[Value of shear wave elastrography image classification in the diagnosis of breast masses].

Objective: To analyze the image features of shear wave elastrography (SWE) in breast masses, and to evaluate their values in the differentiation of benign and malignant breast lesions. Methods: A total of 361 patients with 403 breast lesions who simultaneously underwent conventional ultrasound and SWE examination from February 2015 to January 2018 were selected. Diagnosis in all patients was confirmed by aspiration biopsy or operative pathology. The SWE images were collected and the elastic images were divided into 5 types. The SWE image features of different breast pathological types were summarized, and their values in benign and malignant breast lesion diagnoses were evaluated. Results: The main features of benign breast lesion were type Ⅰ and Ⅱ, the main features of the malignant lesion were type Ⅳ and Ⅴ, and the proportion of which were 43.6% (71/163), 37.4% (61/163), 22.1% (53/240) and 57.9% (139/240), respectively. Type Ⅲ accounted for a certain proportion in both benign and malignant lesions. The SWE image features of benign and malignant lesions were compared and a significant difference was observed (P<0.001). The type Ⅴ features were mainly observed in invasive ductal carcinoma, invasive lobular carcinoma and other types of invasive carcinoma, while the type Ⅳ features were mostly presented in ductal carcinoma in situ and mucinous carcinoma. Fibroadenoma, fibroadenosis accompanied with fibroadenoma, and fibroadenosis were featured with type Ⅰ. Both intraductal papilloma and benign phyllodes tumor were mostly type Ⅱ, while type Ⅲ and Ⅴ were more common in chronic granulomatous mastitis. When type Ⅰ and typeⅡof breast lesions were classified as benign features while type Ⅳ and Ⅴ were malignant features, the sensitivity and specificity of breast malignant lesion diagnosis were 91.2% and 84.7% by application of SWE combined with breast imaging reporting and data system (BI-RADS). The sensitivity of combined diagnosis was slightly lower than that of conventional ultrasound (P>0.05), but the specificity was significantly higher than conventional ultrasound (P<0.01). Conclusion: The SWE is a simple and effective method. Combination of SWE with conventional ultrasound may improve the diagnostic differentiation of benign and malignant breast lesions.

Pulmonary hypertension in patients with stage 1-3 chronic kidney disease.

Pulmonary hypertension (PH) secondary to chronic kidney disease (CKD) is common, but in stages 1-3 CKD patients, it remains unclear. We sought to evaluate the prevalence of PH and elucidate the possible pathogenesis in Chinese patients with early stage kidney disease. Doppler-estimated pulmonary systolic artery pressure (PASP) was measured in 101 CKD patients with glomerular filtration rate (GFR) ≥ 60 mL/min/1.73 m(2) and 27 CKD patients with GFR < 60 mL/min/1.73 m(2). Echocardiographic parameters, plasma brain natriuretic peptide (BNP), and baseline characteristics of patients were recorded. PH was defined as a PASP ≥ 35 mmHg. PH prevalence was 23.76% (24/101) in GFR ≥ 60 mL/min/1.73 m(2) group and 48.15% (13/27) in GFR < 60 mL/min/1.73 m(2) group, P < 0.05. Mean lnBNP was 4.93 ± 1.60 pg/mL in 37 cases with PH and 2.89 ± 1.29 pg/mL in those without, P < 0.01. Left atrial diameter (LA) showed deviation between patients with (43.94 ± 5.81 mm) and without PH (37.76 ± 7.48 mm), P < 0.01. GFR declined significantly in PH group (44.10 ± 22.90 mL/min/1.73 m(2)) compared to non-PH group (75.59 ± 31.62 mL/min/1.73 m(2)), P < 0.01. lnBNP, LA and GFR were independent determinants (r = 0.651, 0.595, -0.488, P < 0.01) of PASP. PH is prevalent among stage 1-3 CKD patients in China. Doppler-estimated PASP is strongly associated with lnBNP, enlarged LA and GFR. Monitoring PASP, plasma BNP and evaluation renal function may help to detect and prevent severe PH in CKD.

