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BACKGROUND@#Three-dimensional shear wave elastography (3D-SWE) is a promising method in distinguishing benign and malignant thyroid nodules. By combining with conventional method, it may further improve the diagnostic value. The study aimed to assess the diagnostic value of American College of Radiology (ACR) thyroid imaging reporting and data system (TI-RADS) combined with 3D-SWE in ACR TI-RADS 4 and 5 thyroid nodules.@*METHODS@#All nodules were examined by conventional ultrasonography, ACR TI-RADS classification, and 3D-SWE examination. Conventional ultrasonography was used to observe the location, size, shape, margin, echogenicity, taller-than-wide sign, microcalcification, and blood flow of thyroid nodules, and then ACR TI-RADS classification was performed. The Young's modulus values (3D-C-Emax, 3D-C-Emean, and elastography standard deviation [3D-C-Esd]) were measured on the reconstructed coronal plane images. According to the receiver operating characteristic (ROC) curve, the best diagnostic efficiency among 3D-C-Emax, 3D-C-Emean, and 3D-C-Esd was selected and the cut-off threshold was calculated. According to the surgical pathology, they were divided into benign group and malignant group. And appropriate statistical methods such as t -test and Mann-Whitney U test were used to compare the difference between the two groups. On this basis, 3D-SWE combined with conventional ACR TI-RADS was reclassified as combined ACR TI-RADS to determine benign or malignant thyroid nodules.@*RESULTS@#Of the 112 thyroid nodules, 62 were malignant and 50 were benign. The optimal cut-off value of three-dimensional maximum Young's modulus in coronal plane (3D-C-Emax) was 51.5 kPa and the area under the curve (AUC) was 0.798. The AUC, sensitivity, specificity, and accuracy of conventional ACR TI-RADS were 0.828, 83.9%, 66.0%, and 75.9%, respectively. The AUC, sensitivity, specificity, and accuracy of combined ACR TI-RADS were 0.845, 90.3%, 66.0%, and 79.5%, respectively. The difference between the two AUC values was statistically significant.@*CONCLUSIONS@#Combined ACR TI-RADS has higher diagnostic efficiency than conventional ACR TI-RADS. The sensitivity and accuracy of combined ACR TI-RADS showed significant improvements. It can be used as an effective method in the diagnosis of thyroid nodules.
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Humans , Thyroid Nodule/pathology , Elasticity Imaging Techniques/methods , Retrospective Studies , Ultrasonography/methodsABSTRACT
Objective:To explore the pathological mechanism of SN hyperechogenicity by investigating the characteristics of substantia nigra (SN) hyperechogenicity on transcranial sonography (TCS) and serum iron metabolism parameters in the postural instability gait difficulty and tremor dominant subtypes of Parkinson′s disease (PD), and the correlation between them.Methods:A total of 155 PD patients recruited in Parkinson′s Disease Specialty in the Second Affiliated Hospital of Soochow University from January 2019 to December 2021 were divided into postural instability gait difficulty group( n=95) and tremor dominant group( n=60). Meanwhile, 49 healthy gender- and age-matched healthy individuals who sought for physical examination during the same period were included as the control group. All subjects underwent TCS and blood test, and the echo of SN between the postural instability gait difficulty group and tremor dominant group, serum iron metabolism parameters among the three groups were compared. The postural instability gait difficulty group and tremor dominant group were subdivided into with SN hyperechogenicity (SN+ )subgroup and without SN hyperechogenicity (SN-) subgroup respectively according to TCS results, and the differences in serum iron metabolism parameters between the subgroups were further compared. The association between SN hyperechogenicity and serum iron metabolism parameters of the postural instability gait difficulty group and tremor dominant group were further analyzed. Results:The total area of bilateral SN+ , the area of SN+ on the larger side, and the ratio of the total area of SN+ to the midbrain area (S/M) in postural instability gait difficulty group were larger than those in tremor dominant group (all P<0.001). The value of serum ceruloplasmin and transferrin in both postural instability gait difficulty group and tremor dominant group were lower than those in control group (all P<0.001), and compared with tremor dominant group and control group, the postural instability gait difficulty group had lower serum ferritin(all P<0.01). In both postural instability gait difficulty group and tremor dominant group, serum ceruloplasmin in SN+ subgroup was lower than that in SN-subgroup ( P=0.001, 0.032). Moreover, there was a negative correlation between serum transferrin and the area of SN hyperechogenicity in two subgroups(postural instability gait difficulty group: rs=-0.454, P<0.001; tremor dominant group: rs=-0.494, P<0.001). Conclusions:Compared with the tremor dominant patients, the postural instability gait difficulty patients have larger area of SN hyperechogenicity and lower serum ferritin level. The area of SN hyperechogenicity is significantly negatively correlated with serum transferrin level, indicating that the production of this imaging characteristics is related to iron metabolism.
