. The distribution of medical resources in various districts is uneven. The type of hospital visited,the degree of understanding of medical alliance,the expe-rience of medical alliance and the satisfaction toward medical alliance will have an impact on the willingness about basic initial diagnosis,and the influence make a significant statistical sense. Conclusions:The Medical alliance con-struction in Beijing has achieved a certain effect,as first visit at primary health care institutions will be the initial for-mation. But the unbalanced distribution of medical resources in various districts,the service capacity of primary care institutions which does not meet the needs of patients,the insufficient sensitization of relevant policy and the current health insurance policy are seen as limiting factors to the development of medical alliance.
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BACKGROUND: Polymethylmethacrylate (PMMA), commonly known as bone cement, has been widely used in the orthopedic surgery. It ensures the immediate stability of prosthesis and the minimal micromotion at the cement-bone interface, allowing early weight-bearing after surgery. OBJECTIVE: To investigate the biomechanical performance of Sanders type III fracture of the calcaneus by using PMMA bone cement as a treatment. METHODS: Eight adult cadaveric ankle and calcaneus specimens were selected and served as normal controls after detection of biomechanical properties. Another eight specimens were collected and randomized into experimental group and control group to make a model of Sanders type III fracture in the calcaneus. In the experimental group, PMMA bone cement was injected into the defect area. In the control group, the artificial bone was implanted in the defect area and a steel plate was used to fix the lateral calcaneus. Biomechanical properties of the specimens in the experimental and control group were detected. RESULTS AND CONCLUSION: (1) Strain and stress of the calcaneus: The stress distribution of the calcaneus in the normal control group was consistent with that in the experimental group, and there was no significant difference between the two groups. The stress of the calcaneus in the experimental group was similar to that in the control group with no significant difference. (2) Displacement and axial stiffness of the calcaneus: Compared with the normal control group, the calcaneal displacement in the experimental group only decreased slightly, and there was no significant difference between the two groups, and likewise, the calcaneal displacement in the control group increased slightly. In the experimental group, the axial compression strength was (21.98±1.88) MPa and the axial compression stiffness was (1 633±150) N/mm. Therefore, there was no significant difference between the experimental group and the normal control group (P > 0.05). (3) Contact strength of the subtalar joint: Fractures basically recovered with good outcomes after PMMA bone cement injection. To conclude, by using PMMA bone cement in the treatment of calcaneus fractures, the scientific validity and clinical utility can be ensured.
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Objective To discuss the value of color Doppler ultrasound in the diagnosis and differential diagnosis of ovarian granulosa cell tumor (OGCT) . Methods Fourteen cases were diagnosed as OGCT by pathology postoperatively had been examined by color Doppler ultrasound check-up before the surgery . In image appearance ,the tumors were divided into cystic mass ,solid mass or mixed cystic-solid mass respectively according to their own pathological features . Additionally ,the blood flowing signal of OGCT was labeled from 0 to 3 grade with Adler standard based on the blood flowing imaging observed by color Doppler flow imaging ( CDFI) . The CDFI results were compared with the pathological diagnosis . Results Ultrasound image appearance of OGCT varied in the 14 cases .Two of them could be characterized as cystic mass ,5 solid mass and 7 mixed cystic-solid mass . The mixed cystic-solid OGCT contained solid mass in multiple cystic degeneration area . There was a significant difference in the diameter among three kinds of OGCT ( P = 0 .0006) . The more visible cystic lesion indicated the longer diameter of OGCT . According to the CDFI ,4 ,5 ,3 and 2 cases were 0 ,1 ,2 ,3 grade respectively in Adler standard . No significant difference was found among the four standards groups ( P =0 .056) . The localization diagnosis accordance rate of the Doppler imaging in OGCT was 71 .4％ (10/14) and the qualitative diagnosis accordance rate was 35 .7％ (5/14) . Conclusions The color Doppler ultrasonography can be the first-line preoperative imaging investigation in the diagnosis and differential diagnosis of OGCT ,as well as in the long-term following after surgery . It can provide more details and evidences for the treatment and prognosis assessment of OGCT .
