Ultrasound-based radiomics for the differential diagnosis of breast masses: A systematic review and meta-analysis.

OBJECTIVES: Ultrasound-based radiomics has demonstrated excellent diagnostic performance in differentiating benign and malignant breast masses. Given a few clinical studies on their diagnostic role, we conducted a meta-analysis of the potential effects of ultrasound-based radiomics for the differential diagnosis of breast masses, aiming to provide evidence-based medical basis for clinical research. MATERIALS AND METHODS: We searched Embase, Web of Science, Cochrane Library, and PubMed databases from inception through to February 2023. The methodological quality assessment of the included studies was performed according to Quality Assessment of Diagnostic Accuracy Studies checklist. A diagnostic test accuracy systematic review and meta-analysis was performed in accordance with PRISMA guidelines. Sensitivity, specificity, and area under curve delineating benign and malignant lesions were recorded. We also used sensitivity analysis and subgroup analysis to explore potential sources of heterogeneity. Deeks' funnel plots was used to examine the publication bias. RESULTS: A total of 11 studies were included in this meta-analysis. For the diagnosis of malignant breast masses worldwide, the overall mean rates of sensitivity and specificity of ultrasound-based radiomics were 0.90 (95% confidence interval [CI], 0.83-0.95) and 0.89 (95% CI, 0.82-0.94), respectively. The summary diagnostic odds ratio was 76 (95% CI, 26-219), and the area under the curve for the summary receiver operating characteristic curve was 0.95 (95% CI, 0.93-0.97). CONCLUSION: Ultrasound-based radiomics has the potential to improve diagnostic accuracy to discriminate between benign and malignant breast masses, and could reduce unnecessary biopsies.

[Preliminary application of indocyanine green fluorescence imaging technology in nasal endoscopic tumor surgery].

Objective:To preliminarily study the practical value of Indocyanine green（ICG） molecular fluorescence imaging technology in nasal endoscopic tumor surgery. Methods:Five patients with tumors related to nasal sinuses, orbital wall and skull base in the Department of Otolaryngology head and Neck Surgery, General Hospital of Xinjiang Military Command from December 2022 to April 2023 were enrolled. Among them, 3 were benign tumors and 2 were malignant tumors. All patients underwent surgery under the guidance of ICG molecular fluorescence imaging. ICG was administered intravenously through cubital vein at a dose of 0.5 mg/kg 12 to 24 h before surgery. Tumors were labeled by fluorescence imaging during the operation. surgeons cleared the tumor tissue strictly according to the labeled range and depth, malignant tumors were further expanded and cleaned according to pathology results. Results:All 5 patients achieved accurate tumor localization with the aid of fluorescence imaging technology. Resections were performed with reference to fluorescent labeling boundaries, all patients achieved complete tumor cleanup or negative margins. Conclusion:For tumor-related surgery under nasal endoscopy, ICG molecular fluorescence imaging technology can not only achieve accurate real-time positioning, but also provide evidence for surgeons to judge tumor boundaries. Therefore, we believe that the technology should have certain practical value in nasal endoscopic tumor surgery.

Contrast-enhanced ultrasound of polyp malignant transformation with multiple metastases in a patient with Peutz-Jeghers syndrome.

Multi-systemic metastasis in patients with Peutz-Jeghers syndrome (PJS) is very rare, and there are nearly no relevant imaging reports, especially in contrast-enhanced ultrasound (CEUS). We present here a 40-year-old male patient who underwent several partial small bowel resections and endoscopic polypectomy for intestinal polyps. After reviewing the patient's clinical diagnosis and treatment process, CEUS with sulfur hexafluoride microbubbles (SonoVue, Bracco, Milan, Italy) in the liver and gastrointestinal tract was performed. We imaged multiple abnormal masses with sonographic features consistent with malignancies. Combined with other imaging examinations and 18 gauge core-needle puncture biopsy of liver masses, multiple metastases outside the gastrointestinal tract were considered. This case report suggests CEUS may be an easy, effective, and supplementary method for evaluating PJS patients with suspected multi-systemic malignant lesions including the gastrointestinal tract.

Application of Biologic Graft in Nasal Septal Perforation Repair.

Objective: To explore the clinical outcome when biomaterials are used to repair nasal septal perforations. Methods: A total of 12 patients were treated. The nasal septum was dissected via endoscopic approach. A 4 cm × 7 cm biologic graft (Biodesign® Tissue Graft) was folded to form a double layer, was placed over the perforation, and was affixed into place using suture. Results: Follow-up ranged from 2 to 8 months after the operation. One patient was not completely healed and presented with a remaining defect of about 2 mm × 8 mm in the upper part of the nasal septum. The remaining 11 patients healed completely. Conclusion: Using a biologic graft to repair nasal septal perforations is an easy operation as it prevents the need to take autologous tissue from the patient, allows for a repair to be performed without creating septal flaps, and has good histocompatibility. It is a safe and effective method that can be used clinically.

