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ObjectiveThe purpose of this study was to determine the values of the hemodynamic parameters of Doppler sonography in the diagnosis of renal artery stenosis (RAS) (diameter reduction ≥50%) and to investigate their possible influencing factors.MethodsFive Doppler parameters, including renal peak systolic velocity (RPSV), renal-aortic ratio (RAR), renal-renal ratio (RRR), renal-segmental ratio (RSR), and renal-interlobar ratio (RIR), were measured in 81 patients before arteriography. Arteries with ≥50% diameter reduction were considered stenosed at renal arteriography. Receiver operating characteristic curve analysis was performed to determine the optimal parameters. The sensitivity, specificity, positive and negative predictive values, and accuracy at various threshold values were calculated.ResultsSixteen accessory renal arteries (15 normal, one mild stenosis) were identified at arteriography. Of the 153 main renal arteries demonstrated at arteriography, 79 were normal or demonstrated stenosis

The association of prenatal signs of tuberous sclerosis complex (TSC) and renal cystic disease is very rare. We report the case of a male fetus with a cardiac mass and a renal cortical cyst detected in utero by sonography at 20 weeks' gestation. A postmortem examination showed polycystic kidney disease (PKD) and a cardiac rhabdomyoma, which is a prenatal marker of TSC. On the basis of the maternal history of TSC associated with radiographic features resembling autosomal dominant polycystic kidney disease (ADPKD), the early onset of the cardiac rhabdomyoma and renal cystic changes in the fetus strongly suggested TSC2/PKD1 contiguous gene syndrome or an impaired functional linkage between products of the 2 genes inherited from the mother.

Diabetic ulcers are one of the most serious and costly chronic complications for diabetic patients. Hyperglycemia-induced oxidative stress may play an important role in diabetes and its complications. The aim of the study was to explore the effect of heme oxygenase-1 on wound closure in diabetic rats. Diabetic wound model was prepared by making an incision with full thickness in STZ-induced diabetic rats. Wounds from diabetic rats were treated with 10% hemin ointment for 21 days. Increase of HO-1 protein expression enhanced anti-inflammation and antioxidant in diabetic rats. Furthermore, HO-1 increased the levels of VEGF and ICAM-1 and expressions of CBS and CSE protein. In summary, HO-1 promoted the wound closure by augmenting anti-inflammation, antioxidant, and angiogenesis in diabetic rats.

As a fundamental step in biomedical information extraction tasks, biomedical named entity recognition remains challenging. In recent years, the neural network has been applied on the entity recognition to avoid the complex hand-designed features, which are derived from various linguistic analyses. However, performance of the conventional neural network systems is always limited to exploiting long range dependencies in sentences. In this paper, we mainly adopt the bidirectional recurrent neural network with LSTM unit to identify biomedical entities, in which the twin word embeddings and sentence vector are added to rich input information. Therefore, the complex feature extraction can be skipped. In the testing phase, Viterbi algorithm is also used to filter the illogical label sequences. The experimental results conducted on the BioCreative II GM corpus show that our system can achieve an F-score of 88.61 %, which outperforms CRF models using the complex hand-designed features and is 6.74 % higher than RNNs.

Background This study aimed to confirm whether strain ratio should be added after evaluation of lesions with 5-point elasticity scoring for differentiating benign and malignant breast lesions on ultrasonographic elastography(UE). Materials and Methods From June 2010 to March 2012, 1080 consecutive female patients with breast lesions were recruited into a multicenter retrospective study, which involved 8 centers across China. Each institutional ethic review board approved the study, and all the patients gave written informed consent. All the patients underwent the UE procedure and the strain ratios were calculated and the final diagnosis was made by histological findings. The sensitivity, specificity, accuracy, PPV and NPV were calculated for each of the two evaluation systems and the areas under the ROC curve were compared. Results The strain ratios of benign lesions (mean, 2.6±2.0) and malignant lesions (mean,7.9±5.8) were significantly different (p 0.05). The strain ratio method shows better a diagnosis performance of the lesions with elasticity score 3 and 4. Conclusions Although the two UE methods have similar diagnostic performance, separate calculation of the strain ratios seems compulsory, especially for the large solid breast lesions and the lesions with elasticity score 3 and 4.

Accurate assessment of tumor size is necessary when selecting patients for breast-conserving surgery. In the study of breast contrast-enhanced ultrasound (CEUS), we found that tumor size discrepancy between CEUS and conventional ultrasound (US) existed in some breast lesions, for which the reasons are not clear. Breast CEUS examinations were performed in 104 patients with breast lesions. The measurement of the 104 breast tumors on conventional US was obtained and compared with the measurement on CEUS. A difference in measuring tumor size of >3 mm for tumors up to 1.7 cm and 4 mm for tumors >or=1.7 cm, was defined as a significant discrepancy between conventional US and CEUS. The histopathological examination of size discrepancy was performed and the margin characteristics of breast cancers with larger measurements were compared with those with unchanged measurements. Among the 104 lesions (43 malignant, 60 benign, 1 borderline), the size of 27 breast cancers and one granulomatous mastitis appeared larger at CEUS. Pathologic examinations of the region corresponding to the measurement discrepancy were mainly ductal carcinomas in situ (DCIS), invasive carcinoma with a DCIS component, adenosis with lobular hyperplasia in breast cancers and inflammatory cell infiltration in one granulomatous mastitis. Well-defined margin characteristics were significantly different between breast cancers with larger measurements at CEUS and those with unchanged measurements of size (p = 0.002), whereas no significant difference was found between the two groups in ill-defined, spiculated, hyperechoic halo, microlobulated and angulated margins (p = 0.463, 0.117, 0.194, 0.666 and 0.780, respectively). This initial study suggests that significant discrepancy of breast lesion measurement between conventional US and CEUS is more likely presented in breast cancer than benign lesions. The pathologic findings corresponding to the region of size increased at CEUS are malignant in most malignant lesions and benign in benign lesions. It is difficult to predict whether the size measurement of the breast cancer increases at CEUS based on the margin characteristics showed on conventional US.

