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Objective To compare the value of diffusion kurtosis imaging (DKI) mode and mono-exponential mode in predicting the response to neoadjuvant chemotherapy (NAC) for locally advanced breast carcinoma using DWI.Methods From January 1,2013 to December 31,2016,eighty patients with locally advanced breast carcinoma were enrolled into this prospective clinical study.The diagnosis was confirmed on the basis of histopathological results.The clinical stage stayed at Ⅱ or Ⅲ.The patients would receive breast-conserving surgery after NAC.All the patients underwent DWI examination by using both mono-exponential mode and DKI mode before chemotherapy was initiated.The parameters included ADC,mean diffusivity (MD) and mean kurtosis (MK).Within 1 to 3 days before or after MRI examination,the patients underwent aspiration biopsy,received 4 to 8 cycles of NAC and followed by surgery.According to histologic grading before NAC,the patients were classified into well-differentiated and poor-differentiated group.According to the comparison between pathological results acquired from biopsy before NAC and specimen acquired after surgery,the patients were classified into pathologic complete response (pCR) and pathologic non-complete response (non-pCR) according to treatment effect.The imaging parameters were compared between the pCR and the non-pCR group using t test.The predicting ability of two imaging modes was compared and analyzed with ROC analysis.The relationships between multiple imaging parameters,pathologic,clinical characteristics of tumor and treatment effect were analyzed using logistic multi-variate regression analysis,and further analyzed using Wald test.Results There were 30 cases of pCR and 50 cases of non-pCR.The ADC and MD values were lower in the pCR group than in the non-pCR group (P＜0.05).MK value was higher in the pCR group than in the non-pCR group (P＜0.05).ROC analysis showed that the area under ROC curve of ADC,MD and MK in predicting treatment effect were 0.732,0.866 and 0.683 respectively.Logistic regression analysis showed that,according to predicting ability,MD,ADC and MK successively were the independent predictors for the early response to chemotherapy.Conclusion Compared with mono-exponential mode,DKI mode can reflect the real micro-environment and water diffusion restriction within the tumor area more reliably and accurately,and is more suitable to serve as an imaging technique for predicting the response to NAC for locally advanced breast carcinoma.
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Objective To study the effect of soluble amyloid precursor protein α (sAPPα) on nerve cell apoptosis and neurological function in subarachnoid hemorrhage (SAH) rats.Methods Sixty male SD rats were randomly divided into control group (n=20),SAH+saline group (n=20) and SAH+sAPPα group (n=20).A SAH model was established by injecting autologous blood into cistern magna in rats.After a SAH model was established for SAH + saline group and SAH + sAPPα group by injecting saline and sAPPα respectively into the cistern magna of rats,the apoptotic cells were detected by immunofluorescene with TUNEL staining and the neurological function was scored in 10 rats from each group on day 3 after injection of sAPPα and saline.Results The number of apoptotic cells in brain tissue was significantly greater in SAH+saline group than in control group (P＜0.05) and was significantly smaller in SAH+sAPPα group than in SAH+ saline group (P＜0.05).The neurological function score was 26.7±0.5,13.9±0.7 and 23.0±0.8 respectively in control group,SAH + saline group and SAH + sAPPα group.Conclusion sAPPα alleviates secondary damage of neurological function by inhibiting the apoptosis of nerve cells in rats after SAH and can thus improve their neurological function.
