To assess the clinical usefulness of automated breast ultrasound (ABUS) in predicting pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in HER-2 positive breast cancer patients.

A retrospective analysis was performed on 248 HER-2 positive female breast cancer patients admitted to the Department of Breast Surgery, Xijing Hospital Affiliated to Air Force Military Medical University from March 2019 to May 2023. The differences in parameters before NAC were compared between patients with pCR and non-pCR (npCR) patients. Multivariate binary Logistic regression analysis was performed to identify the independent predictors of pCR in HER-2 positive breast cancer. Additionally, a nomogram prediction model was developed based on features obtained from ABUS. The Bootstrap method (1000 times of sampling) was used to verify the model internally. Receiver operating characteristic (ROC) curve analysis was employed for assessing the discriminative performance of the model, and decision curve analysis (DCA) was used to evaluate the clinical benefit and application value of the model.

There were significant differences in ER status, PR status, molecular subtype, skin invasion, posterior echo, retraction phenomenon in the coronal plane, and white wall sign in the coronal plane between the the pCR and npCR groups before NAC (P<0.05 for all). Binary Logistic regression analysis showed that molecular subtype, skin invasion, retraction phenomenon in the coronal plane, and white wall sign in the coronal plane were independent predictors of pCR in HER-2 positive breast cancer (P<0.05 for all). A nomogram model was constructed based on these variables, and the area under the ROC curve of this model for predicting pCR in HER-2 positive breast cancer was 0.805 (95% confidence interval [CI]: 0.751~0.859). The Hosmer-Lemeshow test showed that the model had a good fit (χ²=6.597, P=0.360). The calibration curve demonstrated an excellent correspondence between the predicted and observed probabilities of the joint model, thereby indicating its high accuracy and reliability. The Bootstrap method was used to iterate for 1000 times for internal verification, and the calculated average AUC was 0.806 (95%CI: 0.742-0.855), indicating that the model was stable. The DCA showed that the clinical benefit and application value of the model were high.

The nomogram model based on the ABUS features of tumors before NAC can accurately predict the pCR to NAC in HER-2 positive breast cancer to a certain extent, thus providing an ultrasound imaging basis for the formulation of clinical treatment plans for breast cancer patients.

To assess the application value of contrast-enhanced ultrasound in the diagnosis and biopsy of American College of Radiology breast imaging reporting and data system (BI-RADS) category 4a breast nodules.

A retrospective analysis was performed on the imaging data and coarse needle biopsy or surgical pathological results of 126 patients with BI-RADS category 4a breast nodules who received contrast-enhanced ultrasound examination at the First People's Hospital of Jiashan County, Zhejiang Province from January 2020 to February 2023. Single factor analysis and multivariate regression analysis were conducted to identify independent risk factors for breast nodule malignancy. Using pathological results as the gold standard, receiver operating characteristic (ROC) curve analysis was performed to calculate the sensitivity, specificity, and accuracy of contrast-enhanced ultrasound for diagnosing benign and malignant nodules, and analyze the diagnostic efficacy of contrast-enhanced ultrasound for BI-RADS category 4a breast nodules. The puncture biopsy rate, malignant nodule detection rate, and missed detection rate of all breast BI-RADS 4A nodules were compared with those of nodules that tended to be malignant after contrast-enhanced ultrasound.

Among the 126 cases of breast BI-RADS 4A nodules, there were 97 cases of pathologically benign nodules and 29 cases of pathological malignant nodules. The results of multivariate logistic regression analysis showed that the expansion of lesion size after enhancement (odds ratio [OR]=10.800, P=0.048) and the "crab foot" sign or nutrient vessels (OR=6.909, P=0.027) were independent risk factors for breast nodule malignancy. The area under the ROC curve of contrast-enhanced ultrasound in the diagnosis of benign and malignant BI-RADS category 4a breast nodules was 0.792, and the sensitivity, specificity, and accuracy were 86.2%, 72.2%, and 75.4%, respectively. After contrast-enhanced ultrasound examination, the biopsy rate for the 126 BI-RADS category 4a breast nodules decreased from 100.0% before contrast to 41.2% (χ²=104.76, P<0.001), and the detection rate of malignant nodules increased from 23.0% to 48.1% (χ²=10.93, P=0.001), with a missed detection rate of only 3.1% (χ²=1.759, P=0.815).