OBJECTIVE The aim of this study was to evaluate the differences in the tardus-parvus pattern between atherosclerotic and nonatherosclerotic renal artery stenosis (RAS) and to explore the causes of these differences. METHODS In 81 patients, including a nonatherosclerotic group (29 cases of Takayasu arteritis and 22 cases of fibromuscular dysplasia) and an atherosclerotic group (n = 30), RAS was detected by color Doppler sonography and confirmed by renal arteriography. Doppler spectra were obtained at the upper, middle, and lower pole interlobar arteries, and the one with the most prolonged acceleration time (AT) was selected for recording the AT and resistive index (RI). RESULTS Renal angiography revealed 16 moderate RASs, 80 severe RASs, and 15 occlusions. No statistically significant differences were found in the AT between the atherosclerotic and nonatherosclerotic groups in the mild (P = .24), moderate (P = .63), and severe stenotic (P = .41) subgroups; however, there were statistically significant differences in the RI between the atherosclerotic and nonatherosclerotic groups in the mild (P < .001), moderate (P < .01), and severe (P < .001) subgroups. The RI values in the atherosclerotic group were much higher than those in the nonatherosclerotic group for the 3 stenotic subgroups. CONCLUSIONS The AT measurement method used widely now cannot differentiate potential differences in pulsus-tardus waveforms between atherosclerotic and nonatherosclerotic RAS; however, it remains a useful approach to detect RAS. Different RI cutoff values should be established according to atherosclerotic and nonatherosclerotic RAS, and consideration of influencing factors for the RI will help reduce misdiagnosis.

Backgound and aims: Dermatophagoides peteronyssinus is one of the important house dust mites responsible for allergic asthma that can be tentatively managed by specific immunotherapy. The present study was to construct a vector encoding T-cell epitopes of major allergen group 1 of Dermatophagoides pteronyssinus as a vaccine delivered by MHC class II pathway.the nucleotide sequences of the 3 target genes were synthesized, including TAT, IhC and the recombinant fragment of Der p 1 encoding 3 T-cell epitopes. After amplification of the 3 target fragments by PCR and digestion with corresponding restriction endonucleases, the recombinant gene TAT-IhC-Der p 1-3T was ligated using T4 DNA ligase and inserted into the prokaryotic expression vector pET28a(+) to construct the recombinant plasmid pET- 28a(+)-TAT-IhC-Der p 1-3T, which was confirmed by digestion with restriction endonucleases and sequencing. The recombinant vector was transformed into E. coli strain BL21 (DE3) and induced with IPTG, and the induced protein TAT-IhC-Der p1-3T was detected by SDS-PAGE. After purification, the recombinant protein was confirmed by Western blotting and its allergenicity tested using IgE-binding assay.the recombinant plasmid pET-28a-TAT-IhCDer p1-3T was successfully constructed as confirmed by restriction endonuclease digestion and sequencing, and the expression of the recombinant protein TAT-IhC-Der p1-3T was induced in E. coli. Western blotting verified successfull purification of the target protein, which showed a stronger IgE-binding ability than Der p1.we successfully constructed the recombinant expression vector pET-28a-TAT-IhC-Der p1-3T expressing a T-cell epitope vaccine delivered by MHC II pathway with strong IgE-binding ability, which provides a basis for further study on specific immunotherapy via MHC class II pathway.Antecedentes y objetivo: el Dermatophagoides peteronyssinus es uno de los principales ácaros del polvo doméstico responsables del asma alérgica que se pueden administrar provisionalmente para una inmunoterapia específica. El presente estudio busca construir un vector que codifique epítopos de células T del grupo de alérgenos principal, el Grupo 1 de Dermatophagoides pteronyssinus como una vacuna suministrada mediante la vía MHC de clase II. Métodos: se sintetizaron las secuencias de nucleótidos de los 3 genes objetivo, incluyendo TAT, IhC y el fragmento recombinante de Der p 1 encargado de codificar 3 epítopos de célula T. Después de la amplificación de los 3 fragmentos objetivo por PCR y digestión con endonucleasas de restricción correspondientes, el gen recombinante TAT-IhC-Der p 1-3T se ligó usando T4 DNA ligasa y se insertó en el vector de expresión procariota pET28a (+) para construir el plásmido recombinante pET 28a (+)-TAT-IHC-Der p 1-3T, que se confirmó por digestión con endonucleasas de restricción y secuenciación. El vector recombinante se transformó en E. coli cepa BL21 (DE3) y se indujo con IPTG, y la proteína inducida TATIHC- Der p1-3T se detectó mediante SDS-PAGE. Después de la purificación, la proteina recombinante se confirmó por análisis de inmunotransferencia (Western blot) y se probó su alergenicidad usando el ensayo de unión a IgE. Resultados: el plásmido recombinante pET-28a-TATIHCDer p1-3T se construyó con éxito, se confirmó por digestión con endonucleasas de restricción y la secuenciación y la expresión de la proteína recombinante TAT-IHCDer p1-3T fue inducida en E. coli. Purificación con éxito verificada mediante Western blot de la proteína objetivo, que mostró una capacidad de unión a IgE más fuerte que Der p1. Conclusión: hemos construido con éxito el vector de expresión recombinante pET-28a-TAT-IHC-Der p1-3T que expresa una vacuna de epítopo de células T administrada por vía MHC II con fuerte capacidad de union a IgE. Este trabajo proporciona una base para seguir estudiando la inmunoterapia específica mediante la vía MHC de clase II.

OBJECTIVE:To retrospectively compare the sonographic and clinical features of papillary thyroid microcarcinoma (PTMC) ≤5 mm and PTMC >5 mm to improve the diagnostic value of ultrasonography. METHODS:A total of 367 cases of PTMC between January 2013 and December 2014 was included in this study. The patients were classified into group A (≤5 mm, n = 181) or group B (>5 mm, n = 186), and the sonographic and clinical features were reviewed and compared between the two groups. RESULTS:There was no significant difference in the shape, ratio of length/width, boundary, peripheral halo ring, echogenicity, cystic change and accompanying Hashimoto's thyroiditis between these two groups. However, the calcification (61.3% vs. 72.6%) and hypervascularity (13.8% vs. 24.7%) were more frequent in group B (p = 0.026 and 0.008, respectively). The patients were younger, and more patients were aged less than 45 years (41.4% vs. 57.0%) in group B. Capsular invasion (7.2% vs. 34.4%), multifocality (21.5% vs. 48.9%), bilaterality (17.1% vs. 39.8%), central lymph node metastasis (13.8% vs. 38.2%) and lateral lymph node metastasis (1.1% vs. 5.4%) were more frequent in group B. No clinical or sonographic feature was related to cervical lymph node metastasis in group A, while less than 45 years in age (p = 0.010), male gender (p = 0.040), capsular invasion (p5 mm, including an irregular shape, a length/width ratio of ≥1, an unclear boundary, no peripheral halo ring, hypoechogenicity, no cystic change, calcification, no hypervascularity and no accompanying Hashimoto's thyroiditis. The clinical features of PTMC ≤5 mm were less aggressive than those of PTMC >5 mm.

