Objective To investigate the value of MRI in evaluation of metastatic axillary lymph nodes in patients with breast carcinoma. Methods 60 patients with breast carcinoma underwent MRI before surgical management.Tumor maximal diameter,tumor SERmax (Maximal Signal Enhancement Ratio),the size,shape,border,signal intensity and enhancement pattern of ipsilateral axillary lymph nodes were recorded respectively.The results of MRI observation were compared with the histopathological results.Results Among the 60 patients,MRI showed that 28 cases had metastatic axillary lymph nodes,and 22 of them were confirmed by pathology.Its sensitivity,specificity and accuracy were 90.91%,78.95%,83.33% in the diagnosis of lymph nodes metastasis.Meanwhile,57 cases were underwent ultrasound examination,its sensitivity,specificity and accuracy were 59.09%,94.29%,80.70%.The sizes of lymph nodes in the patients with metastatic lymph nodes and the patients with no metastatic lymph nodes were(1.20±0.59)cm, (0.85±0.24)cm respectively.There was statistically significant difference between the two groups(t=3.258,P=0.001<0.05). There was statistically significant difference between the above two groups in the tumor maximum of SER(t=4.167,P=0.000<0.05),SERmax in metastatic lymph nodes were higher than in no metastatic ones.Irregular shape and border,inhomogeneous signal intensity and heterogeneous enhancement patterns were suggestive of metastatic lymph nodes.Conclusion MRI is an effective imaging modality in evaluation of axillary lymph nodes status in patients with breast carcinoma comprehensively before operation.

Background Silicon oil tamponade eyes following vitrectomy accelerate and induce lens opacification,so the accurate measurement and calculation of intraocular lens (IOL) diopter before cataract extraction+ IOL implantation is very important for the recovery of visual function.Objective This study was to compare the differences of IOL powers measured and calculated by different apparatus and different IOL power formulas before cataract extraction + IOL implantation silicon oil tamponade combined with cataractous eyes.Methods A prospective,consecutive,nonrandomized study was performed.Thirty-six silicon oil tamponade with cataract eyes of 36 patients were included in the Second Affiliated Hospital of Soochow University from August 2011 to October 2013.Patients with silicone oil emulsification for 4 months to 2 years prepared to treat by cataract extraction + IOL implantation+silicon oil removal.Axial length (AL),corneal curvature (CC) and anterior chamber depth (ACD) were measured with IOLMaster and A-scan with manual kerameter (MK) in the eyes for the prediction of IOL power by SRK-Ⅱ,SRK/T,Hoffer Q,Holladay 1 and Haigis formulas under the oral informed consent.The mean predictive error (MPE) and mean absolute refractive error (MAE) between predictive IOL diopters before operation and actual IOL diopters after operation were evaluated.Results The AL and ACD values measured by IOLMaster was (25.43± 0.90)mm and (3.22±0.38)mm,which were significantly higher than (25.21±1.02)mm and (3.07±0.62) mm by A-scan+ MK respectively,the difference between the two measure methods was statistical significance (both at P =0.000).No significant difference was found in measured CC values between IOLMaster and A-scan+MK ([44.58±1.57] D vs.[44.56±1.62] D) (P=0.568).When the parameters measured by IOLMaster were used,the MAE from SRK/T formula was smaller than that from SRK-Ⅱ,Hoffer Q,Holladay 1 and Haigis formulas (P =0.017,0.009,0.012,0.001),and the MAE from Haigis formula was significantly larger than that from SRK-Ⅱ,Hoffer Q and Holladay 1 formulas (P =0.026,0.035,0.021).When measured by A-scan + MK,the MAE from Haigis formula was significantly larger than that from SRK-Ⅱ,SRK/T,Hoffer Q and Holladay 1 formulas (P=0.007,0.004,0.018,0.006).There was no significant difference in the number of eyes with MAE ≤ 1.0 D between IOLMaster and A-scan+MK measurements under the calculation of SRK-Ⅰ,SRK/T,Hoffer Q and Holladay 1 formulas (x2 =0.107,2.250,0.845,0.084,all at P＞0.05).However,the number of eyes with MAE ≤ 1.0 D was significantly increased in IOLMaster measurement compared with A-scan+MK under the calculation of Haigis formula (x2 =4.431,P =0.035).Conclusions In silicon oil-filled cataract eyes,SRK/T formula appears to have a more accurate predictive value of IOL power than that of other formulas when employ IOLMaster;when use A-scan+MK measurement,the predictive value of IOL power seems to be better by using SRK-Ⅱ,SRK/T,Holladay 1 or Hoffer Q formulas.

