目的探讨早期康复对屈指肌腱Ⅱ区损伤患者手功能恢复的影响。方法12例24指屈指肌腱Ⅱ区损伤患者,根据肌腱损伤修复术后康复介入时间分成两组,手术后4周内进行康复的7例13指为早期康复组,手术4周后进行康复的5例11指为对照组。两组采用近似的康复方法。肌腱功能采用肌腱总活动度测定(TAM)评定。结果治疗后,早期康复组TAM优于对照组(P<0.05)。结论屈指肌腱Ⅱ区损伤术后应尽早进行康复。

Objective To explore the utility of ADC histogram analysisin differentiation of clear cell renal cell carcinoma(ccRCC)and non-clear cell renal cell carcinoma(non-ccRCC)with r-Fov DWI. Methods Sixty-six renal tumors(46 patients with 47 ccRCCs and 18 patients with 19 non-ccRCCs)in 64 patients, who underwent preoperative routine renal MRI sequences and r-FOV DWI, were retrospectively evaluated. The whole-lesion ADC values derived from histogram anlysis(including ADC mean, ADC median, ADC_5th, ADC_25th, ADC_75th, ADC_95th, skew and kurtosis)were measured for each patient. All parameters between ccRCC and non-ccRCC were compared by using the Student's t test or Mann-Whitney U test. ROC analysis was used to assess the diagnostic performance of ADC histogram in distinguishing the two groups. Results The postive skewness of ADC histograms were mostly seen in the non-ccRCC group, while the negtative skewness were present in the majority of ccRCCs. The skewness was significantly higher in non-ccRCCs than those of ccRCCs(P<0.05). Mean ADC, median ADC, 5th percentile ADC, 25th percentile ADC, 75th percentile ADC and 95th percentile ADC(all P<0.05)were significantly lower in non-ccRCC . There was no significant difference of Kurtosis between two groups(P>0.05). 75th percentile ADC achieved the highest AUC(0.987)in differentiating ccRCC and non-ccRCC, whena cutoff value was 1.81× 10-3 mm2/s. The sensitivity and specificity were 100.0％and 94.7％. Conclusion ADC histograms of r-FOV DWI may be helpful to differentiate ccRCC from non-ccRCC, and the diagnostic accuracy of 75th percentile ADC is highest.

Objective MRI manifestations of infiltrative renal pelvis carcinoma were analyzed and evaluated,to improve its diagnostic accuracy. Methods MRI features of 21 cases of infiltrative renal pelvis carcinoma confirmed pathologically were analyzed retrospectively.All patients underwent plain MRI scan and DWI examination,3 cases underwent PWI examination.Results The center of lesions for all cases were located in the renal collection system,with no change of the renal contour.Most lesions were presented as low signal intensity on T1 WI and slightly low signal intensity on T2 WI,and heterogeneous signal intensity were showed on T1 WI and T2 WI in 5 cases.All lesions were presented as high signal intensity on DWI.After contrast enhancement,mild and moderate enhanced lesions were demonstrated in 3 cases.Renal arteries were wrapped by renal pelvis carcinoma on renal AMRA in 3 cases.4 patients were accompanied with venous tumor thrombus and 1 1 patients with retroperitoneal lymph node metastasis.Adrenal gland metastases were showed in 3 cases.1 case was accompanied with ureter urothelial carcinoma,and 2 cases with bladder carcinomas.Conclusion MRI has a multi-parameter imaging capability and high resolution of soft tissue,and can clearly show the boundary of lesions and surroundings.MRI plays an important role in the diagnosis and differential diagnosis of infiltrative renal pelvis carcinoma.

Objective To evaluate the clinical value of regular and dual-time-point 18-fluorodeoxyglucose positron emission tomography-CT(FDG PET/CT)imaging for recurrence and metastasis in esophageal carcinoma(EC)after curative esophagectomy. Methods A retrospective study was done on 48 patients received curative esophagectomy, who underwent FDG PET/CT scans to detect doubtful recurrent or metastatic lesions. The diagnostic accuracy of FDG PET-CT was assessed with the help of pathological findings as well as clinical or follow-up data. Using Fisher's Exact Test from SPSS 11.5 to analyze the data.Results Of the 48 patients, after a median follow-up of 21.5 months, 61 sites of local and regional recurrence or metastasis were finally confirmed in 34 patients. The sensitivity, specificity and accuracy of regular FDG PET/CT imaging in detecting recurrence of all sites were 93.44%, 74.29% and 86.46%respectively. The specificity and accuracy of local recurrence and regional metastasis were 57.14% ,78.95% and 77.78% ,84.62%, respectively. The sensitivity, specificity and accuracy of dual-time-point FDG PET/ CT imaging in detecting local and regional recurrence(96.97% ,96.00% and 96.55%)were higher than those of regular FDG PET/CT(90.90%, 72.00% and 82.76%)and there were significant differences of specificity and accuracy(P = 0.049, P = 0.029). Conclusions Regular FDG PET/CT imaging is highly effective in detecting recurrence and metastasis in EC patients after curative esophagectomy despite the low specificity and accuracy. Dual-time-point FDG PET/CT imaging can elevate the specificity and accuracy.