Correlation of forkhead box transcription factor O1 and myosin heavy chain isoforms in porcine skeletal muscle.

We examined the expression of myosin heavy chain (MyHC) isoforms and forkhead box transcription factor O1 (FoxO1) in porcine soleus and extensor digitorum longus (EDL) muscles to clarify the correlation of FoxO1 and the relative abundance of transcripts of MyHC isoforms. Soleus muscle was found to be redder than EDL muscles in pigs, and immunohistochemical fast MyHC staining showed more oxidative type I fibers compared to EDL. qRT-PCR quantification of MyHC isoforms I, IIa, IIx, and IIb showed that expression of MyHC I and MyHC IIa mRNAs was much higher, whereas expression of MyHC IIx and MyHC IIb mRNAs was much lower in porcine soleus muscle compared to EDL muscle. Expression of FoxO1 mRNA and p-FoxO1 protein was significantly more abundant in porcine soleus muscle compared to EDL muscle. The expression of phosphorylated FoxO1 (p-FoxO1) was positively correlated with the expression of MyHC I (R = 0.9747, P < 0.01) and negatively correlated with the expression of MyHC IIx (R = -0.9963, P < 0.01) and MyHC IIb (R = -0.9834, P < 0.01). Taken together, these results suggested that FoxO1 may play a pivotal role in the determination of muscle fiber type.

Adhesion and invasion to duck embryo fibroblast cells by Riemerella anatipestifer.

Here, we investigated adhesion and invasion of Riemerella anatipestifer (RA) to primary duck embryo fibroblast (DEF) cells. The ability of RA to adhere to, and more importantly, to invade DEF cells was demonstrated by using a gentamicin invasion assay and was confirmed by transmission electron microscopy (TEM). Adhesion of RA could be found by TEM after 1 h of inoculation. Both apoptosis and necrocytosis of DEF were indicated by TEM after 10 h of incubation, which suggested a complex mechanism of DEF cell death induced by RA. Our results showed that internalized RA had the ability to leave the DEF cells. Inhibition studies indicated that RA proteins play a role in adhesion. Moreover, invasion of RA to DEF cells was shown to require rearrangement of actin microfilaments and microtubular cytoskeletal elements. Because the adhesion and invasion ability of RA to DEF cells could be demonstrated in vitro, similar processes might occur in vivo, where DEF cells play a crucial role in the diffusion of RA in ducks.

Intestinal epithelium-derived BATF3 promotes colitis-associated colon cancer through facilitating CXCL5-mediated neutrophils recruitment.

Inflammation is a critical player in the development and progression of colon cancer. Basic leucine zipper transcription factor ATF-like 3 (BATF3) plays an important role in infection and tumor immunity through regulating the development of conventional type 1 dendritic cells (cDC1s). However, the function of BATF3 in colitis and colitis-associated colon cancer (CAC) remains unclear. Here, BATF3 wild-type and knockout mice were used to construct an AOM/DSS-induced CAC model. In addition, DSS-induced chronic colitis, bone marrow cross-transfusion (BMT), neutrophil knockout, and other animal models were used for in-depth research. We found that BATF3 deficiency in intestinal epithelial cells rather than in cDC1s inhibited CAC, which was depended on inflammatory stimulation. Mechanistically, BATF3 directly promoted transcription of CXCL5 by forming a heterodimer with JunD, and accelerated the recruitment of neutrophils through the CXCL5-CXCR2 axis, ultimately increasing the occurrence and development of CAC. Tissue microarray and TCGA data also indicated that high expression of BATF3 was positively correlated with poor prognosis of colorectal cancer and other inflammation-related tumors. In summary, our results demonstrate that intestinal epithelial-derived BATF3 relies on inflammatory stimulation to promote CAC, and BATF3 is expected to be a novel diagnostic indicator for colitis and CAC.

Post-operative complications of gastric cancer surgery: female gender at high risk.