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Objective To detect the expression of micro RNA (miR)-433 and histone deacetylase 6 (HDAC6) in glioma tissues and investigate the effect of miR-433 on cell proliferation and invasion of human glioma cell line U251. Methods (1) Forty-two glioma samples, collected from patients accepted surgical resection and conformed by pathology in our hospital from January 2010 to December 2014, and 13 healthy brain tissues, collected from patients accepted surgery for craniocerebral trauma at the same time period, were used in our study; reverse transcription (RT)-PCR was used to detect the mRNA expression levels of miRNA-433 and HDAC6 in the glioma samples and brain tissues. (2) Human glioma cell line was routinely cultured and divided into blank control group, nonsense sequence control group and miRNA-433 mimics group;cells in the later two groups were transfected with nonsense sequences or miRNA-433 mimics, and cells in the blank control group did not give any treatment;the mRNA expression levels of miRNA-433, P21 and HDA C6 in these 3 groups were detected by RT-PCR;the cellular viability was measured by CCK-8 assay;flow cytometry was used to monitor the changes of cell cycle and apoptosis; cell invasion was evaluated by Transwell assay; HDAC6 protein expression was detected by Western blotting. (3) Wide-type (WT)HDAC63'-UTR and mutant type (MUT)HDAC63'-UTR luciferase report vectors were established; miR-433 mimics+WT HDAC63′-UTR and nonsense sequences+WT HDAC63'-UTR were transfected into the U251 cells, and dual-luciferase experiment was used to detect the fluorescence intensity of the cells; miR-433 mimics+MUT HDAC63'-UTR and nonsense sequences+MUT HDAC63'-UTR were transfected into the U251 cells, and dual-luciferase experiment was used to detect the fluorescence intensity of the cells. (4) U251 cells were divided into nonsense sequence control group, HDAC6 expression plasmids group and HDAC6 siRNA group, and nonsense sequences, HDAC6 expression plasmids or HDAC6 siRNA were transfected respectively; RT-PCR was used to detect the P21 and HDAC6 mRNA expressions and miRNA-433 expression; U251 cells were divided into miR-433 mimics group and miR-433 mimics+HDAC6 expression plasmids group, and miR-433 mimics or miR-433 mimics+HDAC6 expression plasmids were transfected, respectively, and one-5 d after that, CCK-8 was used to detect the cellular viability. Results (1) The miRNA-433 expressions gradually increased and HDA C6 mRNA expressions gradually decreased in the high-grade gliomas, low-grade gliomas and normal brain tissues, and significant differences were noted among each two groups (P<0.05);the miRNA-433 expression was negatively correlated with HDA C6 mRNA expression in the glioma tissues (r=0.829, P=0.000). (2) As compared with blank control group and nonsense sequence control group, miRNA-433 mimics group had significantly higher miRNA-433 and P21 mRNA expressions, cell percentage at G0/G1 stage, and apoptotic rate (P<0.05), and had statistically lower HDAC6 mRNA expression, cellular viability on 2-5 d of culture, number of transmembrane cells and HDAC6 protein expression (P<0.05). (3) The luciferase activity in cells from miR-433 mimics+WT HDAC63'-UTR group was significantly lower as compared with that in the nonsense sequences+WT HDAC63'-UTR group (P<0.05);the luciferase activity in cells from miR-433 mimics+MUT HDAC63'-UTR group and nonsense sequences+MUT HDAC63'-UTR group showed no significant differences (P>0.05). (4) The HDA C6 mRNA expressions were gradually increased, and P21 mRNA expressions were gradually decreased in the HDAC6 siRNA group, nonsense sequence control group, and HDAC6 expression plasmids group, with significant differences (P<0.05);on 2-5 d of culture, the cellular viability in the miR-433 mimics+HDAC6 expression plasmids group was significantly higher than that in the miR-433 mimics group (P<0.05). Conclusions The miRNA-433 expression level is low in human glioma tissues;miRNA-433 over-expression may inhibit the cell activity and promote cell apoptosis of glioma cell line U251 in vitro via inhibiting the HDAC6 expression.
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The paper analyzes and discusses the necessity of integrating computational thinking into basic computer teaching by combining characteristics of medical undergraduates and the current situation and tendency of basic computer teaching,and states the thought and method of solving problems with the computational thinking by taking mind mapping and program design thought as the teaching cases,in order to cultivate the consciousness and ability of students in constructing problem solutions by taking advantage of the computational thinking.
