Abbreviated Versus Full-Protocol MRI for Breast Cancer Neoadjuvant Chemotherapy Response Assessment: Diagnostic Performance by General and Breast Radiologists.

BACKGROUND. Abbreviated protocols could allow wider adoption of MRI in patients undergoing breast cancer neoadjuvant chemotherapy (NAC). However, abbreviated MRI has been explored primarily in screening settings. OBJECTIVE. The purpose of this article was to compare diagnostic performance of abbreviated MRI and full-protocol MRI for evaluation of breast cancer NAC response, stratifying by radiologists' breast imaging expertise. METHODS. This retrospective study included 203 patients with breast cancer (mean age, 52.1 ± 11.2 [SD] years) from two hospitals who underwent MRI before NAC initiation and after NAC completion before surgical resection from March 2017 to April 2021. Abbreviated MRI was extracted from full-protocol MRI and included the axial T2-weighted sequence and precontrast and single early postcontrast T1-weighted sequences. Three general radiologists and three breast radiologists independently interpreted abbreviated and full-protocol MRI in separate sessions, identifying enhancing lesions to indicate residual tumor and measuring lesion size. The reference standard was presence and size of residual tumor on pathologic assessment of post-NAC surgical specimens. RESULTS. A total of 50 of 203 patients had pathologic complete response (pCR). Intraobserver and interobserver agreement for abbreviated and full-protocol MRI for general and breast radiologists ranged from substantial to nearly perfect (κ = 0.70-0.81). Abbreviated MRI compared with full-protocol MRI showed no significant difference for general radiologists in sensitivity (54.7% vs 57.3%, p > .99), specificity (92.8% vs 95.6%, p = .29), or accuracy (83.4% vs 86.2%, p = .30), nor for breast radiologists in sensitivity (60.0% vs 61.3%, p > .99), specificity (94.6% vs 97.4%, p = .22), or accuracy (86.0% vs 88.5%, p = .30). Sensitivity, specificity, and accuracy were not significantly different between protocols for any reader individually (p > .05). Mean difference in residual tumor size on MRI relative to pathology for abbreviated protocol ranged for general radiologists from -0.19 to 0.03 mm and for breast radiologists from -0.15 to -0.05 mm, and for full protocol ranged for general radiologists from 0.57 to 0.65 mm and for breast radiologists from 0.66 to 0.79 mm. CONCLUSION. Abbreviated compared with full-protocol MRI showed similar intraobserver and interobserver agreement and no significant difference in diagnostic performance. Full-protocol MRI but not abbreviated MRI slightly overestimated pathologic tumor sizes. CLINICAL IMPACT. Abbreviated protocols may facilitate use of MRI for post-NAC response assessment by general and breast radiologists.

Multimodel functional MRI in the differential diagnosis of breast mucinous carcinoma and phyllodes tu-mor(≥3 cm) / 实用医学杂志

Objective To investigate the application value of functional MRI in the differential diagnosis between breast mucinous carcinoma and phyllodes tumor(≥ 3 cm). Methods 55 cases of breast mucinous adeno-carcinoma and phyllodes tumors(≥ 3 cm)from January 2012 to December 2017 were retrospectively analyzed. MRI features of 20 mucinous carcinomas and 35 phyllodes tumors were analyzed,compared with pathology. Re-sults There were 20 cases of breast mucinous carcinoma in current study,including 14 cases of pure mucinous carcinoma and 6 cases of mixed mucinous carcinoma. There were 35 cases of phyllodes tumors,including 9 be-nign,18 borderline and 8 malignant cases. There was no significant difference in T1WI signal and enhancement mode between breast mucinous carcinoma and phyllodes tumors. There were significant differences in age,long di-ameter,morphology,lobulation,border,ADC value,EER,T2WI signal and TIC curve pattern(P < 0.05). The area under ROC(AUC)of ADC value and EER for breast mucinous adenocarcinoma and phyllodes tumor was 0.7036 and 0.8029,respectively. Conclusions Multi-model functional MRI can effectively distinguish breast mucinous adenocarcinoma from phyllodes tumor(≥ 3 cm),and EER is more accurate than ADC value.

