Objective To study the accuracy and the clinical significance of sentinel lymph node biopsy (SLNB)after neoadjuvant chemotherapy for breast cancer.Methods A total of 90 patients with StageⅡorⅢbreast cancer and negative axillary node after neoadjuvant chemotherapy were enrolled in the study.Mapping proce- dure and SLNB were performed using methylene blue injected at the site of the primary breast cancer,followed by the axillary lymph node dissection.Results The sentinel lymph node(SLN)was successfully identified in 82 out of 90 patients(91.1%).The number of sentinel harvested nodes ranged from 1 to 4(average 1.6).The accuracy of SLNB to predict the axillary lymph node status was 93.9 %(77/82),the sensitivity,positive predictive value,nega- tive predictive value and false negative rate were 87.5 %(40/45),100 %,88.1% and 11.1%(5/45),respectively. The SLN identification rate tended to be higher and false negative rate tended to be lower in patients with T2 prima- ry tumor before neoadjuvant chemotherapy.Conclusion Our study indicated that SLNB after neoadjuvant chemotherapy in patients with StageⅡorⅢbreast cancer had a similar effect as SLNB in non-neoadjuvant studies. SLNB was considered to be able to accurately predict the axillary lymph node status in patients with T2 primary tu- mor before neoadjuvant chemotherapy.

To investigate the value of MRI for the diagnosis of achilles tendon closed rupture. 1.5T Maestro Class MRI scanner was used for the conventional scanning of 15 patients confirmed with achilles tendon closed ruptures by operation, and then the findings by imaging were compared with those by operation. The 15 patients proved with achilles tendon closed rupture, including 4 cases of incomplete rupture and 11 cases of complete rupture. MRI could display clearly the changes in morphology and signal of incomplete or complete closed ruptures of Achilles tendon, and the results were consistent with those by operation. MRI can make an accurate display of the lo-cation and extent of achilles tendon rupture.

Objective To explore whether dynamic contrast-enhanced MRA (DCE MRA) can provide an effective assessment of renal vascular in living donors before transplantation.Methods Thirty five healthy living renal donor candidates were scanned on MR system before transplantation.After injection of Gd-DTPA 1 ml in vein, a test-bolus scan was used to get the time delay of Gd-DTPA reaching renal artery.Then, a 3D T1-weighted fast low-angle shot sequence (3D FLASH) was performed in the coronal plane.The 3D FLASH scan would repeat four times with an inter-phase of 10 seconds.Thus, the imaging of the renal arterial, venous and collecting systems were got.Two radiologists observed renal arteries and veins on original imaging and MIP reconstructed imaging.The quality of MR angiography was evaluated on a fivepoint scale and the vascular anatomy or variations of the arterial and venous systems were recorded, using intraoperative findings as a standard of reference.Results The quality for all MRA was good or very good for the most of living renal donors.Among 70 renals, several variations of vascular were found, including 5 left accessory artery, 9 right accessory artery, 3 left proximal arterial branch and 6 right proximal arterial branch.Among 70 renal veins, 1 right accessory veins and 2 left varieocele were observed.One small accessory artery of right kidney was missed with DCE MRA, but identified by operation.Conclusion DCE MRA was noninvasive tool for evaluation of the renal vasculature and variations with high accuracy.It would be a good modality in preoperative evaluation of living renal donors.

Objective To investigate the feasibility of measuring liver volume with Argus methoct Methods Thirty-two healthy liver transplant donor candidates underwent liver MRI on a 3.0 T MR unit.Volume interpolated body examination(VIBE)was performed after the administration of gadobenate dimeglumine.The VIBE data was transferred to the diagnostic workstation,and then multiple planar reconstruction(MPR)images were acquired.Firstly.two observers manually drawn the liver shape and calculated three volumes:the whole liver volume and right lobes volumes include middle hepatic vein (MHV)and exclude MHV,respectively.Secondly,the same data was transferred to Argus software.calculated that three volumes.Each measurement time was recorded.Actual graft volume(the right lobe)wag measured during surgery.The correlation between right lobes volume of two measurements and actual graft volume was analyzed.The time needed for Argus and that needed for manual method were compared with paired t test.Results The right lobe volumes measured by Argus,manually and surgery method were (813±187),(807 ± 181)and(713 ± 137)mm3,respectively.Argus method and manual method showed good correlation with surgery method,and the correlation coefficients were 0.897(Argus method)and 0.884(manual method),respectively.The time for manual method and Argu8 method were(44.3 ±2.7)and(12.2.±1.0)min,respectively.There was significant difference between Argus and manual methods (t=76.39,P＜0.05).Conclusion Compared with manual method,use of the Liver volumetric measurement by Argus software not only correlated well with Actual graft volume,but also saves time.Argus has potential clinical value for volumetric measurement in living liver transplant donors.