The study described here sought to identify specific ultrasound (US) automated breast volume scanning (ABVS) features that distinguish benign from malignant lesions. Medical records of 750 patients with 792 breast lesions were retrospectively reviewed. Of the 750 patients, 101 with 122 cystic lesions were included in this study, and the results ABVS results were compared with biopsy pathology results. These lesions were classified into six categories based on ABVS sonographic features: type I = simple cyst; type II = clustered cyst; type III = cystic masses with thin septa; type IV = complex cyst; type V = predominantly cystic masses; and type VI = predominantly solid masses. Comparisons were conducted between the ABVS coronal plane features of the lesions and histopathology results, and the positive predictive value (PPV) was calculated for each feature. Of the 122 lesions, 90 (73.8%) were classified as benign, and 32 (26.2%) were classified as malignant. The sensitivity, specificity and accuracy associated with ABVS features for cystic lesions were 78.1%, 74.4% and 75.4%, respectively. The 11 cases (8.9%) of type I-IV cysts were all benign. Of the 22 (18.0%) type V cysts, 16 (13.1%) were benign and 6 (4.9%) were malignant. Of the 89 (72.9%) type VI cysts, 63 (51.7%) were benign and 26 (21.3%) were malignant. The typical symptoms of malignancy on ABVS include retraction (PPV = 100%, p < 0.05), hyper-echoic halos (PPV = 85.7%, p < 0.05), microcalcification (PPV = 66.7%, p < 0.05), thick walls or thick septa (PPV = 62.5%, p < 0.05), irregular shape (PPV: 51.2%, p < 0.05), indistinct margin (PPV: 48.6%, p < 0.05) and predominantly solid masses with eccentric cystic foci (PPV = 46.8%, p < 0.05). ABVS can reveal sonographic features of the lesions along the coronal plane, which may be of benefit in the detection of malignant, predominantly cystic masses and provide high clinical values.

To evaluate the accuracy of endorectal ultrasound (ERUS) in predicting the circumferential resection margin (CRM) and maximum tumor thickness (MTT) of in T3 rectal cancer.Clinicl data of 53 patients with pT3 rectal cancer admitted to the Department of General Surgery in the Peking Union Medical College Hospital from June 2011 to January 2014 were retrospectively analyzed. CRM and MTT measured by ERUS were compared with corresponding pathologic measurements to assess the accuracy of ERUS diagnosis.ERUS correctly predicted CRM status in 52 patients (98.1%, 52/53), whose sensitivity was 100%, specificity was 97.8%, positive predictive value was 85.7%, and negative predictive value was 100%. ERUS correctly predicted MTT status in 51 patients (96.2%, 51/53), whose sensitivity was 100%, specificity was 95.5%, positive predictive value was 66.6%, and negative predictive value was 100%. In the Bland and Altman plot, the agreement between ERUS and pathology was good.Endorectal ultrasonography can accurately diagnose CRM and MTT, which can satisfy the clinical need for preoperative staging of rectal cancer.

Sancassania berlesei (S. berlesei) is the leading threatening mite in breeding industry of Eupolyphaga sinensis and public health.Living specimens of S. berlesei were obtained from the surface of Eupolyphaga sinensis and purified with double-distilled water. The egg, larva, nymph, hypopus, adult male and female of S. berlesei were screened and picked out under microscope.Morphological variations of S. berlesei, including its legs, setae, external genitalia and accessories, are clearly identified under SEM. The larva has three pairs of legs, with no leaf-like setae, yet its coxal rod is well-developed. By nymph stage, four pairs of legs and the fourth dorsal seta arise, whereas the genital area looks still under-developed. At hypopus, the claws and tarsules appear well-built, and leaf-like setae, setae of tibia and setae of genu are seen. The sucker plate totally contains nine suckers and four shell-like dimplings in which there are symmetric distributions with 1 pair of central suckers, 2 pairs of side suckers and 1 pair of anterior suckers, respectively. One pear-like posterior sucker is located at the back of sucker plate. All suckers are smooth except for anterior sucker with radial stripe. The genital sense organ of adults exhibits itself with cordiform external aspect and typical ossification texture; whereas the male is dissimilar with the female regarding seta number on the genital sense organ.Description of the morphological structure in great detail for S. berlesei tends to supply the important information for the taxonomy and further study.Objetivo: sancassania berlesei (S. berlesei) es el lider en la industria de cría amenaza mite eupolyphaga sinensis y la salud pública.Métodos: los especimenes vivos de S. berlesei fueron obtenidos a partir de la superficie de eupolyphaga sinensis y purificado con agua bidestilada.El huevo, larva, ninfa, hypopus, macho adulto y la hembra de S. berlesei fueron evaluados y elegidos bajo microscopio.Resultados: las variaciones morfológicas de S. berlesei, incluidas sus piernas, setas, genitales externos y accesorios, están claramente identificadas en la SEM.La larva tiene tres pares de patas, sin hojas como setas, pero su coxal Rod es desarrollada.Por la etapa de ninfa, cuatro pares de patas y el cuarto dorsal seta surgen, mientras que la zona genital se ve aún en desarrollo.En hypopus, las garras y tarsules aparecen bien construido, y la hoja como setas, setas de tibia y setas de Genu son vistos.La ventosa plato totalmente contiene nueve retoños y cuatro Shell como dimplings en que hay distribuciones simétricas con 1 par de mamones, 2 pares de lado anterior de ventosas y 1 par de tontos, respectivamente.Una pera como posterior ventosa está ubicado en la espalda de Sucker plato.Todos los tontos son suaves excepto anterior Sucker con franja radial.El órgano de sentido genital adultos exhibe con cordiforme aspecto externo y osificación típica textura; mientras que el macho es diferente con la hembra respecto a seta numero en el sentido de órganos genitales.Conclusión: descripción de la estructura morfologica en gran detalle para S. berlesei tiende a suministrar la información importante para la taxonomía y más estudio.