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Objective To explore the atypical ultrasonic appearances of breast fibroadenoma and analyze the cause of mis diagnosis.Methods A total of 493 lesions in 485 patients of breast fibroadenoma detected by ultrasound examination andconfirmed by pathology were retrospectively analyzed.Atypical appearances were analyzed and misdiagnosis rate were cal-culated.Statistical methods were taken to compare the misdiagnosis rates in lesions with various atypical appearances andthose with none or single atypical appearance.Misdiagnosis rates in lesions with different sizes and pathological types wereanalyzed statically.Then misdiagnosing causes were analyzed.Results A total of 404 lesions were diagnosed correctly,in-cluding 99 lesions with atypical appearances,and the other 89 lesions were misdiagnosed,which showed atypical appear-ances.The misdiagnosis rate of lesions with ≥2 atypical features was higher than that with none or single atypical feature(x2 =256.40,P＜ 0.05).Large lesions (maximum diameter＞ 3 am) showed higher misdiagnosis rates than small ones(maximum diameter ≤3 cm,x2=6.73,P＜0.05),and complex fibroadenoma lesions also showed higher misdiagnosisrate than simple ones (x2 =188.01,P＜0.05).Conclusion The lesions with various atypical appearances,large size andcomplex fibroadenoma in pathology are easy to be misdiagnosed.
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Objective To discuss the value of color Doppler ultrasonography in the diagnosis and differential diagnosis of urinary tract urothelial carcinoma (UTUC).Methods Color Doppler ultrasonography exam was practiced in 84 UTUC patients preoperatively.According to ultrasound characteristics,lesions was classified into nodular type,wall thickening type and solid mass type,which were confirmed by pathology in all cases postoperatively.Results In the total of 84 cases (76 transitional-cell carcinoma,5 adenocarcinoma and 3 epidermoid carcinoma),lesions infiltrated laminae propria and surrounding tissue in 65 cases.In the nodular type of UTUC,there were nodules raising into lumen.Wall thickening type of UTUC was characterized by irregularly wall thickening,lumen narrowing,truncating and breaking.Similarly,obstruction broke off the ureteral lumen suddenly in solid mass type of UTUC.A clear demarcation could be found between the pipe wall and surrounding tissue in nodular type.However,such clear demarcation could not be found in wall thickening type and solid mass type.The accordance rate of ultrasonographic located diagnosis were 92.9 ％ (78/84),with 6 missed diagnosis cases.The accordance rate of qualitative diagnosis were 89.7％ (70/78).Conclusions As result of color Doppler ultrasonography,there were different relationship between lesion and the peripheral tissue in different types of UTUC.In types of wall thickening and solid mass,the demarcation was unclear and it is easier to violate the surrounding tissue.Color Doppler ultrasonography can provide more effective information for diagnosis and therapy UTUC.
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Objective To compare the clinical efficacy and safety between LARS system and autografts in anterior cruciate ligament (ACL) reconstruction. Methods The PubMed database, China. National Knowledge Infrastructure (CNKI), Chinese biomedical literature database (CBMdisc), and Wanfang database were searched to obtain the published article comparing the LARS and autografts for ACL reconstruction. The references, of the retrieved articles were also read for related articles. Results A total of 9 articles with 456 cases were included in this study. The results showed that Lysholm and Tegner scores were improved significantly after LARS replacement (Lysholm: MD=50. 05, 95% CI 48. 41-51. 68; Tegner: MD = 4. 41; 95% CI 3. 40-5. 42). Compared with autografts, the improvements of Lysholm and Tegner scores for LARS replacement were more significant 2 years postoperatively (Lysholm: MD=0. 20, 95% CI 0. 04-0. 35; Tegner: MD=0. 18, 95% CI 0. 040. 32). Meanwhile, complication (such as synovitis) rate of LARS replacement was low2 years postoperatively, showing no notable difference with that of autograft techniques. Conclusion The LARS artificial ligament is effective and safe for ACL reconstruction. LARS has more advantages than autografts concerning the stability 2 years postoperatively. However, high] quality studies with long-term follow-up are required for further confirmation.