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Objective@#To investigate the value of preoperative dynamic contrast-enhanced MRI in reducing the rate of tumor-positive resection margins after breast conserving surgery in patients with early non-mass breast carcinoma.@*Methods@#Seventy-two patients with early non-mass breast carcinoma received ultrasonographic and mammographic examination and subsequently underwent dynamic contrast-enhanced MRI examination before breast conserving surgery. The control group consisted of 74 patients who had early non-mass breast carcinoma. They only received ultrasonographic and mammographic examination and didn′t undergo contrast-enhanced MRI examination. The comparison of the rate of tumor-positive resection margins between two groups was performed. The MRI findings that had the significant influence on the rate of tumor-positive resection margins were analyzed using Logistic regression model.@*Results@#In 28 patients (28/72, 38.9%), dynamic contrast-enhanced MRI could correct or supplement the ultrasonographic and mammographic findings and resulted in the reasonable change of surgical program. The preoperative MRI examination group (n=30) had lower rate of tumor-positive resection margins than control group for invasive ductal carcinoma (23.3% vs 40.0%, P=0.02), but there was no significant difference (21.4% vs 26.9%, P=0.10) between two groups for ductal carcinoma in situ (n=28). The preoperative MRI examination group (n=14) had lower rate of tumor-positive resection margins than control group for the other pathologic types of breast carcinoma (14.3% vs 38.9%, P=0.02). The statistical analysis on the basis of Logistic regression model showed that some main MRI findings, including change surrounding the tumor, distance between tumor and nipple and tumor size, had the significant influence on the rate of tumor-positive resection margins.@*Conclusion@#Preoperative dynamic contrast-enhanced MRI significantly increased the accuracy of resection margins evaluation, and greatly reduced the rate of tumor-positive resection margins after breast conserving surgery in patients with early non-mass breast carcinoma.
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Objective To investigate the feasibility and value of CT perfusion imaging in combination of CTA 320-slice CT with dual-low-dose in detection of acute cerebral ischemia.Methods Forty patients with acute stroke underwent perfusion imaging and CTA using a single scan with 320-slice CT with dual-low-dose schedule.CTA,4D-CTA,4D-perfusion imaging and fusion images were generated at a post-processing workstation.All patients also underwent a 3.0T magnetic resonance imaging with DWI for a comparison.Quality of the images,degree of vascular stenosis,and location of ischemic lesions were evaluated.Results The vascu-lar stenosis or occlusion was found in 33 patients,8 of whom were confirmed by the DSA.The ratio of better images of CTA was 82.5%.CTP showed 297 lesions with abnormal perfusion.202 lesions were confirmed as infarct by DWI,while 95 ones were nor-mal on DWI but with increased DLY and TTP and slightly decreased CBF and CBV in 49,increased DLY and TTP and normal CBF and CBV in 21,and increased DLY and TTP and slightly increased CBF and CBV in 25.Conclusion CT perfusion in combination with CTA by 320-slice CT with dual-low-dose is feasible and useful to observe accurately the vascular structures and the ischemic status of the whole brain at early stage.
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PurposeTo investigate the feasibility and clinical value of 3.0T MRI iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) technique in imaging normal lumbosacral nerve roots.Materials and Methods Twenty-five healthy volunteers and 15 patients with lumbosacral pain were examined on MR scanner using IDEAL sequence thin-layer coronal scanning and reconstruction technique. The evaluation of bilateral lumbosacral nerve roots from L1 to S1 included the detection rate of lumbosacral nerve roots, the length of preganglionic nerve, the width and length of dorsal root ganglia (DRG) and the length of nerve root sheath.Results The anatomic structure and the contour of spinal nerve roots were well demonstrated on IDEAL sequence imaging, with 100% detection rate for preganglionic nerve and DRGs of nerves from L1 to S1 level, as well as the structures posterior to the ganglions from L3 to S1 level. The structures posterior to the ganglions at L1 to L2 level were shown as grade I in 12% and 42%, grade II in 16% and 32%, grade III in 72% and 26%. The length of preganglionic nerve, DRGs and nerve root sheath from L1 to S1 were gradually increased (P<0.05 orP<0.001). Normal lumbosacral nerve roots appeared as isointense linear structure in the nerve canals.ConclusionIDEAL sequence can depict the anatomic structure of the lumbosacral nerve roots and provide reference standards for lumbosacral nerve roots compression.