Analysis of Pathogen Characteristics and Nursing Factors of Tonsil Infection Based on Regression Equation.

In order to meet the needs of the analysis and application of regression equation in clinical medicine of tonsil infection, this paper focuses on the semiparametric regression model method, cross-validation method, empirical method, and multiple regression equation analysis of atypical data using regression equation. The general method of analyzing this kind of data is given, and the parameter estimation and hypothesis testing of the model are systematically studied. The experimental results showed that among the 90 paraffin-embedded tissue specimens of chronic tonsillitis and adenoid hypertrophy in this study, 26 out of 49 male children were EBERs positive, accounting for 53.06% of male children (26/49 cases). 28 of the 41 female children were positive, accounting for 68.29 of the female children (28/41 cases). There were 14 cases in infant group, 20 cases in preschool age group, 25 cases in school-age group, and 31 cases in adolescence group; the EBERs-positive rate was 42.86% (6/14 cases) in early childhood and 55.00% in early school-age (11/20 cases), and the EBERs-positive rate was 60.00% in school-age group (15/20 cases) and 70.97% in adolescent group. The results showed that the latent infection rate of adenoid hypertrophy EBV in children with chronic tonsillitis showed no significant difference between genders. It is proved that the regression equation method can meet the needs of clinical analysis and application of tonsil infection.

Research on the efficacy of laryngendoscopic low-temperature plasma ablation on early glottic cancer.

PURPOSE: To evaluate the efficacy and safety of self-retaining laryngendoscope-assisted low-temperature plasma ablation (LTPA) in the treatment of patients with early glottic cancer. METHODS: The clinical data of 84 patients with early glottic cancer treated in our department from May 2013 to May 2016 were collected. All patients were divided into the Plasma group (n=42, treated with the laryngendoscopic LTPA) and the Laryngofissure group (n=42, treated with traditional laryngofissure). The operation conditions, pain and cough visual analogue scale (VAS) scores, postoperative complications, mucosal recovery and voice recovery indexes were compared between the two groups, the postoperative recurrence rate was recorded, and the patients were followed up for tumor recurrence and survival. RESULTS: In the Plasma group, the operation time was significantly shorter than that in the Laryngofissure group, the amount of intraoperative bleeding was significantly less than that in the Laryngofissure group (p<0.001), and the postoperative hospitalization time was also significantly shorter than that in the Laryngofissure group. The postoperative pain and cough VAS scores in the Plasma group were obviously lower than those in the Laryngofissure group. The proportion of smooth vocal mucosa after operation in the Plasma group was evidently higher than that in the Laryngofissure group. In Plasma group, the voice parameters Jitter, Shimmer and harmonic to noise ratio (HNR) were all remarkably superior to those in the Laryngofissure group. The overall survival (OS) and progression-free survival (PFS) had no statistically significant differences between the two groups according to the log-rank test. CONCLUSIONS: Self-retaining laryngendoscope-assisted LTPA has definite efficacy in the treatment of early glottic cancer, after which the recurrence rate and survival rate are similar to those after open laryngofissure, but LTPA is characterized by short operation time, less postoperative bleeding, quick recovery of patients and better voice recovery.

A new strategy for accurate targeted diagnosis and treatment of cutaneous malignant melanoma: dual-mode phase-change lipid nanodroplets as ultrasound contrast agents.

BACKGROUND: Currently, effective detection and treatment of cutaneous malignant melanoma (CMM) still face severe challenges. Ultrasound molecular imaging as a noninvasive and easy-to-operate method is expected to bring improvements for tumor detection. PURPOSE: The aim of this research is to prepare novel phase-change ultrasound contrast agents, Nds-IR780, which can perform not only dual-mode molecule-targeted imaging but also targeted photothermal therapy for CMM. METHODS: A double emulsion process was used to prepare the Nds-IR780. Then, the entrapment rate and drug loading of IR-780 iodide in Nds-IR780 were detected by high-performance liquid chromatography. The biocompatibility of Nds-IR780 was evaluated by a CCK-8 assay and the characteristics and stability of that were verified through the particle size analyzer, laser scanning confocal microscopy (LSCM) and transmission electron microscopy (TEM). The abilities of dual-mode molecule-targeted imaging and targeted photothermal therapy for Nds-IR780 were confirmed via the in vitro and in vivo experiments. RESULTS: Nds-IR780 had good size distribution, polydispersity index, stability and biosafety. The in vitro and in vivo experiments confirmed that Nds-IR780 were capable of targeting CMM cells with high affinity (22.4±3.2%) and facilitating dual-mode imaging to detect the primary lesion and sentinel lymph nodes (SLNs) of CMM. Furthermore, the photothermal ablation of CMM mediated by Nds-IR780 was very effective in vivo. CONCLUSION: The newly prepared Nds-IR780 were observed to be effective targeted theranostic probe for the precise detection and targeted treatment of CMM.

