Analysis of occupational health examination results of radiation workers in Dezhou, China / 中国辐射卫生

Objective To investigate the occupational health status of radiation workers in Dezhou, China, explore the effects of low-dose ionizing radiation on the health of radiation workers, and provide a basis for improving the health of radiation workers. Methods A total of 1101 radiation workers in Dezhou who underwent occupational health examination in 2021 were selected. The effects of physical examination type, type of work, sex, length of service, and age on the health status of radiation workers were compared and analyzed. Results The abnormal rates of abdominal color Doppler ultrasound and eye lens were significantly higher in pre-post radiation workers than in radiation works (P < 0.05). The abnormal rates of eye lens increased with the length of service in radiation workers (P < 0.05). The abnormal rate of abdominal color Doppler ultrasound in male workers was higher than that in female workers, while the abnormal rates of blood routine and thyroid function were higher in female workers than in male workers (P < 0.05). Conclusion The abdominal rates of color Doppler ultrasound and eye lens are relatively high among radiation workers in Dezhou. It is necessary to improve the protection awareness and strengthen the level of radiation protection, so as to ensure the occupational health of radiation workers.

Evaluation of the Quadri-Planes Method in Computer-Aided Diagnosis of Breast Lesions by Ultrasonography: Prospective Single-Center Study.

BACKGROUND: Computer-aided diagnosis (CAD) is a tool that can help radiologists diagnose breast lesions by ultrasonography. Previous studies have demonstrated that CAD can help reduce the incidence of missed diagnoses by radiologists. However, the optimal method to apply CAD to breast lesions using diagnostic planes has not been assessed. OBJECTIVE: The aim of this study was to compare the performance of radiologists with different levels of experience when using CAD with the quadri-planes method to detect breast tumors. METHODS: From November 2018 to October 2019, we enrolled patients in the study who had a breast mass as their most prominent symptom. We assigned 2 ultrasound radiologists (with 1 and 5 years of experience, respectively) to read breast ultrasonography images without CAD and then to perform a second reading while applying CAD with the quadri-planes method. We then compared the diagnostic performance of the readers for the 2 readings (without and with CAD). The McNemar test for paired data was used for statistical analysis. RESULTS: A total of 331 patients were included in this study (mean age 43.88 years, range 17-70, SD 12.10), including 512 lesions (mean diameter 1.85 centimeters, SD 1.19; range 0.26-9.5); 200/512 (39.1%) were malignant, and 312/512 (60.9%) were benign. For CAD, the area under the receiver operating characteristic curve (AUC) improved significantly from 0.76 (95% CI 0.71-0.79) with the cross-planes method to 0.84 (95% CI 0.80-0.88; P<.001) with the quadri-planes method. For the novice reader, the AUC significantly improved from 0.73 (95% CI 0.69-0.78) for the without-CAD mode to 0.83 (95% CI 0.80-0.87; P<.001) for the combined-CAD mode with the quadri-planes method. For the experienced reader, the AUC improved from 0.85 (95% CI 0.81-0.88) to 0.87 (95% CI 0.84-0.91; P=.15). The kappa indicating consistency between the experienced reader and the novice reader for the combined-CAD mode was 0.63. For the novice reader, the sensitivity significantly improved from 60.0% for the without-CAD mode to 79.0% for the combined-CAD mode (P=.004). The specificity, negative predictive value, positive predictive value, and accuracy improved from 84.9% to 87.8% (P=.53), 76.8% to 86.7% (P=.07), 71.9% to 80.6% (P=.13), and 75.2% to 84.4% (P=.12), respectively. For the experienced reader, the sensitivity improved significantly from 76.0% for the without-CAD mode to 87.0% for the combined-CAD mode (P=.045). The NPV and accuracy moderately improved from 85.8% and 86.3% to 91.0% (P=.27) and 87.0% (P=.84), respectively. The specificity and positive predictive value decreased from 87.4% to 81.3% (P=.25) and from 87.2% to 93.0% (P=.16), respectively. CONCLUSIONS: S-Detect is a feasible diagnostic tool that can improve the sensitivity, accuracy, and AUC of the quadri-planes method for both novice and experienced readers while also improving the specificity for the novice reader. It demonstrates important application value in the clinical diagnosis of breast cancer. TRIAL REGISTRATION: ChiCTR.org.cn 1800019649; http://www.chictr.org.cn/showproj.aspx?proj=33094.

