A clinical-radiomics nomogram based on multimodal ultrasound for predicting the malignancy risk in solid hypoechoic breast lesions.

Background: In routine clinical examinations, solid hypoechoic breast lesions are frequently encountered, but accurately distinguishing them poses a challenge. This study proposed a clinical-radiomics nomogram based on multimodal ultrasound that enhances the diagnostic accuracy for solid hypoechoic breast lesions. Method: This retrospective study analyzed ultrasound strain elastography (SE) and automated breast volume scanner images (ABVS) of 423 solid hypoechoic breast lesions from 423 female patients in our hospital between August 2019 and May 2022. They were assigned to the training (n=296) and validation (n=127) groups in a 7:3 ratio by generating random numbers. Radiomics features were extracted and screened from ABVS and SE images, followed by the calculation of the radiomics score (Radscore) based on these features. Subsequently, a nomogram was constructed through multivariate logistic regression to assess the malignancy risk in breast lesions by combining Radscore with Breast Imaging Reporting and Data System (BI-RADS) scores and clinical risk factors associated with breast malignant lesions. The diagnostic performance, calibration performance, and clinical usefulness of the nomogram were assessed by the area under the curve (AUC) of the receiver operating characteristic curve, the calibration curve, and the decision analysis curve, respectively. Results: The diagnostic performance of the nomogram is significantly superior to that of both the clinical diagnostic model (BI-RADS model) and the multimodal radiomics model (SE+ABVS radiomics model) in training (AUC: 0.972 vs 0.930 vs 0.941) and validation group (AUC:0.964 vs 0.916 vs 0.933). In addition, the nomogram also exhibited a favorable goodness-of-fit and could lead to greater net benefits for patients. Conclusion: The nomogram enables a more effective assessment of the malignancy risk of solid hypoechoic breast lesions; therefore, it can serve as a new and efficient diagnostic tool for clinical diagnosis.

Establishment of a mouse model of thoracic aortic dissection with acute lung injury by BAPN / 中国实验动物学报

Objective A feasible and stable mouse model of thoracic aortic dissection(TAD)combined with acute lung injury(ALI)was established using β-aminopropionitrile monofumarate(BAPN)1 g/(kg·d)administered in drinking water.The mouse model of TAD combined with acute lung injury(ALI)was established to provide a rational animal model to study TAD combined with ALI.Methods Forty-five SPF-grade 3-week-old C57BL/6J male mice were selected and randomly allocated to a CON group(normal dietary water;15 mice)or BAPN group(administration in sterile water at 1 g/(kg·d);30 mice)for 4 weeks.During the experimental period,the general condition and modeling rate of mice were observed.TAD model mice were validated,and the BAPN group was divided into TAD and non-TAD groups by measuring the maximum diameter of the thoracic aorta and HE staining of aortic tissues.HE pathological staining,the wet/dry weight(W/D)ratio,total protein level in bronchioalveolar lavage fluid(BALF),and interleukin(IL)-1 β,IL-6,and tumor necrosis factor-α(TNF-α)in BALF)were used to validate the TAD combined ALI model in mice.Results BAPN treatment significantly delayed the increase in body mass and water intake of mice.Compared with CON and non-TAD groups,the maximum diameter of the thoracic aorta of mice in the TAD group was significantly thickened(P＜0.05).HE staining of the aorta showed significant thickening of the middle aortic layer,and the structure of the aortic wall was damaged and disordered.HE staining of lung tissues showed significant interstitial edema and inflammatory exudation accompanied by enlargement of alveolar lumen,alveolar wall epithelial exfoliation and hyaline membrane formation,and a significant increase in the pathological scores of lung injury(P＜0.05).Total protein levels and expression of IL-1β,IL-6,and TNF-α in lung tissue,W/D ratio,and BALF were also significantly increased(P＜0.05),whereas no significant difference was observed in the above indexes between the other two groups.Conclusions A mouse model of thoracic aortic dissection combined with acute lung injury can be established by BAPN administration in drinking water.

Study on the association between vasoactive-inotropic score and mortality of total arch replacement in type A aortic dissection patients / 中华胸心血管外科杂志

Objective:To study on the association between vasoactive-inotropic score(VIS) and mortality of total arch replacement in Stanford type A aortic dissection(TAAD) patients.Methods:Data of TAAD patients admitted from January 2018 to November 2018 were analyzed retrospectively. According to the inclusion and exclusion criteria, 187 patients were finally included in the analysis. 30-day mortality was calculated and the patients were divided into death group(18 cases) and non-death group(169 cases). The VIS at each time point and perioperative indexes of the two groups were compared. The value of VIS in predicting mortality was analyzed.Results:The 30-day mortality was 9.63%(18/187). The operation time, cardiopulmonary bypass time, ventilator assistance time, the incidence of tracheotomy and major postoperative complications in the death group were significantly higher than those in the non-death group( P<0.05). VIS of death group was significantly higher than that of non-death group( P<0.05). At each time point, the area under ROC curve(AUC) of VIS was greater than 0.500( P<0.05), among which AUC of ICU 48 h VIS was the largest(0.817), and the best cut-off point of ICU 48 h VIS was determined to be 9, sensitivity 61.1%, specificity 92.3%. Logistic regression analysis showed that ICU 48 h VIS was an independent risk factor for predicting the death of total arch replacement in TAAD patients( OR=1.465, 95% CI: 1.194-1.796, P<0.001). Conclusion:When ICU 48 h VIS≥9, the risk of death was increased in patients with total arch replacement of TAAD. VIS may be a useful reference index for predicting the mortality of total arch replacement in TAAD patients in the early postoperative period.