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Objective:To evaluate the clinical value of musculoskeletal ultrasound in the diagnosis of sarcopenia by measuring the muscle mass and hardness of medial head of gastrocnemius.Methods:According to the diagnostic criteria of Asian Working Group for Sarcopenia(AWGS), 60 patients with sarcopenia were selected as the case group and 24 normal elderly people with matched age as the control group.Two dimensional gray-scale ultrasound was used to measure the muscle thickness, pinnate angle and fascicle length of the right gastrocnemius muscle, and the shear wave elastography was used to measure the Young's modulus(the dynamic stiffness)of the muscle in the states of relaxation and contraction, respectively.The differences of various ultrasound parameters between the two groups were compared, and the relativity of muscle thickness of the medial head of the right gastrocnemius muscle, the feather horn, fascicle length in the case group with sarcopenia was analyzed.The value of the ultrasound measurements in predicting sarcopenia was analyzed by ROC curve.Results:The muscle thickness(10.0±2.1)mm, pinnate angle(16.9±3.2)°, fascicle length(30.5±3.2)mm and Young's modulus[(11.5±2.2)kPa in relaxation state, (23.2±4.0)kPa in contraction state]of the right gastrocnemius muscle were lower in the sarcopenia group than in the control group with matched age[(14.8±1.2)mm, (21.7±2.5)°, (34.2±1.6)mm, (15.0±1.5)kPa, (30.6±2.8)kPa, respectively, t=10.454, 3.612, 5.631, 6.922, 8.173, all P<0.05]. The Young's modulus value was lower in relaxed state than in the contraction state.Pearson correlation analyses showed the muscle thickness and Young modulus were negatively correlated with the age( r=-0.307, -0.285, P<0.05), and the muscle thickness was positively correlated with the limb skeletal muscle mass index( r=0.838, 0.761, P<0.01). Logistic regression analysis showed the muscle thickness and Young's modulus were significantly correlated with sarcopenia( OR=4.576, 3.867). ROC analysis revealed that the threshold values of ultrasound examination of the right gastrocnemius muscle medial head for diagnosis of sarcopenia were as follows: muscle thickness of 11 mm, pinnate angle of 17 degrees, fascicle length of 32 mm, Young modulus at the relaxation state of 12.4 kPa.The sensitivity and specificity of muscle thickness for diagnosis of sarcopenia were the best(86.7% and 100%, respectively)as compared with other measurements. Conclusions:The measurement of muscle mass and muscle hardness of the medial head of gastrocnemius by ultrasound can reflect the decrease of muscle mass and muscle hardness quantitatively, and provide imaging indicators for the prediction of sarcopenia.
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Objective:To construct a chronic obstructive pulmonary disease (COPD) assessment test (CAT) score prediction model based on a deep network fused with air data, and to explore its significance.Methods:From February 2015 to December 2017, the outdoor environmental monitoring air data near the residential area of the patients with COPD from the Respiratory Outpatient Clinics of Peking University Third Hospital, Peking University People′s Hospital and Beijing Jishuitan Hospital were collected and the daily air pollution exposure of patients was calculated. The daily CAT scores were recorded continuously. The CAT score of the patients in the next week was predicted by fusing the time series algorithm and neural network to establish a model, and the prediction accuracy of the model was compared with that of the long short-term memory model (LSTM), the LSTM-attention model and the autoregressive integrated moving average model (ARIMA).Results:A total of 47 patients with COPD were enrolled and followed up for an average of 381.60 days. The LSTM-convolutional neural networks (CNN)-autoregression (AR) model was constructed by using the collected air data and CAT score, and the root mean square error of the model was 0.85, and the mean absolute error was 0.71. Compared with LSTM, LSTM-attention and ARIMA, the average prediction accuracy was improved by 21.69%.Conclusion:Based on the air data in the environment of COPD patients, the fusion deep network model can predict the CAT score of COPD patients more accurately.
