目的 采用高频超声观察丹毒患者皮肤厚度的变化以评估系统应用抗生素治疗的基础上短期联合糖皮质激素与单用抗生素治疗丹毒的临床疗效.方法 2021年1-12月于东南大学附属中大医院诊断为丹毒并住院治疗的患者,按就诊顺序随机分为研究组和对照组.研究组系统应用头孢硫脒7 d后加口服甲泼尼龙片(0.4 mg·kg1·d-1)治疗,对照组仅接受头孢硫脒治疗.采用高频超声记录两组患者治疗前及治疗10 d后患侧病变最严重处及健侧对应部位表真皮厚度、皮下组织厚度,治疗前后检测外周血白细胞(WBC)计数、中性粒细胞(NEU)计数、C反应蛋白(CRP)水平.采用t检验、非参数检验进行两组间疗效比较.结果 纳入23例丹毒患者,研究组12例,男8例,女4例,年龄(71.4±11.4)岁;对照组11例,男7例,女4例,年龄(67.4±11.1)岁.治疗前,研究组患侧表真皮厚度[(0.33±0.12)cm]、皮下组织厚度[(1.08±0.49)cm]与对照组[(0.25±0.09)cm、(0.98±0.46)cm]比较差异均无统计学意义(t=1.83、0.49,P=0.081、0.626).治疗10d后,两组患侧表真皮厚度、皮下组织厚度均较治疗前减少(均P＜0.05),研究组皮下组织厚度下降程度[(0.32±0.33)cm]显著高于对照组[(0.10±0.07)cm,t=2.20,P=0.039].治疗前,研究组WBC计数、NEU计数、CRP水平与对照组比较差异均无统计学意义(t值或Z值分别为0.60、0.71、-0.85,均P＞0.05).治疗10d后,两组WBC、NEU、CRP水平均较治疗前显著下降(P＜0.05).结论 系统应用抗生素治疗的基础上短期联合糖皮质激素治疗丹毒能有效减轻皮肤炎症,与单用抗生素相比可更快消除皮下组织水肿.

Background: To diagnose gastroparesis, it is necessary to assess gastric emptying accurately. This study aims to investigate the role of three-dimensional ultrasonography (3-D US) on the measurement of gastric volume to evaluate gastric accommodation in healthy patients. Methods: In this study, 21 volunteers, 46 patients with diabetic gastroparesis (DG), and 22 patients with postsurgical gastroparesis (PSG) underwent 3-D US after oral administration of 250 mL gastrointestinal contrast at 2, 30, 60, and 90 min. The volume of the contrast agent in the stomach was then calculated using the virtual organ computer-aided analysis (VOCAL) (Virtual Organ Computer-aided AnaLysis, General Electric Medical Systems, Kretztechnik, Zipf, Austria). Results: In the DG group, the gastric residue volumes at postprandial 60 and 90 min were significantly higher than those in the healthy group (P<0.05), and the areas under the receiver operating characteristic (ROC) curve of these parameters were 0.830 and 0.957, respectively. There were significant differences between the PSG and healthy groups at 60 and 90 min; however, the AUC of gastric residue at 90 min (0.955) was higher than the AUC at 60 min (0.697). Conclusions: Therefore, this study showed that the 3-D US is a powerful tool for assessing gastric emptying and provides a new strategy for diagnosing gastroparesis.

Objective:To evaluate the sternocleidomastoid muscle hardness in patients with tension-type headache (TTH) by acoustic radiation force impulse (ARFI), and to explore its clinical value in evaluating TTH.Methods:Thirty-five patients with TTH admitted to our hospital from March 2019 to March 2020 and 35 subjects accepted physical examination at the same time period were enrolled in this study. The thicknesses of sternocleidomastoid muscles were measured by two-dimensional ultrasound. On this basis, shear wave velocity (SWV) of sternocleidomastoid muscles was quantitatively evaluated by ARFI. The correlation between thicknesses of sternocleidomastoid muscles and headache was further analyzed.Results:The thickness of sternocleidomastoid muscles, SWV in transverse and longitudinal sections, visual analogue scale (VAS) scores in patients with TTH during headache and after massage were significantly higher than those in the heathy subjects ( P<0.05). Meanwhile, SWV in transverse and longitudinal sections, VAS scores decreased significantly in TTH after massage, which showed significant difference as compared with those during headache ( P<0.05). During headache, the thickness of sternocleidomastoid muscles was negatively correlated with VAS scores ( r=-0.397, P=0.002), SWV in longitudinal section of sternocleidomastoid muscles was positively correlated with VAS scores ( r=0.643, P=0.000). Conclusions:The thickness and hardness of sternocleidomastoid muscle are closely related with TTH. ARFI can quantitatively evaluate the thickness and hardness of sternocleidomastoid muscle.

