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Objective:To compare the predictive value of contrast-enhanced ultrasound(CEUS) Liver Imaging Reporting and Date System(LI-RADS) version 2017 with magnetic resonance imaging(MRI) LI-RADS version 2018 applied alone or in combination for focal liver lesions in high-risk patients.Methods:From January 2018 to October 2021, the clinical and imaging datas of 212 patients with 300 nodules underwent CEUS and contrast-enhanced MRI(CEMRI) within 4 weeks in Ruijin Hospital and its Wuxi branch were retrospectively analyzed. Each nodule was categorized according to the CEUS LI-RADS v2017 and CT/MRI LI-RADS v2018. Inter-modalities agreement was assessed with Cohen′s Kappa. The diagnostic performances of the two classification criteria applied alone and in combination for the predictive value of malignant risk of focal liver lesions were compared using histopathology or follow-up as gold standard.Results:The inter-modalities agreement of CEUS LI-RADS v2017 and MRI LI-RADS v2018 was moderate (Kappa=0.441). The specificity of CEUS LR-5, MRI LR-5 and CEUS LR-5+ MRI LR-5 in the diagnosis of HCC was 93.66%, 95.07% and 88.73% ( P>0.05), respectively, positive predictive values of them were 93.13%, 93.81% and 89.81%( P>0.05), respectively. The sensitivity of CEUS LR-M, MRI LR-M and CEUS LR-M+ MRI LR-M in the diagnosis of non-HCC malignancy was 85.71%, 82.86% and 100%, respectively. CEUS LR-M+ MRI LR-M had higher sensitivity than MRI LR-M( P=0.033), whereas no difference was found between CEUS LR-M+ MRI LR-M and CEUS LR-M( P=0.063). Conclusions:The inter-modalities agreement of the LI-RADS category between CEUS and MRI is moderate. The specificity and positive predictive values of HCC in LR-5 of the CEUS and MRI LI-RADS are comparable. In addition, the sensitivity of non-HCC malignancy in LR-M of the CEUS and MRI LI-RADS are comparable. The combined application of CEUS and MRI LR-M can improve the diagnostic sensitivity of non-HCC malignancy.
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Objective To investigate the polypropylene mesh used transvaginal Mesh for improve clinical efficacy and benefit the quality of life of pelvic organ prolapse( POP) .Methods 80 patients with POP were randomly divided into A group and B group,40 cases in each group.A group received vaginal mesh suspension surgery for treatment,B group used traditional vaginal hysterectomy and vaginal wall repair for treatment.The operation situations of the two groups preoperation and postoperation, the quality of life after 6 months were compared.Results In A group,the operative time[(83.32 ±21.34)min],blood loss[(87.43 ±33.52)mL],retention catheter time[(3.23 ± 0.54)d],postoperative hospital stay[(5.32 ±0.69)d]were significantly less than those in group B[(1 084.34 ± 27.88)min,(98.65 ±12.43)mL,(2.9 ±0.87)d,7.97d](all P<0.01),and the physiological function,physical function,bodily pain,general health,vitality,social functioning and mental health and other seven dimensions of A group were significantly improved,compared with group B(P <0.01).Conclusion Trans -vaginal Mesh has obvious therapeutic effect and improves patients'living quality on POP.It is worthy of clinical application.
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Objective To establish a new quality control standard for danshen capsules. Methods The qualitative identification of danshen capsules was characterized by ultraviolet fluorescence and thin-layer chromatography( TLC ). The contents of tanshinoneⅡA,cryptotanshinone,salvianolic acid B,danshensu and protocatechuic aldehyde in danshen capsules were determined by high performance liquid chromatography(HPLC)on a C18 column. The flow rate was 1 mL·min-1,and the column temperature was 35 ℃. Results The HPLC linear ranges of tanshinone ⅡA,cryptotanshinone,salvianolic acid B, danshensu and protocatechuic aldehyde were 2. 046-40. 92 μg · mL-1 ,1. 482 25 -59. 29 μg · mL-1 ,1. 502 55 -60. 102 μg·mL-1 ,11. 49-459. 582 μg·mL-1 ,and 0. 617 4-24. 696 μg·mL-1 ,respectively,and r values were 0. 999 9. The average recoveries were 99. 66%(RSD of 0. 91%)for tanshinoneⅡA,99. 26%(RSD of 0. 88%)for cryptotanshinone,99. 09%(RSD of 0. 76%)for salvianolic acid B,100. 51%(RSD of 0. 62%)for danshensu,and 100. 62%(RSD of 0. 82%)for protocatechuic aldehyde,respectively. The contents of the tanshinoneⅡA,cryptotanshinone,salvianolic acid B,danshensu showed a certain high level in the 3 batches of danshen capsule samples,but protocatechuic aldehyde was low by comparison. Conclusion The HPLC method is proven to be sensitive,accurate,repeatable,and can be used for quality control of the danshen capsules.
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Objective To study the effect of blood glucose level and duration of type 2 diabetes mellitus on carotid intima-media thickness (CIMT) and quantitative carotid stiffness (QCS) in the patients with type 2 diabetes mellitus. Methods Two hundred and seventy-four type 2 diabetic patients (diagnosed according to the World Health Organization criteria) were involved in this study. The subjects were divided into three groups according to the HbAlclevels and duration of diabetes mellitus: 60 with duration ≤2 years (as newly diagnosed) , 96 with duration≥5 years and HbAlc <6.5%, and 118 with duration≥5 years and HbAlc≥6.5%. CIMT and QCS of the common carotid artery were assessed by the high-resolution B-mode ultrasound unit and an echo-tracking system integrated in an uhrasound unit respectively. Results (1) In categorical analyses, the mean level of CIMT was increased from 720 μm in subjects with a duration of diabetes mellitus ≤2 years to 770 μm in subjects with a duration of diabetes mellitus > 2 years and plasma HbAlc< 6.5% (P < 0.05), and to 800 μm in subjects with a duration of diabetes mellitus > 5 years and plasma HbAlc≥ 6.5 % (P < 0.01). The corresponding values for Q CS values were 4.5, 4.5 and 5.1 (P <0.05), respectively. (2) In multiple stepwise regression analyses, CIMT wassignificantly associated with the duration of diabetes mellitus, systolic blood pressure and serum concentration of total cholesterol, whereas QCS was significantly associated with age, duration of diabetes mellitus, smoking, HbAlc, systolic blood pressure (P < 0.05 or P < 0.01). Conclusion QCS is suitable in evaluating the impact of blood glucose on carotid artery, while CIMT is an appropriate tool for long-term follow-up of diabetic patients.