RESUMEN
The reductive cleavage of C(Ar)-X bonds is the key step for the cross coupling of Ar-X with other groups. In this work, under the irradiation of 407 nm LEDs using sodium formate as reductant and thiol as hydrogen atom transfer agent, a variety of (hetero)aryl chlorides, bromides, and iodides could be reduced to corresponding (hetero)arenes. The key intermediates, aryl radicals, could be trapped by either hydrogen, phosphite, or borates. The same reduction conditions can be extended to the deprotection of sulfonamides.
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A retrospective study was carried out to evaluate the diagnostic accuracy and the factors influencing the diagnostic accuracy of 648 procedures of ultrasound-guided percutaneous needle biopsy (PNB) for peripheral pulmonary lesions (PPLs). We reviewed the histopathology results, the clinical records and the procedure reports of these 648 biopsies and the final diagnoses of 637 PPLs to determine the diagnostic accuracy of ultrasound-guided PNB. Factors that influenced the diagnostic accuracy were assessed by analysis of the biopsy procedures, which were classified as diagnostic cases (true-positive and true-negative) and non-diagnostic cases (false-positive, false-negative and indeterminate). Statistical analyses of factors that related to patient demographic characteristics, lesion characteristics and biopsy details were performed to determine possible effects on diagnostic accuracy. Biopsies were successfully performed in all cases, and 11 patients underwent second biopsies for the same lesions. Among the 637 PPLs, there were 326 (51.2%) malignant lesions, 272 (42.7%) benign lesions and 39 (6.1%) indeterminate lesions. Of the 272 benign lesions, 114 (41.9%) were found to be tuberculous. The overall diagnostic accuracy was 81.8%, and the rates of hemoptysis, symptomatic pneumothorax and chest-tube insertion were 8.0%, 1.7% and 0.9%, respectively. Lesions sizes were divided into 3 groups according to the measurement by ultrasound. For lesions that measured ≤20 mm, 21-49 mm and ≥50 mm, the diagnostic accuracy was 72.0%, 86.8% and 79.7%, while sensitivity and specificity were 54.3%-79.2%, 88.3%-90.7% and 79.4%-89.5% and 77.3%-100%, 96.8%-100% and 58.6%-100%, respectively. Diagnostic accuracy was significantly affected by lesion size when lesion size was measured by ultrasound (p = 0.006) and computed tomography (CT) (p = 0.001). In the 3 lesion groups of ≤20 mm, 21-49 mm or ≥50 mm, diagnostic accuracy among each group was significantly different (p <0.001). When lesion size was measured by ultrasound (p <0.001) and CT (p <0.001) and the 3 groups were analyzed (p <0.001), there was a statistically significant relationship between lesion size and the presence of necrosis. The rates of the presence of necrosis in lesions that measured ≤20 mm, 21-49 mm and ≥50 mm were 3.9%, 11.7% and 28.8%, respectively. No significance was found for age (p = 0.119), gender (p = 0.25), lesion location (p = 0.55), the presence of necrosis (p = 0.226), patient position (p = 0.25), needle size (p = 0.26), puncture angle (p = 0.34) and needle passes (p = 0.21). Ultrasound-guided PNB is an effective and safe diagnostic method for PPLs; the diagnostic accuracy is significantly affected by lesion size and decreases in smaller (≤20 mm) and larger (≥50 mm) lesions.
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Enfermedades Pulmonares/diagnóstico por imagen , Enfermedades Pulmonares/patología , Ultrasonografía Intervencional/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja , Niño , Femenino , Humanos , Biopsia Guiada por Imagen , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad , Adulto JovenRESUMEN
To evaluate acoustic radiation force impulse (ARFI) inthe differential diagnosis of small (≤20 mm) solid breast lesions and identify the most efficient ARFI parameters. Conventional ultrasonography and ARFIwere performed in 120 patients with 121 small solid breast lesions. The area ratios (ARs) of the lesion on virtual touch tissue compared to B-mode were calculated. The shear wave velocity of the inner (SWVi) and boundary (SWVb) of the lesions and surrounding fatty tissue (SWVf) was measured. The ratio of SWVi to SWVf (SWVrat) was calculated. AR, SWVi, SWVb, and SWVrat were significantly larger in malignant lesions (all P < 0.001). A cutoff AR of 1.17 yielded the highest area under the receiver operating characteristic curveamong the various parameters (91.2% sensitivity, 85.9% specificity, 88.4% accuracy) for the differential diagnosis of small breast lesions, but this value did not significantly differ from SWVi (P = 0.1144). This AR cutoff indowngradingcategory 4a to category 3 would avoid 83.3% unnecessary biopsies, and improved diagnostic specificity up to 73.4% without decreasing sensitivity. AR and SWVi are efficient parameters for the differential diagnosis of small breast lesions, whichwill improve diagnostic specificity and reduce unnecessary biopsies.
