Diagnostic performance of a new two-dimensional shear wave elastography expression using siemens ultrasound system combined with ACR TI-RADS for classification of benign and malignant thyroid nodules: A prospective multi-center study.

Objective: The present study aimed to evaluate the efficacy of a new two-dimensional shear wave elastography (2D-SWE) method using a Siemens ultrasound system and its combination with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) for the differential diagnosis of benign and malignant thyroid nodules. Methods: Conventional ultrasound images and 2D-SWE (E-whole-mean and E-stiffest-mean) were prospectively analyzed in 593 thyroid nodules from 543 patients. Nodules were divided into diameter (D) ≤10 mm and D > 10 mm groups and graded using ACR TI-RADS. The receiver operating characteristic curve was plotted using pathological findings as the gold standard. Diagnostic performance was compared among 2D-SWE, ACR TI-RADS, and their combination. Results: The area under the curve (AUC) for E-whole-mean was higher than that for E-stiffest-mean (0.858 vs. 0.790, P < 0.001), which indicated that it was the better 2D-SWE parameter for differentiating malignant nodules from benign nodules with an optimal cut-off point of 11.36 kPa. In the all-sizes group, the AUC for E-whole-mean was higher than that for ACR TI-RADS (0.858 vs. 0.808, P < 0.001). The combination of E-whole-mean and ACR TI-RADS resulted in a higher AUC (0.929 vs. 0.858 vs. 0.808, P < 0.001), sensitivity (87.0% vs. 80.3% vs. 85.2%), specificity (85.1% vs. 74.0% vs. 73.6%), accuracy (86.3% vs. 78.1% vs. 81.1%), positive predictive value (91.5% vs. 85.1% vs. 85.6%), and negative predictive value (78.0% vs. 67.0% vs. 72.9%) compared to E-whole-mean or ACR TI-RADS alone. The AUC for the combination of 2D-SWE and ACR TI-RADS was superior to that for E-whole-mean or ACR TI-RADS alone in both D ≤ 10 mm and D > 10 mm groups (P < 0.001). Conclusion: As the better 2D-SWE parameter, E-whole-mean had a higher diagnostic power than ACR TI-RADS and enhanced the diagnostic performance of ACR TI-RADS when identifying benign and malignant thyroid nodules. The combination of E-whole-mean and ACR TI-RADS improved the diagnostic performance compared to using ACR TI-RADS alone, providing a new and reliable method for the clinical diagnosis of thyroid nodules.

The Analgesic Effect of Transcutaneous Electrical Acupoint Stimulation on Labor: A Randomized Control Study.

OBJECTIVE: This study aimed to investigate the analgesic effect of transcutaneous electrical acupoint stimulation (TEAS) on labor. METHODS: Primiparas with single birth and head presentation were enrolled in this study and randomly divided into three groups: TEAS group (n = 76), patient-controlled epidural analgesia (PCEA) group (n = 75), and control group without any analgesic measures (n = 78). RESULTS: Compared with the control group, the visual analog scores of the TEAS group and the PCEA group at each time point decreased (P < 0.01). The decrease was greater in the PCEA group than that in the TEAS group (P < 0.01). At 120 minutes after analgesia, there were significant differences in plasma ß-endorphin content between the TEAS group, PCEA group, and control group (P < 0.01). The difference between the PCEA group and the control group was statistically significant (P < 0.01). Among the parturients having a vaginal delivery, the duration of the first stage of labor was significantly shorter in the TEAS group and control group than in the PCEA group (P < 0.01). The duration of the second stage of labor was significantly shorter in the TEAS group than in the PCEA group (P < 0.01). Oxytocin usage rate during labor was significantly lower in the TEAS group and control group than in the PCEA group (P < 0.01), and adverse reactions were significantly fewer in the TEAS group and control group than in the PCEA group (P < 0.01). CONCLUSION: The duration of the first and second stage of labor is significantly shorter in the TEAS group than in the PCEA group. TEAS does not increase the use rate of oxytocin or the rate of cesarean section and will not bring about obvious maternal or fetal adverse reactions.

[Effect of transcutaneous electrical acupoint stimulation on labor analgesia].

OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on labor pain. METHODS: A total of 151 primiparas who were vaginal delivery were randomized into a TEAS group (76 cases) and a peridural group (75 cases). In the peridural group, peridural blockage was applied to analgesia. In the TEAS group, TEAS was applied at Hegu (LI 4)，Neiguan (PC 6), Jiaji T10~L1 (EX-B 2) and Ciliao (BL 32), disperse-dense wave (2 Hz/100 Hz), 15-50 mA in current intensity. The analgesic time was from 3 cm to completely opening of cervix. The visual analogue scale (VAS) scores were observed before analgesia, after 30, 60, 120 min of analgesia in the two groups. The time of different stages of labor, usage rate of oxytocin, incidence rate of adverse reaction and amount of postpartum hemorrhage were recorded. The newborn's 1 and 5 min Apgar scores were evaluated. RESULTS: The VAS scores showed a downward trend in the two groups after analgesia (P<0.01), and the change of the TEAS group was less than the peridural group (P<0.01). The active phase on the first stage and second stage of labor in the TEAS group were shorter than the peridural group (P<0.01, P<0.05), there was no significant difference in the time of third stage of labor between the two groups (P>0.05). The usage rate of oxytocin and incidence rate of adverse reaction in the TEAS group were 9.2% (7/76) and 2.6% (2/76), which were lower than 34.7% (26/75) and 18.7% (14/75) in the peridural group (P<0.01). There was no significant difference in the amount of postpartum hemorrhage and newborn's 1 and 5 min Apgar scores between the two groups (P>0.05). CONCLUSION: The analgesic effect of TEAS is inferior to peridural blockage, but TEAS could relieve labor pain to the tolerance, shorten the time of active phase on the first stage and second stage of labor and reduce the use of oxytocin, has mild adverse reaction.

Anticancer activity of sugiol against ovarian cancer cell line SKOV3 involves mitochondrial apoptosis, cell cycle arrest and blocking of the RAF/MEK/ERK signalling pathway.

INTRODUCTION: Ovarian cancer is one of the leading causes of cancer-related deaths in women. Treatments for ovarian cancer include surgery followed by chemotherapy. However, the survival rate for ovarian cancer is still not satisfactory. Moreover, the current chemotherapy has numerous associated side effects. Therefore there is an urgent need to look for novel and more viable treatment options. Against this backdrop the present study was designed to evaluate the anticancer activity of sugiol against ovarian cancer cells. MATERIAL AND METHODS: Cell viability was assessed by CCK8 assay, apoptosis by DAPI, AO/ER and annexin V/PI staining. Mitochondrial membrane potential and cell cycle analysis was performed by flow cytometry. Cell migration was investigated by wound healing assay. Protein expression was monitored by western blotting. RESULTS: The results of the present study indicated that sugiol exerts significant (p < 0.0001) anticancer effects on SKOV3 cancer cells with an IC50 of 25 µM. However, sugiol exhibited less cytotoxicity against normal ovarian cells with an IC50 of 62.5 µM. The anticancer effects of sugiol were found to be due to G0/G1 cell cycle arrest and mitochondrial apoptosis. Sugiol also inhibited cell migration of SKOV3 cells dose dependently. Moreover, the results showed that sugiol could inhibit the RAF/MEK/ERK signalling pathway in a dose-dependent manner. CONCLUSIONS: The results of the present study indicate that sugiol exerts potent anticancer effects on SKOV3 cells via induction of cell cycle arrest, mitochondrial apoptosis and inhibition of the RAF/MEK/ERK signalling pathway.

Screening of differential proteins of placenta tissues in patients with pre-eclampsia by iTRAQ proteomics techniques.

BACKGROUND: Isotopically labeled relative and absolute quantification (iTRAQ) were applied together with liquid chromatogram-tandem mass spectrometry (LC-MS/MS) technique to screen and differentiate normal tissues and differential proteins of placenta tissue in the pre-eclampsia group, and to seek for a pre-eclampsia biomarker. METHODS: Thirty patients with severe pre-eclampsia (pre-eclampsia group) and 30 patients with normal full-term pregnancy (control group), who were admitted by the Obstetrical Department of The Affiliated Hospital of Qingdao University from December 2014 to June 2015, were collected for this study. Part of the placenta tissue was sampled following cesarean section to extract the total protein that was degenerated, reduced and enzymatically hydrolyzed. Following iTRAQ, mass spectroscopy was used for differentiation to obtain differential proteins in the expression. RESULTS: A total of 234 differential proteins were identified. The comparison between the severe pre-eclampsia group and the control group indicated over 1.5-folds of expression abundance difference (upregulation ratio >1.50, or downregulation ratio <0.67). The difference was statistically significant in 24 protein points in total, among which the expression of 14 protein points was upregulated compared with that of the control group, and the expression of 10 protein points was downregulated. CONCLUSIONS: iTRAQ combined with the LC-MS/MS technique can effectively screen differential proteins in placenta tissues of patients with pre-eclampsia.

