Objective: To identify the Chinese medicinal granule (CMG) by measuring IR fingerprints. Methods : 12 species drugs were extracted with butanone respectively and then the obtained extracts were measured by the FT-IR spectrometer. Results : By IR fingerprint of 12 kinds of CMG, we found that different batches of the same CMG had a stable and repeatable fingerprint. Conclusion : By using IR fingerprint, CMG can be identified. It provides a rapid monitoring for drug identification and quality control.

Objective To evaluate the effieaey of test bolus technique with multi-slice spiral CT (MSCT) for determining the optimal scan delay time in CT Hepatic artery (HA)-portal vein (PV) angiography and multi-phase scanning.Methods MSCT liver angiography and multi-phase scanning were performed in 187 patients divided randomly into two groups.In group A (n =59),the scan delay time was set according to the subjective experiences of operators; in group B (n=128),the scan delay time was determined by test bolus technique.Abdominal aorta and superior mesenteric,vein were selected as target blood vessels,and 50 HU was set as enhancement threshold value.20 ml contrast agent was injected intravenously and time-density curve of target blood vessels were obtained,then HA-PV scanning delay time were calculated respectively.The quality of CTA images obtained by using these 2 methods were compared and statistically analysed using Chi-square criterion.Resuits For hepatic artery phase,the images of group A are:excellent in 34(58%),good in 17(29%),and poor in 8 (13%),while those of group B are excellent in 128( 100%),good in 0(0%),and poor in 0(0%).For portal vein phase,the images of group Aare:excellent in 23(39%),good in 27(46%),and poor in 9(15%),while those of group B are excellent in 96 (75%),good in 28 (22%),and poor in 4 (3%) respectively.There was statistically significant difference between the ratios of image quality in group A and group B (X2=14.97,9.18,P < 0.05).Conclusion Accurate scan delay time was best determined by using test bolus technique,which can improve the image quality of liver angingraphy and multi-phase scanning.

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.

OBJECTIVE: To determine the clinical characteristics and cognitive dysfunction of bipolar depression and unipolar depression. METHODS: Fifty patients with unipolar depression, 48 bipolar depression, and 50 normal controls were assessed with Hamilton Depression Scale, Hamilton Anxiety Scale, Life Events Scale, and The Wisconsin Card Sorting Test. General demographic data, clinical data, and the scores of recognitive function in the 3 groups were compared. RESULTS: The patients with bipolar depression occured at young age and had obvious family history compared with those with unipolar depression. The patients with bipolar or unipolar disorders had lower scores in most neuropsychological tests than those in the control group (P<0.05). The patients with bipolar depression in understanding memory and Wisconsin card sorting test were worse than those with unipolar depression (P<0.05). CONCLUSION There is cognitive dysfunction in patients with bipolar or unipolar disorder. Understanding memory and executive function damage may be cognitive features in bipolar disorder.
Adolescent ; Adult ; Bipolar Disorder ; complications ; diagnosis ; physiopathology ; China ; Cognition ; physiology ; Cognition Disorders ; complications ; physiopathology ; Depressive Disorder ; complications ; diagnosis ; physiopathology ; Female ; Humans ; Male ; Neuropsychological Tests ; Young Adult

OBJECTIVE: To determine the long-term effect and security of refractory schizophrenia with brain stereotaxis multi-target therapy technique. METHODS: A total of 87 patients with refractory schizophrenia were treated with brain stereotaxis multi-target therapy and were followed up over 2 years. The scores of Clinical Global Impression, Brief Psychiatric Rating Scale, Positive and Negative Symptom Scale, Wechsler Adult Intelligence Scale, Wechsler Memory Scale, Actives of Daily Living, and Social Disability Screening Schedule were compared before and after the operation. RESULTS: Of the 87 patients, 40 obviously improved, 24 improved, 12 improved little, 7 did not change. None grew worse, 1 died, and 3 shed. There was a significant difference in the scales before and after the operation (P<0.01). No severe complications and sequelae occurred. CONCLUSION Stereotaxic multi-target therapy is effective and safe for refractory schizophrenia. After the operation, drug therapy should be maintained and recovery of social function is helpful.
Adult ; Brain ; surgery ; Brief Psychiatric Rating Scale ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Psychiatric Status Rating Scales ; Schizophrenia ; surgery ; Stereotaxic Techniques ; Young Adult

