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Objective To investigate the clinical value of contrast-enhanced ultrasound (CEUS) in differential diagnosis between benign and malignant gallbladder lesions which diameter more than 1 cm. Methods A retrospective analysis included CEUS data of 142 cases with gallbladder lesions diameter more than 1 cm. All lesions were confirmed by surgical pathology, enhanced CT/MRI or clinical diagnosis with following up more than 2 years. To summarize the CEUS characteristics of benign and malignant gallbladder lesions over 1 cm in diameter, the CEUS characteristics of benign and malignant gallbladder lesions diameter more than 1 cm were analyzed, referring to the gallbladder CEUS guidelines. The contrast medium washout before 35 s and 60 s were used as the combined diagnosis with CEUS standard to identify gallbladder cancer, and the diagnostic efficiency was calculated respectively. Results There were statistical differences between the malignant group and the benign group in terms of CEUS enhancement pattern, contrast arrival time, washout time, and gallbladder wall continuity, as well as enhancement levels (P

Objective: To explore the ultrasonographic characteristics of lymph nodes associated with positive fine-needle aspiration thyroglobulin (FNA-Tg) in eluent for suspected metastatic lymph nodes of papillary thyroid carcinoma (PTC). Methods: A total of 87 patients with PTC who were treated between January 2019 and December 2021 were selected, with 109 suspected metastatic lymph nodes examined by fine needle aspiration cytology and detected for FNA-Tg. Those with FNA-Tg/serum Tg>1 was defined as metastastic lymph nodes, and with FNA-Tg/serum Tg≤1 was defined as non-metastastic lymph nodes. All suspicious lymph nodes had ultrasonographic signs of suspicious metastasis, including local hyperechogenicity, cystic change, absence of hilum, microcalcification, solbiati index

Ultrasonography is recommended as an ideal imaging technique for surveillance and screening of liver tumors by guidelines in many countries. Contrast-enhanced ultrasound (CEUS) based on conventional ultrasound can provide function information of tissue microcirculation and perfusion.CEUS has advantages over contrast-enhanced CT/MRI in providing real-time, continuous, dynamic monitoring without radiation damage. The ultrasound contrast microbubbles is excreted through the lung,with no evidence of any effect on cardiac, renal and thyroid function. Contrast microbubbles can be applied to patients with renal insufficiency. There is a very low incidence of allergic reaction about ultrasound contrast agents. CEUS has been recommended as a first-line enhanced imaging technique for the diagnosis and differential diagnosis of focal liver lesions by domestic and international guidelines. Compared with conventional ultrasound, CEUS has better performance in detection,diagnosis and differential diagnosis of focal liver lesions(FLL). The contrast-enhanced ultrasound liver imaging reporting and data system (LI-RADS) issued by the American College of Radiology (ACR) is used to describe the full spectrum of intrahepatic lesions in high-risk patients, predicte the risk stratification of focal liver lesions, and recommend clinical management strategies. CEUS LI-RADS aimed to achieve an extremely high (ideally 100 %) positive predictive value for the diagnosis of hepatocellular carcinoma. CEUS LI-RADS is also applicable to the Chinese population. In the aspect of intervention, CEUS is helpful to optimizing of the path and identification of target in puncture biopsy of FLL, improving the success rate of puncture and positive rate of specimen, and is applied in the guidance during ablation surgery, instant assessment, long-term efficacy evaluation and postoperative follow-up. In addition, intraoperative application of CEUS can improve the detection rate of small liver metastases and identify disappearing liver metastases carcinoma after chemotherapy on regular images, thus helping clinicians to revise surgical protocols. CEUS also has certain application value in evaluating the efficacy of systemic treatment of liver malignancies. In conclusion, CEUS is playing an increasingly important role in the diagnosis and treatment of liver tumors

Objective: To analyze the value of lncRNA ENST0000048967 detection in biopsy tissue of papillary thyroid carcinoma (PTC) by ultrasound-guided fine-needle aspiration (US-FNA) for diagnosing cervical lymph node metastasis. Methods: A total of 110 PTC patients with pathologically confirmed cervical lymph node metastasis in Ruijin hospital during June 2020 to December 2020, were enrolled (study group). Another 110 PTC patients without cervical lymph node metastasis were served as the control group. The expression level of ENST00000489676 in FNA biopsy samples from 220 patients were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The correlation of ENST00000489676 expression with lymph node metastasis in PTC patients was explored. ROC curve was used to calculate the cutoff value of ENST00000489676 expression level for diagnosing cervical lymph node metastasis of PTC in puncture specimens. The sensitivity, specificity and accuracy of ultrasonography alone and combined with ENST00000489676 detection in FNA biopsy samples for diagnosis of lymph node metastasis were also calculated respectively. Results: The expression of ENST0000048967 in study group was significantly lower than that in non-lymph node metastasis group(t=-4.198, P