Objective To investigate the molecular and cell signal transduction mechanisms by Lactobacillus cell wall extract(LCWE)inducing human-β-defensin-2(hBD-2)expression in human vaginal epithelial cells.Methods The induction of hBD-2 in human vaginal epithelial cells(WZV-1)by LCWE was observed using real-time PCR and Western blot.After stimulating WZV-1.the activation of NF-κB and p38MAPK signaling pathways were determined by Western blot.The induction of hBD-2 in WZV-1 cells by LCWE was observed with signaling pathways inhibitors of NF-κB and p38MAPK using real-time PCR and Western blot.Results The results showed that LCWE significantly upregulated hBD-2 expression in the time and dose-dependent manner.The maximal stimulatory effect of LCWE on the expression of hBD-2mRNA in WZV-1 cells were observed at the concentration of 50μg/ml after treatment for 8 h.After stimulation by 50μg/ml LCWE,Western blot analysis demonstrated that the phosphorylation of p38MAPK increased at 0.5 h significantly,peaked at 1 h,moreover the concentration of NF-κB in nucleus increased at 0.5 h significantly(P<0.05),peaked at 2 h.Blocking with inhibitor of NF-κB and(or)p38MAPK pathways results in decreased levels of HBD-2 expression.Conclusion These findings suggest that p38MAPK and NF-κB pathways play the important roles in induction of hBD-2 expression by LCWE in human vagihal epithelial cells.

Objective To investigate the changes of brain volumes in neuromyelitis optica (NMO)patients using voxel-based morphometry (VBM) method, and preliminarily explore the pattern of cerebral anatomical impairment. Methods Twenty-three clinically defined NMO patients and 15 gender and age matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 3.0 Tesla MR systen. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Whole brain volumes included grey matter volume (GMV), white matter volume (WMV), total intracranial volume (TIV), grey matter fraction (GMF), white matter fraction (WMF),brain tissue fraction (BTF) and regional brain volumes between the two groups were compared by independent samples t-test and an Pearson were performed to compare the regional brain volumes and the ages. Results GMV of NMO group[(610. 2 ± 55.0) ml] was significantly decreased comparing to healthy control group[(657. 2 ± 36. 3) ml] (t = - 2. 915, P ＜ 0. 05). The age of NMO patients [(40 ± 9) years old] showed negative correlation with GMF [(42. 5 ± 2. 6) %] (r = - 0. 673, P ＜ 0. 05). Regional brain volume analysis showed decreased GMV in left insula and bilateral posterior cingutates in NMO patients,while decreased WMV was found in left frontal and left parietal white matter. Conclusion VBM could detect brain volume changes sensitively. Total grey matter volume in NMO patients was decreased comparing to HC group. Regional grey matter atrophy in NMO patients occurred in left insular and bilateral posterior cingutates, regional white matter atrophy occurred in left frontal and left parietal lobe.

Objective To evaluate the effect of Chinese gentian extracts on the proliferation of,apoptosis and phosphorylation of epidermal growth factor receptor (EGFR) in HaCaT cells induced by epidermal growth factor (EGF).Methods Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferation of HaCaT cells pretreated with EGF of 20 μg/L for 24 hours followed by 24 hours of treatment with various concentrations of Chinese gentian extracts.Flow cytometry was carried out to detect apoptosis in HaCaT cells pretreated with EGF of 20 μg/L for 24 hours followed by 4 hours of treatment with different concentrations of Chinese gentian extracts.Western blot was conducted to measure the level of phosphorylated EGFR in HaCaT cells treated with different concentrations of Chinese gentian extracts for 24 hours followed by treatment with EGF of 20 μg/L for 10 minutes.Results Chinese gentian extracts inhibited the proliferation (r =-0.991,P ＜ 0.01),but promoted the apoptosis (r =0.996,P ＜ 0.05) of HaCaT cells induced by EGF in a dose-dependent manner.At the same time,the extracts suppressed the phosphorylation of EGFR in HaCaT cells induced by EGF,and the suppressing effect increased with the rise in the concentration of the extracts.Conclusions Chinese gentian may inhibit the proliferation,but promote the apoptosis of keratinocytes by decreasing EGFR phosphorylation and blocking relevant intracellular signaling pathways.

