Therapeutic effect of low frequency electric pulse therapy on cisplatin-based chemotherapy-induced nausea and vomiting in patients with lung adenocarcinoma: A prospective controlled study.

To explore the efficacy of low-frequency electric pulse therapy (LFEPT) combined with 2 antiemetics in the prevention and treatment of cisplatin-based chemotherapy-induced nausea and vomiting (CINV) in patients with lung adenocarcinoma. A total of 82 patients with lung adenocarcinoma who received cisplatin-based chemotherapy were randomly divided into the experimental group (n=41) and control group (n=41) by random numerical table method. The experimental group was treated with LFEPT combined with 2 antiemetic drugs (tropisetron hydrochloride and dexamethasone hydrochloride), while the control group was treated with the same 2 antiemetic drugs. Revised index of nausea and vomiting and retching (R-INVR) and Functional Living Index-Emesis (FLIE) scale were used to quantitatively evaluate the symptoms of nausea and vomiting after chemotherapy, and the effect of LFEPT in the prevention and treatment of CINV was observed. The baseline characteristics had no statistical difference between the 2 groups. The degree of nausea reaction, vomiting, and dry retching were similar in 2 groups on the first day after chemotherapy. However, the degree of nausea reaction, vomiting, and dry retching were significantly improved in the experimental group than that of the control group on 2 to 5 days with all P<.05. The score of FLIE had no difference between the 2 groups on the first day after chemotherapy (84.05 vs 82.69, P=.30), and the score was significantly higher in experiment group on day 6 compared with the control group (103.71 vs 89.38, P=.02). The side effects had no difference between the 2 groups. The LFEPT can significantly ameliorate CINV in patients with lung adenocarcinoma, which is worthy of clinical application.

Regional Contrast-Enhanced Ultrasonography (CEUS) Characteristics of Breast Cancer and Correlation with Microvessel Density (MVD).

BACKGROUND The aim of this study was to investigate the perfusion characteristics of different breast lesion regions in contrast-enhanced ultrasonography (CEUS). MATERIAL AND METHODS A total of 161 malignant and benign breast lesion cases were subjected to CEUS. Perfusion parameters were analyzed and compared between the central and peripheral lesion regions, and surrounding tissue. Mass section was marked with methylene blue. Samples were subjected to immunohistochemistry, and microvessel density (MVD) was calculated. RESULTS There were significant differences in perfusion performance between the central and peripheral lesion regions, and surrounding tissue. In the malignant tumors, the fast-in and fast-out pattern was the most common type in the peripheral region (57.98%), while the slow-in and slow-out patterns were the major types in the central region and surrounding tissue (49.58% and 57.98%, respectively). Compared with the surrounding tissue, the peripheral region in the cancers exhibited hyperechoic enhancement and fast-in and slow-out pattern, with large area under the curve (AUC), while the central region showed isoechoic enhancement and equally-in and slow-out pattern, with large AUC. In the benign lesions, the peripheral region exhibited hyperechoic enhancement and fast-in and fast-out pattern, with small AUC, while the central region showed isoechoic enhancement and equally-in and -out pattern, with the same AUC value. Moreover, the perfusion parameters in the central and peripheral regions were significantly associated with MVD. CONCLUSIONS It is more objective to evaluate the perfusion performance of breast lesions with the reference of surrounding tissue. Compared with the central region, the peripheral region could better reflect the perfusion characteristics of malignant lesions.

Role of multi-mode ultrasound in the diagnosis of level 4 BI-RADS breast lesions and Logistic regression model.

OBJECTIVE: This study is to investigate the diagnostic role of multi-mode ultrasound in level 4 BI-RADS breast lesions and to establish a Logistic regression model. METHODS: Totally 179 patients with 182 sites of breast lesions were enrolled in this study. Preoperatively, the examinations of routine ultrasonography, elastography, contrast-enhanced ultrasonography and three-dimensional color Doppler were performed. Postoperatively, the breast lesions were diagnosed as benign and malignant lesions according to pathological results. Diagnostic indicators of each ultrasound analysis were determined and compared. The relationship between these diagnostic indicators and the benign and malignant features of breast lesions was analyzed by single factor analysis. Logistic regression model was established. RESULTS: The diagnostic indicators with high sensitivity and specificity were tumor edge, enhanced range and score of elastography. Four factors of tumor edge, enhanced order, contrast mode and score of elastography were related with the benign and malignant features of breast lesions. The prediction model was Logit (P) = 0.636 + 4.471X1 + 4.337X2 + 3.753X3 + 3.014X4 + 2.525X5 + 2.105X6. Likelihood ratio test showed that the model was statistically significant (χ(2) = 161.876, P < 0.0001). This model could effectively distinguish between benign and malignant tumors (R(2) = 0.813, prediction accuracy 92.3%). The differences in sensitivity and specificity between multi-mode ultrasound diagnosis and routine ultrasound diagnosis were statistically significant (P < 0.001). However, there was no significant difference between Logistic regression model and multi-mode ultrasound diagnosis. CONCLUSION: Multi-mode ultrasound and Logistic regression model are more effective in diagnosing level 4 BI-RADS breast lesions.

Expression of Hypoxia-Inducible Factor-1α in the Infiltrative Belt Surrounding Hepatic Alveolar Echinococcosis in Rats.

