钼靶和超声检查在乳腺癌临床诊断的准确性的比较分析

摘要 目的：比较与分析钼靶和超声检查在乳腺癌临床诊断的准确性。方法：2018年8月到2021年1月选择在本院进行诊治的乳腺肿瘤患者110例作为研究对象,所有患者都给予钼靶和超声检查,记录影像学特征并判断诊断价值。结果：在110例患者中,病理诊断为乳腺良性肿瘤76例、乳腺癌34例。恶性组钼靶的分叶征、钙化、大角征、毛刺征等比例高于良性组,病灶大小也高于良性组(P<0.05)。恶性组超声的形态不规则、边缘不光整、高回声晕、回声衰减、微钙化等比例高于良性组(P<0.05)。钼靶乳腺影像报告及数据系统(Breast imaging report and data system,BI-RADS)判断为乳腺良性肿瘤72例,乳腺癌38例;超声BI-RADS判断为乳腺良性肿瘤75例,乳腺癌35例,钼靶鉴别诊断乳腺癌的敏感性为93.4%,特异性为97.1%,准确性为94.5%;超声鉴别诊断乳腺癌的敏感性为98.7%,特异性为100.0%,准确性为99.1%。多因素logistic回归分析显示病灶大小、分叶征、回声衰减、毛刺征为导致误诊的重要因素(P<0.05)。结论：乳腺癌在钼靶和超声检查中都有明显的征象特征,超声诊断的准确性更高,病灶大小、分叶征、回声衰减、毛刺征为影响诊断效果的很重要因素。     

实时影像融合的超声虚拟导航技术联合射频消融术治疗原发性肝癌合并门静脉癌栓患者的疗效及对血清Bax、Cyfra21-1的影响

摘要 目的：探讨实时影像融合的超声虚拟导航技术联合射频消融术治疗原发性肝癌合并门静脉癌栓患者的疗效及对血清BCL-2同源的水溶性相关蛋白（Bax）、细胞角蛋白19片段（Cyfra21-1）的影响。方法：选择本院2017年1月到2021年4月收治的原发性肝癌合并门静脉癌栓患者82例作为研究对象,根据1：1随机数字表法将患者分为虚拟导航组与对照组各41例,虚拟导航组给予实时影像融合的超声虚拟导航技术联合射频消融术治疗,对照组给予单纯超声引导联合射频消融术治疗。结果：虚拟导航组的进针次数、融合时间、布针时间少于对照组（P<0.05）;虚拟导航组治疗后3个月的胆汁瘤、肝脓肿、膈肌损伤、肺部感染等并发症发生率为4.9 %,低于对照组的29.3 %（P<0.05）。虚拟导航组治疗后3个月的总有效率为82.9 %,高于对照组的51.2 %（P<0.05）。两组治疗后3个月的血清谷丙转氨酶（ALT）、谷草转氨酶（AST）水平低于治疗前,虚拟导航组低于对照组（P<0.05）。两组治疗后的血清Bax、Cyfra21-1含量低于治疗前,虚拟导航组低于对照组（P<0.05）。结论：实时影像融合的超声虚拟导航技术联合射频消融术治疗原发性肝癌合并门静脉癌栓能降低血清Bax、Cyfra21-1含量,改善患者的肝功能,提高消融效率,还可减少并发症的发生,最终提高患者的总体治疗效果。     

