Objective To investigate the diagnostic significance of microcalcifications in breast cancer.Methods 120 cases of breast lesions with microcalcifications confirmed by pathology were included in this study,of them,97 cases were breast carcinoma,including infiltrating ductal carcinoma(n=71),invasive lobular carcinoma(n=23),and others 3 cases,23 cases were benign breast diseases.All cases underwent mammography,X-ray features of microcalcification were analysed in comparison with that of pathology.Results (1)The microcalcifications of breast in totally 120 cases could be divided into 3 types according to the density of calcifications,those were high (45/120),middle (34/120) and low (41/120) density.The middle and low dense microcalcifications were more seen in breast cancer(73.19%,71/97),high dense microcalcifications were more seen in benign breast diseases(82.00%,19/23).(2)The malignant calcifications were mostly less than 0.5 mm in diameter.The calcifications appeared as sandy in 68/97,bulky in 18,“Y”,“V”,branch or club in 8 and worm in 3.The benign calcifications were mostly more than 0.5 mm in diameter with regular form and defined margin.(3)Dense or clustered microcalcifications were often seen in breast cancer (82/97),scatter and/or bulky microcalcifications were more seen in benign breast diseases(16/23).Conclusion Microcalcification is important finding in diagnosis of breast cancer,espcially early cancer on macrography,but it should differentiate with benign breast microcalcifications.

Objective To explore the appearances of DSA and therapeutic methods of tanscatheter hepatic artery chomoembolization (THACE) of hepatic carcinoma with arteriovenous fistula(avf).Methods The indirect hepatic portal vein angiography (Superior mesenteric artery angiography) and celiac trunk angiography (common hepatic artery) were performed in 673 cases with hepatic carcinoma confirmed by pathology,then hepatic artery infusion-chemotherapy and/or embolizations were done. Results Heptic carcinoma to be accompanied with arteriovenous fistula(AVF) 151 was totally cases(22.4%),including artery-portal vein fistula 127 cases,artery-vein fistula 15 cases, mixed 9 cases.Of them, hepatic artery embolizations in 131 cases with artery-vein fistula(86.6%) were performed once or more times, in 20 cases due to the embolization of artery-vein fistula couldn’t be performed and/or with tumor embolus inside common portal vein while only arterial infusion-chemotherapy were performed.Conclusion DSA is accurate and direct diagnostic method in hepatic carcinoma with artery-vein fistula. Hepatic artery embolization and infusion-chemotherapy is an effective way for the patients with artery-vein fistula.

Objective To improve the radiological diagnosis of breast cancer .Methods The authors collected 15 cases of breast carcinoma confirmed by operation and pathology. All these cases were misdiagnosed by mammography.Mammographic manifestations and data of clinic were analyzed retrospectively. Results 4 cases changed like small fibroadenoma, 3 cases showed microcalcification, 3 cases showed localized mammary gland architecture distrotion,2 cases showed multiple small patchy shadows in the hyperplasic mammary gland, 2 case showed small focus of increased density, 1 case no abnormal sign, 4 cases among of them can not be palpated mass .Conclusion The combination between palpation and radiology is valuable for diagnosis of breast carcinoma and decreasing misdiagnosis.

Objective To study the effectiveness of different treatment modalities for iatrogenic injury of distal common bile duct during operation.Methods We browsed Chinese Medical Full-text Data-base with the term of “distal common bile duct injury”.All the clinical studies associated with perioperative latrogenic injury of distal common bile duct and adjacent tissue published after 1990 were enrolled,and we collected the clinical data,mortality and reoperation rate with different treatments for analysis.Results Thirty-four case series and case reports with 233 patients were included.14 patients with isolated duodenal injury were excluded.The overall mortality of the remaining 219 patients was 9.6％,and the reoperation rate was 17.4％.A total of 145 patients who were diagnosed with distal common bile duct injury during and after operation from 21 articles were compared.The mortality and reoperation rate were both 1.9％ among 106 patients who were diagnosed during operation.The figures were 43.6％,and 84.6％ among 39 patients who were diagnosed after operation,respectively.In 9 articles with 46 patients,the clinical outcomes of 21 patients who were treated by intraoperative suture was compared with 25 patients who underwent enhanced biliary and retroperitoneal drainage.The mortality and reoperation rates were 0 in both groups.Conclusions Early detection and management are crucial to perioperative common bile duct injury.Furthermore,no significant difference of clinical outcomes observed between bile drainage and perforation suture groups.

Objective To evaluate gastrobiliary duct drainage in the treatment for iatrogenic distal common bile duct injury found during the operation.Methods We analyzed clinical data of 17 cases with application of gastrobiliary duct drainage in immediate treatment for the injury of distal common bile duct found during the operation from June 2010 to June 2016.Postoperative bile drainage,postoperative gastrointestinal function recovery,time for removal of the gastrobiliary duct and hospitalization time were recorded.Postoperative bile leakage,intestinal fistula and pancreatic leakage were observed.Patients were followed up until June 2016.Results The mean volume of bile drainage on the third postoperative day were (310 ± 112)ml,the mean time of postoperative gastrointestinal function recovery were (3.0 ± 1.5) days,time for removal of the gastrobiliary stent were (7.5 ± 1.0) days and hospitalization time were (9.5 ± 1.5) days.There was no postoperative bile leakage,intestinal fistula and pancreatic leakage.All patients were followed up for a median time of 12 months (range,1-45 months).Meanwhile,we found no significant biliary strictures and cholangitis patients.Conclusion Gastrobiliary duct drainage is a simple,rational and effective treatment for iatrogenic injury of distal common bile duct during common bile duct exploration.

Objective To compare the efficacy of surgical drainage versus repair in the treatment of iatrogenic injury of the distal common bile duct detected during operation,and to evaluate the effect of gastrobiliary duct drainage.Methods Patients with iatrogenic choledochal injury were divided into two groups:the drainage group (n =17) and the repair group (n =7).Data on the amounts of postoperative biliary and abdominal cavity drainage,gastrointestinal function recovery,the duration of biliary drainage and hospitalization were compared.Results When compared with the repair group,there were no significant differences in the amounts of postoperative biliary drainage [(310.0± 112.0) vs.(264.0± 144.0) ml] and abdominal cavity drainage [(42.0±25.0) ml vs.(125.0± 195.0) ml)] (both P＞0.05).However,gastrointestinal function recovery [(3.0±1.5)d vs.(4.7±2.0)d],durations of biliary drainage [(7.5±1.0)d vs.(12.7±5.4)d] and hospitalization [(9.5±1.5)d vs.(15.1±5.6)d] of the drainage group were significantly shorter than the repair group (P＜ 0.05).No biliary strictures of cholangitis were detected in the two groups.Conclusion When compared with traditional repair,gastrobiliary drainage was a simpler,safer,and more effective therapeutic strategy for patients with iatrogenic distal common bile duct injury,and with a quicker recovery after treatment.