目的 探讨胃三维容积超声造影与上消化道碘水造影在经口内镜下幽门肌切开术(G-POEM)疗效评估中的价值.方法 选取确诊为胃轻瘫且需行G-POEM的患者94例,随机分为胃三维容积超声检查组48例(A组)和X线碘水造影检查组46例(B组),A组口服超声造影剂后5 min、15 min、30 min、60 min及90 min分别行超声检查,B组口服碘水造影剂后于上述相同时间点行上腹部平片检查,于G-POEM前后各测量一次,获得三维容积超声造影和X线碘水造影估测的胃容积,分析手术前后胃排空时间和胃排空率的差异,评估G-POEM后的胃排空改善情况.结果 ①A组胃三维容积超声造影检查的成功率97.9％(47/48),B组上消化道碘水造影检查的成功率97.8％(45/46),两组比较差异无统计学意义;②A、B组分别有31例患者的术后胃排空时间较术前明显减少(均P<0.05);③A组16例患者术前及术后胃排空时间均为90 min,90 min时间点测得胃排空率较术前明显改善者8例,差异均有统计学意义(均P<0.05),胃排空率无明显改善者8例,与术前比较差异均无统计学意义.B组14例患者术前及术后胃排空时间均为90 min,90 min时间点测得胃排空率较术前明显改善者5例,差异均有统计学意义(均P<0.05),胃排空率无明显改善者9例,与术前比较差异均无统计学意义;④A组47例超声造影患者中,31例胃排空情况较术前显著改善,8例有一定改善,余8例患者无明显改善;B组45例碘水造影患者中,31例胃排空情况较术前显著改善,5例有一定改善,余9例无明显改善.两组胃排空改善率比较差异无统计学意义(83％vs.80％).结论 胃三维容积超声造影和上消化道碘水造影均可有效评估G-POEM前后的胃排空情况,临床可首选胃三维容积超声造影评估G-POEM前后的胃排空情况和术后胃排空功能的改善效果,上消化道碘水造影可作为补充方法,为临床提供客观的影像学信息.