To construct a vector encoding T-cell epitopes of major allergen group 1 of Dermatophagoides pteronyssinus as a vaccine delivered by MHC class II pathway.The nucleotide sequences of the 3 target genes were synthesized, including TAT, IhC and the recombinant fragment of Der p 1 encoding 3 T-cell epitopes. After amplification of the 3 target fragments by PCR and digestion with corresponding restriction endonucleases, the recombinant gene TAT-IhC-Der p 1-3T was ligated using T4 DNA ligase and inserted into the prokaryotic expression vector pET28a(+) to construct the recombinant plasmid pET-28a(+)-TAT-IhC-Der p 1-3T, which was confirmed by digestion with restriction endonucleases and sequencing. The recombinant vector was transformed into E. coli strain BL21 (DE3) and induced with IPTG, and the induced protein TAT-IhC-Der p 1-3T was detected by SDS-PAGE. After purification, the recombinant protein was confirmed by Western blotting and its allergenicity tested using IgE-binding assay.The recombinant plasmid pET-28a-TAT-IhC-Der p 1-3T was successfully constructed as confirmed by restriction endonuclease digestion and sequencing and the expression of the recombinant protein TAT-IhC-Der p 1-3T was induced in E. coli. Western blotting verified successfull purification of the target protein, which showed a stronger IgE-binding ability than Der p 1.We successfully constructed a recombinant expression vector pET-28a-TAT-IhC-Der p 1-3T expressing a T-cell epitope vaccine delivered by MHC II pathway with strong IgE-binding ability, which provides a basis for further study on specific immunotherapy via MHC class II pathway.

To investigate the protective effect of hydrogen sulfide (H2S) on tissue factor-induced disseminated intravascular coagulation (DIC) in rabbits and its mechanism.Thirty-two healthy rabbits were randomly divided into four groups: normal control group, NaHS control group, DIC model group, NaHS pretreatment group (each, n = 8). Ten minutes before model reproduction, rabbits in NaHS control and pretreatment groups were given 3.4 mg/kg NaHS (dissolved in normal saline to 5 mL) via ear vein, while rabbits in normal control and DIC model groups were given an equivalent volume of normal saline. Ten minutes later, rabbits in DIC model and NaHS pretreatment groups were intravenously given tissue factor (TF) 2 mL/kg (dissolved in normal saline to 30 mL, at the speed of 1 mL/min for 5 minutes, 2 mL/min for 5 minutes, and 3 mL/min for 5 minutes), and rabbits in normal control and NaHS control groups were given normal saline. 3 mL of blood was collected 10 minutes before TF injection, and 3, 5, 8, 10, 13, 15, 45, 85, 135 minutes after TF injection for determination of prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen content (FIB), fibrin degradation products (FDP), and platelet count (PLT). Microcirculation in the mesentery was also observed under microscope.Compared with normal control group, PT and APTT became shorter at 5 minutes after TF injection, and the rate of their change was increased [PT: -8.3 (-11.7 to -5.3)% vs. 1.3 (-2.5 to 3.8)%, P0.01; APTT: -19.1 (-30.4 to -9.4)% vs. -2.6 (-6.2 to 3.0)%, P0.05]. PT and APTT were prolonged 15 minutes after TF injection, and their changes were more significant [PT: 31.0 (25.0 to 36.9)% vs. -1.3 (-6.3 to 5.0)%, APTT: 61.3 (50.0 to 72.9)% vs. 0.0 (-10.0 to 10.0)%, both P0.01] in DIC model group. TT was gradually reduced after TF injection, FIB and PLT were gradually decreased, and their changes were more obvious at 15 minutes in DIC model group compared with those in normal control group [TT: -9.5 (-12.0 to -6.2)% vs. -2.0 (-4.0 to 0.7)%, FIB: -4.3 (-9.9 to -2.2)% vs. -1.0 (-5.8 to 4.3)%, PLT: -90.0 (-93.4 to -86.5)% vs. -1.0 (-3.9 to 2.6), all P0.01]. After TF injection, it appeared latex-like particles in FDP test board, and it was gradually increased within 3-15 minutes, and then it gradually became less marked. The rate of blood flow in mesenteric capillaries was decreased obviously within 10 minutes, and it became faster accompanying with obvious hemorrhage. PT and APTT in NaHS pretreatment group became shortened 5 minutes after TF injection, and their rate of change was significantly decreased compared with that of DIC model group [PT: -6.3 (-8.6 to 0.0)% vs. -8.3 (-11.7 to -5.3)%, APTT: -13.6 (-24.2 to -2.3)% vs. -19.1 (-30.4 to -9.4)%, both P0.05], and prolonged at 15 minutes, and their rate of change was significantly decreased compared with that of DIC model group [PT: 10.1 (3.8 to 15.2)% vs. 31.0 (25.0 to 36.9)%, P0.01; APTT: 27.8 (-15.8 to 39.7)% vs. 61.3 (50.0 to 72.9)%, P0.05]. TT, FIB, and PLT were reduced at 15 minutes in NaHS pretreatment group, and their rate of change was markedly decreased compared with that of DIC model group [TT: -4.5 (-7.8 to -1.3)% vs. -9.5 (-12.0 to -6.2)%, P0.01; FIB: -3.3 (-8.0 to 1.9)% vs. -4.3 (-9.9 to -2.2)%, P0.05; PLT: -58.8 (-53.0 to 64.0)% vs. -90.0 (-93.4 to -86.5)%, P0.01]. The rate of agglutination of latex particles in NaHS pretreatment group was decreased significantly at each time point compared with DIC model group; mesenteric capillary blood flow slowed down gradually within 10 minutes, but it was faster as compared with the DIC model group. It became faster later, but bleeding was obviously less.These results show that H2S protects against TF-induced DIC by inhibiting the activity of coagulation system and platelet aggregation.

To evaluate and determine Doppler criteria for predicting a severe transplant renal artery stenosis (80%-99% diameter reduction) and to compare the Doppler findings in patients with end-to-end and end-to-side anastomosis.We performed Doppler sonography on 16 consecutive patients with transplant renal artery stenosis (TRAS) confirmed by digital subtraction arteriography (DSA). Fourteen patients had end-to-end anastomosis, and 2 had end-to-side anastomosis. Eleven patients were re-evaluated with color Doppler sonography within 4 days after intervention. Seven Doppler parameters, including the peak systolic velocity (PSV) in the renal, iliac and interlobar artery, Pre-PSV ratio (the ratio of the PSV in the renal artery to that in the iliac artery), Post-PSV ratio (the ratio of the PSV in the renal artery to that in the interlobar arteries, acceleration time and resistance index, were measured. In the patients with severe TRAS the measurements of these parameters were compared before and after successful intervention.In the 16 patients with a single transplanted kidney, arteriography demonstrated 14 main renal arteries with severe stenosis, and 3 renal arteries with moderate stenosis. When using the cutoff values of Post-PSV ratio13, renal artery PSV4 m/sec, acceleration time0.06 second, and resistance index0.5 for the detection of all 14 severe stenoses, the sensitivities were 100%, 71%, 93%, and 50%, respectively. For assessing all 14 severe stenoses and 12 severe stenoses of end-to-end anastomosis, the cutoff value of Pre-PSV ratio5 had sensitivities of 86% and 100%, respectively. Pre-PSV ratios in severe stenoses of end-to-end anastomosis (range, 5.1-11.5) were significantly greater than those recorded in severe stenoses of end-to-side anastomosis (range, 2.8-3.1). Statistically significant differences before and after successful intervention were found for all 7 Doppler parameters in the 7 patients with severe stenosis.An 80%-99% diameter reduction of the renal artery can be diagnosed based on a Post-PSV ratio13 for patients with either end-to-end or end-to-side anastomosis. A Pre-PSV ratio5 for patients with end-to-end anastomosis and acceleration time0.06 second are helpful in the diagnosis of severe TRAS.

