A Nomogram Based on Contrast-Enhanced Ultrasound to Predict the Microvascular Invasion in Hepatocellular Carcinoma.

OBJECTIVE: The aim of this study was to establish and validate a contrast-enhanced ultrasound (CEUS) nomogram for pre-operative microvascular invasion (MVI) prediction in hepatocellular carcinoma (HCC), and compare it with the nomogram based on gadopentetate dimeglumine-enhanced magnetic resonance imaging (Gd-MRI). METHODS: A total of 251 patients with a single HCC were enrolled in this prospective study, including 176 patients in the training cohort and 75 patients in the validation cohort. Contrast-enhanced ultrasound (CEUS) with Sonazoid and Gd-MRI was performed pre-operatively. Post-operative histopathology was the gold standard for MVI. Univariate and multivariate logistic regression was performed to determine independent risk factors for MVI. Nomograms based on CEUS and Gd-MRI were established, and their discrimination, calibration and decision curve analysis were evaluated and compared. RESULTS: Multivariate logistic regression revealed that arterial circular enhancement, non-enhancing area and thick ring-like enhancement in the post-vascular phase were independent risk factors for MVI. The areas under the receiver operating characteristic curve of the nomogram were 0.841 (0.779-0.892) and 0.914 (0.827-0.966) in the training and validation cohorts, with no significant difference compared with the Gd-MRI nomogram (p = 0.294, 0.321). The C-indexes were 0.821 and 0.870 in the training and validation cohorts. Decision curve analysis revealed that the CEUS nomogram had better clinical applicability than the Gd-MRI nomogram when the threshold probability was between 0.35 and 0.95. CONCLUSION: The CEUS-based nomogram was available for predicting MVI in HCC, and its predictive performance was not inferior to that of Gd-MRI.

Ring-like enhancement on Contrast-Enhanced ultrasound may correlate well with histopathological capsule of Hepatocellular Carcinoma: Comparison with the enhancing capsule on Gadopentetate-enhanced MRI.

PURPOSE: To evaluate the correlation of ring-like enhancement (RE) on contrast-enhanced ultrasound with Sonazoid (S-CEUS) with the fibrous capsule of HCC, and compared it with the enhancing capsule on Gadopentetate-enhanced MRI (Gd-MRI). METHOD: Consecutive patients with pathologically-proven resected HCCs from January 2021 to December 2021 were reviewed in this retrospective study. Preoperatively, the RE on the S-CEUS and the enhancing capsule on Gd-MRI were evaluated for each lesion. We analyzed the correlation of the presence, integrity, and thickness of imaging features with the histopathological fibrous capsule. The diagnostic performance to recognize the capsule between two modalities was compared by the McNemar test. RESULTS: Ninety-one patients (mean age, 58.30 ± 11.13 years; 82 men) with ninety-seven HCCs (mean size, 4.67 ± 2.70 cm) were reviewed. The RE on S-CEUS correlated with the presence of the fibrous capsule (P = 0.006). The sensitivity, specificity, and accuracy were 92.05 %, 44.44 %, and 82.47 %, respectively, which was not different from Gd-MRI (P = 0.388). The integrity of RE in the post-vascular phase correlated with the integrity of the fibrous capsule (P = 0.018), whose diagnostic performance was not statistically different from Gd-MRI (P > 0.999). The thickness shown both on S-CEUS and Gd-MRI was thicker than that in histopathology (P < 0.001), and the thickness on Gd-MRI was not statistically different from that in the vascular phase of S-CEUS (P = 0.563), but thinner than that in the post-vascular phase (P = 0.001). CONCLUSIONS: Compared with the Gd-MRI, RE on S-CEUS had a similarly well correlation with the presence and integrity of fibrous capsule of HCC.