Objective:To investigate the safety and effectiveness of cytoreductive nephrectomy and tumor thrombectomy in patients with metastatic renal cancer with renal vein or inferior vena cava tumor thrombus.Methods:From February 2015 to May 2019, 56 cases of metastatic renal cell carcinoma with venous tumor thrombus were analyzed retrospectively, including 44 male (78.6%) and 12 female (21.4%)cases, and the average age was (59.2±10.7)(22-82). The clinical presentations covered local symptoms in 26 cases (46.4%), systemic symptoms in 8 cases (14.3%), both local symptoms and systemic symptoms in 12 cases (21.4%), and asymptomatic in 10 cases (17.9%). Among them, renal tumors were located in 35 cases (62.5%) on the right and 21 cases (37.5%) on the left. The average tumor diameter was (10.1±3.8)(1.5-21.1) cm. Forty-five cases (80.4%) scored 2 points and 11 cases (19.6%) scored 3 points by the American Society of anesthesiologists(ASA). Preoperative hemoglobin was (118.2±23.1)(72-178) g/L, and albumin was (37.9±5.6)(23-50) g/L, total protein was (67.7±6.7)(43-81) g/L, serum creatinine was (111.3±119.6)(32-958) μmol/L. There were 16 cases of Mayo 0 (28.6%), 14 cases of Mayo Ⅰ(25.0%), 17 cases of Mayo Ⅱ(30.4%), 4 cases of Mayo Ⅲ(7.1%), and 5 cases of Mayo Ⅳ(8.9%). Fourteen cases (25.0%) were in the stage of cN 0 and 42 cases (75.0%) in the stage of cN 1. Five cases (8.9%) had simple bone metastasis, 16 cases (28.6%) had simple lung metastasis, 2 cases (3.6%) had simple adrenal metastasis, 6 cases (10.7%) had simple liver metastasis, and 27 cases (48.2%) had 2 or more multiple system metastasis. According to the location of the organ system, 91 metastatic lesions were found in 56 patients. Among them, 37 cases (40.7%) had lung metastasis, 18 cases (19.8%) had liver metastasis, 21 cases (23.1%) had bone metastasis and 15 cases (16.5%) had adrenal metastasis. All 56 patients belonged to IMDC prognosis score model medium risk group. The surgical treatment of Mayo grade 0 tumor thrombus was the same as that of routine radical nephrectomy. The tumor thrombus of Mayo grade Ⅰ was removed after IVC was partially blocked by Satinsky′s forceps. The Mayo Ⅱ tumor thrombus was removed, after blocking the distal vena cava, the contralateral renal vein and the proximal vena cava. Mayo grade Ⅲ tumor thrombus needed pringer's method to block the first porta hepatis. For grade Ⅳ tumor thrombus the diaphragm could be cut directly, or the thrombus could be removed by cardiopulmonary bypass. Laparoscopic surgery was performed in 22 cases (39.3%) and open surgery in 30 cases (53.6%). Six cases (10.7%) underwent IVC wall resection because of tumor invasion. 32 cases (57.1%) underwent ipsilateral adrenalectomy because of tumor invasion or adrenal metastasis, and 23 cases (41.1%) underwent ipsilateral lymphadenectomy. In this study, there were 11 cases of solitary metastasis, 8 cases of which were operated on and 3 cases of which were not operated on. Forty-three patients were treated with sunitinib after palliative nephrectomy, 9 patients were treated with pazopanib, 3 patients were treated with acitinib, and 1 patient was treated with sorafenib. Results:The operations were successfully completed in 56 patients. Four cases (7.1%) changed from laparoscopic surgery to open surgery. The operation time was (326.8±114.9)(108-589) min. Intraoperative hemorrhage was (1 435.2±1 513.4)(20-6 000) ml, intraoperative red blood cells transfusion was (1 456.7±832.8)(400-3 600) ml in 30 cases, and intraoperative plasma transfusion was (700.0±473.6)(200-1 800) ml in 15 cases. The postoperative hospital stay was (10.6±4.6)(5-26) days. The serum creatinine one week after operation was (109.5±98.7) (47-772) μmol/L. There were 46 cases (82.1%) of renal clear cell carcinoma, 7 cases (12.5%) of papillary renal cell carcinoma and 3 cases (5.4%) of unclassified renal cell carcinoma. One case was WHO/ISUP 2016 nuclear grade 1 (1.8%), 20 cases(36.4%) was grade 2, 18 cases(32.7%)was grade 3, and 16 cases(29.1%)was grade 4. Early postoperative complications occurred in 22 cases (39.3%). Among them, 1 case of Clavien gradeⅠ was wound infection. There were 16 cases with Clavien gradeⅡ, including 5 cases who received blood transfusion due to anemia, 3 cases with chylous fistula, 4 cases with postoperative pulmonary infection, 2 cases with postoperative lower extremity venous thrombosis, 1 case with atrial fibrillation and 1 case with epididymitis. Clavien gradeⅢ a was found in 1 case with pneumothorax. Clavien gradeⅣ was found in 2 cases, including 1 case of acute cerebral infarction and 1 case of renal insufficiency.There were 2 cases with Clavien gradeⅤ with perioperative death. Among the 56 patients, 5 lost the follow-up, 2 died during the perioperative period, and the other 49 patients were followed up for 1-39 months, with a median follow-up of 14 months. The mean survival time was (25.6±2.5) months, and the median survival time was 25 months.Conclusions:It was relatively safe and effective to perform cytoreductive nephrectomy and tumor thrombectomy in patients with metastatic renal cancer with tumor thrombus. For the patients with clinical symptoms, IMDC prognosis score model medium risk group, and strong desire for surgery, the combination of cytoreductive nephrectomy with tumor thrombectomy and postoperative targeted medical therapy was recommended.

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.