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Purpose@#This study was conducted to evaluate the hypothesis that an enlarged prostate in old rats may lead to complications associated with voiding dysfunction involving ionotropic P2X2/3-type purinergic receptors @*Methods@#Intact animals were divided into male young (MYR; 8–10 weeks old) and male old (MOR; 20 months old) rats. The animals underwent simultaneous detrusor electromyography (EMG) and suprapubic cystometry (CMG) under urethane anesthesia. Immunofluorescence techniques were used to evaluate prostatic autonomic innervation and P2X3R expression in bladder urothelial cells. The functional role of P2X3R was characterized by intramuscular application of AF-353, a selective P2X2/3R antagonist. @*Results@#The prostate index significantly increased in MOR, suggestive of an enlarged prostate affecting micturition patterns. Significant EMG and CMG differences were found between MYR and MOR. Higher immunoreactivity for P2X2/3R in the urothelial layer and for prostatic neurofilaments was seen in MOR. Systemic inhibition of P2X2/3R had minimal effects on MYR responsiveness, but improved voiding function in MOR with a marked decrease of intravesical pressure and bladder contractile responses. @*Conclusions@#The data support the hypothesis that an enlarged prostate in MOR may contribute to voiding dysfunction involving activation of P2X2/3R, which enhances a prostate-bladder reflex. This reflex may increase bladder afferent transmission and activation of increased prostate innervation, leading to voiding dysfunction.
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Objective@#To discuss the neuroimaging characteristics of transcranial ultrasound in end-stage renal disease (ESRD) with restless legs syndrome.@*Methods@#Transcranial sonography (TCS) was performed in ESRD with restless legs syndrome (RLS+ group, n=41), ESRD without restless legs syndrome (RLS- group, n=57) and control group (n=47), who were enrolled in the Second Affiliated Hospital of Soochow University from January 2017 to December 2018. The differences of the neuroimaging characteristics of TCS in substantia nigra (SN), brainstem raphe (BR) and red nucleus(RN) among the three groups were analyzed.@*Results@#The rate of SN hypoechogenicity was significantly higher in RLS+ group (36.6%, 15/41) than that in RLS- group (19.3%, 11/57) and control group(8.5%, 4/47) (χ2=10.6, P<0.05). The rate of abnormal BR echogenicity was significantly higher in RLS+ group (34.1%, 14/41) and RLS- group (29.8%, 17/57) than that in control group(10.6%, 5/47) (χ2=7.7, P<0.05). The rate of RN hyperechogenicity was significantly higher in RLS+ group (51.2%, 21/41) than that in RLS- group (21.1%, 12/57) and control group (10.6%, 5/47) (χ2=19.8, P<0.05). Between RLS+ and RLS- groups, when SN, BR and RN were all of positive performance, the accuracy of diagnosing RLS+ reached 70% (7/10).@*Conclusions@#The echogenicity changes of SN, BR and RN on TCS could provide valuable neuroimaging information for the clinical diagnosis and treatment of ESRD with restless legs syndrome.
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Objective To discuss the neuroimaging characteristics of transcranial ultrasound in end‐stage renal disease ( ESRD ) with restless legs syndrome . Methods T ranscranial sonography ( TCS ) was performed in ESRD with restless legs syndrome ( RLS + group , n ＝ 41 ) ,ESRD without restless legs syndrome ( RLS － group , n ＝57) and control group ( n ＝47) ,w ho were enrolled in the Second Affiliated Hospital of Soochow University from January 2017 to December 2018 . T he differences of the neuroimaging characteristics of TCS in substantia nigra ( SN ) ,brainstem raphe ( BR) and red nucleus ( RN ) among the three groups were analyzed . Results T he rate of SN hypoechogenicity was significantly higher in RLS +group ( 36 .6% ,15/41) than that in RLS － group ( 19 .3% ,11/57) and control group( 8 .5% ,4/47) ( χ2 ＝10 .6 ,P＜0 .05) . T he rate of abnormal BR echogenicity was significantly higher in RLS + group ( 34 .1% , 14/41) and RLS － group ( 29 .8% ,17/57) than that in control group( 10 .6% ,5/47) ( χ2 ＝7 .7 , P ＜0 .05) . T he rate of RN hyperechogenicity was significantly higher in RLS + group ( 51 .2% ,21/41 ) than that in RLS － group ( 21 .1% ,12/57) and control group ( 10 .6% ,5/47) ( χ2 ＝19 .8 , P ＜0 .05 ) . Between RLS+and RLS － groups ,when SN ,BR and RN were all of positive performance ,the accuracy of diagnosing RLS+ reached 70% ( 7/10 ) . Conclusions The echogenicity changes of SN ,BR and RN on TCS could provide valuable neuroimaging information for the clinical diagnosis and treatment of ESRD with restless legs syndrome .
