Objective To analyze and compare the independent and combined diagnostic values of high frequency ultrasonography (HFU) and molybdenum target imaging (MTI) for early breast tumor in a prospective study.Methods 258 patients with breast mass which were suspected as breast tumors by physical examination received HFU,MTI,their combined applications and operative treatments.Comparative studies were made between the surgical pathology and imaging evaluations.Results Totally 258 cases were enrolled in this study.Surgical pathology confirmed 135 cases of early breast cancer and 123 cases of benign breast tumor.For the diagnosis of early breast cancer,combined application was more effective than HFU or MTI alone in sensitivity (P<0.05),and more superior than MTI alone in accuracy.While the specificity,positive predictive value,negative predictive value, false positive rate, false negative rate had no difference among HFU, MTI and combined applications (P>0.05).In the patients of early breast cancer, compared with HFU,MTI found less nodules of calcification(18.3% vs 36.5%,P<0.01),but revealed more axillary lymph metastasis (69.0% vs 33.3%,P<0.01).Conclusion HFU and MTI alone or their combined application are reliable imaging methods for the diagnosis of early breast cancer.For the sensitivity and accuracy of diagnosis, combined applications has more superior advantages.

Objective To establish animal model of arterial vulnerable plaques for molecular imaging study.Methods Fifteen New Zealand white rabbits were randomly divided into high lipid diet+balloon-injury group (A),high lipid diet group (B)and regular diet group (C).Ultrasound (US)and magnetic resonance (MR)imaging were used to dynamically observe the formation of plaque in abdominal aorta. Results were compared with blood lipid level and pathological indicators.Results At 4 weeks,several plaques could be seen in group A.The plaque number increased rapidly and reached to 22 at 12 weeks,which was in parallel with the change of blood lipid. Only a few plaques were observed in group B,while no vulnerable plaque was revealed in group C.All the plaques were judged to be soft plaques on US and MR images,which was consistent with the macrophages gathering and smooth muscle cell proliferating in plaques.Conclusion High lipid diet+balloon-injury is an ideal method to build animal model for molecular imaging of atherosclerotic plaque.

ObjectiveTo investigate the value of diffusion tensor imaging (DTI) at high b value for unilateral middle cerebral artery (MCA) occlusive disease in patients without obvious infarct lesions on conventional MR imaging.MethodsDTI at high b value (2200 s/mm2 ) was performed using a 3.0 Tesla MR scanner in 34 patients with unilateral middle cerebral artery occlusion,who had no obvious infarct lesions on conventional MR imaging. Fractional anisotropy (FA),apparent diffusion coefficient (ADC),axial diffusivity (eigenvalue λ1) and radial diffusivity (eigenvalues λ2,λ3) were measured at the ipsilateral and contralateral corona radiata,anterior and posterior limbs of the internal capsule,cerebral peduncle and pons in all subjects.Mean ADC,FA,λ1,λ2 and λ3 values of corona radiata,anterior and posterior limbs of the internal capsule,cerebral peduncle and pons were compared between the ipsilateral and contralateral MCAterritory by t test. Results Among the 34 patients,left MCA occlusion in M1 segment occurred in 16 patients and right MCA occlusion in Ml segment occurred in 18 patients.At the ipsilateral corona radiata,mean FA,ADC,λ1,λ2 and λ3 were 0.419 ±0.032,(5.975 ±0.272) × 10 3,(5.704 ±0.365) ×10-3,(6.412 ±0.368) × 10-3 and (6.605 ±0.343) × 10-3 mm2/s,respectively.At the contralateral corona radiata,mean FA,ADC,λ1,λ2 and λ3 were 0.443 ± 0.033,(5.804 ± 0.282) × 10 -3,(5.651 ±0.350) × 10-3,(6.099 ±0.353) × 10-3 and(6.372 ±0.355) × 10-3 mm2/s,respectively.At the ipsilateral corona radiata,mean FA was significantly decreased(t =11.614,P ＜0.01),and mean ADC (t=12.421,P＜0.01),λ1(t =7.447,P＜0.01),λ2(t=10.244,P＜0.01) and λ3(t=9.890,P＜0.01) were significantly increased.At the ipsilateral anterior and posterior limb of the internal capsule,mean FA were 0.609 ±0.026 and 0.674 ±0.033,λ1 were(5.330 ±0.462) × 10 -3 and(5.171 ±0.456) ×10-3 mm2/s,respectively.At the contralateral anterior and posterior limb of the internal capsule,FA were 0.622 ±0.026 and 0.694 ±0.034,λ1 were(5.064 ± 0.448) × 10 -3 and(4.924 ± 0.365) × 10 -3 mm2/s,respectively.Mean FA was significantly decreased (t =7.823,8.013,all P ＜ 0.01) and mean λ1 was significantly increased (t =7.811,8.800,all P ＜0.01) at the ipsilateral anterior and posterior limbs of the internal capsule.There was no significant difference in ADC,λ2 and λ3 value between the ipsilateral and contralateral sides.And all the DTI parameters,including mean ADC,FA,λ1,λ2 and λ3 values,showed no statistical difference between both sides of cerebral peduncle and pons.ConclusionDTI at high b valuc can provide useful information for visualizing ischemic white matter injury in patients without obvious infarct lesions on conventional MR imaging.