Objective: To investigate the effect of ultrasound by computer aided diagnosis (CAD) system in diagno-sing nodules in patients with diffuse thyroid lesions. Methods: A total of 342 patients with diffuse thyroid lesions and thyroid nodules who underwent thyroid surgery in our hospital during August 2017 to December 2017 were enrolled. Based on guidelines for adult thyroid nodules and differentiated thyroid cancer, ultrasound with and without CAD were performed on 533 nodules from the patients. The findings of ultrasound were compared with pathological results, and sensitivity, specificity, positive predictive value, negative predictive value, and area under the ROC curve(AUC) were calculated to observe difference in efficacy between ultrasound and ultrasound by CAD system. Results: The sensitivity, specificity of conventional ultrasound for diagnosing malignant and benign nodules in diffuse thyroid lesions was 96.6%, 72.5%, with AUC of 0.846. While the diagnostic sensitivity, specificity of ultrasound and ultrasound by CAD system was 96.6%, 80.9%, with AUC of 0.888. The use of CAD system enabled ultrasound achieve a higher specificity and AUC (P

The potential risks arising from excessive supply chain concentration have received more and more attention. In practice, high supply chain concentration hinders firms' sustainable development, especially for firms in emerging markets. However, how to reduce supply chain concentration remains an underexplored problem. Outward foreign direct investment (OFDI) has been an important strategy for firms to reallocate and optimize their supply chain relationships. Thus, we tried to explore whether OFDI can serve as an effective method to reduce supply chain concentration by analyzing their relationship. Using the data of Chinese A-share listed firms from 2008 to 2022, this paper empirically examines the impact of OFDI on supply chain concentration through a two-way fixed-effects model. We find that OFDI significantly reduces supply chain concentration, and this conclusion still holds after using alternative measures of the independent variable and dependent variable, endogeneity treatment, the Heckman two-stage model test, controlling for provincial factors, and excluding special samples. Channel analysis reveals that OFDI reduces supply chain concentration mainly through increasing market share, enhancing innovation capacity, and improving reputation. Cross-sectional analysis shows that the negative effect of OFDI on supply chain concentration is more pronounced in state-owned firms, firms under high industry competition, and high-tech firms. Our findings have important implications for firms to build sustainable supply chain relationships and strengthen supply chain resilience, and for policymakers to guide OFDI reasonably. Future research could further explore the effect of firms' investment decisions on supply chain configuration. [ABSTRACT FROM AUTHOR]

Objective To evaluate the clinicopathological characteristics of papillary thyroid microcarcinoma (PTMC) located in the isthmus. Methods The clinical and pathological data of 477 cases with PTMC diagnosed pathologically were retrospectively analyzed. Differences in PTMC between isthmus and lateral lobe were compared. Results Multivariate analysis showed that there were significantly difference in cancer capsule contact (30.5% vs. 10.4%, P=0.001) and lymph node metastasis (LNM) (42.7% vs. 18.7%, P

Objective: To compare the value of thyroglobulin(Tg) measurement by fine needle aspiration and by fine needle capillary techniques for diagnosing node metastases from thyroid papillary carcinoma(PTC). Methods: Fifty-four patients with suspicious metastatic lymph nodes from PTC were enrolled during January 2018 to December 2018. Ultrasound guided fine needle aspiration cytology(FNAC) and fine needle capillary cytology(FNCC) were performed for detecting suspicious lymph nodes, and the level of Tg in the eluent was measured. According to the post-operative pathologic results and clinical follow-up results, the difference of diagnostic efficacy between the two groups was compared. Results: A total of 76 suspicious lymph nodes were examined, and 48 of them were confirmed as metastasis by pathology. The mean level of Tg in needle washouts by FNAC and by FNCC were （4 588.02±1 042.09） ng/mL and (1 678.57±420.57) ng/mL (P=0.010 6), respectively. The area under receiver operating characteristic curve of Tg value in washouts by FNAC and by FNCC were 0.943 and 0.913, respectively. The difference was significant between methods (P=0.032). The cut-off value of Tg in FNAC group was 14.385 ng/mL, and the diagnostic sensitivity and specificity were 0.938 and 0.893, respectively. The cut-off value of Tg in FNCC group was 12.155 ng/mL, and the diagnostic sensitivity and specificity were 0.875 and 0.893, respectively. Conclusions: Both measurement of Tg in the eluent by FNCC and by FNAC are helpful to the diagnosis of metastatic lymph nodes from PTC. However, FNAC had more advantage over FNCC in diagnosing metastatic lymph nodes.