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Objective To analyze the multimodal imaging findings of nonspecific granulomatous prostatitis (NSGP)and improve our understanding of the disease.Methods 1 427 patients underwent transrectal ultrasoundGguided prostate biopsies in our department,then 1 3 nodules in 11 patients were proven NSGP by pathology,of which 3 nodules were in inner gland and 10 were in outer gland.The characteristics of these nodules on MRI,transrectal ultrasound elastography (TRE)and contrastGenhanced ultrasonography (CEUS)were retrospectively analyzed. Results MRI:All of the nodules showed similar performances:hypointensity on T1 WI and T2 WI,low ADC and high signal on DWI (highGbGvalue),early enhancement and faded fast or slow,depressed citrate (Cit)and relatively elevated choline (Cho)peak.TRE:The cutGoff point of strain ratio (SR)was determined as 5.97 to diagnose prostate cancer and the SRs of 8 nodules were greater than 5.9 7.CEUS:1 1 nodules showed early enhancement and great intensity,but the rest of nodules showed same performance with normal tissue.Conclusion The multimodal imaging helps to improve the understanding of NSGP and plays a positive role in guiding targeted biopsy.Moreover,the operators could lessen the number of needle punctures properly according to the multimodal imaging findings, which would reduce the risk of puncture complications on patients.
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Objective To investigate the therapeutic effect of endoscopic plastic stent and metal stent placement in relieving obstructive jaundice in patients with pancreatic cancer,and to analyse the cost effectiveness.Methods A retrospective review was performed on the clinical data of 102 pancreatic cancer patients with obstructive jaundice in General Hospital of Northern Theater Command between January 2013 to January 2014.The patients were divided into plastic stent group (n =26) and metal stent group (n =76)based on the type of biliary stent placed under endoscopy.The complication and short-term therapeutic effect were compared between two groups.The number of endoscopic stent placement,treatment interval,hospitalization cost and median survival time were recorded.Results The levels of alanine aminotransferase (ALT) and total bilirubin (TBiL) in the two groups 5-7 days after endotherapy were significantly lower than those before treatment,but the difference was not statistically significant between the two groups (P ＜0.05).No severe complication was observed.The average number of treatments in the metal stent group was significantly lower than that in the plastic stent group (1.7 times vs 2.9 times),and the treatment interval was significantly longer[(271.7 ± 42.3) d vs (113.4 ± 38.2) d].The difference above between these two groups was statistically significant (P＜0.05).However,there was no significant difference on the average total hospitalization cost (84227.2 yuan vs 86906.8 yuan) or median survival time (15.6 months vs 13.1 months)between these two groups.Conclusions Primary placement of metal biliary stents for obstructive jaundice in adult patients with metastatic pancreatic carcinoma was cost-effective than plastic stents,and their effects were comparable.
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Fifty postherpetic neuralgia (PHN) patients with a course ≥3 years and the Pain Numeric Rating scale (NRS)≥5 were included in the analysis.All patients were treated with nerve block and subcutaneous injection in the affected area.The paravertebral nerve blocks were performed by injecting 5 ml lidocaine in the concentrations of 0.3％;the concentration of lidocaine for branch blockage and peripheral nerves was 1.0％,and that for subcutaneous injection was 0.3％,respectively;2 mg dexamethasone and 0.5 mg vitamin B12 were added in the injections.The NRS scores and quality of life scores were documented before and after the treatment.The NRS score was significantly decreased at different time points of treatment (F=279.6,P＜0.01).At the end of the treatment and at 1 month,3months,6months of follow-up,the scores were significantly lower than those before the treatment.All patients showed enormous improvement in the quality of life at 1,3 and 6 months after treatment.The pain relief was "excellent" or "good" in 38 cases.The efficacy of treatment is associated with skin scar and allodynia.The study indicates that nerve block and subcutaneous injection has a satisfactory efficacy in treatment of chronic postherpetic neuralgia.
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OBJECTIVE:To investigate therapeutic efficacy of ezetimibe combined with tirofiban in the treatment of acute coronary syndrome patients and its influence on the content of ischemia modified albumin (IMA) in peripheral blood.METHODS:A total of 82 patients with acute coronary syndrome in our hospital from Jan.2016 to Jan.2017 were divided into observe group and control group according to random number table,with 41 cases in each groups.All patients were given general treatment containing statins,glyceryl trinitrate and so on.Control group was additionally given Ezetimibe tablet 10 mg orally once a day.Observation group was additionally given Tirofiban hydrochloride sodium chloride injection 5 mg intravenously once a day,on the basis of control group,for consecutive 15 d.Clinical efficacies of 2 groups were evaluated.The dose of glyceryl trinitrate,duration and frequency of angina pectoris attack,left ventricular function indexes (SV,LVDD,CO,LVEF) were compared before treatment and after last medication.The contents of IMA in peripheral blood were detected before treatment and 3,6,9,12,15 h after the first day medication.ADR of the 2 groups were observed closely during the treatment.RESULTS:The total response rate of observation group was 92.7％,which was significantly higher than 72.3％ of control group (P＜0.05).Compared with before treatment,dose of glyceryl trinitrate and the content of IMA in 2 groups were decreased significantly after last medication,duration and frequency of angina pectoris attack were shortened significantly;the levels of SV,CO and LVEF were increased significantly while the level of LVDD was decrease significantly;the effect of observation group was significantly better than that of control group,with statistical significance (P＜0.05).No severe ADR was found in all patients during the treatment.CONCLUSIONS:Based on general treatment of glyceryl trinitrate therapeutic efficacy of ezetimibe combined with tirofiban is better than that of ezetimibe alone in the treatment acute coronary syndrome patients,and can decrease the content of IMA in peripheral blood more quickly.