Clinical value of preoperative perfluorobutane contrast-enhanced ultrasound in the evaluation of microvascular invasion and recurrence of hepatocellular carcinoma / 中华肝胆外科杂志

Objective:To study the use of perfluorobutane contrast-enhanced ultrasound (CEUS) in preoperative detection of microvascular invasion (MVI), and postoperative short-term recurrence of hepatocellular carcinoma (HCC).Methods:Patients who underwent hepatectomy with curative intent at the Chinese PLA General Hospital from January 2021 to April 2021 were prospectively enrolled into this study. Of 42 patients in this study, there were 36 males and 6 females, with age of (56.51±11.95) years old. All patients underwent preoperative perfluorobutane CEUS, and the characteristics of ultrasound, the vascular phase and Kupffer phase of perfluorobutane CEUS were recorded. Based on the pathological results, these patients were divided into the MVI and non-MVI groups. These patients underwent liver MRI once every 3 months postoperatively to diagnose tumor recurrence. According to the recurrence of HCC 6 months after operation, these patients were divided into the non-recurrence and the recurrence groups. Independent risk factors for MVI and short-term recurrence were analyzed by univariate and multivariate analyses.Results:Two patients had two lesions, and the remaining 40 patients had a single lesion. The pathological diagnosis of all the lesions were HCC (14 patients in the MVI group and 28 patients in the non-MVI group). The median follow-up was 6 (3, 6) months, and there were 8 patients in the recurrence group and 34 patients in the non-recurrence group. On logistic analysis, independent risk factors for MVI included the number of vessels detected on color Doppler flow imaging (CDFI) ( OR=5.762, 95% CI: 1.597-20.785, P=0.007), increased tumor size by more than 10% after CEUS arterial enhancement ( OR=10.186, 95% CI: 3.647-28.447, P=0.037), and thickness of corona enhancement at Kupffer phase of greater than 5 mm ( OR=17.340, 95% CI: 6.124-49.095, P=0.040). Cox regression showed the independent risk factors for short-term recurrence to include the number of vessels in CDFI ( RR=7.519, 95% CI: 1.086-52.051, P=0.041) and thickness of corona enhancement at Kupffer phase of greater than 5 mm ( RR=10.623, 95% CI: 1.265-89.218, P=0.030). Conclusion:Preoperative perfluorobutane CEUS had potential values in detecting MVI and in predicting postoperative short-term recurrence of HCC.

Design of a portable oxygen supply respirator / 军事医学

Objective To design a portable respirator that can facilitate both cardiopulmonary resuscitation and auxiliary oxygen inhalation.Methods Positive pressure design as well as pneumatically powered and controlled design were adopted for this respirator.Theoretical calculation of key components was carried out.The virtual prototype was established and the structure checked using the three dimensional design software Solidedge.Finally,the prototype was processed,assembled and tested.Results Experimental tests proved that the designed respirator was capable of cardiopulmonary resuscitation and auxiliary oxygen inhalation when oxygen supply pressure reached 3 -5.5 bar.It could achieve the expected technical indicators,such as the oxygen flow rate that was between 10 and 12 L/min.Conclusion The portable oxygen supply respirator has the advantages of a small size,light weight,simple operation,and automatic power supply.It has broad prospects of application.

Design and implementation of auto-control system for high-throughput and multi-channel DNA synthesis / 军事医学

Objective To establish an auto-control system for high-throughput and multi-channel DNA synthesis which can simultaneously and quickly synthesize up to 96 different oligonucleotides in a 96-well microtiter format.Methods The PLC and its extended modules is used as the main-control unit, which executes the DNA automatic synthesis process according to the synthesis sequences and steps set by the user,and the manual injecting reagent etc.And the configuration software and VC6.0 were used for programming the man-machine interface sofeware to set synthesis parameters, position calibration,flux calibration data etc, and communicated with PLC.Results The synthesis application of about 150 000 DNA chains has proved that the synthesis cycle time for 96 couplings was 4 min,the average coupling efficiency was 99%across the entire 96-well plate,the monomer reagent usage was reduced by 50 percent,and the synthesis configuration was more flexible.Conclusion A reliable and simple auto-control system is provided for parallel synthesis of 96-channel oligonucleotide chains,which can meet the demands of high-throughput and multi-channel DNA synthesis.