Verification and comparisons of different ultrasound risk-stratification systems in the evaluation of thyroid nodules / 中华超声影像学杂志

Objective To verify and compare the TI-RADS developed by Kwak et al .( Kwak TI-RADS ) ,2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer ( ATA Guideline Classification) ,2017 TI-RADS released by the American College of Radiology (ACR TI-RADS) and TI-RADS developed by Zhou et al .(Zhou TI-RADS) in the evaluation of thyroid nodules . Methods The ultrasound images of 339 thyroid nodules in 273 patients were analyzed by retrospective study . The thyroid nodules were categorized into aforementioned four stratified systems . Based on the pathological findings considered the "gold standard",the receiver operating characteristic( ROC ) curve was created to compare the clinical application value of aforementioned four stratified systems . Results The percentage of nodules that could not be categorized were 1 .2％ ,17 .5％ ,0 and 1 .2％ for the Kwak TI-RADS ,ATA guidelines ,ACR TI-RADS ,and Zhou TI-RADS ,respectively and the area under the ROC curve ( AUC) was 0 .899 ,0 .879 ,0 .876 ,and 0 .918 ,respectively . The sensitivity of Kwak TI-RADS ,ATA guidelines classification ,and ACR TI-RADS were higher than that of Zhou TI-RADS (all P < 0 .05) ,whereas the specificity of Zhou TI-RADS was the highest (all P < 0 .05) . As for the accuracy ,no statistically significant differences were observed between any two of Kwak TI-RADS ,ATA guidelines ,ACR TI-RADS ,and Zhou TI-RADS systems ( all P > 0 .05) . Conclusions Four thyroid risk stratification systems provide effective risk assessment for thyroid nodules ,Zhou TI-RADS has relatively lower sensitivity ,but its specificity and AUC value are the highest among the four evaluated systems . In addition ,ACR TI-RADS can classify the most nodules ,while the number of nodules that can′t be categorized by ATA guideline is maximum .

Protective effect of growth differentiation factor 11 on myocardial injury in type II diabetic mice / 中国实验动物学报

Objective To observe the protective effect of growth differentiation factor 11(GDF11) on myocardial injury and the changes of myocardial apoptosis in type 2 diabetic C57BL/6J mice.Methods Sixty male C57BL/6J mice weighing 20-25 g were randomly divided into three groups: control group (control), type 2 diabetes mellitus group (DM) and GDF11 intervention group (DM + GDF11).To establish mouse model of type 2 diabetes, the mice were fed with high fat and high sugar diet for 4 weeks, and i.p.injected consecutively three times of streptozotocin (STZ) in a dose of 60 mg/kg.After the continuous high-fat and high-sugar diet for 4 weeks, the cardiac function was detected by small animal ultrasound, TUNEL staining was used to detect the apoptosis in myocardium, and the expressions of cleaved-caspase-3, Bcl-2, Bax were measured.Results Diabetic injury significantly reduced the left ventricular ejection fraction and left ventricular short axis shortening rate, and increased myocardial apoptosis.Recombinant GDF11 protein significantly improved cardiac function and reduced myocardial apoptosis.Conclusions Exogenous GDF11 can significantly reduce myocardial apoptosis and improve heart function after diabetic injury.

Primary Report on Hip Joint Superficial Substitution / 浙江中医药大学学报

[Objective]Primarily discuss cases selection and operation skill of hip joint superficial substitution.[Method]From Oct.2004 to Feb.2007,10 hip joints of 8 cases were made superficial substitution,paying attention on cases selection and operation skill.[Result]All cases had no such complications as femur neck fracture,infection,joint dislocation,vessel or nerve injury,deep vein embolism or ectopic ossification in early stage.The patients' score increased to 93~99 and average 95 from 35~56 and 45 before operation,the unequal limbs were corrected for DDH cases.On X-ray measurement:40?~50?for acetabula abduction angle,44?in average;134?~143?,139?for short-handle eversion angle of femur lateral;average off-set rate was 0.20 for femur neck;no loose prosthesis or narrow femur neck,no bright zone around short-handle.[Conclusion]Hip joint superficial substitution is very fit for young people with much sports,but we should pay attention to case selection and operation skill.