Our main aims were to investigate hypoxia inducible factor-1α (HIF-1α) expression in the surrounding invasion range of hepatic alveolar echinococcosis (HAE) lesions and determine the pathological basis of angiogenesis. In total, 23 Wistar rats with hepatic echinococcus multilocularis infection were killed and their livers, which contained 27 HAE lesions, obtained. Specimen segments were generated from 119 paraffin blocks. Comparative analysis of the tissue samples containing HAE nodules and hepatic parenchyma of the surrounding region was performed with the immunohistochemical SP method in this animal experiment. Expression patterns of HIF-1α in the surrounding invasion range and the hepatic parenchyma were compared. The HIF-1α positive expression rate was 97.5% (116/119 samples). Expression of HIF-1α in the actively multiplying infiltrative region of the HAE lesions was significantly higher than that in hepatic parenchyma (P < 0.05). Overexpression of HIF-1α in the actively multiplying infiltrative region of HAE lesions in rats is closely related to angiogenesis and microvasculature. The sensitivity of HIF-1α facilitates its application as a representative maker of HAE. Our data indicate that the invasion range of HAE lesions is based on extrusion and compression, and induces anoxia and ischemia in hepatic tissue. Thus, HIF-1α provides a valuable index for evaluating HAE activity, and induces anoxia and ischemia in hepatic tissue.

[Contrast-enhanced ultrasonography of hepatic alveolar echinococcosis in rats: the correaltion of imaging fratures and histologic microvascular density].

OBJECTIVE: To correlate the characteristic images of hepatic alveolar echinococcosis (HAE) in rats using contrast-enhanced ultrasonography (CEUS) and microvascular density (MVD) in the surrounding invasion range of HAE lesions. METHODS: Thirty Wistar rats were infected with Echinococcus multolocularis suspension (approximately 800 protoscoleces in 0.2 ml per rat) through abdominal opening injection in liver. Three months after the inoculation, rats with hepatic E. multilocularis infection were examined by conventional and contrast-enhanced ultrasonography. The location, size, shape, boundary, inner echogenicity, and blood flow of the lesions, signal intensity and dynamic enhancement pattern were recorded. The positive rats were sacrificed and their livers were obtained. The structure of HAE lesions was observed by HE staining. Immunohistochemistry staining was performed on the infiltrative region of HAE lesion and the expression of CD34 in the surrounding hepatic parenchyma. Scoring was based on the percentage of positively stained cells and stain intensity. The correlation of MVD and the characteristic images of HAE using CEUS was analyzed. RESULTS: Twenty-three Wistar rats with hepatic E. multilocularis infection were killed, and 27 HAE lesions was found. The largest diameter of HAE lesion was 2.24 cm, and the average size was (0.97 +/- 0.48) cm. The shape of HAE lesions was round, oval, or irregular. HAE lesions presented a complex internal echo pattern. Spot-like color flow signal was observed in the tissues around the lesions, no blood flow signal was observed in HAE lesions. In 25 lesions, a circular rim-like enhancement belt was visualized at the periphery during early arterial phase, and honeycomb enhancement appeared in the other two lesions. The positive expression rate of CD34 in infiltrative zones surrounding HAE lesions was 99.2% (118/119), with 17.6% (21/119) of strong positive, 73.1% (87/119) of moderate positive, 8.4% (10/119) of weak positive, and 0.8% (1/119) of negative, respectively. In normal liver tissues, the positive expression rate of CD34 was 25.2% (30/119), no strong positive was found, with 4.2% (5/119) of moderate positive, 21.0% (25/119) of weak positive, and 74.8% (89/119) of negative, respectively. The sonographic infiltrative region in HAE lesion correlated with microvascular density (r = 0.238, P < 0.05). CONCLUSION: There is a positive correlation between the circular rim-like enhancement belt surrounding HAE lesions and the microvascular density in the rat model.

[Value of BI-RADS ultrasonic scores of direct and indirect ultrasonographic signs in diagnosis of solid breast lesions].

OBJECTIVE: To explore the value of BI-RADS ultrasonic scores of direct and indirect ultrasonographic signs in diagnosis of solid breast lesions. METHODS: Reference to the standard BI-RADS score, ultrasonic scores of direct and indirect ultrasonographic signs of 132 solid breast lesions were assigned, and were compared with pathological results. RESULTS: By the direct signs of breast lesions (aspect ratio, shape, border, internal echo, posterior echo, flow grade, sand-like calcification) and indirect signs (changes in local skin thickness, Cooper ligament changes, axillary lymph nodes, depth of reinforcement membrane changes, mass changes in the surrounding burr), the integral from the total scores in benign and malignant breast masses showed a statistically significant difference. The total score of malignant lesions (8.94 ± 2.85) was significantly higher than that of benign tumors (3.09 ± 1.97, P < 0.05). Except skin thickness, all the remaining scores of the signs of benign and malignant breast tumors showed a significant difference between the two groups (P < 0.05). By receiver operating curve (ROC) analysis, the best critical value of the total score of direct signs was ≥ 4, with a sensitivity and specificity of 0.84 and 0.93, respectively, in distinguishing breast carcinoma from benign lesions. The best critical value of the total score of indirect signs was ≥ 1, with a sensitivity and specificity of 0.82 and 0.74, respectively. The critical value of the combination of the direct and indirect signs was ≥ 5 in differential diagnosis of malignant and benign lesions, with a sensitivity and specificity value of 0.88 and 0.90, respectively. CONCLUSION: The assignment score to the ultrasound characteristics of the direct and indirect signs of solid breast lesions can make a more objective diagnosis, yet it is a simple, effective, comprehensive and semi-quantitative analysis method.