The application of three color warning in obstetric disease / 中国医师杂志

Objective To investigate the effect of three-color warning management on maternal and child outcomes in high-risk pregnant women with major diseases and severe complications.Methods Retrospective analysis of hospitalized 703 cases of high risk obstetrics was included in the three color warning management of maternal data between May 2015 to July 2016 in our hospital.Maternal disease spectrum changes of three color warning,the rate of intensive care unit (ICU) admission,and maternal mortality rate were observed.Results There were 497 cases (70.70％) of blue warning,78 cases (20.48％) of yellow warning,and 62 cases (8.82％) of red warning.There was 1 case of maternal death and the rate of ICU admission was 7.85％ in blue warning;2 case of maternal death and the rate of ICU admission was 24.31％ in yellow warning;5 cases of maternal death,the rate of ICU admission was 43.55％ in red warning.Conclusions Three color warning management system can be used to assess the severity of the disease,improve the diagnosis and treatment of disease,improve patient survival,improve pregnancy outcomes,and reduce maternal complications.

The application of three color warning in obstetric disease / 中国医师杂志

Objective To investigate the effect of three-color warning management on maternal and child outcomes in high-risk pregnant women with major diseases and severe complications.Methods Retrospective analysis of hospitalized 703 cases of high risk obstetrics was included in the three color warning management of maternal data between May 2015 to July 2016 in our hospital.Maternal disease spectrum changes of three color warning,the rate of intensive care unit (ICU) admission,and maternal mortality rate were observed.Results There were 497 cases (70.70％) of blue warning,78 cases (20.48％) of yellow warning,and 62 cases (8.82％) of red warning.There was 1 case of maternal death and the rate of ICU admission was 7.85％ in blue warning;2 case of maternal death and the rate of ICU admission was 24.31％ in yellow warning;5 cases of maternal death,the rate of ICU admission was 43.55％ in red warning.Conclusions Three color warning management system can be used to assess the severity of the disease,improve the diagnosis and treatment of disease,improve patient survival,improve pregnancy outcomes,and reduce maternal complications.

Association between hyperuricemia and hypertension in a Chinese population at a high risk of hypertension.

In this cross-sectional study, we examined whether hyperuricemia is associated with hypertension and the association exists in a Chinese population at a high risk of hypertension. The study population included 813 consecutively clinical patients with suspected cardiovascular disease, including the subjects with the current use of antihypertensive medications and self-reported diagnosis of hypertension. The subjects underwent three measures of blood pressure and were divided into two groups: 502 non-hypertensive subjects and 311 hypertensive subjects. Clinical and biochemical variables were measured. Results showed that uric acid level, fasting glucose, low-density lipoprotein (LDL)-cholesterol, total cholesterol and urea nitrogen were significantly higher (all p<0.05) in hypertension subjects than in non-hypertension subjects. The risk of hypertension was significantly higher in the group with higher uric acid (>400 micromol/l), compared with that with lower uric acid (<200 micromol/l) (odds ratio: 2.09, 95% CI 1.13-3.88). The odds ratio was 1.73, 95% CI 1.05-2.85 in the higher uric acid (200-400 micromol/l) group, compared with that with lower uric acid. In addition, age, gender, weight, fasting glucose, triglycerides and total cholesterol were also significantly associated with the incidence of hypertension. In age-adjusted logistic regression analysis, the effect of uric acid concentration on hypertension was attenuated. In conclusion, hyperuricemia is associated with hypertension in a Chinese population at a high risk of hypertension.

The effect of HAART to serum soluble interleukin-2 receptors in AIDS patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To approach the effect of HAART to serum soluble interleukin-2 receptors in AIDS patients.</p><p><b>METHODS</b>90 cases of AIDS patients were chosen for detection of their slL-2R levels by enzyme-linked immunosorbent assay (ELISA), peripheral blood CD4 T cell counts by flow cytometry and viral load by Branch DNA amplification.</p><p><b>RESULTS</b>The slL-2R levels were (3154 +/- 905) m9icrog/ml before HAART and (2216 +/- 884) pg/ml after( P < 0.001), After HAART, the sIL-2R levels were(2846 +/- 963) microg/ml in ineffective HAART group and (1879 +/- 875) pg/ml in effective HAART group (P < 0.001).</p><p><b>CONCLUSION</b>The serum sIL-2R levels of AIDS patients were lowered by effective HAART, and it could judge the efficacy of HAART in same extent.</p>