We applied physiological and operative severity score for the enumeration of morbidity and mortality (POSSUM) to evaluate overall surgical outcome and investigated the role of gender for early post-operative complications in gastric cancer surgery. The data from a total of 357 patients of gastric cancer were analysed by univariate and multivariate analysis. Post-operative complications were recorded according to definition of POSSUM. Post-operative complications of male and female patients were compared separately. The observed to estimated morbidity ratio (O:E) was 1.01. Among the pre-operative variables, patient gender was one of the independent risk factors for a higher rate of post-operative complications (risk ratio 1.777, P = 0.024). Post-operative complication was significantly higher in female patients. Similarly, post-operative length of stay was significantly longer and more severe complications were observed in female patients (P = 0.03). In conclusion, POSSUM system is a valid algorithm for risk-adjusted surgical audit. We conclude that a patient's gender influences the early post-operative complications after gastric cancer surgery. A detailed understanding on disparity of early post-operative complications between men and women may provide valuable information to improve surgical outcome of gastric cancer. However, results of this study need further confirmation by a prospective study involving a larger cohort.

[The clinical efficacy analysis of the surgery of the posterior approach parotid gland region resection preserving retinal ganglion and parotid fascia].

Objective:To explore the clinical efficacy analysis the surgery of the posterior approach parotid gland resection preserving retinal ganglion and parotid fascia for the treatment of benign parotid tumour.Method:One hundred and twelve cases were randomly divided into control group and treatment group. The control group was treated by anterior approach parotid gland region resection preserving retinal ganglion and parotid fascia. The treatment group was treated by posterior approach parotid gland region resection preserving retinal ganglion and parotid fascia. The data of operation time, postoperative local numbness, Frey syndrome, facial paralysis and postoperative recurrence case were analyzed. Result:There was no postoperative recurrence case in both two groups, and there was no significant difference between two the groups in operation time and the percent of facial paralysis（all P>0.05）.However, the percent of postoperative local numbness and Frey syndrome in control group were significantly higher than those in treatment group（all P<0.05）. Conclusion:The treatment group had similar clinical efficacy with the traditional surgical operation. In addition, the operation of treatment group contributed to decreased postoperative complications.

Association between the resistin gene-420 C>G polymorphism and obesity: an updated meta-analysis.

OBJECTIVE: The aim of this study was to assess the relationship of the resistin gene (RETN)-420 C>G polymorphism and obesity susceptibility by conducting an updated meta-analysis. MATERIALS AND METHODS: The electronic databases including PubMed, Medline, Embase, China National Knowledge Infrastructure, Chinese Wanfang Database, and Chinese VIP database were searched for relevant studies published before December 2013. The fixed effect model or random effects model was used based on the heterogeneity test results. The sensitivity analysis was performed in the allelic model and the dominant genetic model, respectively. Publication bias was assessed via funnel plot. The meta-analysis was performed using the software of RevMan 5.2. RESULTS: Data were obtained from 10 included studies, involving 5,069 cases and 6,673 controls. The overall odds ratios (ORs) with its 95% confidence interval (CI) showed no association between RETN-420 C>G polymorphism and obesity in the allelic model (p = 0.09; OR = 1.10; 95% CI = 0.991.24), the dominant model (p = 0.09; OR = 1.16; 95% CI = 0.98-1.36), and the recessive model (p = 0.71; OR = 1.02; 95% CI = 0.90-1.16). Sensitivity analysis showed statistical differences of association analysis within the allelic model (p = 0.04; OR = 1.14; 95% CI = 1.01-1.28) and the dominant genetic model (p = 0.04; OR = 1.21; 95% CI = 1.01-1.45), when 1 study was omitted. No publication bias was observed. CONCLUSIONS: The RETN-420 C>G polymorphism may be related to obesity with G allele as a risk factor.

Evaluation in vivo of a potent parathyroid hormone antagonist: [Nle8,18,D-Trp12,Tyr34]bPTH(7-34)NH2.