The shear modulus of lower-leg muscles correlates to intramuscular pressure

Shear wave elastography (SWE) is emerging as an innovative tool to evaluate muscle properties and function. It has been shown to correlate with both passive and active muscle forces, and is sensitive to physiological processes and pathological conditions. Similarly, intramuscular pressure (IMP) is an important parameter that changes with passive and active muscle contraction, body position, exercise, blood pressure, and several pathologies. Therefore, the objective of this study was to quantify the dependency of shear modulus within the lower-leg muscles on IMP in healthy individuals. Nineteen healthy individuals (age: Mean age ± SD, 23.84 ± 6.64 years) were recruited. Shear modulus was measured using ultrasound SWE on the tibialis anterior (TA) and peroneus longus (PL) muscles using pressure cuff inflation around the thigh at 40 mmHg, 80 mmHg, and 120 mmHg. Changes in IMP were verified using a catheter connected to a blood pressure monitor. It was found that IMP was correlated to TA and PL shear modulus (spearman's rank correlation = 0.99 and 0.99, respectively). Applying a gradual increase of cuff pressure from 0 to 120 mmHg increased the shear modulus of the TA and PL muscles from 15.83 (2.46) kPa to 21.88 (4.33) kPa and from 9.64 (1.97) kPa to 12.88 (5.99) kPa, respectively. These results demonstrate that changes of muscle mechanical properties are dependent on IMP. This observation is important to improve interpretation of ultrasound elastograms and to potentially use it as a biomarker for more accurate diagnosis of pathologies related to increased IMP.     

Potential roles and targeted therapy of the CXCLs/CXCR2 axis in cancer and inflammatory diseases

The chemokine receptor CXCR2 and its ligands are implicated in the progression of tumours and various inflammatory diseases. Activation of the CXCLs/CXCR2 axis activates multiple signalling pathways, including the PI3K, p38/ERK, and JAK pathways, and regulates cell survival and migration. The CXCLs/CXCR2 axis plays a vital role in the tumour microenvironment and in recruiting neutrophils to inflammatory sites. Extensive infiltration of neutrophils during chronic inflammation is one of the most important pathogenic factors in various inflammatory diseases. Chronic inflammation is considered to be closely correlated with initiation of cancer. In addition, immunosuppressive effects of myeloid-derived suppressor cells (MDSCs) against T cells attenuate the anti-tumour effects of T cells and promote tumour invasion and metastasis. Over the last several decades, many therapeutic strategies targeting CXCR2 have shown promising results and entered clinical trials. In this review, we focus on the features and functions of the CXCLs/CXCR2 axis and highlight its role in cancer and inflammatory diseases. We also discuss its potential use in targeted therapies.     

Does Anthropomorphism of Dogs Affect Pain Perception in Animal-Assisted Interventions? An Exploratory Study

The purpose of this exploratory study was to determine the effects of anthropomorphism of a therapy dog on pain perception during an animal-assisted intervention. Participants were 32 college women who were randomly assigned to the anthropomorphism condition or the control condition. All participants engaged in a pretest cold pressor task to measure base-line individual differences in pain tolerance and perceptions of pain intensity and pain unpleasantness. After completing this task, participants in the anthropomorphism group engaged in a task intended to prime them to view a therapy dog anthropomorphically. Specifically, they rated photos of dogs on a series of humanlike traits (e.g., “this dog would be a good listener”). Participants in the control condition rated photos of dogs on a series of canine traits (e.g., “this dog would make a good watchdog”). After this experimental manipulation, participants engaged in a second cold pressor task in the presence of a therapy dog and the therapy dog handler. We hypothesized that participants in the anthropomorphism group would demonstrate greater pain tolerance and report lower levels of pain intensity and pain unpleasantness during the second cold pressor task than participants in the control group. Results provide partial support for these hypotheses. Participants in the anthropomorphism group reported lower posttest pain intensity than participants in the control group. In addition, they demonstrated greater posttest pain tolerance than participants in the control group—but only under conditions of medium or high pretest pain tolerance. The two groups did not differ with respect to posttest pain unpleasantness. The results of this exploratory study provide preliminary evidence that prompting individuals to view a therapy dog anthropomorphically may augment their experience of pain relief from a therapy dog visit.     