Ultrasonography, the preferred imaging modality for breast diseases, has merits such as absence of radiation, high diagnostic accuracy, and convenience for follow-up, thus playing an important role in clinical diagnosis and management. The American College of Radiology (ACR) proposed Breast Imaging-Reporting and Data System (BI-RADS ) and has updated for several times. Gradually, the BI-RADS has been accepted and adopted by ultrasound physicians at all levels of hospitals in China, and it has played a certain role in improving the diagnostic level of breast ultrasound in China. In order to standardize breast ultrasound application and raise the status of ultrasound in clinical decision-making of breast diseases, based on the latest edition of ACR BI-RADS Atlas 2013, the committee has reached the “Expert Consensus on Clinical Frequently Asked Questions in Breast Ultrasonography”on a number of controversial Frequently Asked Questions (FAQs) in clinical practice (hereafter referred to as “Consensus”), and will be dedicated to updating the contents of the “Consensus”, through further experience in clinical practice and the advent of new information from further studies. This consensus is only for reference purposes for medical personnel, and the processes outlined are not mandatory by law.

Objective.To investigate skin elasticity using acoustic radiation force impulse (ARFI) quantification in systemic sclerosis (SSc), and compare the modified Rodnan skin score (mRSS) with measured shear wave velocity (SWV) and thickness of the skin.Methods.Fifteen patients with diffuse cutaneous SSc (dcSSc) and 15 age-matched and sex-matched healthy controls were evaluated. The SWV and thickness of skin were measured at 17 sites corresponding to those assessed in the mRSS in each participant. The SWV measurements of skin were compared between patients with dcSSc and healthy controls. The correlations between the mRSS and the skin SWV and thickness were explored using Spearman’s correlation.Results.The SWV values were higher in patients with dcSSc compared with healthy controls at right hand dorsum, right forearm, left hand dorsum, left forearm, right foot dorsum, and left foot dorsum (p < 0.05). In patients with dcSSc, the SWV values of uninvolved skin were higher than those of controls (p < 0.001), and the SWV values increased with increasing skin scores except for skin score 3 (p < 0.05). The sum of the SWV values correlated with total clinical skin score (r = 0.841, p < 0.001), and the sum of the skin thickness correlated with total clinical skin score (r = 0.740, p = 0.002).Conclusion.ARFI quantification is feasible and reliable for assessing the skin involvement in dcSSc. ARFI quantification could identify early skin change that may precede palpable skin involvement, and may be a valuable adjunct to skin evaluation in patients with SSc.

Purpose. The purpose of this prospective study was to evaluate and determine criteria for locating acquired arteriovenous fistulas using color Doppler sonography. Methods. We performed color Doppler sonography on 12 consecutive patients with acquired arteriovenous fistulas. We evaluated the morphologic and hemodynamic changes in the involved vessels to help locate the fistulas (10 in the extremities, 1 in the neck, and 1 in the abdomen). Results. In all cases, turbulent high-velocity flow spectrum and flow signals were present at the fistula sites, and arterialized waveforms from the draining veins were detected. In the 10 cases of acquired arteriovenous fistulas in the extremities, the resistance indices in the arteries proximal to the fistulas were all less than 1.00 (mean, 0.65), whereas the resistance indices in the arteries distal to the fistulas were all 1.00 or greater (mean, 1.17). In 70% of the cases, the diameter of the artery proximal to the fistula was at least 1.2 mm larger than that distal to the fistula. The fistula site was inferred by the point of maximal venous dilatation in 70% of the cases and by the focal perivascular color artifact in 82% of the cases. The fistula site was identified on gray-scale sonography and color flow imaging in 33% and 75% of the cases, respectively. Conclusions. Fistula sites can be located effectively and quickly by a combination of major and minor diagnostic criteria. The major diagnostic criteria are (1) junction of low- and high-resistance flow in the supplying artery, (2) a high-velocity arterialized waveform in the draining vein, and (3) a turbulent, high-velocity flow spectrum at the junction of the artery and the vein. The minor diagnostic criteria are (1) direct communication between the involved artery and vein, (2) significant change in the diameter of the supplying artery, (3) a focal point of venous dilatation, and (4) a focal perivascular color artifact. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:336–342, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.10084

Rationale Intravascular epithelioid hemangioendothelioma (EHE) is a rare endothelial tumor with an intermediate grade of malignancy. We present a case of one woman affected by EHE of the femoral vein. Contrast-enhanced ultrasonography played a role in diagnosing EHE and helped differentiate it from thrombosis. To our knowledge, this is the first reported contrast-enhanced ultrasonography of intravascular EHE in the imaging literature. Patient concerns A 46-year-old woman presented to our hospital due to pain and swelling in her right lower limb since 5 years prior to her presentation. Diagnoses The patient was misdiagnosed as having thrombosis by ultrasound. Contrast-enhanced ultrasonography showed solid lesions with visible blood supply, suggesting angiogenic tumors. Interventions The patient was treated by complete surgical removal of the mass and postoperative radiotherapy. Pathological examination confirmed the diagnosis of EHE. Outcomes During follow-up, there were no signs of local or distant relapse. Lessons Intravenous EHE may be misdiagnosed as thrombosis by ultrasound and contrast-enhanced ultrasonography can help make the differential diagnosis.