A massive transfusion protocol for the abdominal surgical patients with traumatic shock / 中华普通外科杂志

Objective To investigate the clinical value of the massive transfusion protocols (MTP) in abdominal surgical patients with traumatic shock.Methods An analysis was made on the clinical data of patients before and after the use of MTP,including the general condition,amount of blood transfusion,transfusion components and ratio,blood and coagulation function test,and blood transfusion related complications and mortality.Results Before implement of MTP,the average RBC transfusion in the first 24 hours was 19.5U,FFBwas 12.6U,and the ratio ofRBC ∶ FFB was 1.55 ∶ 1.After implement of MTP,the average RBC transfusion in the first 24 hours was 17.3 U,and the ratio of RBC:FFB was 1 ∶ 1.There were no significant statistical differences between the two groups about PT,APTT,Hb and PLT on admission.After 24 hours of admission,there was no significant difference in Hb between the two groups,there were significant differences of PT,APTT and PLT.Blood transfusion related complications were 11 (14.9％) in control group and 7 (11.9％) in MTP,group,and the mortality was 9.46％ and 6.78％ respectively.Conclusions MTP improves blood coagulation function,reduces blood transfusion and enhances survival rate of abdominal surgical patients with traumatic shock.

Research on 4 116 TCM Prescriptions in Treatment of Gastric Cancer with Method of Scale-free Networks / 世界科学技术-中医药现代化

In this study , 4116 traditional Chinese medicine ( TCM ) prescriptions of 994 outpatients of gastric cancer from the Jiangsu Provincial Hospital of Traditional Chinese Medicine were analyzed with the use of Clinical Research Information Sharing System and the data mining method of scale-free networks . The core drugs and compatibility were visually displayed on diagrams which revealed the characteristics of gastric cancer treatment with TCM prescriptions in this hospital with high credibility . This method has certain meaning and value for the study of TCM prescriptions .

Core Drugs and Compatibility Analysis of Ulcerative Colitis Based on Data Mining / 世界科学技术-中医药现代化

This study was aimed to discover core agent for the treatment of ulcerative colitis and explore the medication rules . A total of 525 ulcerative colitis medical records in the Jiangsu Province Hospital of TCM were selected from 2009 to 2013 . The records were input into the structured information acquisition system of clinical diagnosis and treatment . The complex network analysis was used to analyze core drugs of prescription and drug compatibility after data mining and rule processing . The results showed that the core drugs are Diyu , Huanglian, Muxiang, Baishao, Xianhecao, Danggui, Chaobaizhu, Huangqin, Zicao, Yiyiren, Fuling, Shanyao. It was concluded that data mining can be an objective method in the analysis of core drugs and compatibility in the treatment of ulcerative colitis. It can also be used to guide the clinical prescription medication.

Ultrasonic image reconstruction with feature extraction of bones and skin of residual limb / 中国康复理论与实践

@#Objective In the prosthetic socket design process, the high cost and radiation deficiency caused by CT scanning which is a routine way to obtain the cross section image of the residual limb remain problems. Ultrasonic measuring approach is proposed to gain the bones and skin contour of the residual limb. MethodsAn ultrasonic measuring device to get the multiple ultrasonic images of the residual limb was developed firstly, a compound algorithm to reconstruct the multiple images into 2D image was designed, and then the feature extraction on the bones and skin was made. Results Conclusion Comparing with the like-kind cross sectional scanning technique, the ultrasonic measuring method has the characteristic of no radiation and low cost.

Development of LG-1000 chromatography freezer / 医疗卫生装备

LG -1000 high -capacity chromatography freezer can be widely applied in biochemistry, medicine and pharmaceutics to make a constant cryogenic environment and refrigeration for medical materials available. The freezer is reliable, automatic and adopts some CFC-free materials, so the defficiency in related field in Chian can be made up for.

Development of ultrasound measurement system for residual lower limbs / 医疗卫生装备

It is an important approach for CAD/CAM of prosthetic sockets to establish digital model of residual lower limbs from amputees. In this thesis, ultrasonic imaging technology is utilized to extract the internal and external contours of residual lower limbs for their 3D modeling , and an ultrasound measurement system is developed.