In an effort to design and select potent parathyroid hormone (PTH) antagonists suitable for clinical utility, a PTH analog was evaluated in vivo in an animal model to assess its properties in preparation for human studies. The previously described PTH antagonist, [Nle8,18,D-Trp12,Tyr34]bPTH(7-34)NH2, which is highly active in vitro, was documented in these studies to be an effective antagonist of the PTH-stimulated calcemic response in vivo. In thyroparathyroidectomized (TPTX) rats, the efficacy of the antagonist was demonstrated to be dose-dependent. Inhibition was demonstrated when intravenous administration of antagonist started 1 h prior to coinfusion with the PTH agonist [Nle8,18,Tyr34]bPTH(1-34)NH2. Maximal inhibition by antagonist (an 84% decline in serum calcium levels compared with agonist alone) of the calcemic response was observed when a 200-fold molar excess of antagonist (12 nmol/h) was administered. At dose ratios of antagonist:agonist as low as 10:1, a 40-50% inhibition of PTH-stimulated calcemic response is evident, provided a longer (2 h) lead time for antagonist infusion is allowed. Based on these and related studies, the antagonist [Nle8,18,D-Trp12,Tyr34]bPTH(7-34)NH2 has displayed sufficient potency to obtain approval from the appropriate institutional and regulatory agencies for clinical trials in hypercalcemic states of parathyroid and tumor origin.

cHa-ras proto-oncogene. Amplification and overexpression in UV-B-induced mouse skin papillomas and carcinomas.

The role of cellular proto-oncogene activation in shortwave UV light in the B range (UV-B)--induced skin carcinogenesis was investigated. Epidermal papillomas and carcinomas were induced on the depilated skin surface of Sencar mice with single-dose UV-B irradiation (7 x 10(4) J/m2). The tumors thus initiated were present in 18.8% of treated animals and were primarily benign papillomas, while a few (6 of 17) progressed to form squamous cell carcinomas. A 5- to 10-fold stimulation of cHa-ras gene expression in both papillomas and carcinomas was observed. Other cellular proto-oncogenes such as cKi-ras, c-myc, or c-fos specific messenger RNAs were not detected in these UV-B--induced skin tumors. Subsequent Southern blot analysis revealed a threefold to fivefold amplification of cHa-ras gene in skin papillomas and carcinomas. However, only the carcinoma and not the papilloma DNA induced foci in the classic NIH-3T3 transformation assay, suggesting that activation of cHa-ras gene alone is not sufficient to exhibit this phenotypic expression of transformed cells. The NIH-3T3 transformants exhibited (1) anchorage independent growth on soft agar, (2) tumor induction in athymic mice, and (3) overexpression and amplification of the cHa-ras gene. We propose that overexpression of a ras gene by gene amplification plays a role in the UV-B--induced skin carcinogenesis process.

Ni-Ti memory alloy clamp plate for fracture of short tubular bone.

The clamp shape implant has a special memorial function. It consists of one main rod and 3 or 4 pairs of curved short arms located at both sides of the rod. Each pair of arms rolls into a circle, which can embrace 2/3 of the circumference of the fractured bone shaft, thus fixing fragmental bones at multiple points more securely without any limitation to the motion of adjacent joints. Therefore, clamp implant is especially useful for comminuted fracture of the short tubular bone, which is difficult to fix by other methods.

Effect of dietary supplemental levels of vitamin A on the egg production and immune responses of heat-stressed laying hens.

Two experiments were conducted to evaluate the effect of vitamin A supplementation of a commercial layer diet on the laying performance and immune function of heat-stressed hens. In Experiment 1, two different levels of vitamin A supplementation (3,000 and 9,000 IU/kg) were used to investigate the laying performance and antibody titer against Newcastle disease virus (NDV) of heat-stressed hens. Results showed that the high level of vitamin A supplementation (9,000 IU/kg) had a beneficial effect on the feed intake and laying rate of heat-stressed hens (P < 0.05), compared with the control group (3,000 IU/kg). The antibody titers were not influenced by the level of vitamin A (P > 0.05). In Experiment 2, the effect of four levels of vitamin A (3,000, 6,000, 9,000, and 12,000 IU/kg) on the antibody titer to NDV and T lymphocyte proportion was studied. The experimental birds were exposed to a high temperature (31.5 C) 15 d after NDV vaccination (Treatment 1) or immediately (Treatment 2). The results showed that the egg weight was increased (P < 0.01) by the high levels of vitamin A supplementation (6,000 and 9,000 IU/kg), but feed intake, laying rate, and body weight loss were not (P > 0.05). In Treatment 1, vitamin A had no significant effect on antibody titers against NDV in normal or hot environments but increased (P < 0.01) the proportion of alpha-naphthyl acetate esterase (ANAE)-positive cells. Vitamin A supplementation had a significant effect on NDV antibody titer and ANAE-positive cell proportion in Treatment 2 (P < 0.01). The results of the present study suggested that vitamin A supplementation in commercial layer diets to layer chickens under heat stress was beneficial to laying performance and immune function.