Superb microvascular imaging compared with contrast-enhanced ultrasound to assess microvessels in thyroid nodules.

PURPOSE: Contrast-enhanced ultrasound (CEUS) and superb microvascular imaging (SMI) can detect microvessels in thyroid nodules. Here, SMI and CEUS were compared for differentiating thyroid nodules. METHODS: Seventy-six patients (102 nodules) underwent SMI and CEUS. The SMI blood flow (BF) grade and CEUS enhanced intensity (EI) were recorded for the periphery and center of each nodule, and evaluated relative to pathological findings. RESULTS: SMI of malignant nodules showed abundant BF in the periphery but lack of BF in the center, while CEUS showed hypoenhancement in the center and periphery. Large and small vessels had greater saliency on SMI-BF grade and CEUS-EI, respectively. Analysis of SMI-BF as diagnostic of thyroid carcinoma specifically at the nodule periphery indicated rates of 82.2%, 79.3%, and 81.3% for sensitivity, specificity, and accuracy, respectively. The corresponding rates for CEUS hypoenhancement were 80.8%, 86.2%, and 82.3%, respectively. Thus, SMI and CEUS rates were similar. CONCLUSION: SMI-BF grade was more affected by vessels of larger inner diameter, while CEUS-EI was more affected by vessels of smaller inner diameter. SMI alone is sufficient for evaluation of blood flow in thyroid nodules, and the diagnostic value of SMI-BF of the periphery is comparable to CEUS hypoenhancement to differentiate thyroid cancer.

Performance of Computer-Aided Diagnosis in Ultrasonography for Detection of Breast Lesions Less and More Than 2 cm: Prospective Comparative Study.

BACKGROUND: Computer-aided diagnosis (CAD) is used as an aid tool by radiologists on breast lesion diagnosis in ultrasonography. Previous studies demonstrated that CAD can improve the diagnosis performance of radiologists. However, the optimal use of CAD on breast lesions according to size (below or above 2 cm) has not been assessed. OBJECTIVE: The aim of this study was to compare the performance of different radiologists using CAD to detect breast tumors less and more than 2 cm in size. METHODS: We prospectively enrolled 261 consecutive patients (mean age 43 years; age range 17-70 years), including 398 lesions (148 lesions>2 cm, 79 malignant and 69 benign; 250 lesions≤2 cm, 71 malignant and 179 benign) with breast mass as the prominent symptom. One novice radiologist with 1 year of ultrasonography experience and one experienced radiologist with 5 years of ultrasonography experience were each assigned to read the ultrasonography images without CAD, and then again at a second reading while applying the CAD S-Detect. We then compared the diagnostic performance of the readers in the two readings (without and combined with CAD) with breast imaging. The McNemar test for paired data was used for statistical analysis. RESULTS: For the novice reader, the area under the receiver operating characteristic curve (AUC) improved from 0.74 (95% CI 0.67-0.82) from the without-CAD mode to 0.88 (95% CI 0.83-0.93; P<.001) at the combined-CAD mode in lesions≤2 cm. For the experienced reader, the AUC improved from 0.84 (95% CI 0.77-0.90) to 0.90 (95% CI 0.86-0.94; P=.002). In lesions>2 cm, the AUC moderately decreased from 0.81 to 0.80 (novice reader) and from 0.90 to 0.82 (experienced reader). The sensitivity of the novice and experienced reader in lesions≤2 cm improved from 61.97% and 73.23% at the without-CAD mode to 90.14% and 97.18% (both P<.001) at the combined-CAD mode, respectively. CONCLUSIONS: S-Detect is a feasible diagnostic tool that can improve the sensitivity for both novice and experienced readers, while also improving the negative predictive value and AUC for lesions≤2 cm, demonstrating important application value in the clinical diagnosis of breast cancer. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1800019649; http://www.chictr.org.cn/showprojen.aspx?proj=33094.