Contrast-enhanced ultrasound has high efficacy in the differential diagnosis of benign and malignant BI-RADS category 4a breast nodules, with the potential to reduce unnecessary biopsy of BI-RADS 4A nodules and improve the detection rate of malignant nodules.

To assess the value of echocardiography combined with electrocardiogram (ECG) in predicting left ventricular hypertrophy among high-level swimming athletes in a university.

A retrospective analysis was conducted on 152 college students selected from Beijing Foreign Studies University from January 2019 to December 2020. including 40 high-level swimmers as an athlete group, and 112 ordinary college students who participated in volleyball, tennis, football, or track and field competitions during the same period as a control group. All students underwent ECG examination. Cardiac ultrasound examination was performed on all high-level athletes and ordinary college students whose ECG indicated high left ventricular voltage.

Among the 152 study subjects included, 16 had left ventricular high voltage on ECG. Further ultrasound examinations were conducted on 40 high-level athletes and 8 ordinary college students with abnormal electrocardiogram. Among them, 8 ordinary college students with abnormal electrocardiogram showed no significant abnormalities in left heart structure and systolic function on resting state echocardiography. Among 40 high-level athletes, 21 (52.5%) had ECG indicating left ventricular enlargement or fullness. The aortic root diameter (AoD), left atrial anteroposterior diameter (LAAPD), left ventricular end diastolic septal thickness (IVSd), left ventricular end diastolic posterior wall thickness (LVPWd), left ventricular end diastolic anteroposterior diameter (LVEDD), left ventricular end systolic anteroposterior diameter (LVESD), left ventricular myocardial weight (LVM), and left ventricular myocardial mass index (LVMI) of athletes were all significantly higher than those of ordinary college students (P<0.05), but athletes had significantly lower left ventricular ejection fraction (LVEF) and left ventricular shortening fraction (LVFS) than ordinary college students (P<0.05).

The positive rate of pure left ventricular high voltage on ECG is low, and high-level swimmers have a higher positive rate of left ventricular abnormalities diagnosed by ECG. Doctors should be cautious when making conclusions about ventricular hypertrophy by ECG diagnosis.

To explore the value of ultrasound strain elastography (SUE) combined with magnetic resonance diffusion-weighted imaging (MRI-DWI) guided targeted puncture in the diagnosis of prostate lesions.

Patients with suspected prostate space-occupying lesions who were treated at Huizhou Central People's Hospital from May 2019 to May 2022 were prospectively collected as the research subjects. Rectal ultrasound, SUE, and MRI-DWI were performed before puncture, and the suspicious areas were recorded. All patients underwent transrectal systematic prostate puncture under the guidance of rectal ultrasound, and targeted puncture of suspicious lesions under the guidance of SUE combined with MRI-DWI. The imaging characteristics were recorded. Taking the pathological results as the "gold standard", the positive detection rates by systematic puncture and targeted puncture were compared. The receiver operating characteristic (ROC) curve of apparent diffusion coefficient (ADC) was plotted to analyze the value of ADC in diagnosing prostate lesions. The Gleason scores of the two puncture biopsy schemes were compared.