Objective To explore the predictive value of neuron-specific enolase (NSE) in patients with mild cognitive impairment (MCI) secondary to mild,moderate craniocerebral injury.Methods Seventy-six patients with mild,moderate craniocerebral injury,admitted to our hospital from March 19,2014 to September 1,2015,were chosen in our study;16 of them had secondary MCI during follow up (experimental group) and 60 did not show cognitive dysfunction (control group).Their clinical data between the two groups were compared.The predictive value of different NSE levels for secondary MCI was analyzed.Logistic regression analysis was performed to analyze the risk of secondary MCI in patients with different NSE levels.Multiple linear regression analysis was used to analyze the influence of mini-mental state examination (MMSE) scores in cognitive level of secondary MCI patients.Results (1) There were significant differences in age,salvage time,proportion of hypertension,ratio of skull fracture,injury severity scale (ISS) scores and total cholesterol (TC) between the experimental group and control group (P＜0.05).(2) A lowest quartile group,second quartile group,third quartile group and highest quartile group were divided using NSE levels as independent variables (9.31 ng/mL-12.08 ng/mL,12.09 ng/mL-15.68 ng/mL,15.69 ng/mL-19.65 ng/mL and 19.66 ng/mL-23.47 ng/mL);following the increase of NSE levels,the age,salvage time,proportion of hypertension,and ISS scores were significantly increased (P＜0.05);Single-factor and multivariate Logistic regression analyses showed that the risk of secondary MCI in the highest quartile group was 1.42 and 1.21 folds,respectively,as compared with that in the lowest quartile group.(3) Multiple linear regression analysis showed that baseline NSE level,age,salvage time,and ISS scores were the nfluence factors of MMSE scores in patients with secondary MCI;when the NSE content increased 1 ng/mL,MMSE decreased 0.369 points.Conclusion NSE level in patients with traumatic brain injury is an independent risk factor for secondary MCI,and its level is significantly associated with cognitive impairment.

Objective To study the Homer1a protein expression and its relationship with neurological deficit and neuronal apoptosis in craniocerebral trauma patients. Methods Forty-two craniocerebral trauma patients, admitted to our hospital from May 2012 to March 2016, were selected as craniocerebral trauma group; 50 healthy subjects accepted physical examination at the same period in our hospital were selected as normal control group (n=50). Immediately after admission, serum contents of Homer1a protein and nerve function damage indices (neurospecific estrogenase [NSE]), fatty acid binding protein [FABP], insulin-like growth factor [IGF-1], and S100B protein) were measured by enzyme linked immunosorbent assay (ELISA). Serum apoptotic indices (soluble apoptotic factor [(sFas)], sFas ligand [sFasL], and cell lymphoma-2 [Bcl-2]) were detected by radioimmunoassay. Results Immediately after admission, serum content of Homer1a protein content in craniocerebral trauma group ([113.27±12.19] pg/mL) was significantly higher than that in normal control group ([53.93±4.06] pg/mL, P<0.05); the median serum Homer1a protein level was 115.302 pg/mL, and according to this level, the patients from the craniocerebral trauma group were further divided into high Homer1a group and low Homer1a group. Serum NSE, FABP, S100B, sFas and sFasL levels in the high Homer1a group, low Homer1a group and normal control group were decreased in sequence, and IGF-1 and Bcl-2 levels increased in sequence, with significant differences (P<0.05). Conclusion Expression of Homer1a protein is increased in patients with traumatic brain injury, and its content is directly related to nerve injury and neuron apoptosis.