Objective To make a summary of radiation-induced changes in ocular lens and retinal lesions based on dynamic follow-up of a patient exposed to a radiation exposure from 192 Ir source accident,in order to provide the information and experience for the clinical diagnosis and treatment of such injury in emergency of a nuclear or radiation accident.Methods The examination methods included eye lens and visual acuity,slit-lamp examination,fundus examination,automated perimetry,optical coherence tomography (OCT) examination,fundus photography,and fundus fluorescein angiography (FFA).The patient was followed-up for 20 months.Comparative analyses were made of the follow-up results.Results One month after 192Ir radiation exposure,the visual acuities in both eyes were 1.0.Mild age-related opacities were observed in peripheral cortex,but the fundus looked normal.Twenty months later,the patient was followed-up.The visual acuities reduced to about 0.6,evident powder-and punctuate-like opacities could be observed in the cortex of the right lens,and mild turbid foci in the posterior polar and capsule.Multiple scotomata appeared in the superior temporal and inferior nasal in the right eye.The macular fovea thickness was not changed significantly in the right eye.Examination with fundus photography demonstrated mild optical nerve atrophy,drusens,and pale optic discs,while FFA examination showed punctuate or flocculent leakages in both eyes.Conclusions The lens opacity could be induced or accelerated by radiation exposure.In addition to the posterior capsule and pole cataracts,punctuate opacity within cortical layer may also occur.It also suggests that cataract and fundus injuries may occur later during long-term follow-up,even though the eyes may look normal during early examination after the patient exposed to the radiation.

BACKGROUND:Neural stem cel transplantation provides an important way to treat sequela of traumatic brain injury, but the timing for treatment is inconclusive.
OBJECTIVE:To explore the clinical effect of neural stem cel transplantation in the treatment of sequela of traumatic brain injury and the choice of the best treatment time.
METHODS: Totaly 178 patients with sequela of traumatic brain injury who underwent neural stem cel transplantation were divided into three groups as per the timing for neural stem cel transplantation: group A (with 6 months after injury,n=60), group B (6-12 months after injury,n=59), and group C (over 12 months after injury,n=59). Improvement in clinical symptoms and scores on function independent measure (FIM) were recorded and compared in the three groups.
RESULTS AND CONCLUSION:The total effective rate of group A was significantly higher than that in groups B and C (P < 0.05). FIM scores were significantly improved in the three groups after cel transplantation (P < 0.05). At 3 months after the fourth transplantation, the FIM score in the group A was significantly higher than that in the other two groups, and the incidence of adverse reactions in the group A was significantly lower than that in the other two groups (P < 0.05). These findings indicate that neural stem cel transplantation at different timing can al harvest certain clinical effects, but the best timing for neural stem cel transplantation is within 6 months after injury.

AIM: To investigate the effect of dexmedetomidine (DEX) on renal injury induced by lung ischemia/reperfusion (I/R) in mice and its relationship with endoplasmic reticulum stress response.METHODS: Healthy SPF male C57BL/6J mice, weighing 20~24 g, aged 8~10 weeks, were randomly divided into 5 groups (n=10 each): sham operation group (sham group), I/R group, atipamezole (Atip) group, DEX group, and DEX+Atip group.In vivo lung I/R model was established by occlusion of the left pulmonary artery for 30 min followed by 180 min of reperfusion in the mice.The Atip (250 μg/kg), DEX (20 μg/kg) and DEX+Atip were intraperitoneally infused into the mice before left pulmonary hilus was blocked in Atip group, DEX group and DEX+Atip group, and other operations were the same as I/R group.After experiment, the mice were killed, and the renal tissues were harvested to observe the morphological changes.The enzymatic activity of caspase-3, serum creatinine and blood urea nitrogen, and cell apoptotic index of the renal cells were also analyzed.The expression of c-Jun N-terminal kinase (JNK), caspase-12, CCAAT/enhancer-binding protein homdogous protein (CHOP) and glucose-regulated protein 78 (GRP78) at mRNA and protein levels in the renal tissues was determined by RT-PCR and Western blot.RESULTS: Compared with sham group, the enzymatic activity of caspase-3, serum creatinine and blood urea nitrogen, renal cell apoptotic index, and the mRNA and protein levels of JNK, caspase-12, CHOP and GRP78 in I/R group were significantly increased (P<0.01), and the renal tissues had obvious damage under light microscope.Compared with I/R group, Atip group and DEX+Atip group, the enzymatic activity of caspase-3, serum creatinine and blood urea nitrogen, renal cell apoptotic index, and the mRNA and protein levels of JNK, caspase-12 and CHOP in DEX group were significantly decreased, and the expression level of GRP78 significantly increased (P<0.01).Furthermore, the renal tissue damage was obvious reduced.CONCLUSION: DEX effectively relieves the renal injury induced by lung I/R in mice, which may be associated with exciting α2-adrenergic receptor and inhibiting endoplasmic reticulum stress response.