Application of superb microvascular imaging and contrast enhanced ultrasound in the differential diagnosis of thyroid nodules / 中南大学学报(医学版)

To compare the clinical value of superb microvascular imaging (SMI) and contrast enhanced ultrasound (CEUS) in the differential diagnosis of thyroid nodules, and to further study whether the combination of SMI and/or CEUS with thyroid imaging reporting and data system (TI-RADS) can improve the diagnostic value of TI-RADS.
 Methods: SMI, CEUS, TI-RADS, TI-RADS combined with CEUS, TI-RADS combined with SMI, TI-RADS combined with SMI and CEUS were used to differentiate thyroid nodules. TI-RADS 4b, 5 categories in two-dimensional ultrasound, hypoenhancement in CEUS, and peripheral blood flow with penetrating vessels in SMI were considered malignant signs. The diagnostic efficacy of these methods was compared according to post-operative pathology or fine needle aspiration cytology.
 Results: A total of 237 patients with 296 thyroid nodules were included in the study. The sensitivity, specificity and accuracy for TI-RADS were 78.4%, 77.7% and 78.0% respectively, 75.5%, 86.6% and 81.4% in SMI, 82.0%, 88.5% and 85.5% in CEUS, 92.1%, 90.4% and 91.2% in TI-RADS combined with SMI and CEUS. Area under the receiver operating characteristic curve (AUROC) showed no significant difference between SMI, CEUS, TI-RADS (χ2=4.29, P=0.117). AUROC of both TI-RADS combined with CEUS (χ2=39.62, P<0.001), TI-RADS combined with SMI (χ2=36.61, P<0.001) were higher than TI-RADS. AUROC of TI-RADS combined with SMI and CEUS was higher than TI-RADS combined with SMI (χ2=4.50, P=0.033) or TI-RADS combined with CEUS (χ2=4.24, P=0.039).
 Conclusion: Peripheral blood flow with penetrating vessels in SMI possesses high diagnostic value in differentiating thyroid cancer. The combination of SMI and/or CEUS with TI-RADS can be used to improve the diagnostic efficacy of TI-RADS in differential diagnosis of thyroid nodules.

Verification and comparisons of different ultrasound risk-stratification systems in the evaluation of thyroid nodules / 中华超声影像学杂志

Objective To verify and compare the TI-RADS developed by Kwak et al .( Kwak TI-RADS ) ,2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer ( ATA Guideline Classification) ,2017 TI-RADS released by the American College of Radiology (ACR TI-RADS) and TI-RADS developed by Zhou et al .(Zhou TI-RADS) in the evaluation of thyroid nodules . Methods The ultrasound images of 339 thyroid nodules in 273 patients were analyzed by retrospective study . The thyroid nodules were categorized into aforementioned four stratified systems . Based on the pathological findings considered the "gold standard",the receiver operating characteristic( ROC ) curve was created to compare the clinical application value of aforementioned four stratified systems . Results The percentage of nodules that could not be categorized were 1 .2％ ,17 .5％ ,0 and 1 .2％ for the Kwak TI-RADS ,ATA guidelines ,ACR TI-RADS ,and Zhou TI-RADS ,respectively and the area under the ROC curve ( AUC) was 0 .899 ,0 .879 ,0 .876 ,and 0 .918 ,respectively . The sensitivity of Kwak TI-RADS ,ATA guidelines classification ,and ACR TI-RADS were higher than that of Zhou TI-RADS (all P < 0 .05) ,whereas the specificity of Zhou TI-RADS was the highest (all P < 0 .05) . As for the accuracy ,no statistically significant differences were observed between any two of Kwak TI-RADS ,ATA guidelines ,ACR TI-RADS ,and Zhou TI-RADS systems ( all P > 0 .05) . Conclusions Four thyroid risk stratification systems provide effective risk assessment for thyroid nodules ,Zhou TI-RADS has relatively lower sensitivity ,but its specificity and AUC value are the highest among the four evaluated systems . In addition ,ACR TI-RADS can classify the most nodules ,while the number of nodules that can′t be categorized by ATA guideline is maximum .