The role of mitochondria in sepsis-induced cardiomyopathy

Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Myocardial dysfunction, often termed sepsis-induced cardiomyopathy, is a frequent complication and is associated with worse outcomes. Numerous mechanisms contribute to sepsis-induced cardiomyopathy and a growing body of evidence suggests that bioenergetic and metabolic derangements play a central role in its development; however, there are significant discrepancies in the literature, perhaps reflecting variability in the experimental models employed or in the host response to sepsis. The condition is characterised by lack of significant cell death, normal tissue oxygen levels and, in survivors, reversibility of organ dysfunction. The functional changes observed in cardiac tissue may represent an adaptive response to prolonged stress that limits cell death, improving the potential for recovery. In this review, we describe our current understanding of the pathophysiology underlying myocardial dysfunction in sepsis, with a focus on disrupted mitochondrial processes.     

Ulinastatin attenuates liver injury and inflammation in a cecal ligation and puncture induced sepsis mouse model

Sepsis is a syndrome of life-threatening multiorgan dysfunction caused by host response dysregulation to infection. Ulinastatin (UTI), a serine protease inhibitor, possesses anti-inflammatory properties and has been suggested to modulate lipopolysaccharide-induced sepsis. However, little is known about the mechanism underlying its effects on sepsis. In the current study, we investigated the protective effect of UTI on liver injury in a cecal ligation and puncture (CLP)-induced sepsis of C57BL/6 mouse model and explored the possible mechanisms. Mice underwent CLP as sepsis models and were randomized into five groups including the sham group, UTI group, CLP group, UTI-L group, and UTI-H group. UTI was intraperitoneally administered at doses of UTI 1500 U/100 g (UTI-L group) or 3000 U/100 g (UTI-H group), before CLP. The mice were killed, and immunohistochemical changes, cytokine levels, and antioxidant enzyme activities were detected. Our results showed that UTI ameliorated CLP-mediated increases in serum aspartate aminotransferase and alanine aminotransferase activities, histological activity index, degenerative region ratio, and infiltrated inflammatory cell numbers. Moreover, UTI also decreased nitrotyrosine and 4-hydroxynonenal, activated caspase-3, and activated poly (ADP-ribose) polymerase (PARP) levels and inhibited the mitogen-activated protein kinase pathway activation in liver tissues. Our results indicated that UTI could inhibit CLP-induced liver injury by suppressing inflammation and oxidation. Our results indicated that UTI may serve as a potential therapeutic agent for sepsis.     

Emerging technologies in therapeutic ultrasound: Thermal ablation to gene delivery

Ultrasound is used today in medicine as a modality for diagnostic imaging. Recently, there have been numerous reports on the application of thermal and nonthermal ultrasound energy for treating various diseases. In addition to thermal ablation of tumors, non-thermal ultrasound combined with drugs and genes have led to much excitement especially for cancer treatment, vascular diseases, and regenerative medicine. Ultrasound energy can enhance the effects of thrombolytic agents such as urokinase for treatment of stroke and acute myocardial infarction. New ultrasound technologies have resulted in advanced devices such as a) ultrasound catheters, b) Non-invasive methods as high intensity focused ultrasound (HIFU) in conjunction with MRI and CT is already being applied in the clinical field, c) Chemical activation of drugs by ultrasound energy for treatment of tumors is another new field recently termed "Sonodynamic Therapy", and d) Combination of genes and microbubble have induced great hopes for ideal gene therapy (sonoporation). Various examples of ultrasound combined modalities are under investigation which could lead to revolutionary therapy.     

动脉内灌药,内支架安置双介入治疗十二指肠恶性梗阻

通过动脉内灌药,内支架安置双介入治疗提高对十二指肠恶性梗阻姑息性治疗的疗效。十二指肠恶性梗阻病例１４例,男５例,女９例,年龄２０－６９岁,经口安置自膨式十二指肠金属支架共１５枚,其中１２例在支架安置后定期行肿瘤供血动脉插管介入化疗,所有病例梗阻症状解除,２例未行动脉灌药治疗者分别于２个月及４个月死亡,１２例双介入者生存期明显延长,最短６月,最长已达一年,结论：双介入治疗能够姑息治疗疗效延长晚期瘤患