[Potential application of human amniotic mesenchymal cells for seeding cells in bone tissue engineering].

OBJECTIVE: To investigate the potential of human amniotic mesenchymal cells (hAMC) serving as seeding cells in bone tissue engineering. METHODS: hAMC were isolated and cultured. The third passage of hAMC was cultured in osteogenic induced media [DMEM supplemented with 10% (v/v) FBS, 0.1 mumol/L dexamethasone, 50 mg/L ascorbic acid and 10 mmol/L beta-glycerophosphate] for one week. Calcified nodules were shown by alizarin red staining and counted under light microscope. Immunofluorescence cytochemical staining was used to detect collagen I (COL I) and alkaline phosphatase (ALP). Expression of FasL was examined in the amnion and hAMC by immunohistochemistry or immunocytochemistry. RESULTS: After osteoblast differentiation, calcified nodules were formed, on the average 18 per well. hAMC in calcified nodules showed positive expression of COL I and ALP. FasL was detected positive both in cells contained in amnion and in hAMC. CONCLUSION: hAMC are potential ideal candidates for seeding cells in bone tissue engineering.

[Association between insulin resistance and cholesteryl ester transfer protein gene polymorphism in type 2 diabetes mellitus].

OBJECTIVE: To study the association between cholesteryl ester transfer protein (CETP) gene polymorphism and insulin resistance in type 2 diabetes. METHODS: CETP-TaqIB gene was genotyped with polymerase chain reaction-restriction enzyme fragment polymorphism analysis in 108 patients with type 2 diabetes and in 60 normal controls. Plasma lipids, fasting insulin, insulin sensitivity index and insulin resistance index were determined in 108 patients with type 2 diabetes. RESULTS: The distribution of CETP-TaqIB genotypes and B1B2 allele frequency in the patients with type 2 diabetes were similar to that in general population. High density lipoprotein cholesterol (HDL-C), apolipoprotein A1(apoA1) and insulin sensitivity index (ISI) levels were significantly higher in B2B2 genotype than in B1B1 genotype. Fasting insulin (FINS) and Homeostasis model assessment-insulin resistance (HOMA-IR) levels were significantly lower in B2B2 genotype than in B1B1 genotype. No significant differences in triglyceride (TG), total cholesterol(TC),low density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB) levels were observed among different CETP-TaqIB genotype groups. By multivariate analysis, the determinants of ISI and HOMA-IR were body mass index (BMI), TC, HDL-C and CETP-TaqIB genotype. CONCLUSION: The CETP-TaqIB genotype is independently associated with insulin resistance and lipid metabolism. It may be an important risk factor of insulin resistance in type 2 diabetes.

[Remote fetal monitoring for gestational diabetes mellitus].

OBJECTIVE: To investigate the clinical value of remote fetal monitoring network in the antepartum management of gestational diabetes mellitus (GDM). METHODS: Non-stress test (NST) was preformed in 50 GDM cases by remote electronic fetal monitoring network (test group), and another 50 monitored by daily fetal movement counting and regular NST check-up in hospital served as the control group. Abnormal NST and perinatal outcome were compared between the two groups. RESULTS: The incidence of abnormal NST was significantly higher in the test group than in the control group (34.6% and 25.5%, P<0.05), as with Apgar scores of the neonates between the two groups (9.58+/-0.77 vs 8.70+/-1.23, P<0.01). The incidences of neonatal asphyxia (12.0%) and preterm birth (8.0%) in the test group were lower than those in the control group (24.0% and 22.0%, respectively, P<0.05). There was no significant difference in the rate of cesarean section between the two groups (P>0.05). CONCLUSION: Remote fetal monitoring network can be used to improve perinatal outcome of GDM, and offers a new option of self-monitoring means for pregnant women with GDM.