[Total hip arthroplasties in 190 cases: follow-up study].

One hundred and ninety-six cemented total hip arthroplasties performed in 190 patients (mean age, 62 years) followed-up with an average of 8.7 years were reviewed. The results were compared with the same group previously reported at an average follow-up of 4 years. Clinically satisfactory results were observed at the short- and medium-terms. Evaluation of the study with Harris score system showed that the score records fell from 85 to 78.4 points in the same group and the revision rate rose from 6.84% to 14.73%. The main causes of the prosthesis failure were loosening of the prosthesis and of breakage of the prosthesis stem. This follow-up study showed that the short-term prosthesis failure was mainly related to the cement-fixing technique, while the medium-term failure was due to side effects of the cement. This series showed that cemented prosthesis is a good selection especially for elderly patients.

Optical stabilizer using a Michelson interferometric bistable optical device with a ceramic electrostrictor.

We propose a new optical bistable device composed of a Michelson interferometer and a ceramic electrostrictor. Optical bistability is proved theoretically and experimentally. An optical stabilizer made use of this bistable device to stabilize the optical output power of He-Ne, cw Nd(3+):YAG, Ar(+), and CO(2) lasers. In the experiment we used it to stabilize the optical output power of a He-Ne laser and a cw Nd(3+):YAG laser and obtained satisfactory results.

Extraosseous and intraosseous arterial supply to the first metatarsal and metatarsophalangeal joint.

The extraosseus and intraosseous circulation to the first ray was evaluated by means of vascular injection techniques. The first metatarsal and metatarsophalangeal joint receive their blood supply from the first dorsal metatarsal artery, the first plantar metatarsal artery, and the superficial branch of the medial plantar artery. These three source arteries provide variable numbers of branches to the base, shaft, and head of the first metatarsal. Ramifications of branches to the head form an extensive capsular network that is more consistent and abundant on the dorsal and lateral aspects of the joint. The source of intraosseous vascularity consists of a diffuse network of fine periosteal arteries enveloping the diaphysis of the metatarsal, a single nutrient artery that perforates the first metatarsal at the lateral aspect of the shaft distally, and a system of metaphyseal and capital arteries that appear to constitute a major source of blood supply to the metatarsal head.

Free gracilis transfer in the treatment of gluteus medius paralysis after poliomyelitis.

Paralysis of the gluteus medius after poliomyelitis often gives rise to secondary spinal deformity and inclination of the pelvis; the patient presents with a typical waddling gait. The paralysis is usually associated also with varying degrees of involvement and deformity of the extremities. Current treatment for paralysis of the gluteus medius has not been totally satisfactory. With the development of micro-neurovascular procedures, transfer of free muscle grafts for paralyzed or functionless muscles can be performed with functional recovery. The authors present a series of 12 cases, of which 10 were followed-up from 12 to 35 months. All of them had good cosmetic and functional results, with increased hip stability and stable gait. The operative technique, as well as the surgical anatomy, are described.

Vascular anatomy of the fifth metatarsal.

The extraosseous and intraosseous vascular anatomy to the fifth metatarsal as visualized in a group of below-the-knee amputation specimens has been described. The extrinsic circulation to the area is provided by the dorsal metatarsal artery, the plantar metatarsal arteries, and the fibular plantar marginal artery. These three source arteries supply branches to the metatarsal and adjacent joints. The intraosseous vascularity consists of a periosteal plexus, a nutrient artery, and a system of metaphyseal and capital vessels.