OBJECTIVETo investigate possible causes of micromotion in distal femoral prosthesis.

METHODSBased on the assumption that the femur and prosthesis were considered as concentric cylinders with completely bonded interface, a theoretical model simulating the interfacial stress transfer was established. The distributions of the interfacial shear and radial stresses with the changing of z were obtained through mathematics and mechanics deducing.

RESULTSThe maximum interfacial shear stress occurred at the position of z=0, namely, the cross section of the femur neck. The interfacial shear stress sharply decreased with the increasing of z and came to nearly zero at the range of z> 0.1 m. While the interfacial radial stress increased with the increasing of z,at the range of z >0.05 m it was constant and reached the maximum.

CONCLUSIONThe micromotion in distal prosthesis is caused by the interfacial radial stress.

Biomechanical Phenomena ; Femur ; anatomy & histology ; physiopathology ; surgery ; Hip Prosthesis ; adverse effects ; Humans ; Joint Instability ; etiology ; physiopathology ; Models, Theoretical ; Motion ; Prosthesis Design ; Shear Strength ; Stress, Mechanical

OBJECTIVETo study the changes of fibronectin (FN) and type IV collagen (ColIV) expression in cultured rat mesangial cells (MsC) transfected with Smad 2 vector and to investigate the molecular mechanism of glomerular extracellular matrix accumulation in glomerulosclerosis via transforming growth factor-beta (TGF-beta)/Smad signal pathway.

METHODSSmad 2 vector was transfected into MsC by calcium phosphate. Western blot analysis was used to detect Smad 2 protein. The expression of FN and ColIV proteins and their mRNAs was determined by Western blot and reverse transcriptase-polymerase chain reaction respectively.

RESULTSFour MsC clones (T-12, T-31, T-35, T-40) with Smad 2 overexpression were established. The expression of FN and ColIV was significantly increased at mRNA and protein levels in two (T-12, T-31). Compared with controls, the expression of FN proteins and mRNAs in these two clones was 2.4 times (P < 0.05) and 2.7 times (P < 0.05) higher respectively. The expression of ColIV proteins and mRNAs was 2.9 times (P < 0.01) and 3.3 times (P < 0.01) higher respectively.

CONCLUSIONSIt is postulated that Smad 2 in TGF-beta/Smad signal pathway is important in promoting the accumulation of FN and ColIV in sclerotic glomeruli of diseased kidneys.

Animals ; Cells, Cultured ; Collagen Type IV ; biosynthesis ; genetics ; Fibronectins ; biosynthesis ; genetics ; Genetic Vectors ; Mesangial Cells ; cytology ; metabolism ; Plasmids ; RNA, Messenger ; biosynthesis ; genetics ; Rats ; Signal Transduction ; Smad2 Protein ; genetics ; metabolism ; Transfection ; Transforming Growth Factor beta ; metabolism

OBJECTIVETo investigate the stress distribution and fracture mechanism of proximal femur under impact loads.

METHODSThe image data of one male's femur were collected by the Lightspeed multi-lay spiral computed tomography. A 3D finite element model of the femur was established by employing the finite element software ANSYS, which mainly concentrated on the effects of the directions of the impact loads arising from intense movements and the parenchyma on the hip joint as well as those of the femur material properties on the distribution of the Mises equivalent stress in the femur after impact.

RESULTSThe numerical results about the effects of the angle sigma of the impact loads to the anterior direction and the angle gamma of the impact loads to the femur shaft on the bone fracture were given. The angle sigma had larger effect on the stress distribution than the angle gamma, which mainly represented the fracture of the upper femur including the femoral neck fracture when the posterolateral femur was impacted. This result was consistent with the clinical one. The parenchyma on the hip joint has relatively large relaxation effect on the impact loads.

CONCLUSIONSA 3D finite element analysis model of the femoral hip joint under dynamic loads is successfully established by using the impact dynamic theory.