Partially cystic thyroid nodules (PCTNs) are common on ultrasound (US). However, there are insufficient data on the prevalence of thyroid carcinoma among such nodules. The purpose of this study was thus to evaluate the prevalence and differentiation of partially cystic thyroid cancers in US-guided fine needle aspiration (FNA). A total of 1342 consecutive patients with 1360 thyroid nodules underwent prospective US diagnosis and FNA biopsy. In total, 281 nodules (20.7%) were partially cystic lesions. The nodules were prospectively analyzed based on US features (ie, solid portion positions, shapes, margins, and microcalcifications) and US diagnosis (benign, suspicious, or malignant). Of the 281 partially cystic lesions, 22 nodules (8%) had inadequate FNA results, 14 nodules were diagnosed as malignant, 9 were suspicious for malignancy, and 236 were benign on FNA. Thirteen cancers were confirmed upon surgical histopathology examination or FNA, yielding a 4.6% rate of malignancy. Twelve of these cancers were papillary carcinomas, and 1 was an anaplastic carcinoma. The following individual sonographic characteristics had a statistically significant association with thyroid cancer: nodule composition (solid portion ≥50%, P = .000), eccentric solid portion (P = .001), irregular nodule shape (P = .000), microcalcification (P = .000), and intranodular vascularity (P = .001). The sensitivity, specificity, and accuracy of the US-based diagnoses were 84.6%, 84.0%, and 84.0%, respectively. Fewer than 5% of the partially cystic nodules in this FNA series were malignant. Sonographic characteristics can be used to prioritize nodules for FNA biopsy.

Integrating photoacoustic (PA) and ultrasound (US) into a handheld probe to perform PA/US dual-modal imaging has been widely studied over the past few years. However, optical fluence decreases quickly in deeper tissue due to light scattering and absorption, which would significantly affect the quantitative PA imaging. In this paper, we performed a fluence compensation for a PA imaging study of human breast. The comparison of PA/US image with and without optical fluence compensation demonstrated that the fluence compensation could effectively improve imaging quality for handheld probe.

Supplemental Digital Content is available in the text, Background: Fine-needle aspiration (FNA) is the most dependable tool to triage thyroid nodules for medical or surgical management. However, Bethesda class III cytology, namely “follicular lesion of undetermined significance” (FLUS) or “atypia of undetermined significance” (AUS), is a major limitation of the US-FNA in assessing thyroid nodules. As the most important imaging method, ultrasound (US) has a high efficacy in diagnosing thyroid nodules. This meta-analysis aimed to assess the role of US in evaluating Bethesda class III thyroid nodules. Methods: With keywords “Undetermined Significance,” “Bethesda Category III,” “Bethesda system,” “Cytological Subcategory,” “AUS/FLUS,” “Atypia of Undetermined Significance,” and “Ultrasound/US,” papers in PubMed, Cochrane Library, Medline, Web of Science, Embase, and Google Scholar from inception to December 2016 were searched. A meta-analysis of these trials was then performed for evaluating the diagnostic value of thyroid ultrasound in Bethesda Category III thyroid nodules. Results: Fourteen studies including 2405 nodules were analyzed. According to the criteria for US diagnosis of thyroid nodules in each article, with any one of suspicious features as indictors of malignancy, US had a pooled sensitivity of 0.75 (95% CI 0.72–0.78) and a pooled specificity of 0.48 (95% CI 0.45–0.50) in evaluating Bethesda Class III Nodules. The pooled diagnostic odds ratio was 10.92 (95% CI 6.04–19.74). The overall area under the curve was 0.84 and the Q∗ index was 0.77. With any 2 or 3 of US suspicious features as indictors of malignancy, the sensitivity and specificity were 0.77 (95% CI 0.71–0.83) and 0.54 (95% CI 0.51–0.58), 0.66 (95% CI 0.59–0.73) and 0.71 (95% CI 0.68–0.74), respectively. Conclusions: US was helpful for differentiating benign and malignant Bethesda class III thyroid nodules, with the more suspicious features, the more likely to be malignant.

OBJECTIVES The purpose of this study was to prospectively assess the diagnostic efficacy of contrast-enhanced sonography for differential diagnosis of sub-1-cm breast lesions. METHODS Contrast-enhanced sonography was performed in 46 women with 46 sub-1-cm breast lesions scheduled for surgery or biopsy. Histologic results were used as a reference standard. The contrast enhancement pattern, enhancement degree, direction, margin, radial vessels surrounding the lesion, and lesion size discrepancy between contrast-enhanced and conventional sonography were evaluated. RESULTS The detection rates for increased size, radial vessels surrounding the lesion, and hyperenhancement on contrast-enhanced sonography were significantly higher in the malignant than the benign group (P < .05). The sensitivity, specificity, and accuracy for increased size were 72.7%, 80.0%, and 78.2%, respectively. The sensitivity, specificity, and accuracy for radial vessels surrounding the lesion were 54.5%, 97.1%, and 87.0%. The sensitivity, specificity, and accuracy for hyperenhancement were 81.8%, 60.0%, and 65.0%. No significant difference was found for the enhancement pattern, direction, and margin between the groups. CONCLUSIONS Contrast-enhanced sonographic features of sub-1-cm breast lesions included increased size on contrast-enhanced sonography, radial vessels surrounding the lesion, and hyperenhancement. Identification of these features is useful for differentiation of small breast lesions.

Allergic asthma is associated with the major house dust mite group 1 allergens Der p 1 and Der f 1, which belongs to the papin-like protease family and is the most potent of indoor allergens and allergen-specific immunotherapy (SIT), is seen as effective intervention for the entity. The current study was designed to verify the SIT efficacies of the enzymatic hydrolysates (papain and trypsin) in mice with asthma. We initially developed the asthmatic mouse models with ProDer f 1, and respectively applied recombinant ProDer f 1 protein and the two kinds of enzymatic hydrolysates for SIT. The results were verified by measuring the contents of IL-4, IL-10, IL-17 and IFN-γ changed in both bronchoalveolar lavage fluid (BALF) and supernatant of splenocyte culture as well as level changes of specific IgE and IgG2a in the serum. After SIT intervention, the symptoms of allergic inflammation was alleviated significantly in mice treated with ProDer f 1 protein and the two enzymatic hydrolysates via detection of the lung tissue sections, and infiltration of inflammatory cells was also notably depressed as compared with the models, though the epithelial structure in airways remained similar with the PBS group. In addition, we observed lower serum contents of the specific IgE antibody and lower levels of IL-4, IL-17 in BALF and splenic cells in mice undergone SIT, whereas specific IgG2a, IFN-γ and IL-10 in BALF and supernatant of splenocyte culture were higher as compared to the asthma group. The findings suggest the SIT using the above two kinds of hydrolysates may effectively inhibit the allergic inflammation in the airways of mouse models sensitized with ProDer f 1 protein.