OBJECTIVETo examine the effect and mechanism of artesunate (Art) on embryo development.

METHODSRat embryo and placental glutathione peroxidase (GSH-Px)and malondialdehyde (MDA) were identified by using DTNB (dithionitrobenzene) direct method and TBA (thiobarbituric acid). We investigated the damage of decidual cells caused by Art using cell culture techniques.

RESULTSSubcutaneous administration of Art in rats on d 6 approximate, equals d 10 of gestation induced developmental toxicity. Absorption increased when progressively increased doses were given (r=0.996,P<0.01). Twenty four hours post injection, GSH-Px in embryo decreased significantly while MDA content was significantly higher than that in the control group (P<0.05). GSH Px: study group was(43.7+/-10.7)micromol/min.mg(-1)Hb, control group was(54.5+/-10.1)micromol/min.mg(-1)Hb; MDA:study group was(230.2+/-19.8)nmol/g tissue, control group was(150.4+/-44.1)nmol/g tissue. Placental GSH-Px activity was significantly higher than that in the control group(P<0.01). After cultured human decidual cells were exposed to Art for 24 h, the LC50 was (25.2+/-3.5)mg/L.

CONCLUSIONArt may induce developmental toxicity in rat embryo and placenta by neutralizing the antioxidant defense mechanism.

Animals ; Antimalarials ; toxicity ; Artemisinins ; toxicity ; Embryo, Mammalian ; drug effects ; metabolism ; Female ; Glutathione Peroxidase ; metabolism ; Lipid Peroxidation ; drug effects ; Male ; Placenta ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley ; Sesquiterpenes ; toxicity

Objective To compare the efficacy and the side-effect of three different ways in treating the patients with malignant pleural effusion. Methods 98 patients histologically proved malignant pleural effusion were randomly divided into three groups, bleomycin group(BLM), bleomycin with mycobacterium group( BLM + UTL) and blemycin with intertleukino2 ( BLM +IL). 31 patients were treated with bleomycin intrapleural injection in BLM group,32 patients were treated with bleomycin and Utilin's(mycobacterium) intrapleural injection in BLM + ULL group and 35 patients were treated with bleomycin and intertleukin-2 intrapleural injection in BLM + IL group. The therapeutic efficacy, change of performance and side effects were compared among the three groups after one period of treatment. The changes of CEA and TNF in the pleural effusion were examined before and after treatment. Results The therapeutic efficacy and performance improvement were higher in BLM+UTL and BLM+IL group than that of BLM group(P＜0. 05) ,the pleural CEA of post-treatment in three groups were lower than that of pre-treatment(P＜0.01) ,the CEA after treatment in BLM+UTL group and BLM+IL group was lower than that of BLM group(P＜0. 01,respectively). The pleural TNF of post-treatment in BLM+UTL and BLM+IL groups was higher than that of pre-treatment(P＜0. 01 ) in BLM group. The pleural TNF of post-treatment in BLM+UTL and BLM+IL group was higher than that of BLM group ( P＜0. 01 ). Conclusion Intrapleural injection of mycobacterium with bleomycin or interlekin-2 with bleomycin has better efficacy than using bleomycin only in treating malignant pleural effusion.