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Objective To evaluate dual-source dual-energy CT(DSCT) for the differentiation of urinary stone composition in vitro. Methods Ninety-seven urinary stones were obtained by endoscopic lithotripsy and scanned using dual-source dual-energy CT. The stones were divided into six groups according to infrared spectroscopy stone analysis: uric acid ( UA ) stones ( n = 10 ), cystine stones ( n = 5 ), struvite stones( n = 6), calcium oxalate ( CaOx ) stones ( n = 22 ), mixed UA stones ( n=7 ) and mixed calcium stones(n=47). Hounsfield units (HU) of each stone were recorded for the 80 kV and the 140 kV datasets by hand-drawing method. HU difference, HU ratio and dual energy index ( DEI ) were calculated and compared among the stone groups with one-way ANOVA. Using dual energy software to determine the composition of all stones, results were compared to infrared spectroscopy analysis. Results There were statistical differences in HU difference [(-17±13), (229±34),(309 ±45), (512 ±97), (201±64)and (530±71) HU respectively], in HU ratio (0.96±0.03, 1.34 ±0.04, 1.41 ±0.03, 1.47 ±0.03,1.30±0.07, and 1.49 ±0.03 respectively), and DEI( -0.006 ±0.004, 0.064 ±0.007, 0.080 ±0. 007, 0. 108±0.011 ,0. 055 ±0.014 and 0. 112 ±0.008 respectively ) among different stone groups(F=124. 894,407.028, 322. 864 respectively, P ＜0. 01 ). There were statistical differences in HU difference,HU ratio and DE1 between UA stones and the other groups( P ＜ 0. 01 ). There were statistical differences in HU difference, HU ratio and DEI between CaOx or mixed calcium stones and the other four groups (P＜0. 01 ). There was statistical difference in HU ratio between cystine and struvite stones ( P ＜ 0. 01 ). There were statistical differences in HU difference, HU ratio and DEI between struvite and mixed UA stones (P＜0. 05 ). Dual energy software correctly characterized 10 UA stones, 4 cystine stones, 22 CaOx stones and 6 mixed UA stones. Two struvite stones were considered to contain cystine. One cystine stone, 1 mixed UA stone, 4 struvite stones and 47 mixed calcium stones were considered to contain oxalate. Conclusions DSCT has the ability to differentiate urinary stone composition in vitro. With dual energy software, the UA, cystine and mixed UA stones can be differentiated from other types of stones.
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Objective To study the Hainan Utstein templates used for cardiac arrest and resuscitation registries to evaluate the epidemiological characteristics and outcomes of the patients with CPR by multi-center study. Methodsccording to the Utstein templates for cardiac arrest and CPR set by International Liaison Committee on resuscitation in 2004, a Hainan Utstein CPR registry chart was designed and a prospective descriptive study was carried out to evaluate the epidemiological characteristics, impact factors and outcomes of the patients with resuscitation attempt in emergency departments of thirteen hospitals in Hainan Island between January 2007 and December 2010.Results Of 1125 patients with cardiac arrest, male accounted for 73. 8％ and female was 26. 2％. The mean ( ± S. D) age of the cardiac arrest patients was 53.9 ± 13. 1 years old.Coronary heart diseases and hypertension were the most common preexisting chronic diseases in the studied patients. The ROSC rate and discharge rates after survival in 1125 patients with CPR were 23. 8％ and 7.4％ respectively. The ROSC rate and discharge rates after survival were 36. 3％ and 11.6％ in the in-hospital cardiac arrest (IHCA) group, respectively whereas 11.5％ and 3. 3％ in out-hospital cardiac arrest (OHCA) group. Of 188 patients with ventricular fibrillation/Pulseless ventricular tachycardia, the ROSC rate and discharge rate after survival were 58.0％and 21.8％,respectively. Of them, 448 (39. 8％ ) of the cardiac arrest patients had underlying cardiac causes, and the ROSC rate and discharge rate after survival were 36. 3％ and 11.5％ respectively in IHCA group whereas 11.6％ and 3. 3％ in OHCA group. The ROSC rate and discharge rate after survival were 69. 8％ and 7. 4％respectively in the tertiary hospitals whereas 30. 2％ and 7. 3％ in the secondary hospitals. Conclusions Patients experienced cardiac arrest were predominantly male. Coronary heart disease and hypertension were the two most common preexisting chronic diseases. The ROSC rate and discharge rate of patients with IHCA were higher than those with OHCA. ROSC rate and discharge rate after survival were higher in the ventriculat fibrillation/Pulseless ventricular tachycardia group than the other cardiac rhythms first witnessed groups. The time delayed of starting CPR after onset of cardiac arrest had a critical impact on survival and discharge rate in both IHCA and OHCA groups.
