[Value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between benign and malignant renal neoplasms].

OBJECTIVE: To investigate the value of contrast enhanced ultrasound (CEUS) imaging in the differential diagnosis between benign and malignant renal neoplasms. METHODS: Two hundred and forty-five cases of renal space-occupying lesions confirmed by biopsy or surgical pathology were included in this study. The CEUS features of the renal space-occupying lesions, i.e., the enhancement degree, homogeneity of enhancement, washing-in and washing-out time and enhancement pattern, were retrospectively analyzed. RESULTS: There were 210 cases of malignant renal tumors and 35 cases of benign lesions. The CEUS modes of the malignant renal tumors included "quick in and quick out" 82 cases, "quick in and slow out" 64 cases, "slow in and quick out" 18 cases and "slow in and slow out" 46 cases; good enhancement 150 cases (71.4%) and inhomogeneous enhancement 180 cases (85.7%).Both the contrast agent filling defect area and solid component enhancement of solid-cystic tumors were important features of malignant renal tumors. In the 35 cases of benign lesions,the CEUS modes included "quick in and quick out" 4 cases, "quick in and slow out" 8 cases, "slow in and quick out" 10 cases and "slow in and slow out" 13 cases. Most of the benign tumors showed low enhancement 51.4% (18/35) and inhomogeneous enhancement 54.3% (19/35). There were significant differences between the malignant and benign renal neoplasms in CEUS mode, degree of enhancement and homogeneity of enhancement (P < 0.05), and in time of increasing, peak time, peak intensity and peak intensity ratio (P < 0.05). The accuracy rates of contrast-enhanced ultrasound for diagnosis of benign and malignant tumors were 77.1% and 83.8%, respectively, while the two-dimensional ultrasound diagnosis of benign and malignant tumors were 68.6% and 76.7%, respectively, with a significant difference (P < 0.05). CONCLUSIONS: CEUS may provide more information to improve the diagnostic accuracy for renal neoplasms, and may play important role in differential diagnosis between benign and malignant renal lesions.

[Diagnostic value of thyroid microcarcinoma with a taller-than-wide shape in thyroid nodules].

OBJECTIVE: To explore the diagnostic value of thyroid microcarcinoma with a taller-than-wide shape (A/T ≥ 1) in transverse ultrasonographic planes. METHODS: There were a total of 683 thyroid nodules in 491 patients undergoing consecutive ultrasonography and surgery at our hospital between 2011 and 2012. The ultrasonography examinations of thyroid nodules were routinely performed in the transverse planes. A taller-than-wide shape was defined as a ratio of anteroposterior diameter to transverse diameter in transverse plane ≥ 1. The sensitivity and specificity for thyroid carcinoma were analyzed. The data of thyroid carcinoma were formulated as follows: group 1, nodules > 1 centimeter; group 2, ≤ 1 centimeter. Their ratios of A/T were compared. The data were analyzed with SPSS 17.0 statistical software package. RESULTS: Among 683 nodules, 499 were malignant and 184 benign. The sensitivity and specificity for malignancy were 61.5% and 84.2% respectively. There was significant difference (P = 0.000). A taller-than-wide shape (A/T ≥ 1) was more frequent in criterion 2 than criterion 1 (χ(2) = 4.380, P = 0.036). CONCLUSIONS: A taller-than-wide shape (A/T ≥ 1) is associated with thyroid malignancy especially thyroid microcarcinoma. And it is a useful ultrasonic feature for predicting thyroid microcarcinoma.

Sulfated polymannuroguluronate inhibits Tat-induced SLK cell adhesion via a novel binding site, a KKR spatial triad.

AIM: Sulfated polymannuroguluronate (SPMG), a candidate anti-AIDS drug, inhibited HIV replication and interfered with HIV entry into host T lymphocytes. SPMG has high binding affinity for the transactivating factor of the HIV-1 virus (Tat) via its basic domain. However, deletion or substitution of the basic domain affected, but did not completely eliminated Tat-SPMG interactions. Here, we sought to identify other SPMG binding sites in addition to the basic domain. METHODS: The potential SPMG binding sites were determined using molecular simulation and a surface plasmon resonance (SPR) based competitive inhibition assay. The effect of SPMG on Tat induced adhesion was evaluated using a cell adhesion assay. RESULTS: The KKR domain, a novel high-affinity heparin binding site, was identified, which consisted of a triad of Lys12, Lys41, and Arg78. The KKR domain, spatially enclosed SPMG binding site on Tat, functions as another binding domain for SPMG. Further functional evaluation demonstrated that SPMG inhibits Tat-mediated SLK cell adhesion by directly binding to the KKR region. CONCLUSION: The KKR domain is a novel high-affinity binding domain for SPMG. Our findings provide important new insights into the molecular mechanisms of SPMG and a potential therapeutic intervention for Tat-induced cell adhesion.

Clinical features and survival analysis of very young (age<35) breast cancer patients.

OBJECTIVES: To compare the clinicalpathological features and prognosis between premenopausal breast cancer patients aged of <35 and ≥35 years old. METHODS: The clinical data and survival status of 1498 cases premenopausal operable breast cancer treated in our hospital from 2002.1 to 2004. 12 were collected, 118 cases were aged <35. They were divided into 4 groups: Luminal A, Luminal B, HER2-positive, Triple-negative. The disease free survival (DFS) and overall survival (OS) were identified. RESULTS: The 5-year DFS and OS rates were significantly lower in age<35 than in age≥35 patients. In the Luminal B, HER2-positive, Triple-negative group, the 5-year recurrence risk was higher in age<35 than in age≥35 patients, and age<35 patients' 5-year death risk was higher only in Luminal B, Triple-negative group. Regardless of whether lymph node involved, age<35 patients had a bad prognosis in both DFS and OS. CONCLUSIONS: Compared with premenopausal age ≥35 breast cancer, age<35 patients had a worse outcome.

Application of Real-time Ultrasound Elastography in Diagnosing Benign and Malignant Thyroid Solid Nodules.

OBJECTIVE: Real-time ultrasound elastography (US-E) is a helpful tool in diagnosing thyroid nodules. This study aims to evaluate thyroid solid nodules, to establish the accuracy of US-E in providing information on the nature of these nodules, and to assess the clinical value of elasticity scores (ES) and strain ratio (SR) in differentiating thyroid solid nodules and to explore its distribution characteristics using pathological analysis as reference. METHODS: Traditional ultrasonography and US-E were performed on 131 thyroid solid nodules (99 benign ones and 32 malignant ones) in 120 patients (78 females and 41 males). Three radiologists evaluated the nodules based on a four-degree elasticity scoring system. The nodules were classified according to the ES as soft (ES 1-2) or hard (ES 3-4). The SR was calculated online. RESULTS: The sensitivity and specificity of the ES for thyroid cancer diagnosis were 78% and 80%, respectively. SR values ≥ 2.9 used as a standard to distinguish benign from malignant nodules had a sensitivity of 87% and a specificity of 92%. The SR of the benign lesions was 1.64±1.37, which was significantly different from that of malignant lesions, which was 4.96±2.13 (P<0.01). CONCLUSIONS: Both the ES and SR were higher in malignant nodules than those in benign ones. Real-time US-E was a useful index in the differential diagnosis of thyroid solid nodules. It can provide quantitative information on thyroid nodule characterization and improve diagnostic confidence.