Purpose: Encapsulated microbubbles (MBs) have been reported as new theranostic carriers for simultaneous imaging and ultrasound (US)-triggered therapy. Here, we designed a dual-modality US/NIRF contrast agent and extended its applications from image contrast enhancement to combined diagnosis and therapy with US-directed and site-specific targeting. Methods Gold nanorods (AuNRs) resonant at 880 nm together with the NIR797 dye were first encapsulated in lipid-shelled MBs to construct fluorescent gold microbubbles (NIR797/AuMBs) via thin film hydration and mechanical shaking in the presence of sulfur hexafluoride (SF6) gas. Then, polyethylenimine (PEI)-DNA complexes were electrostatically conjugated onto the surface of the NIR797/AuMBs, forming theranostic encapsulated MBs (PEI-DNA/NIR797/AuMBs). The potential of the PEI-DNA/NIR797/AuMBs for use as a dual-modality contrast enhancement agent was evaluated in vitro and in vivo. The antitumor effect of US/NIR laser irradiation mediating double-fusion suicide gene and photothermal therapy was also investigated using Bel-7402 cells and xenografts. Results The developed theranostic AuMB complexes could not only provide excellent US and NIRF imaging to detect tumors but also serve as an efficient US-triggered carrier for gene delivery and photothermal ablation of tumors in xenografted nude mice. And US + laser exposure group showed a much higher rate of cell inhibition, apoptosis and necrosis as well as a higher Bel-7402 xenograft inhibition rate than the single gene therapy or single exposure (US or laser) group. Conclusions PEI-DNA/NIR797/AuMBs would be of great value for providing more comprehensive diagnostic information and to guide more accurate and effective synergistic cancer therapy. Statement of Significance This is an original paper focusing on developing a dual-modality US/NIRF contrast agent and extended its applications from image contrast enhancement to combined diagnosis and therapy with US-directed and site-specific targeting. The developed theranostic AuMB complexes could not only provide excellent US and NIRF imaging to detect tumors but also serve as an efficient US-triggered carrier for gene delivery and photothermal ablation of tumors in xenografted nude mice. PEI-DNA/NIR797/AuMBs would be of great value for providing more comprehensive diagnostic information and to guide more accurate and effective synergistic cancer therapy. (C) 2019 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Purpose: Encapsulated microbubbles (MBs) have been reported asnew theranostic carriers for simultaneous imaging and ultrasound (US)-triggered therapy. Here, we designed a dual-modality US/NIRF contrastagent and extended its applications from image contrast enhancement tocombined diagnosis and therapy with US-directed and site-specifictargeting.Methods: Gold nanorods (AuNRs) resonant at 880 nm together with theNIR797 dye were first encapsulated in lipid-shelled MBs to constructfluorescent gold microbubbles (NIR797/AuMBs) via thin film hydration andmechanical shaking in the presence of sulfur hexafluoride (SF6) gas.Then, polyethylenimine (PEI)-DNA complexes were electrostaticallyconjugated onto the surface of the NIR797/AuMBs, forming theranosticencapsulated MBs (PEI-DNA/NIR797/AuMBs). The potential of the PEIDNA/NIR797/AuMBs for use as a dual-modality contrast enhancement agentwas evaluated in vitro and in vivo. The antitumor effect of US/NIR laserirradiation mediating double-fusion suicide gene and photothermal therapywas also investigated using Bel-7402 cells and xenografts.Results: The developed theranostic AuMB complexes could not only provideexcellent US and NIRF imaging to detect tumors but also serve as anefficient US-triggered carrier for gene delivery and photothermalablation of tumors in xenografted nude mice. And US + laser exposuregroup showed a much higher rate of cell inhibition, apoptosis andnecrosis as well as a higher Bel-7402 xenograft inhibition rate than thesingle gene therapy or single exposure (US or laser) group.Conclusions: PEI-DNA/NIR797/AuMBs would be of great value for providingmore comprehensive diagnostic information and to guide more accurate andeffective synergistic cancer therapy.

目的:应用彩色多普勤显像(color Doppler flow imaging,CDFI)对磁共振血管显像(magnetic resonance artery,MRA)诊断的椎动脉优势患者进行再评估,探讨CDFI对椎动脉优势的再评估价值.方法:选取150例经MRA诊断并经CT血管造影(computer technology angiography,CTA)或数字减影血管造影(digital subtraction angiography,DSA)确认为椎动脉优势的住院患者,测量双侧椎动脉内径(DMRA),椎动脉CDFI测及双侧椎动脉内径(DCDFI内)、外径(DCDFI外),并测量收缩期峰值流速(Vs)、舒张期末期血流速度(Vd)、平均血流速度(Vm)、搏动指数(PI)、阻力指数(RI)等血流动力学参数.对测及数据进行统计,分析其与后循环缺血的关系.结果:根据超声检查结果,MRA诊断为椎动脉优势的患者可分为两组:椎动脉先天性发育不良型(134例),椎动脉管壁增厚而引起的椎动脉弥漫性狭窄型(16例),前组两侧椎动脉血流速度(包括Vs、Vd和Vm)均高于后者,PI和RI小于后者,差异具有统计学意义(P＜0.05);同时,两组人群的基础资料和PCI的发生率具有明显差异(P＜0.05).结论:CDFI对MRA诊断的椎动脉优势的再评估具有重要临床价值,可鉴别椎动脉优势的产生根本原因,从而为临床治疗提供依据.