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Objective The present research aimed to explore the relationship of serum CA19-9,CEA,CA125 and sICAM-1 concentration with the diagnosis valuation and tumor metastasis of pancreatic cancer.Methods Ninety pancreatic cancer patients in First Affiliated Hospital of Hebei North University from January 2014 to December 2016 were enrolled in this study.The concentrations of serum CA19-9,CEA,CA125 and sICAM-1 were assayed in different stage of pancreatic cancer patients.The concentrations of these parameters were also detected in metastasis patients and non-metastasis patients.In the same period,90 cases of health examination as contrd group.Measurement data were represented as ~ ± s.Comparison between groups was analyed using t test.single-factor analysis of variance (ANOVA) was used for comparison among groups,and the resuhs were compared by F test.The correlation analysis was performed by spearman method.Results The results showed that CA19-9/ β-actin (control group and Ⅰ / Ⅱ / Ⅲ/Ⅳ stage pancreatic cancer were 0.25 ± 0.03,0.27 ± 0.04,0.31 ± 0.06,0.38 ± 0.09,0.68 ± 0.10,respectively),CEA/β-actin (control group and Ⅰ / Ⅱ / Ⅲ/Ⅳ stage pancreatic cancer were 0.29 ±0.07,0.34 ±0.08,0.47 ±0.09,0.58 ±0.12,0.68 ±0.14,respectively),CA125/β-actin(control group and Ⅰ/Ⅱ/Ⅲ/Ⅳ stage pancreatic cancer were 0.31 ±0.05,0.36 ±0.07,0.55 ±0.13,0.58 ±0.14,0.63 ± 0.14,respectively),sICAM-1/β-actin (control group and Ⅰ/Ⅱ/ Ⅲ /Ⅳ stage pancreatic cancer were 0.34 ± 0.05,0.36 ± 0.08,0.41 ± 0.08,0.49 ± 0.10,0.58 ± 0.12,respectively) were higher in pancreatic cancer than control(P ＜0.05).The tumor metastasis group was higher than tumor un-metastasis group CA19-9/β-actin(un-metastasis group and metastasis group was 0.36 ± 0.09,0.58 ± 0.12),CEA/β-actin (un-metastasis group and metastasis group was 0.42 ± 0.09,0.61 ± 0.14),CA125/β-actin (un-metastasis group and metastasis group was 0.48 ± 0.09,0.60 ± 0.14),sICAM-1/β-actin (un-metastasis group and metastasis group was 0.42 ±0.09,0.52 ± 0.10) (P ＜ 0.05).The results showed that CA19-9,CEA,CA125 and sICAM-1 concentrations are positively (r value were 0.832,0.698,0.748 and 0.845) with the metastasis of pancreatic cancer patients while negatively with the prognosis (r value were-0.867,-0.832,-0.916 and-0.908) and clinical stage (r value were-0.815,-0.896,-0.798,and0.912) of pancreatic cancer patients.Conclusion CA19-9,CEA,CA125 and sICAM-1 concentrations are positively related with the metastasis of pancreatic cancer patients while negatively with the clinical stage and prognosis of pancreatic cancer patients.
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PURPOSE: To characterize the electromyographic activity of abdominal striated muscles during micturition in urethane-anesthetized female mice, and to quantitatively evaluate the contribution of abdominal responses to efficient voiding. METHODS: Cystometric and multichannel electromyographic recordings were integrated to enable a comprehensive evaluation during micturition in urethane-anesthetized female mice. Four major abdominal muscle domains were evaluated: the external oblique, internal oblique, and superior and inferior rectus abdominis. To further characterize the functionality of the abdominal muscles, pancuronium bromide (25 μg/mL or 50 μg/mL, abdominal surface) was applied as a blocking agent of neuromuscular junctions. RESULTS: We observed a robust activation of the abdominal muscles during voiding, with a consistent onset/offset concomitant with the bladder pressure threshold. Pancuronium was effective, in a dose-dependent fashion, for partial and complete blockage of abdominal activity. Electromyographic discharges during voiding were significantly inhibited by applying pancuronium. Decreased cystometric parameters were recorded, including the peak pressure, pressure threshold, intercontractile interval, and voiding duration, suggesting that the voiding efficiency was significantly compromised by abdominal muscle relaxation. CONCLUSIONS: The relevance of the abdominal striated musculature for micturition has remained a topic of debate in human physiology. Although the study was performed on anesthetized mice, these results support the existence of synergistic abdominal electromyographic activity facilitating voiding in anesthetized mice. Further, our study presents a rodent model that can be used for future investigations into micturition-related abdominal activity.