Femur ; physiology ; Finite Element Analysis ; Humans ; Male ; Models, Biological ; Stress, Mechanical ; Weight-Bearing ; physiology

OBJECTIVETo study the role of connective tissue growth factor (CTGF) in the development of glomerulosclerosis by experimental alteration of fibronectin (FN) and Type IV collagen (Col IV) expression in cultured rat mesangial cells (MsC).

METHODSCTGF expression vector was transfected into MsC by Lipofectimine method. Protein and mRNA expression levels of CTGF, FN and Col IV were studied by Western blot and reverse transcription-polymerase chain reaction (RT-PCR) respectively.

RESULTSTwo of MsC clones (MCT-1 and MCT-2) with CTGF overexpression were successfully established and found to have significant increases of FN and Col IV at both protein and mRNA levels. Compared with the controls, the expression of FN protein and mRNA in the two clones were 3.2 times (P < 0.05) and 2.9 times (P < 0.05) higher respectively. The expression of Col IV protein and mRNA was 3.8 times (P < 0.01) and 2.4 times (P < 0.01) higher respectively.

CONCLUSIONCTGF up-regulates FN and Col IV expression in MsC and may play an important role in the development of glomerulosclerosis.

Animals ; Blotting, Western ; Cells, Cultured ; Collagen Type IV ; genetics ; metabolism ; Connective Tissue Growth Factor ; genetics ; metabolism ; Fibronectins ; genetics ; metabolism ; Genetic Vectors ; genetics ; Mesangial Cells ; cytology ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Transfection

Objective To investigate the extrinsic stain removal efficacy of two commerciallyavailable dentifrices (LION (R) ZACT(R) ).Methods After informed consent was assigned,148 male smokers,aged 19-60 yeas,were recruited in this study.In this double blind,randomized,parallel study,three groups were balanced according to Lobene stain index ( including area and intensity) at baseline and then randomly assigned into three treatment groups:Toothpaste A containing 2％ alumina or Toothpaste B containing 0.5％ four sodium pyrophosphate,Toothpaste C:control dentifrice.Stain level was assessed by one qualified examiner at baseline,4 weeks and 8 weeks after baseline.Results After 4-week use of the assigned dentifrices,the groups using Toothpaste A and B demonstrated significant stain area reduction of 8.48％ and 7.14％,with stain intensity reduction of 5.29％ and 4.23％ compared with the control group ( P ＜ 0.05 ).After 8-week use of Toothpaste A and B,the two groups demonstrated a significant ( P ＜ 0.01 ) stain area reduction of 15.31％ and 14.83％,with stain intensity reduction of 12.65％ and 13.86％,as compared to the control group.Conclusions The dentifrices containing 2％ alumina or 0.5％ four sodium pyrophosphate are effective for the removal of extrinsic tooth stain after four weeks,and eight weeks of use.

Objective: To observe the effects of acupuncture plus spinal manipulations on the physical functioning and levels of alkaline phosphatase (ALP), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and osteoprotegerin (OPG) in patients with ankylosing spondylitis (AS). Methods: A total of 128 AS cases were allocated into a control group and an observation group using random number table method, with 64 cases in each group. Patients in both groups took sulfasalazine and meloxicam. Patients in the observation group received additional acupuncture plus spinal manipulations. The efficacy, Bath AS functional index (BASFI), Bath AS disease activity index (BASDAI), and the levels of ALP, ESR, CRP and OPG were compared between the two groups after eight weeks of treatment. Results: After treatment, the symptom scores of traditional Chinese medicine in both groups were decreased (all P<0.05), and these scores in the observation group were significantly lower than in the control group (all P<0.05); the VAS, BASFI and BASDAI scores in both groups were decreased (all P<0.05), and these scores in the observation group were significantly lower than in the control group (all P<0.05); and the ALP, ESR, CRP and OPG levels in both groups were decreased (all P<0.05), and these levels in the observation group were significantly lower than in the control group (all P<0.05). The total efficacy rate was 92.2％ in the observation group, versus 78.1％ in the control group, presenting a statistical significance (P<0.05). Conclusion: Conventional medication combined with acupuncture and spinal manipulations can improve clinical symptoms, accelerate the recovery of physical functioning, and reduce the ALP, ESR, CRP and OPG levels.