目的 探讨实时剪切波弹性成像(SWE)引导细针穿刺病理学检查(FNA)在甲状腺癌诊断中的应用.资料与方法 收集2016年8月-2017年8月在东南大学附属中大医院超声医学科怀疑为恶性甲状腺结节患者,将甲状腺影像报告和数据系统分类为4b类及以上的结节行超声引导下甲状腺穿刺细胞学(US-FNA)和SWE+FNA检查,检查后高度怀疑恶性倾向的甲状腺结节作为手术指征,将接受外科手术的115例患者共142个甲状腺结节(良性结节19个,恶性结节123个,以病理诊断为"金标准")纳入研究,根据结节大小分为A组(结节长径0.5～1.0 cm)和B组(结节长径1.1～3.0 cm),比较US-FNA和SWE+FNA诊断甲状腺癌的敏感度、特异度、准确率、阳性预测值和阴性预测值.结果 A组中,US-FNA、SWE+FNA诊断甲状腺癌的敏感度分别为76.5％、92.1％,特异度分别为100.0％、100.0％,准确率分别为80.7％、93.5％,阳性预测值分别为100.0％、100.0％,阴性预测值分别为48.3％、73.6％;SWE+FNA联合应用的诊断敏感度、准确率和阴性预测值明显高于US-FNA,差异有统计学意义(Kappa=0.703,P=0.002).B组中,US-FNA、SWE+FNA诊断甲状腺癌的敏感度分别为91.5％、100.0％,特异度分别为100.0％、100.0％,准确率分别为90.7％、100.0％,阳性预测值分别为100.0％、100.0％,阴性预测值分别为50.0％、100.0％;与US-FNA比较,SWE+FNA联合应用的诊断敏感度、准确率和阴性预测值差异均无统计学意义(Kappa=0.816,P=0.500).结论 对于直径在0.5～1.0 cm的甲状腺结节,SWE引导的FNA可明显提高诊断敏感度、准确率及阴性预测值.对于直径在1.1～3.0 cm的甲状腺结节,联合应用对提高诊断效果不明显.

Objective: To explore the effect of nitroglycerin ( NTG ) on cerebral blood flow .Methods: In 15 anesthetized healthy adult rabbits , the diameter ( D ) and blood flow hemodynamic parameters of right common carotid artery ( CCA ) were measured by color doppler flow imaging ( CDFI ) before and after NTG administration . The measuring timing of post-administration were 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55 and 60 min.All data were compared and analyzed .Results:Compared with the basal level in the absence of nitroglycerin , the D in every point did not change ( P>0.05) , PSV, EDV, TAMAX, PI, RI, Q were decreased sharply at first 5 min, and then recovered to basic performance within the following 35 min gradually . Conclusion: After NTG administration , the D of CCA is unchanged in rabbits , the blood flow is decreased , which indicate that the cerebral blood flow has a corresponding transient decline .

Background: Targeted delivery is a promising strategy to improve the diagnostic imaging and therapeutic effect of cancers.In this paper, novel cetuximab (C225)-conjugated, gemcitabine (GEM)-containing magnetic albumin nanospheres (C225-GEM/MANs) were fabricated and applied as a theranostic nanocarrier to conduct simultaneous targeting, magnetic resonance imaging (MRI), and double-targeted thermochemotherapy against pancreatic cancer cells.Methods: Fe 3 O 4 nanoparticles (NPs) and GEM co-loaded albumin nanospheres (GEM/MANs) were prepared, and then C225 was further conjugated to synthesize C225-GEM/MANs.Their morphology, mean particle size, GEM encapsulation ratio, specific cell-binding ability, and thermal dynamic profiles were characterized.The effects of discriminating different EGFRexpressing pancreatic cancer cells (AsPC-1 and MIA PaCa-2) and monitoring cellular targeting effects were assessed by targeted MRI.Lastly, the antitumor efficiency of double/C225/ magnetic-targeted and nontargeted thermochemotherapy was compared with chemotherapy alone using 3-(4, 5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) and flow cytometry (FCM) assay.Results: When treated with targeted nanospheres, AsPC-1 cells showed a significantly less intense MRI T2 signal than MIA PaCa-2 cells, while both cells had similar signal strength when incubated with nontargeted nanospheres.T2 signal intensity was significantly lower when magnetic and C225 targeting were combined, rather than used alone.The inhibitory and apoptotic rates of each thermochemotherapy group were significantly higher than those of the chemotherapy-alone groups.Additionally, both MTT and FCM analysis verified that doubletargeted thermochemotherapy had the highest targeted killing efficiency among all groups.Conclusion: The C225-GEM/MANs can distinguish various EGFR-expressing live pancreatic cancer cells, monitor diverse cellular targeting effects using targeted MRI imaging, and efficiently mediate double-targeted thermochemotherapy against pancreatic cancer cells.