Objective: To explore use of three-dimensional ultrasound for predicting spermatogenic function by monitoring testicular volume before and after treatment in patients with idiopathic hypogonadotropic hypogonadism (IHH),and to compare application value with those of changes in sex hormone levels. Methods: A total of 52 male patients with azoospermia due to IHH received micro-pump pulse infusion of gonarelin for 12 weeks in our hospital from January to August 2019 were selected. Patients were divided into 2 groups :spermatogenic groups(15 cases) and non-spermatogenic group (37 cases, including one case of left cryptorchidism). The testicular volume and sex hormones [follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone（T）] levels before and after treatment in the two groups were compared, as well as the semen routine. Results: After 12 weeks of treatment, the overall testicular volume of patients in the spermatogenic group and the non-spermatogenic group increased (P0.05). The sensitivity of the right and left testicular volume before treatment to predict spermatogenesis after treatment was 93.33% and 99.8%, and the specificity was 75.68% and 81.08% respectively. The increase in T level before and after treatment for predicting spermatogenesis had a sensitivity of 80% and a specificity of 97.3% after treatment. Conclusions: Testicular volume monitoring with three-dimensional ultrasound before treatment is helpful to predict spermatogenesis in male patients with azoospermia, and sensitivity of which is higher than that of increase in T after treament.

Objective: To investigate the difference in the clinicopathologic and ultrasonic features between unifocal and multifocal papillary thyroid carcinomas. Methods: A total of 448 cases with papillary thyroid carcinoma undergone total thyroidectomy were enrolled during Jan. 2007 to Jan. 2019. Patients were divided into two groups which were unifocal tumor group (155 cases) and multifocal tumor group (293 cases). The difference in clinicopathologic and ultrasonic features between two groups were compared using χ2 test and non-parametric tests. Results: The pathological examination revealed that the multifocal tumors presented more microcarcinoma (72% vs 63%, P=0.049), lymph node metastasis （LMN） (56% vs 41%, P=0.004), capsular invasion (10% vs 3%, P=0.009) and less nodular goiter （42% vs 56%, P=0.003） than those of unifocal tumors. Comparing to unifocal tumors, the multifocal tumors occurred more in the middle dorsal and medial lateral side of the thyroid （P=0.029, P=0.008; P=0.002, P=0.011）, and their size measured with three diameters(vertical anteroposterior, left right diameters) was smaller (P=0.004, P=0.001, P=0.023) in ultrasonography. In addition, the multifocal group had less unclear boundary (67% vs 77%, P=0.013), heterogeneous internal echoes (79% vs 88%, P=0.009), calcification (50% vs 63%, P=0.010) and pos-terior echo change （18% vs 28%, P

Borehole strain gauges play a crucial role in geophysical, seismological, and crustal dynamics studies. While existing borehole strain gauges are proficient in measuring horizontal strains within vertical boreholes, their effectiveness in capturing vertical and oblique strains is limited due to technical constraints arising from the cylindrical probe's characteristics. However, the accurate measurement of three-dimensional strain is essential for a comprehensive understanding of crustal tectonics, dynamics, and geophysics, particularly considering the diverse geological structures and force sources within the crustal medium. In this study, we present a novel approach to address this challenge by enhancing an existing horizontal-component borehole strain gauge with a bellows structure and line strain measurement technology to enable vertical and borehole oblique strain measurements. Integrating these enhancements with horizontal strain measurement capabilities enables comprehensive three-dimensional borehole strain measurements within the same hole section. The system was deployed and tested at the Gongxian seismic station in Sichuan Province. Clear observations of solid tides were recorded across horizontal, oblique, and vertical measurement units, with the tidal morphology and amplitude being consistent with the theoretical calculations. The achieved measurement sensitivity of 10-10 meets the requirements for borehole strain measurement, enabling the characterization of three-dimensional strain states within boreholes through association methods. [ABSTRACT FROM AUTHOR]