The discriminatory diagnostic value of multimodal ultrasound combined with blood cell analysis for granulomatous lobular mastitis and invasive ductal carcinoma of the breast.

OBJECTIVE: To explore the discriminatory diagnostic value of multimodal ultrasound(US) combined with blood cell analysis(BCA) for Granulomatous Lobular Mastitis (GLM) and Invasive Ductal Carcinoma(IDC) of the breast. METHODS: A total of 157 breast disease patients were collected and divided into two groups based on postoperative pathological results: the GLM group(57 cases with 57 lesions) and the IDC group(100 cases with 100 lesions). Differences in multimodal ultrasound features and the presence of BCA were compared between the two groups. The receiver operating characteristic(ROC) curve was used to calculate the optimal cutoff values, sensitivity, specificity, 95% confidence interval(CI), and the area under the curve(AUC) for patient age, lesion size, lesion resistive index(RI), and white blood cell(WBC) count in BCA. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and AUC were calculated for different diagnostic methods. RESULTS: There were statistically significant differences(P <  0.05) observed between GLM and IDC patients in terms of age, breast pain, the factors in Conventional US(lesion size, RI, nipple delineation, solitary/multiple lesions, margin, liquefaction area, growth direction, microcalcifications, posterior echogenicity and abnormal axillary lymph nodes), the factors in CEUS(contrast agent enhancement intensity, enhancement pattern, enhancement range, and crab-like enhancement) and the factors in BCA(white blood cells, neutrophils, lymphocytes and monocytes). ROC curve analysis results showed that the optimal cutoff values for distinguishing GLM from IDC were 40.5 years for age, 7.15 cm for lesion size, 0.655 for lesion RI, and 10.525*109/L for white blood cells. The diagnostic accuracy of conventional US combined with CEUS(US-CEUS) was the highest(97.45%). The diagnostic performance AUCs for US-CEUS, CEUS, and US were 0.965, 0.921 and 0.832, respectively. CONCLUSION: Multifactorial analysis of multimodal ultrasound features and BCA had high clinical application value in the differential diagnosis of GLM and IDC.

Three new methylated Δ8-pregnene steroids from the Polyalthia laui-derived fungus Stemphylium sp. AZGP4-2.

Three new methylated Δ8-pregnene steroids, stemphylisteroids A-C (1-3) were isolated from the medicinal plant Polyalthia laui-derived fungus Stemphylium sp. AZGP4-2. Their structures were elucidated by the detailed analysis of comprehensive spectroscopic data. The absolute configuration of 1 was determined by X-ray crystallographic analysis. Compound 1 show antibacterial activity against Escherichia coli with the MIC value of 6.25 µg/mL, and 2 exhibited a broad spectrum of antibacterial activities against six pathogenic bacteria with the MIC values ranging from 12.5 to 50 µg/mL. The discovery of three methylated Δ8-pregnene steroids 1-3 are a further addition to diverse and complex array of methylated steroids.

3,4- seco-Norclerodane Diterpenoids from the Roots of Polyalthia laui.

Ten new clerodane diterpenoids, polylauioids A-J (1-10), and five known analogues (11-15) were isolated from the roots of Polyalthia laui. Among the new compounds, 3 and 8 are artifacts. The structures were elucidated using spectroscopic methods and by comparison with published NMR spectroscopic data. The absolute configurations of 4, 5, and 7 were defined based on single-crystal X-ray diffraction and electronic circular dichroism data. Compounds 1 and 2 represent the first examples of rearranged 3,4- seco-norclerodane diterpenoids, and a putative biosynthesis pathway for these compounds is proposed. Compounds 1, 4, 6, 7, 9, and 10 showed anti-HIV activities with EC50 values ranging from 12.2 to 35.2 µM.

[Clinical analysis of prognostic factors for stage III ovarian epithelial carcinoma].

OBJECTIVE: To evaluate the prognostic factors for stage III ovarian epithelial carcinoma so as to provide scientific basis for further reasonable therapy. METHODS: The clinical records of 369 patients with stage III ovarian epithelial carcinoma, aged 53 +/- 9 (22-77), were reviewed retrospectively. SPSS 10.0 was utilized to analyze the possible prognostic factors statistically. RESULTS: All patients received cytoreductive surgery, 289 cases (71.8%) of which achieved optimal cytoreduction. During the operation, 150 cases (41.8%) and 265 cases (71.8%) were found with intestinal and diaphragmatic involvement respectively. Pathologic results showed that serous type was the most common histological type (48.9%) and mucinous type was the least one (2.2%). The grades G1, G2, and G3 accounted for 1.7%, 42.7%, and 55.6% respectively. 290 cases with effective response to surgery underwent chemotherapy for 3-22 (10 +/- 4) courses. Recurrence was recorded in 190 cases (51.5%) and death was recorded in 152 cases (41.2%). Multivariate analysis revealed that intestinal involvement, diaphragmatic invasion, tumor residuals, and course number of chemotherapy were significantly correlated with prognosis (P < 0.01, < 0.05, < 0.01, and < 0.01 respectively). CONCLUSION: Cytoreduction for the tumor in peritoneal cavity and positive chemotherapy should be emphasized sufficiently and may be helpful for the prognosis of stage III ovarian epithelial carcinoma.

[Clinical aspects of mature ovarian teratoma: result of 695 cases].

OBJECTIVE: To evaluate the clinical aspects of mature ovarian teratoma. METHOD: We retrospectively studied 695 patients operated in PUMC Hospital between January 1990 and December 2000. RESULTS: Laparoscopy surgery had shorter hospitalization day, less blood loss during surgery, shorter operation time compared with laparotomy (P < 0.001). Routine contralateral wedge resection was done in 601 cases, among which 459 had normal inspection and palpatation. Only one (0.22%) was pathologically confirmed bilateral tumor. Torsion was the major complication (7.5%). Average tumor size of torsion was (10.2 +/- 4.5) cm. Probability of torsion increased as the tumor enlarged, which was less than 4.4% when the tumor size was less than 6 cm and greater than 10% if size greater than 8 cm. Rupture, infection, and malignant transformation were rare. CONCLUSIONS: Laparoscopy is superior to laparotomy in the treatment of mature ovarian teratoma. If the contralateral ovarian is within normal configuration, contralateral wedge resection is unnecessary. When the tumor size is greater than 8 cm in diameter, it will have more chance to twist.