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Animals , Female , Humans , Mice , Abdominal Muscles , Electromyography , Lower Urinary Tract Symptoms , Muscle, Striated , Neuromuscular Junction , Pancuronium , Physiology , Rectus Abdominis , Relaxation , Rodentia , Urinary Bladder , UrinationABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical therapeutic effects and safety on infertility of polycystic ovary syndrome (PCOS) in the patients with ovulation induction with letrozole in the treatment with the formula for regulating menstruation and removing phlegm and electroacupuncture (EA).</p><p><b>METHODS</b>A total of 120 patients of PCOS infertility were randomized into 3 groups, 40 cases in each one. In the group A, diane-35 was prescribed for oral administration (one tablet a day since the 5th day of menstruation, continuously for 21 days). After 1 course of treatment (3 months), letrozole was used (one tablet a day since the 5th day of menstruation, continuously for 5 days) for ovulation induction for another 1 course (3 months). In the group B, on the basis of the treatment as the group A, since the 5th day of menstruation, the Chinese herbal formula was combined to regulate menstruation and remove phlegm, one dose a day and discontinued during menstruation. In the group C, on the basis of the treatment as the group B, EA was added since the 5th day of menstruation. The main acupoints were Guanyuan (CV 4), Zusanli (ST 36) and Fenglong (ST 40), etc. EA was applied once every 2 days and discontinued during menstruation. In all of the 3 groups, the treatment for 3 months was as 1 course and the 2 courses were required continuously. Before and after treatment, the menstruation improvements, body weight, body mass index (BMI), serum sex hormones [luteal production hormone (LH), follicle stimulating hormone (FSH), LH/FSH, total testosterone (T) and estradiol (E)] were observed in the patients of each group. The enzyme linked immunosorbent assay was adopted to determine the content of anti-mullerian hormone (AMH) and inhibin B (IHNB). The therapeutic effects, safety, ovulation rate and pregnancy rate were compared among the 3 groups.</p><p><b>RESULTS</b>(1) The differences were significant statistically in the total effective rate, ovulation rate and pregnancy rate in comparison of the 3 groups (all<0.05). The results in the group C were the best and those in the group B were the better in the comparison of the 3 groups. (2) After treatment, the menstrual cycle was remarkably shortened in the 3 groups (all<0.05). The result in the group C was better than that in the group A (<0.05). After treatment, the body weight in the group B and group C was all reduced (both<0.05). The reducing degree in the group C was better than that in the group A (<0.05). The differences in BMI were not significant statistically before and after treatment in each group as well as in comparison among the groups (all>0.05). (3) After treatment, the levels of LH and LH/FSH were all reduced remarkably in the 3 groups (all<0.05). The differences were not significant statistically in comparison among the three groups (all>0.05). After treatment, in the group B and group C, the levels of T and AMH were all reduced remarkably (all<0.05), in which, T value in the group C was lower than that in the group A and group B, that in the group B was lower than the group A (all<0.05). AMH value in the group C was lower than that in the group A (<0.05). The differences were not significant statistically in FSH, Eand IHNB before and after treatment in each group as well as in comparison among the 3 groups (all>0.05). (4) The luteinized unreuptured follicle syndrome (LUFS) did not happen in the group C. There were 3 cases of LUFS (7.5%) in the group B and 5 cases (12.5%) in the group A.</p><p><b>CONCLUSION</b>For PCOS infertility patients receiving ovulation induction with letrozole, the combined treatment with the Chinese herbal formula for regulating menstruation and removing phlegm and EA remarkably improves the menstrual cycle, reduces body weight and the levels of LH, LH/FSH, T and AMH, improves ovulation and pregnancy rates. This therapy does not induce adverse reactions and the therapeutic effects are better than the simple application of letrozole or the combined therapy of letrozole and Chinese herbal medicine.</p>
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Objective To study the value of CA19-9,s-ULBP2 and Dkk1 in the diagnosis of pancreatic cancer and the correlation. Methods From January 2016 to May 2017,56 patients with pancreatic cancer in our hospital were selected,45 healthy subjectsand 33 patients with benign pancreatic diseaseswere enrolled in this study.The differences of serum CA19-9,Dkk1 and s-ULBP2 expression and their relationship with clinicopatholog-ical parameters were compared between the three groups. The diagnostic value of CA19-9,s-ULBP2,Dkk1 and joint detection was analyzed.Results The serum levels of CA19-9,s-ULBP2 and Dkk1 in patients with pancreat-ic cancer were significantly higher than those in the benign pancreatic disease group and the healthy control group (P<0.05).CA19-9 and s-ULBP2 are related to TNM staging and histological differentiation,and CA19-9 is also related to tumor location.Joint test was higher than any of the individual indicators.Conclusion CA19-9,s-ULBP2 and Dkk1 are closely related to pancreatic cancer,and the combined detection of the three can improve the diag-nostic accuracy of pancreatic cancer.