Objective To investigate the role of the predictive prognostic value of BRCA1 screened by whole genome expression profiling in ductal carcinoma in situ.Methods Collected 4 cases of breast ductal carcinoma and 4 cases of breast invasive ductal carcinoma fresh samples from January 2014 to June 2014,and the difference of BRCA1 expression on whole genone expression profiling was analyzed by microarray comparative genomic hybridization.The expression of BRCA1 was detected by immunohistochemistry in 70 cases of ductal carcinoma in situ of the breast,and the prognosis of intraductal carcinoma was evaluated.Results BRCA1 gene differentially expressed in invasive ductal carcinoma and ductal carcinoma in situ by screening.The positive rate of BRCA1 protein in breast ductal carcinoma in 14.3％ (10/70),its expression had no significant relationship with age (P =0.959),menopause (P =0.959),tumor size (P =0.627),axillary lymph node status (P =1.000),HR status (P =0.958),HER-2 status (P =1.000),P53 expression (P =0.460).ductal carcinoma with micro-infiltration ratio in BRCA1 negative group was higher than BRCA1-positive group (P =0.043).The median follow-up of 47 months,Disease-free survival rate of all was 97.1％.Disease-free survival of BRCA1 negative group and BRCA1-positive group had no significant difference (96.7％ vs 100％,P =0.569),over all survival of BRCA1 negative and positive groups was 100％.Conclusions BRCA1 expression may not predict the prognosis of intraductal carcinoma,but ductal carcinoma in situ with microinvasion group ratio in BRCA1 negative was higher than ductal carcinoma in situ group,BRCA1 may take affect within ductal carcinoma infiltration process work.

Objective To study the clinical and pathological characteristics of breast ductal carcinoma in situ (DCIS) and with microinvasion (DCIS-MI). Methods From June 1999 to June 2003, a total of 41 patients with DCIS and DCIS-MI patients were retrospectively studied. Results Pathology varies between DCIS type Ⅰ, type Ⅱ and DCIS-MI patients. Mammographic calcification was the only presenting symptom in 9.76% of patients with DCIS accounting for 50% of these cases. The accordance rate of mammography with final diagnosis was 80%, and 33.3% of mammography in DCIS-MI type 2 showed mass or chaos of gland construction. The initial symptom in 57% of patients was nipple discharge. For fiberoptic ductoscopy, the accordance rate was 95.65%. There were two local recurrent cases in DCIS-MI type 2. Conclusion Breast ductal carcinoma in situ and with microinvasion had their own characteristics, including different prognosis.

Objective Resarech on the value of body mass index (BMI) predicting efficacy of neoadjuvant chemotherapy and prognostic in breast cancer.Methods Clinical data of 99 patients who received neoadjuvant chemotherapy Ⅱ B-Ⅲ C stage breast cancer patients was collected between January 2007 and December 2013 in Women and Children Hospital of Guangdong Province.Anaslysing the relation of BMI and efficacy of neoadjuvant chemotherapy and prognosis.Results In the study, Clinaical complete ressiom was 12.1％ (12/99), partal ressiom was 68.7％ (68/99), stable disease or disease progression was 19.2％ (19/99), respone rate was 80.8％ (80/99), pathlogic complete ression was 9.1％ (9/99).BMI was significantly associated with response rate(P =0.039), but not with pathlogic complete ression (P =0.454).Univariate and multivariate analysis showed that BMI was not significantly associated with disease free survival and overall survival(P ＞ 0.05).Conclusions BMI was significantly associated with response rate, overweight or obese patients would prodict poorly efficacy of neoadjuvant chemotherapy.The relationg of BMI and prognosis of breast cancer who accepted neoadjuvant chemotherapy is not clear, for further study.