Application of a Novel Microvascular Imaging Technique in Breast Lesion Evaluation.

Conventional power Doppler imaging (PDI) and the novel Superb Microvascular Imaging (SMI) technique were applied to observe the distribution of microvessels in 135 breast lesions, using semi-quantitative grading, penetrating vessel evaluation and flow distribution pattern to evaluate diagnostic efficacy. Compared with PDI, SMI detected more flow signals and details of microvessels. Further, when a centrally distributed branching or diffusing mode was used as a criterion for diagnosing malignancy, SMI improved diagnosis of breast masses. Sensitivity, specificity, positive predictive value and negative predictive value of SMI-assessed flow distribution were 85.4%, 92.6%, 83.3% and 93.5%, respectively, compared with 70.7%, 92.6%, 80.5% and 87.9% for PDI. We also found that flow distribution pattern analysis is superior to semi-quantitative grading and the penetrating vessel method in differentiating malignant breast lesions. Our work here further supports SMI as a novel and promising technique in visualizing microvasculature in breast lesions that may be of paramount use in initial diagnosis as well as follow-up assessment in various treatment regimes.

Ultrasound-guided laser thermal ablation for treatment of small liver cancer at high-risk sites / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical value of ultrasound-guided laser thermal ablation (LTA) in the treatment of small liver cancer at high-risk sites.</p><p><b>METHODS</b>A total of 73 lesions ablated with LTA in 68 patients with small liver cancer. After the operation, the rates of complete ablation were compared between patients with lesions of different sizes and at different sites using contrast-enhanced ultrasound and the complications were recorded during the follow-up.</p><p><b>RESULTS</b>The complete ablation rates for carcinomas ≤1 cm, 1-2 cm, and 2-3 cm were 100%, 86.4%, and 82.7%, respectively, showing no significant differences among them (P>0.05). The complete ablation rates of lesions were similar between the high-risk and low-risk groups (85.7% vs 92.1%; P>0.05). The two groups showed no significant difference in the incidence of complications (9.1% vs 5.7%; P>0.05).</p><p><b>CONCLUSION</b>Ultrasound-guided LTA can be a good option for treatment of small liver cancers at high-risk sites.</p>

Clinical application of the 3-dimensional speckle tracking imaging in coronary artery disease / 中南大学学报(医学版)

OBJECTIVE@#To observe the 3-dimensional speckle tracking imaging (3D-STI) in clinical diagnosis of coronary artery disease by quantitatively evaluating left ventricular segmental and global systolic function.@*METHODS@#According to the selective coronary artery angiography, 150 inpatients suspected of coronary artery disease were divided into 5 groups according to the distribution of the affected coronary arteries: a left anterior descending coronary artery group (LAD, n=46), a left circumflex coronary artery group (LCX, n=25), a right coronary artery group (RCA, n=23), a multivessel group (n=26), and a normal group (n=30). Gensini score was calculated according to coronary artery angiography. Conventional echocardiography was applied in each patient and wall motion score index (WMSI) was calculated. 3D-STI was applied in each patient to evaluate the segmental and global systolic function in the left ventricle.@*RESULTS@#Compared with the normal group, ejection fraction was decreased in the multi-vessel group alone (P<0.05). Peak systolic 3D strains in all segments were decreased in the multi-vessel group (P<0.01), while peak systolic 3D strains in the main blood-supply segments were decreased significantly in the rest of the groups (P<0.05). Global 3-dimensional strain (G3DS) was negatively correlated with Gensini score in patients with coronary artery disease (r= -0.76, P<0.01). Receiver operating characteristic curve analysis demonstrated that G3DS was more sensitive and accurate in clinical diagnosis of coronary artery disease.@*CONCLUSION@#3D-STI can quantitatively evaluate the segmental and global systolic function of the left ventricle, and reflect the extent of coronary artery stenosis in patients with coronary artery disease.