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Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Diagnóstico por Imagen/métodos , Adulto , Biopsia , Diagnóstico Diferencial , Diagnóstico por Imagen/normas , Femenino , Humanos , Persona de Mediana Edad , Clasificación del Tumor , Estadificación de Neoplasias , Curva ROC , Sensibilidad y Especificidad , Carga TumoralRESUMEN
OBJECTIVE: This study aims to find out the safety and efficiency of postoperative adjuvant transarterial chemoembolization (TACE) and radiotherapy (RT) in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). METHODS: From 2009 to 2010, a total of 92 HCC patients with PVTT were enrolled in this retrospective study. Patients were divided into three groups according to their adjuvant therapies (conservative group, n=51; TACE group, n=31; RT group, n=10). RESULTS: In our analysis, median survival in patients with postoperative adjuvant TACE (21.91±3.60 months) or RT (14.53±1.61 months) was significantly longer than patients with hepatectomy alone (8.99±1.03 months). But the difference between adjuvant TACE and RT was of no significance (P=0.716). Also a similar result could be observed in median disease-free survival: conservative group (6.51±1.44 months), TACE group (13.98±3.38 months), and RT group (14.03±2.40 months). Treatment strategies (hazard ratio [HR] =0.411, P<0.001) and PVTT type (HR =4.636, P<0.001) were the independent prognostic factors for overall survival. Similarly, the risk factors were the same when multivariate analysis was conducted in disease-free survival (treatment strategies, HR =0.423, P<0.001; PVTT type, HR =4.351, P<0.001) and recurrence (treatment strategies, HR =0.459, P=0.030; PVTT type, HR =2.908, P=0.047). Patients with PVTT type I had longer overall survival than patients with PVTT type II (median survival: 18.43±2.88 months vs 11.59±1.45 months, P=0.035). CONCLUSION: Postoperative adjuvant TACE and RT may be a choice for HCC patients with PVTT.
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OBJECTIVE: To explore the correlation between pathological and ultrasound changes applying conventional ultrasound, Color Doppler ultrasound andVirtual Touch Tissue Quantification (VTQ) technique in newborn hypoxic-ischemic brain damage (HIBD) rat models. To provide theoretical basis for early diagnosis and treatment of HIBD neonatal. METHODS: A total of 90 newborn Wistar rats were divided into ischemia, asphyxia and control group according to different HIBD molding methods. Conventional ultrasound, Color Doppler ultrasound and VTQ were applied on 3 h, 12 h, 24 h, 48 h and 72 h postoperative. After the observation of 72 h, 10 rats in each group were randomly selected for pathological specimens production. The rest rats were raised for 30 days for neuroethology detection. RESULTS: In ischemia group and asphyxia group, there were 4 deaths and 6 deaths in the modeling process; the mortality rate was 13.33% (4/30) and 20.00% (6/30) respectively. For ischemia group, the systoli velocity (Vs), diastolic velocity (Vd) and resistance index (RI) of right middle cerebral artery (MCA) were significantly decreased after operation (P<0.05). For asphyxia group, the Vs and RI of right MCA were significantly decreased after operation (P<0.05), while the Vd of right MCA was significantly increased after operation (P<0.05), which lead to the postoperative RI value in each time point was all significantly lower than that in ischemia group (P<0.05). For ischemia group and asphyxia group, the VTQ results increased significantly postoperative (P<0.05), and compared with ischemia group and control group, the postoperative VTQ value in each time point was all significantly higher in asphyxia group (P<0.05). The neuroethology results were significantly lower in the ischemia group and asphyxia group (P<0.05), and the results in ischemia group were significantly higher than those of asphyxia group (P<0.05). And the results are consistent with the pathological findings. CONCLUSION: There is a consistent correlation among histopathological changes, hemodynamic changes, VTQ values and neuroethology results in HIBD animal models. As noninvasive quantitative ultrasound elastography methods, Color Doppler ultrasound and VTQ can assess the extent of HIBD damages in newborn rats with specific values. This study provides basic research and theory to early diagnosis and early treatment of neonatal hypoxic-ischemic brain damage.