Objective:To investigate the therapeutic efficacy of enteral nutrition through percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) in patients with severe cerebral hemorrhage.Methods:Eighty-five patients with severe cerebral hemorrhage admitted to our hospital from January 2015 to December 2018 were enrolled into this retrospective study. According to ways of enteral nutrition, all 85 patients were divided into nasogastric tube group ( n=44) and PEG/PEJ tube group ( n=41). The clinical data were analyzed retrospectively, and the enteral nutrition treatment efficacy, incidence of complications, and length of hospital stays between the two groups were compared. Results:The incidences of diarrhea (14.6%, 6/41), gastric retention (34.1%, 14/41), and hypoproteinemia (26.8%, 11/41) in PEG/PEJ tube group were significantly lower than those in nasogastric tube group (38.6% [17/44], 59.1% [26/44], and 47.7% [21/44], P<0.05). However, the rate of obstruction ducts in PEG/PEJ tube group (34.1%, 14/41) was significantly higher than that in nasogastric tube group (11.4%, 5/44, P<0.05). As compared with the patients in nasogastric tube group, patients in the PEG/PEJ tube group had significantly shorter average length of hospital stays ([35.2±4.7] d vs. [37.6±5.4] d, P<0.05). The NRS2002 scores of patients in the nasogastric tube group and PEG/PEJ tube group after enteral nutrition treatment were 1.73±0.52 and 1.87±0.64, respectively, without significant difference ( P<0.05). Conclusion:The enteral nutrition treatment through PEG/PEJ could significantly reduce the incidences of diarrhea, gastric retention and hypoproteinemia, and shorten the average length of hospital stays in patients with severe cerebral hemorrhage; rate of obstruction of percutaneous endoscopic jejunostomy ducts should be reduced.

Objective To investigate the application value of CT perfusion (CTP) imaging for the revascularization treatment in adult patients with Moyamoya disease.Methods Adult patients with Moyamoya disease underwent revascularization in the Department of Neurosurgery,Wuhan No.1 Hospital from July 2009 to December 2016 were analyzed retrospectively.CTP and clinical evaluation were performed before and after 3-6 months of procedure.The modified Rankin Scale (mRS) was used to assess the functional outcomes.Results A total of 20 patients were enrolled in the study,including 9 females and 11 males,aged 29 to 73 years,with an average of 53.5 years.The initial symptom was ischemic stroke in 10 patients,transient isehemic attack in 7 patients,and hemorrhagic stroke in 3 patients.All patients underwent superficial temporal artery-middle cerebral artery bypass grafting plus encephalomyo-synangiosis under general anesthesia.All patients have different degrees of improvement in cerebral blood flow after procedure,and the CTP parameters were significantly improved compared with those before procedure (all P ＜0.05).The clinical symptoms were significantly improved in 3 cases (15％) and recovered in 13 cases (65％) at 6 months after procedure.The proportion of the mRS score 0-2 was significantly higher than that before procedure (90.0％ [18/20] 对 50.0％ [10/20];x2 =7.619,P =0.006).Conclusion CTP can evaluate the cerebral perfusion status in various vascular areas through hemodynamic parameters in early stage,which can effectively guide the operation mode of Moyamoya disease,and evaluate the changes of cerebral perfusion status after procedure as a means of follow-up of the disease.