Objective To assess the diagnostic value of fiberoptic ductoscopy(FDS) on the nipple discharge. Methods The clinical data of fifty two consecutive patients with nipple discharge undergoing FDS from November 1998 to April 1999 were retrospectively analysed. Results A total of 62 ducts in 52 patients were successfully examined by FDS. Intraductal tumor of the breast was found in 14 cases(4 cancer and 10 papilloma). The diagnostic rate of FDS on intraductal tumor was 100%; and 85.7% of these patients were microlesions. Six cases were diagnosed as mastitis. Thirty two normal duct cavities presented just simple dilatation. In 73.7% of non tumor patients, the nipple discharge disappeared after irregation via FDS. Conclusions As a simple technique and a minimal traumatic endoscopy, FDS would be useful in detection of the microlesions of breast and might become a new diagnostic method of nipple discharge instead of ductography.

Objective To analyze the effect of functional magnetic stimulation(FMS)at different frequen-cies on the recovery of urination function in patients with urinary retention after stroke.Methods A total of 200 patients with urinary retention after stroke admitted to our hospital from January 2020 to January 2022 were recruited as the research objects.They were divided into 5 Hz,10 Hz,20 Hz,and control groups by simple random method,with 50 patients in each group.All four groups were treated with conventional medication,rehabilitation therapy,and intermittent catheterization.The 5 Hz group,10 Hz group,and 20 Hz group were treated with FMS at 5 Hz,10 Hz,and 20 Hz,respectively,and the control group was treated with sham stimulation at the same site and parameters as the 5 Hz group.Bladder pressure volume index,urination status,recovery time of spontaneous urina-tion,Quality of Life Questionnaire(SQLP)score,and urinary retention efficacy were compared among the four groups.Results There were no significant differences in bladder pressure volume,urination,recovery time of spontaneous urination,and SQLP score among the four groups before treatment(P>0.05).After treatment,the bladder volume and pressure of the first four groups were both increased,with those of the 5 Hz group,10 Hz group,and 20 Hz group significantly higher than those of the control group,while the residual urine volume of the first four groups was significantly lowered,with that of the 5 Hz group,10 Hz group,and 20 Hz group significantly lower than that of the control group(P<0.05),even showing an effect of dose-response;The average daily urination frequency and average single urination volume of the first four groups were all increased,with those of the 5 Hz group,10 Hz group and 20 Hz group all significantly higher than those of the control group,while the average daily urination frequency was all reduced,with that of the 5 Hz group,10 Hz group and 20 Hz group significantly less than the control group(P<0.05),even showing an effect of dose-response;The SQLP scores of the first four groups were all lowered,with those of the 5 Hz,10 Hz and 20 Hz groups significantly lower than those of the control group(P<0.05),and the recovery time of spontaneous urination in the 5 Hz,10 Hz,and 20 Hz groups was significantly shorter than that of the control group,showing an effect of dose-response;The total effective rate of urinary retention in the 5 Hz,10 Hz and 20 Hz groups was significantly higher than that in the control group(P<0.05),showing an effect of dose-response.Conclusion FMS at 5 Hz,10 Hz and 20 Hz can improve the urination function and quality of life of patients with urinary retention after stroke,showing a dose-responsive efficacy.The clinical efficacy by FMS at 20 Hz is better than that at 5 Hz and 10 Hz.

Objective: To investigate the value of combined chemical exchange saturation transfer (CEST) and conventional magnetizationtransfer imaging (MT) in detecting metabolic and structural changes of renal fibrosis in rats with unilateral ureteral obstruction(UUO) at 3T MRI. Materials and Methods: Thirty-five Sprague-Dawley rats underwent UUO surgery (n = 25) or sham surgery (n = 10). Theobstructed and contralateral kidneys were evaluated on days 1, 3, 5, and 7 after surgery. After CEST and MT examinations,18F-labeled fluoro-2-deoxyglucose positron emission tomography was performed to quantify glucose metabolism. Fibrosis wasmeasured by histology and western blots. Correlations were compared between asymmetrical magnetization transfer ratio at1.2 ppm (MTRasym(1.2ppm)) derived from CEST and maximum standard uptake value (SUVmax) and between magnetization transferratio (MTR) derived from MT and alpha-smooth muscle actin (α-SMA). Results: On days 3 and 7, MTRasym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those ofcontralateral kidneys (p < 0.05). On day 7, MTRasym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly differentfrom those of sham-operated kidneys (p < 0.05). The MTRasym(1.2ppm) of UUO renal medulla was fairly negatively correlated withSUVmax (r = -0.350, p = 0.021), whereas MTR of UUO renal medulla was strongly negatively correlated with α-SMA (r = -0.744, p <0.001). Conclusion CEST and MT could provide metabolic and structural information for comprehensive assessment of renal fibrosisin UUO rats in 3T MRI and may aid in clinical monitoring of renal fibrosis in patients with chronic kidney disease.