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The paper analyzes the status of talents in health information field, discusses the necessity and significance of developing health information talents education, puts forward the aim of health information talents education is to build up a reasonable cultivating mechanism of health information talents, for this reason we should strengthen the research in this field.
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Objective To evaluate the clinical applications of helical CT scans in the ureteral diseases.Methods The precontrast and four-phase postcontrast helical CT scans were performed in 110 patients with ureteral diseases confirmed by clinic and pathology, and the multiplanar reformation (MPR) and three-dimensional reconstruction (3D) images were generated from the volumetric data.The ability of helical CT in detecting and diagnosing the ureteral diseases was investigated.The results were then compared with the findings of the other imaging techniques and surgery.Results Combined with axial and MPR images, the location, size, morphology, extension, and the urinary obstruction of the ureteral diseases could be clearly demonstrated in 97.3% cases, and the curved MPR was useful in directly detecting the lesions.The findings of ureteral lesion on helical CT images corresponded well with that of surgery in 81 cases. 3D reconstruction could produce a three-dimensional image that mimics conventional urography, and was useful in displaying the ureteral lesions from multiple views.Helical CT could compensate for some disadvantages of the other imaging techniques.Conclusion Helical CT, with large scanning area and high resolution, can provide comprehensive information about the ureteral diseases, and the curve MPR has the highest value.
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To review the study progresses in venom protein, peptide and amino acids in natural drug. The study progresses were reviewed on the basis of analying the collected articles. Concerning the distribution, chemical structure, property, pharmacology and toxicity of ricin, abrin, riscotoxin, snake venom, bee venom and buthotoxin. These compounds have certain toxicity and biological activity to animals, It's worth exploiting and utilizing them in conjunction with the achievement in modern chemistry and pharmacology.
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Objective:To study the extraction for the curculigoside and polysaccharide of Rhizoma Curculiginis. Methods: The optimum extraction was selected by the orthogonal design. The content of total curculigoside was determined by HPLC, The content of polysaccharide of Rhizoma Curculiginis was determined by spetrophotometry.Results: The extraction times affected significantly total curculigoside and Polysaccharide of Rhizoma Curculiginis. Conclusion: The optimum extraction is as follows: adding 8 times amount of water into Chinese medical materials, and boiling for 90 min each time, extracting three times in all.
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Objective To investigate the value of multislice spiral CT in evaluating the parametrial invasion of cervical carcinoma. Methods 75 cases of FIGO staging II cervical carcinoma who had received the surgery were studied. Their imaging and the FIGO staging were analyzed retrospectively. Results For FIGO staging, the accuracy for evaluating the parametrial invasion was 53.3%(40/75), the rate of underestimation was 26.7%(20/75), the rate of overestimation was 20.0%(15/75); For CT, the accuracy of evaluating the parametrial invasion was 69.3%(52/75), the rate of underestimation was 14.7%(11/75), the rate of overestimation was 17.3%(13/75). In 40 cases, both FIGO staging and evaluation by CT were consistent with the surgical results. In 35 cases, FIGO staging was different from the surgical results. In 29 cases, evaluation by CT was different from the surgical results. In 10 cases, CT could correct the error of FIGO staging. Conclusion CT scan can acquire the multi-plane image, and can directly reflect the parametrial space. It is more accurate than FIGO staging, and is an important complement to FIGO staging.
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Hijack terror is one of the most common terror attacks. In this paper, the definition, the present condition and future development of hijack terror are elucidated. Hijack terrorism may seriously endanger human lives, result in great economic loss, create social panic and political tumult. The medical succor for hijack terror includes treatment and transportation of the wounded, sanitation for epidemic prevention, protection from harmful agents, and medical health care. The challenges confronting medical support for hijach terror are its unexpectedness and abruptness, complexity, and arduousness in its implementation. In order to negotiate these challenges, it is imperative that a flawless counterplan should be worked out, a highly efficient counterterrorism medical organization should be established, intense emphasis should be paid in the studies of anti-neuclear, antimbiological and anti-chemical warfores, and education for psychological prepuredness should be stressed.