The purpose of the study described here was to determine specific characteristics of thyroid microcarcinoma (TMC) and explore the value of contrast-enhanced ultrasound (CEUS) combined with conventional ultrasound (US) in the diagnosis of TMC. Characteristics of 63 patients with TMC and 39 with benign sub-centimeter thyroid nodules were retrospectively analyzed. Multivariate logistic regression analysis was performed to determine independent risk factors. Four variables were included in the logistic regression models: age, shape, blood flow distribution and enhancement pattern. The area under the receiver operating characteristic curve was 0.919. With 0.113 selected as the cutoff value, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 90.5%, 82.1%, 89.1%, 84.2% and 87.3%, respectively. Independent risk factors for TMC determined with the combination of CEUS and conventional US were age, shape, blood flow distribution and enhancement pattern. Age was negatively correlated with malignancy, whereas shape, blood flow distribution and enhancement pattern were positively correlated. The logistic regression model involving CEUS and conventional US was found to be effective in the diagnosis of sub-centimeter thyroid nodules.

Asthma is an etiologically complex disease and develops by the interaction of multiple genes and environmental factors. Previous studies suggested a linkage between the interferon-gamma (INFG) gene cluster in the chromosome 12q region and susceptibility to asthma.This meta-analysis was undertaken to examine the relationship between +874A/T and CA-repeat polymorphisms in INFG gene and asthma. Eligible articles were accumulated via online databases in October 2013. A total of nine articles were included that were associated with the +874A/T polymorphism, involving 470 cases and 574 controls, as well as articles involving CA-repeat polymorphisms, which included 365 cases and 517 controls. The meta-analysis was performed for heterogeneity and calculation of pooled odds ratio and evaluation of publication bias by Egger's linear regression test.The differences between IFNG polymorphism and the susceptibility to asthma may vary across ethnicities and ages, and also that the allelic frequencies of the AA genotypes in IFNG at +874 is associated with an increased risk of asthma in the Chinese Han adult population; additionally, CA14 occurrence in the first intron can increase the risk of asthma in the Japanese population.Our findings suggested that some polymorphisms in the IFNG gene could act as high prevalence-susceptibility markers of asthma. Larger scale studies are warranted to address these associations among different ethnic populations, ages and the severity of asthma prognosis.

The use of ultrasound in the diagnosis of axillary lymph node metastases from breast cancer in a Chinese population was investigated. Data for 1,049 with breast cancer were retrospectively collected. All patients had undergone pre-operative axillary ultrasound and then axillary lymph node dissection. The sensitivity, specificity and accuracy of axillary ultrasound in this cohort were 69.4%, 81.8% and 77.0%, respectively. The overall false-negative rate of ultrasound images was 30.6% (123/402). False-negative ultrasound rates for pathologic N1, N2 and N3 patients were 46.2%, 21.8% and 9.3%, respectively. In patients with stage T1 disease and fewer than three metastatic lymph nodes, the false-negative ultrasound rate was 52.2% (47/90). Moreover, breast cancer patients with a false-negative axillary ultrasound were more likely to have a large tumor (p < 0.001) and high tumor grade (p = 0.009). However, there were no statistically significant differences between accuracy of axillary ultrasound and age of patients or experiences of ultrasound practitioners. In conclusion, the sensitivity, specificity and accuracy of ultrasound in the diagnosis of breast cancer metastasis to the axillary lymph nodes in Chinese patients were assessed. These data could help us to carefully use axillary ultrasound to diagnose and predict breast cancer axillary lymph node metastasis.

To explore effects of natural crude extract of C. elegans on treatment of asthma. Method: Obtain crude extract of C. elegans from synchronically incubated C. elegans via centrifugation, washing and ultrasonic emulsification, etc.; measure C. elegans’s protein molecular weight via SDS-polyacrylamide gel electrophoresis (SDS-PAG electrophoresis); construct animal models of asthma with 6-8-week-old BALB/c female mice sensitized by chicken ovalbumin (OVA); conduct immunotherapy on animals with asthma with different doses of mixture of C. elegans and OVA (COM) respectively; take PBS buffer group and OVA group as control groups; conduct inspection of cell factors and differential count of cells in serum IgE, IgG1 and IgG2a antibodies and bronchoalveolar lavage fluid (BALF) via enzyme linked immunosorbent assay (ELISA); and incise lung tissue for pathology observation. Result: C. elegans’s protein molecular weight is about 50 kd. In bronchoalveolar lavage fluid (BALF) of OVA group, cell factors IL-5 and IL-13 are more than those in PBS buffer group, but IL-2 and IFN-γ are less than those in PBS buffer group; these differences are of statistical significance (P

We investigated the association between two markers in the seventh intron of the tryptophan hydroxylase gene (TPH C218A and C779A) in a population-based case control study of 780 genotyped subjects. As in prior studies, the two markers were in strong linkage disequilibrium. The phenotypes we studied were smoking initiation and progression to nicotine dependence. Allele, genotype, and estimated haplotype frequencies for each marker were highly significantly different for smoking initiation (P < 0.0004 for each comparison) and were nonsignificant for progression to nicotine dependence. An empirical test suggested that the positive results were unlikely to have resulted from population stratification. Our results are similar to those of Lerman et al. [2001: Am J Med Genet (Neuropsychiatr Genet) 105:000-000] in associating these TPH markers with a construct related to smoking initiation but dissimilar in the variable implicated. If these results replicate in other samples, the serotonergic system may be involved in the etiology of smoking initiation given the rate-limiting role of TPH in the biosynthesis of serotonin.

OBJECTIVE: Primary thyroid lymphoma (PTL) is an uncommon thyroid malignancy. Despite the rarity of PTL, it is important to recognize PTL promptly because its management differs from that of all the other thyroid neoplasms. This study was designed to investigate the sonographic features of PTL. METHODS: Twenty-seven pathologically confirmed PTLs were categorized into diffuse and non-diffuse type. Sonographic features including thyroid size, thyroid background echotexture, lesion size, echogenecity, calcification, vascularity, cervical lymphadenopathy of each type were retrospectively analyzed. RESULTS: All 27 PTLs were diffuse large B-cell lymphomas and were accompanied by diffuse Hashimoto's thyroiditis. Ten were diffuse type and seventeen were non-diffuse type sonographically. The observations in diffuse group included goiter (10/10, 100.0%), marked echogenesity (10/10, 100.0%), heterogeneous echotexture (10/10, 100.0%), and cervical lymphadenopathy (4/10, 40.0%). The observations in non-diffuse group included marked hypoechogenicity (17/17, 100.0%), heterogeneous background thyroid gland (17/17, 100.0%), goiter (15/17, 88.2%), increased vascularity (8/13, 61.5%), mulifocality (10/17, 58.8%), and cervical lymphadenopathy (7/17, 41.2%). CONCLUSIONS: Although some common features were found, the sonographic appearance of PTL is unspecific, especially for the diffuse type. Therefore, interventional diagnostic procedures should be warranted in the clinical settings when PTL is suspected.