Establishment and evaluation of rabbit unstable atherosclerotic plaque model induced by cold stress / 中华老年医学杂志

Objective To establish and evaluate unstable atherosclerotic plaque model in abdominal aorta induced by cold stress. Methods Sixty male New Zealand white rabbits were randomly divided into three groups:cold stress group fed with high fat diet and followed by balloon induced arterial wall injury of abdominal aorta at week 2 and exposed to cold (4℃) for 1 h per day except for the first postoperative week,balloon-injury group treated by high fat diet plus balloon-injury, control group fed a normal chow without any treatment. Pathological changes of atherosclerotic plaques among these groups were evaluated at 20 weeks. Meanwhile, serum concentrations of blood lipid,oxidized low density protein(ox-LDL),hypersensitive C-reaction protein (hs-CRP)and interleukin (IL)-8 were determined. Results There was no difference in blood lipid level between cold-stress and balloon-injury groups.Serum concentrations of ox-LDL[(56.1 +14.3)mg/L vs.(42.9± 13.8)mg/L],hs-CRP[(149.1+78.3)mg/L vs. (94.5±57.3)mg/L],IL-8 [(97.6±17.9)μg/L vs.(57.5±18.3)μg/L]and macrophage infiltration[(30.9±5.6)％ vs,(18.7±4.8) ％] were significantly higher in cold stress group than in balloon-injury group (t =2.78,6.91,14.94,6.88,all P＜0.05). Higher angiogenesis rate of atherosclerotic plaque in cold-stress group (23/31,74.1％) was observed in comparison with group balloon-injury(5/25,20,0％)(x2=16.26,P＜0.05). Conclusions Establishment of rabbit unstable atherosclerotic plaque model induced by cold stress in synergy with high fat diet and balloon-injury is feasible, which is superior to conventional method through high fat diet plus balloon-injury surgery.

Evaluation of intraventricular dyssynchrony by quantitative tissue velocity imaging in rats of post-infarction heart failure / 中南大学学报(医学版)

OBJECTIVE@#To evaluate intraventricular systolic dyssynchrony in rats with post-infarction heart failure by quantitative tissue velocity imaging combining synchronous electrocardiograph.@*METHODS@#A total of 60 male SD rats were randomly assigned to 3 groups: a 4 week post-operative group and an 8 week post-operation group (each n=25, with anterior descending branch of the left coronary artery ligated), and a sham operation group (n=10, with thoracotomy and open pericardium, but no ligation of the artery). The time to peak systolic velocity of regional myocardial in the rats was measured and the index of the left intraventricular dyssynchrony was calculated.@*RESULTS@#All indexes of the heart function became lower as the heart failure worsened except the left ventricle index in the post-operative groups. All indexes of the dyssynchrony got longer in the post-operative groups (P0.05).@*CONCLUSION@#Quantitative tissue velocity imaging combining synchronous electrocardiograph can analyse the intraventricular systolic dyssynchrony accurately.