A total of 105 patients with suspected prostate space-occupying lesions were included in this study, of which two withdrew from the study due to their own psychological reasons. Finally, 103 patients were included in this study. All 103 patients were successfully punctured and sampled for examination, among which 66 (64.08%) were pathologically diagnosed with prostate cancer (all were adenocarcinoma). There were 37 cases of benign prostatic hyperplasia, accounting for 35.92% (37/103), of which two were accompanied by intraepithelial neoplasia. A total of 59 patients were diagnosed with malignant lesions, including 55 cases by MRI-DWI and 57 cases by SUE. In patients with malignant lesions, MRI-DWI examination (T2WI) showed that the lesions had nodular low signal, DWI showed high signal, ADC map showed that the ADC value was low, and SUE examination can find a blue area with increased hardness. The malignant lesion detection rate by systematic puncture was 48.54%, and that of SUE combined with MRI-DWI targeted guided puncture was 57.28%; there was no statistical significant difference between them (P>0.05). A total of 1181 needles were used in systematic puncture, of which 379 achieved a pathological diagnosis of malignant lesions, with a single needle detection rate of 32.09%. A total of 218 needles were punctured under the guidance of SUE and MRI-DWI, and 136 needles achieved a pathological diagnosis of malignant lesions, with a single needle detection rate of 62.38%. The single needle detection rate by targeted guidance puncture was significantly higher than that by systematic puncture (P<0.05). The ADC value in malignant lesions was (1.18±0.17) mm²/s, while in benign lesions it was (1.42±0.23) mm²/s; the ADC value in malignant lesions was lower than that in benign lesions (t=6.303, P<0.001). The area under the curve (AUC) of ADC for diagnosis of benign and malignant prostatic lesions was 0.816 (95%CI: 0.718-0.914). The sensitivity and specificity of evaluating benign and malignant prostatic lesions using an ADC value of 1.34 mm²/s as the cutoff point were 83.33% and 67.57%, respectively. There was no statistical significant difference in Gleason scores between the two puncture schemes (P>0.05).

Compared with systematic puncture, SUE combined with MRI-DWI guided targeted puncture can obtain a similar detection rate of prostate malignant lesions with less puncture needles and a higher positive rate of puncture.

To evaluate the safety and effectiveness of ultrasound-guided percutaneous nephrolithotomy without artificial hydronephrosis.

The clinical data of 395 patients who underwent percutaneous nephrolithotomy at the Department of Urology Affiliated Hospital of Jining Medical University from January 2019 to December 2021 were retrospectively analyzed. The patients were divided into three groups (no hydronephrosis, mild hydronephrosis, and moderate/severe hydronephrosis) according to the degree of preoperative CT hydronephrosis assessed by preoperative CT, and each group was further divided into either an artificial hydronephrosis group or a no artificial hydronephrosis group according to the surgical method used. The differences in the one-time puncture success rate, operation time, intraoperative bleeding, one-stage calculus clearance rate, the incidence of postoperative fever, and postoperative hospital stay were compared between the artificial hydronephrosis group and the no artificial hydronephrosis group.

There was no significant difference in general data between the two groups (P＞0.05). For patients without hydronephrosis, operative time [(54.8, 95.5) min vs (5.0, 60.0) min, P＜0.01], intraoperative blood loss [(10, 25) ml vs (5, 20) ml, P＜0.01], and postoperative hospital stay [(3.0, 5.0) d vs (2.0, 4.0) d, P＜0.01] differed significant between the artificial hydronephrosis group and the no artificial hydronephrosis group. For patients with mild hydronephrosis, operative time [(65.0, 115.8) min vs (25.0, 40.0) min, P＜0.01], intraoperative blood loss [(20, 50) ml vs (5, 20) ml, P＜0.01], and postoperative hospital stay [(3.0, 6.0) d vs (2.0, 4.0) d, P＜0.01] also differed significantly between the artificial hydronephrosis group and the no artificial hydronephrosis group. For patients with moderate/severe hydronephrosis, operative time [(60.0, 111.0) min vs (25.0, 60.0) min, P＜0.01], intraoperative blood loss [(10, 30) ml vs (5, 20) ml, P＜0.01], and postoperative hospital stay [(3.0, 5.0) d vs (2.0, 4.0) d, P＜0.01] still differed significantly between the artificial hydronephrosis group and the no artificial hydronephrosis group. There was no significant difference in the one-needle puncture success rate, one-stage calculus clearance rate, and the incidence of postoperative fever between the two groups (P＞0.05).

Ultrasound-guided percutaneous nephrolithotomy without artificial hydronephrosis is safe and effective for the treatment of kidney stones with different degrees of hydronephrosis, which can shorten operation time and accelerate postoperative recovery.