This study sought to establish normal dimensions of the fetal gallbladder throughout pregnancy. The gallbladders in 300 normal fetuses between 15 and 40 weeks of gestation were measured prospectively for length, anteroposterior dimension, and transverse dimension. The gallbladder length, anteroposterior diameter, and transverse diameter have a linear relationship with gestational age between 15 weeks and 30 weeks of gestation, after which a plateau is observed. Calculated gallbladder area, volume, and sagittal perimeter have similar rates of growth in utero. The normative dimensions we have established for the fetal gallbladder throughout pregnancy can be expected to serve as a basis against which aberrant growth can be evaluated prenatally.

A highly monodispersed hetero-nanostructure with two different functional nanomaterials (gold (Au) and iron oxide (Fe(3)O(4,) IO)) within one structure was successfully developed as Affibody based trimodality nanoprobe (positron emission tomography, PET; optical imaging; and magnetic resonance imaging, MRI) for imaging of epidermal growth factor receptor (EGFR) positive tumors. Unlike other regular nanostructures with a single component, the Au-IO hetero-nanostructures (Au-IONPs) with unique chemical and physical properties have capability to combine several imaging modalities together to provide complementary information. The IO component within hetero-nanostructures serve as a T(2) reporter for MRI; and gold component serve as both optical and PET reporters. Moreover, such hetero-nanoprobes could provide a robust nano-platform for surface-specific modification with both targeting molecules (anti-EGFR Affibody protein) and PET imaging reporters (radiometal (64)Cu chelators) in highly efficient and reliable manner. In vitro and in vivo study showed that the resultant nanoprobe provided high specificity, sensitivity, and excellent tumor contrast for both PET and MRI imaging in the human EGFR-expressing cells and tumors. Our study data also highlighted the EGFR targeting efficiency of hetero-nanoparticles and the feasibility for their further theranostic applications.

Through analysis, the elastograms characteristics of breast lesions of Chinese women, a suitable diagnostic standard of quasistatic ultrasound elastography (UE) for Chinese women was proposed.From June 2010 to March 2012, 1036 consecutive female patients (mean age, 44 years old) with breast lesions were recruited into a multicenter retrospective study, which involved 8 centers across China. Each institutional ethic review board approved the study, and all the patients gave written informed consent. All breast lesions underwent ultrasound and UE examination. Two radiologists analyzed the elastograms and separated the elastograms into 10 types. A final diagnosis was made on the basis of histologic findings. The characteristics of the elastograms were analyzed. Receiver operating characteristic curves were plotted for evaluating the diagnostic performance. Sensitivity, specificity, and accuracy were calculated. Differences in sensitivity, specificity, and accuracy were tested by using the McNemar test.There were 1150 lesions (593 benign, 557 malignant). There was a highly significant correlation between the elastogram color distribution and the percentage of malignant lesions, with a value of 0.92 (2P.0001). Through analysis the different malignant percentages in different elastogram types, UE diagnostic standard was proposed, which was correlated with the blue percentage in the elastogram. The specificity, sensitivity, and accuracy of UE were 86.4%, 80.8%, and 83.5%, respectively. The specificity and accuracy of UE were higher than with ultrasound. The area under the curve was 0.86.UE could give valuable assessment in the diagnosis of breast lesions. The proposed UE diagnostic standard was suitable for Chinese women.

OBJECTIVES The purpose of this study was to investigate the influence of atherosclerosis and age on 4 representative Doppler parameters in the diagnosis of renal artery stenosis. METHODS The 4 parameters, renal peak systolic velocity (PSV), renal-aortic ratio, renal-interlobar ratio, and acceleration time, were measured in 208 patients before angiography. The 208 patients were divided into groups according to age and atherosclerosis stratification. The Student t test, 1-way analysis of variance, and the χ(2) test were used to compare all 4 parameters and clinical characteristics. The optimal cutoff values were determined by receiver operating characteristic curves. The diagnostic concordance between atherosclerosis and age strata was evaluated by the Cohen κ coefficient. RESULTS Of the 416 renal arteries shown on Doppler sonography, 204 had a diagnosis of renal artery stenosis and 19 as occlusion on angiography. The optimal cutoff values for the renal-aortic ratio and renal-interlobar ratio in the groups aged 46 years or older and younger than 46 years were much different (2.3 versus 1.4 and 5.1 versus 6.5, respectively), whereas those for the renal PSV and acceleration time were close to each other or the same (170 versus 180 cm/s and 51 versus 51 milliseconds). The κ coefficients for the renal PSV, renal-interlobar ratio, acceleration time, and renal-aortic ratio between the atherosclerosis and age strata were 0.93, 0.99, 1.00, and 0.71. CONCLUSIONS Atherosclerosis and age show comparable influences on Doppler parameters in the diagnosis of renal artery stenosis. For clinical convenience, cutoff values may be separately established on the basis of a 46-year-old borderline for the renal-aortic ratio and renal-interlobar ratio, although this process is not necessary for the renal PSV and acceleration time.

Objectives To prospectively study the ultrasound-guided near-infrared diffuse optical tomography (DOT) findings of the total haemoglobin concentration (THC) detected in invasive breast carcinomas and its contribution to the prediction of axillary lymph node (LN) status. Methods A total of 195 invasive breast carcinomas were prospectively studied with DOT before surgery. Lumpectomy or mastectomy with full axillary nodal dissection was performed. Tumour size and THC level were correlated with LN status by a logistic regression analysis. Results One hundred twenty-four patients (63.59%) was LN(−) and 71 (36.41%) was LN(+). The average THC was significantly higher in the LN(+) group than in the LN(−) group (252.94 ± 69.19 μmol/L versus 203.86 ± 83.13 μmol/L, P = 0.01). A multivariate analysis showed an independent relationship between the probability of axillary metastasis, elevated THC level ( P = 0.01), and tumour size ( P = 0.001). The odds ratio with THC ≥ 140 μmol/L was 13.651 (1.781–104.560), whereas that of tumour size with a 1 cm increment was only 1.777 (1.283–2.246). Conclusions The THC level and the tumour size are independent and preoperative predictors of axillary nodal status; these variables may improve the diagnosis of patients with lymph node metastasis.