Clinical significance of cyclooxygenase-2 and BCRP expressions in non-Hodgkin lymphoma / 白血病·淋巴瘤

Objective To investigate the correlation and significance of cyclooxygenase-2 (COX-2)and the breast cancer resistance protein (BCRP) expressions in non-Hodgkin lymphoma(NHL). Methods Ten patients with reactive lymph nodes (RLN) were considered as a control group. Compared with β-actin as internal control, the BCRP mRNA expressions of 61 NHL samples and 10 lymph tissues in control group were detected by semi-quantitative revere transcription polymerase chain reaction (RT-PCR) assay, while the expressions of COX-2 protein of the above specimens were detected by SP immunohistochemistry. Results The positive rates of COX-2 and BCRP in NHL were 50.8 %(31/61) and 45.8 % (28/61), respectively , and were higher than those in the control group (P ＜0.05). The expression of COX-2 was statistically positive correlated to that of BCRP (X2 =8.795, r=0.355, P＜0.05). The expressions of COX-2 and BCRP were not correlated to clinical and pathological factors, such as age, sex, IPI, LDH, β2-microglobulin level and Ann Arbor stage, however, the expression of BCRP was statistically correlated to chemotherapy efficacy.Conclusion BCRP may be involved in multi-drug resistance (MDR) of NHL, so it may contribute to the assessment of chemotherapy and prediction of NHL. Since there is a strong correlation between COX-2 expression and MDR in NHL, the application of COX-2 inhibitors may enhance sensitivity of chemotherapy.

Removing action of compound danshen di wan on carotid atherosclerotic plaques: Multi-central randomized controlled experiment / 中国组织工程研究

BACKGROUND: It is indicated in a large amount of basic researches that compound danshen di wan has a certain action on removing carotid atherosclerotic plaques (CAP), but there is lack of large sample data in randomized, controlled, multi-central clinical experiment.OBJECTIVE: To observe the removing action of compound danshen di wan on CAP, compared with aspirin.DESIGN: Multi-central, randomized controlled experiment was designed.SETTING: Research Center of Traditional Chinese Medicine and Ultrasonic Department of Xinjing Hospital, Fourth Military Medical University of Chinese PLA; Department of Traditional Chinese Medicine of Second Clinical Hospital, Xi' an Jiaotong University and Department of Cardiac Internal Medicine of Xi' an Hospital of Traditional Chinese Medicine.PARTICIPANTS: Totally 162 cases were selected from the clinic of Research Center of Traditional Chinese Medicine, Fourth Military Medical University of Chinese PLA; Department of Traditional Chinese Medicine, Second Clinical Hospital, Xi' an Jiaotong University and Department of Cardiac Internal Medicine of Xi' an Hospital of Traditional Chinese Medicine from 2002 to 2004, aged varied from 40 to 80 years, the thickness of carotid internal media ≥ 1.2 mm. They were randomized into two groups, named danshen di wan group of 89 cases(cases of soft plaque and hard plaque were 49 and 40 respectively) and aspirin group of 73 cases(cases of soft plaque and hard plaque were 42 and 31 respectively).METHODS: In danshen di wan group: compound danshen di wan was administrated orally(10 pills/time, 3 times/day), in aspirin group, enteric soluble aspirin table was administrated orally(75 mg/time, once a day),continuously for 6 months. The alternations of thickness of carotid internal media were determined with ultrasonic B of high resolving power before and after treatment.MAIN OUTCOME MEASURES: Changes in thickness of carotid internal media before and after treatment.RESULTS: By practical measuring analysis, 143 cases accomplished nation of thickness of carotid internal media in the patients with soft plaque:In danshen di wan group, the thickness was remarkably decreased after treatment[ (2. 12 ± 0. 34), (2.44± 0.40) mm, t = 4. 267, P ＜ 0.01 ] . In aspirin group, it was also reduced relatively after treatment[ (2.25 ± 0. 3),of carotid internal media in the patients with hard plaque: The changes were not significant no matter in danshen di wan group or aspirin group in the comparison before and after treatment[in danshen di wan group: (2.46 ±0.42),(2.34 ± 0. 40) mm; in aspirin group: (2.42 ± 0. 44), (2. 36 ± 0. 38) mm,P＞ 0.05].CONCLUSION: Compound danshen di wan acts on removing soft atherosclerotic plaque and its effect is similar to aspirin.