Significance and clinical applications of ultrasound score in assessing the clinical severity of acute cholecystitis in the elderly.

OBJECTIVE: To investigate the feasibility and significance of the clinical application of ultrasound score in assessing the clinical severity of acute cholecystitis in the elderly. METHODS: Pre-surgery ultrasonography was performed on 72 elderly patients with acute cholecystitis who were scheduled for cholecystectomy to determine the score based on ultrasonic imaging features to reflect clinical severity. Prior to operation, the cases were classified as mild, moderate, and severe according to clinical manifestation. The significance of ultrasonography for the prediction of the severity of acute cholecystitis and its pre-surgery guidance were evaluated based on intraoperative findings and postoperative pathology. RESULT: In the aspect of clinical severity, of the 72 cases, 36 were mild, 21 were moderate, and 15 were severe. The cases that showed enlarged gallbladders, thickened gallbladder walls, double-layer images, gallbladder stones, incarcerated gall-stones, echoes in gallbladder fluid, peri-gallbladder effusions, or adherences were mostly moderate and severe cases. The difference in these cases with the mild cases exhibited statistical significance (P < 0.05). Of the 28 cases that scored ≤5, 26 (92.68 %) were mild cases. The 26 cases that scored between 6 and 9 mainly consisted of 15 moderate cases (57.7 %). The 18 cases that scored ≥10 mainly consisted of 13 severe cases (72.2 %). Significant differences were found in the cholecystostomy cases among the three groups (P < 0.05). CONCLUSION: Prior to cholecystectomy, ultrasound score could accurately determine the severity of acute cholecystitis in the elderly and may be used as a reference for surgical intervention timing and mode selection to guide clinical therapy.

SIS with tissue-cultured allogenic cartilages patch tracheoplasty in a rabbit model for tracheal defect.

CONCLUSIONS: In the rabbit model, small intestinal submucosa (SIS) compounded with tissue-cultured allogenic cartilages appeared to be an efficacious method for the patch repair of partial circumferential tracheal defects instead of autologous grafts. SIS appears to be a safe and promising means of facilitating neovascularization and tissue regeneration. The long-term use of SIS and tissue-cultured allogenic cartilages warrants further investigation. BACKGROUND: Tracheal defect reparation remains a challenging surgical problem that can require reconstruction using autologous grafts or artificial stents. This study was performed to evaluate the efficacy of SIS, a biocompatible, acellular matrix, compounded with different tissue-cultured allogenic cartilages, in the repair of a critical-size tracheal defect. MATERIALS AND METHODS: A full-thickness defect (4 x 8 mm) was created in tracheal rings four to six in adult rabbits. A piece of 8-ply SIS sandwiched in thyroid cartilage, auricular cartilage, or without cartilage, respectively (designated experiment 1, 2, or 3, respectively), was sutured to the edges of the defect with interrupted 4-0 polypropylene sutures. In control animals, the defect was closed with lamina praetrachealis. All animals were followed until signs of dyspnea became apparent or for 4 or 12 weeks. After follow-up and euthanasia, the trachea was harvested and prepared for histologic evaluation using conventional techniques. RESULTS: All animals tolerated the procedure well but two animals in group 1 (n=5), three in group 2 (n=5), and one in group 3 (n=5) had stridor after operation and expired within <1 month with different degrees of obstruction. The other animals in these groups and the control animals (n =3) all survived >1 month. Histologically, neovascularization of the patch was noted with moderate inflammation. The surface of the SIS patch was covered with a lining of ciliated epithelial cells. The tissue-cultured allogenic cartilages degraded to some extent.

[Quarter section cricoid split: its effect on cartilage growth in rabbits].

OBJECTIVE: To investigate the effect of the quarter-section cricoid split on cartilage growth. METHOD: The rabbits were killed 8 months after surgery of anterior, anteroposterior and quarter section cricoid split. The larynxes were harvested and the cross sectional areas of the cricoid cartilage were calculated. RESULT: There was no significant in the cross sectional area of the cricoid cartilage of any of the four groups. CONCLUSION: The quarter section cricoid split has no adverse effect on subsequent growth of cricoid cartilage and animals.

[Anteroposterior cricoid split interposition grafting for laryngotracheal stenosis in children].

OBJECTIVE: To investigate the effects of anteroposterior cricoid split interposition grafting on children with laryngotracheal stenosis. METHOD: This is a retrospective study, from 1991 to 2001 years, 12 children (aged 6 years to 15 years) with laryngotracheal stenosis were operated with cricoid split laryngotracheal reconstruction at our hospital. All of 12 patients were tracheostomy dependent before reconstruction. RESULT: Eleven patients (91.7%) were successfully decannulated with good airway patency and effective phonation. The follow-up period ranged from 1 to 10 years. The effect of operation is steady and the growth and development of children is normal. CONCLUSION: The anteroposterior cricoid split interposition grafting was a safe and effective method for treatment of laryngotracheal stenosis in children.