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OBJECTIVE:To investigate the effects of tirofiban combined with atorvastation before PCI on the miRNA expres-sion of peripheral blood and vascular endothelial function in acute myocardial infarction(AMI)patients. METHODS:A total of 80 patients with AMI selected from our hospital as reaserch objects during Jan. 2015-Jun. 2016 were divided into control group and ob-servation group according to random number table,with 40 cases in each group. Both groups received anticoagulant therapy. Con-trol group was given Aspirin enteric-coated tablets 300 mg+Clopidogrel sulfate tablets 75 mg+ Atorvastatin calcium tablets 20 mg orally 30 min before PCI. Observation group was additionally given Tirofiban hydrochloride for injection with initial dose of 0.5 mg+0.9％ Sodium chloride injection 100 mL,iv,then adjusted to pump injection of 0.4 μg/(kg·min),30 min later adjusted to pump injection of 0.1 μg/(kg·min),for consecutive 24 h. The levels of peripheral miRNA (miRNA-1,miRNA-133a,miR-NA-208b,miRNA-499),the levels of brachial artery diameter and vascular endothelial function indexes(vWF,ET-1,NO)were observed in 2 groups before medication and after PCI,and the occurrence of ADR was recorded. RESULTS:Before treatment, there was no statistical significance in above indexes between 2 groups(P>0.05). After treatment,miRNA expression,the levels of vWF and ET-1 were decreased significantly in 2 groups,and observation group was significantly lower than control group,with statistical significance (P<0.05). The brachial artery diameter and NO levels of 2 groups were increased significantly,and observation group was significantly greater or higher than con-trol group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLU-SIONS:For AMI,tirofiban combined with atorvastation before PCI can reduce miRNA expression,increase brachial artery diame-ter and protect vascular endothelial function with good safety.
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Objective To assess the features of transcranial sonography (TCS) in Parkinson disease (PD) and Alzheimer disease (AD).Methods Totally 38 PD patients (PD group),28 AD patients (AD group) and 26 controls (control group)underwent TCS.The echogenicity of the substantia nigra,widths of third ventricle and parameters of middle cerebral artery among the three groups were analyzed.Results The ratio of hyperechogenicity of substantia nigra in PD group (31/38,81.58％) were higher than those in AD group (8/28,28.57％) and control group (3/26,11.54％;x2 =18.74,30.41,both P＜0.001),and there was no significant difference in hyperechogenicity of substantia nigra between AD group and control group (x2 =2.41,P=0.120).The widths of third ventricle in AD group ([0.82±0.14]cm) were wider than those in PD group ([0.63±±0.16]cm) and control group ([0.56±0.16]cm,both P＜0.001),and there was no significant difference in widths of third ventricle between PD group and control group (P=0.098).The mean velocities in bilateral middle cerebral artery in AD group were lower than that of in PD group and in control group (all P＜0.05).The pulsatility index in right middle cerebral artery in AD group were greater than that in PD group and control group (both P＜0.05).Conclusion According to the changes of echogenicity of substantia nigra,widths of third ventricle and parameters of middle cerebral artery,TCS may provide some useful information for diagnosis of PD and AD.