Objective To evaluate the effect of lumbar multifidus muscle training on muscle thickness.Methods The morphological changes in volunteers' lumbar multifidus muscles were observed in response to 11 kinds of training.Muscle thickness was measured at rest and during contraction using ultrasonography and two examiners.The rate of change in muscle thickness and the contraction rate were calculated.Results There was no significant difference in the contraction rates determined by the two examiners using ultrasound imaging.There was no significant difference in average contraction rate between the males and females.Pairwise,there was no significant difference among contralateral leg-raising,ipsilateral leg-raising,contralateral hand-raising,ipsilateral hand-raising and contralateral leg-lifting.Pairwise,there was no significant difference among ipsilateral leg-lifting and ipsilateral arm-lifting compared with contralateral leg-lifting,contralateral arm-lifting or contralaleral lower limb-lifting.There was no significant difference between contralateral arm-lifting and ipsilateral arm-lifting.There was no significant difference between ipsilateral arm-lifting with contralateral leg-lifting and contralateral arm-lifting with ipsilateral leg-lifting.Pairwise,there was a significant difference in lumbar multifidus muscle contraction rates among these actions.Conclusion Lumbar multifidus muscle training has various effects.Muscle thickness as measured using ultrasonography can provide a basis for formulating a rehabilitation training plan.

目的 探讨超声光散射断层成像测量乳腺癌最大血红蛋白浓度(MHC)与人表皮生长因子受体-2 (HER-2)表达的关系及临床意义.资料与方法 180例经手术病理证实的乳腺癌患者行超声光散射成像测定肿块MHC,以手术病理结果作为对照,检测不同年龄、病理类型、TNM分期的乳腺癌标本HER-2表达,分析乳腺癌HER-2不同表达状态时MHC的变化特点及MHC与HER-2表达之间的关系.结果 180例患者中,HER-2阳性81例(45.0％),阴性99例(55.0％),不同病理类型、发病年龄及临床分期乳腺癌患者HER-2表达阳性率差异均无统计学意义(P＞0.05);对照分析OPTIMUS检测结果,HER-2(+++)组和HER-2(++++)组乳腺癌MHC均显著高于HER-2(-)组(P＜0.05),随着HER-2表达量的增高,MHC显著增加.结论 乳腺癌MHC与HER-2过度表达密切相关,可以为临床制订乳腺癌治疗策略及预测预后提供参考.

Objective To determine the transfection of tyrosine phosphatase SHP2( Src homology phosphatase 2)eukaryotic expression( pcDNA3. 1SHP2) vector into mouse Lewis lung carcinoma( LLC) cells mediated by ultrasound and to observe the effect of SHP2 overexpression on Lewis lung carcinoma( LLC) cell proliferation and invasion and explore its molecular mechanism. Methods After addition of pcDNA3. 1SHP2 vector and 5 μL LipofectamineTM2000 to the mouse LLC cells in the 6-well plates,the cells were exposed to diagnostic dose of ultrasound for 60 s in the presence of 200 μL ultrasound contrast agent and 5 μL of liposome. Expression of SHP2 and P38 proteins was determined by Western blotting.MTT,scratch test and Transwell system were used to detect the proliferation,migration and invasion of LLC cells at 48 h after transfection. Results Overexpression of SHP2 gene and phosphorylation p38 was detected by Western blotting in the LLC cells of the pcDNA3. 1SHP2 vector transfection group,and the ability of proliferation,migration and invasion of the LLC cells was significantly increased. Conclusions Overexpression of SHP2 may enhance the ability of proliferation,migration and invasion of tumor cells,and preliminarily confirmed that SHP2 overexpression may promote the malignant progression of tumor cells through activation of mitogen-activated protein kinase( MAPK) signaling pathway.

Objective: To explore the changes of hemodynamic parameters of superficial artery affected by the pressure put on the probe with color Doppler ultrasound .Methods: Twenty healthy subjects ( aged 21-30 years ) with normal vascular findings were recruited in the study , total of 40 proper palmer digital arteries of middle fingers.Pressure of 0,200 and 400 g were applied on proper palmer digital artery and hemodynamic parameters , such as the peak systolic velocity (PSV),end diastolic velocity (EDV),the average maximum blood flow velocity ( TAMAX ) , resistance index ( RI ) and pulsatility index ( PI ) were measured respectively .Results: With the increase of pressure , PSV, EDV and TAMAX gradually decreased , but PI and RI increased .Conclusions: As hemodynamic parameters are important indicators for ultrasound to evaluate the structure and function of superficial blood vessels , they have been affected by the pressure applied by the examiners .Therefore, we should not ignore the effects of pressure while performing ultrasound scanning .