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Objective To evaluate the clinical effect of endoscopic retrograde biliary drainage (ERBD) and endoscopic naso-biliary drainage (ENBD) on hilar cholangiocarcinoma (HACC).Methods The clinical data of 87 patients with HACC,who underwent ERBD and ENBD form January 2010 to January 2016,were retrospectively analyzed.The incidence of postoperative severe cholangitis,biliary obstruction again within 4 weeks,reduction of total bilirubin and survival time were studied.Results There were significant differences between ERBD group and ENBD group on the incidence of severe cholangitis[29.2％ (14/48) VS 10.3％ (4/39),x2 =4.689,P=0.030] and bile duct obstruction in 4 weeks after operation [47.9％ (23/48) VS 23.1％ (9/39),x2=5.710,P =0.017].The total bilirubin within 2 weeks and 4 weeks postoperatively was significantly reduced compared with that before operation (P＜0.05).There was no statistical difference in descend range of total bilirubin between the two groups.There was significant difference between ERBD group and ENBD group in the median survival time [14 weeks (range,0-60 weeks) VS 34 weeks (range,2-96 weeks),x2 =10.101,P=0.010].Conclusion Compared to ERBD,ENBD has certain advantages on palliative care for HACC.
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Objective To discuss the neuroimaging characteristics of transcranial ultrasound in Parkinson's disease (PD) patients with or without depression.Methods Transcranial sonography (TCS) was performed in PD patients with depression (PDD +,n =50),PD patients without depression (PDD-,n =50),depression patients (D,n =50) and healthy controls (n =50),who were enrolled in the Second Affiliated Hospital of Soochow University from September 2010 to July 2016.The differences of the neuroimaging characteristics of TCS in brainstem raphe (BR) and substantia nigra (SN) in four groups were analyzed.According to the degree of depression,PDD + and D groups were divided into three subgroups:mild,moderate and severe depression,and the differences of echo characteristics in BR were analyzed among the subgroups.Results The rate of abnormal BR echogenicity was significantly higher in PDD + (78.0％,39/50) and D (82.0％,41/50) groups than that in PDD-(18.0％,9/50) and healthy control (10.0％,5/50) groups (x2 =87.80,P ＜0.01),and there was no statistically significant difference among the subgroups (PDD + group,P =0.98;D group,P =0.57).The rate of SN hyperechogenicity was significantly higher in PDD + (80.0％,40/50) and PDD-(86.0％,43/50) groups than that in D (8.0％,4/50) and healthy control (10.0％,5/50) groups (x2 =110.07,P＜ 0.01).Conclusion The echogenicity changes of BR and SN on TCS could provide some useful neuroimaging information for the diagnosis and differential diagnosis of PDD-from PDD +.
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Objective To investigate the substantia nigra (SN) and brainstem raphe (BR) echogenic features of Parkinson's disease (PD) patients with musculoskeletal pain.Methods A total of 115 PD patients recruited in the Second Affiliated Hospital of Soochow University from October 2014 to May 2016 were assessed with the following rating scales:Unified Parkinson's Disease Rating Scale (UPDRS),Hoehn and Yahr Staging Scale (H/Y),Hamilton Rating Scale for Depression (HRSD),Beck Depression Inventory Ⅱ (BDI-Ⅱ) and Visual Analogue Scale (VAS).All the subjects underwent transcranial sonography during the clinical evaluation.And the patients were divided into PD with musculoskeletal pain (n =54) and PD without musculoskeletal pain (n =61) groups,or PD with depression(n =74) and PD without depression(n =41) groups.Results Compared with PD patients without pain,PD patients with musculoskeletal pain had higher scores of UPDRS-Ⅱ,-Ⅲ,HRSD,BDI,NMSQ and H/Y (UPDRS-Ⅱ score:12.56 ±6.01 vs 8.79 ±4.38,t =-3.801,P ＜0.01;UPDRS-Ⅲ score:24.43 ± 12.43 vs 20.07 ± 11.12,t=-1.986,P=0.049;HRSD score:11.65-±6.94 vs 8.38-±5.36,t=-2.844,P=0.005;BDI score:14.09 ±6.20 vs 9.74 ±6.00,t =-3.826,P ＜0.01;NMSQ score:8.57 ± 4.06 vs 5.60 ± 3.38,t=4.193,P＜0.01;H/Y:2.0(1.5,2.6) vs 1.5(1.0,2.0),Z=-3.011,P=0.003).Positive BR was more frequent in depressed than in non-depressed PD patients without pain (63.6％ vs 14.3％;x2 =15.25,P ＜0.01).Positive BR was positively associated with sex(r =0.228,P =0.014),age(r =0.184,P =0.049),disease duration (r =0.196,P =0.035),and depression (r =0.396,P ＜ 0.01).However,positive BR did not correlate with musculoskeletal pain.No correlation was found between positive SN and clinical characteristics of PD patients.Conclusions PD patients with musculoskeletal pain have worse activity of daily living,more severe motor symptoms,more non-motor symptoms,and are more depressed.SN and BR echogenecity do not correlate with musculoskeletal pain,however,hypoechogenic or interrupted BR is associated with depression in PD patients.