Objective To investigate the diagnostic value of DTI anisotropy parameters in breast malignant tumors.Methods Fifty four patients,including 33 patients with malignant tumors and 21 patients with benign lesions,were retrospectively analyzed.The E1,MD and FA of lesions were measured and compared by paired t test between the malignant tumors and the contralateral healthy breast tissue.The difference between malignant tumors and benign lesions was analyzed by independent sample t test.Logistic regression analysis was made using E1,FA,MD as predictors in detecting and differentiating the malignant tumors,ROC curve analysis was performed to compare diagnostic performance based on the area under the curve (AUC).Results E1,MD and FA in malignant tumors were (0.99 ± 0.12) × 10-3mm2/s,(0.85 ±0.26) × 10-3mm2/s and 0.20 ±0.08 respectively,and those in normal breast tissues were(1.46 ± 0.55) × 10-3 mm2/s、(1.48 ± 0.44) × 10-3 mm2/s and 0.29 ± 0.17 respectively.Those parameters in benign lesions were (1.80 ±0.42) × 10-3mm2/s,(1.38 ±0.52) × 10-3mm2/s and 0.22 ± 0.10 respectively.Significant statistic differences were found between malignant tumors and normal breast tissues in E1,MD and FA (t =-4.889,-6.449,-2.842 ; P ＜ 0.01).Significant statistic differences were also found between malignant tumors and benign lesions in E1 and MD (t =-10.476,-4.394; P ＜ 0.01) with no difference found in FA (P ＞ 0.05).E1,MD and FA are independent predictors in malignant tumors' detection,and the combination of E1,MD and FA significantly improved discrimination between cancer and normal tissue over each one alone with the sensitivity 97.0％ (32/33),specificity 97.0％ (32/33),accuracy 97.0％ (64/66).Combination of E1 and MD had a similar AUC with E1 and a more AUC than MD and FA,with the sensitivity 97.0％ (32/33),specificity 100.0％ (21/21),accuracy 98.1％ (53/54).Conclusion The regression model combining E1,MD and FA is most valuable in breast cancer detection and E1 is the preferred index for the differentiation of breast cancers from benigin lesions.

Objective To study the correlation between morphological characteristics of coronary artery calcified plaques and luminal stenosis of local coronary artery segments with 64-slice computed tomography.Methods One hundred and eleven patients who had undergone 64-slice computed tomographic coronary angiography(CTCA)and conventional coronary angiography(CAG)were retrospectively analyzed.The calcified plaques were classified as punctate,nodular,strip-like and nubbly in long-axis view of coronary artery lumen,and were classified as crescent,semilunar,round moon and circinate in short-axis view.The morphologic characteristics of these calcified plaques on CTCA were retrospectively analyzed and compared with luminal stenosis of CAG results.Results Among 528 calcified coronary segments which were analyzed in 111 patients,there were 383(72.5%)punctate calcified plaque segments and 145(27.5%)of non-punctate plaques.There were 34(23.4%,34/145)non-punctate calcified plaques which caused severe stenosis(≥75%),including 4(11.8%)nodular,8(23.5%)stripe-like and 22(64.7%)nubbly calcified plaques on the long-axis view,and 0(0.0%)cresent,8(23.5%)semilunar,18(52.9%)round moon and 8(23.5%)circinate calcified plaques on the short-axis view.The ratios of different morphological coronary artery calcifications which caused severe stenoses were significantly different with each other(all P＜0.01).Conclusion Different figures of coronary artery calcified plaques demonstrate different degrees of stenoses of local coronary artery lumen.Severe stenoses were mostly caused by nubbly calcified plaque on long-axis view,round moon and circinate calcified plaque on short-axis view.

Objective:To analyze the application of indocyanine green (ICG) fluorescence imaging in laparoscopic resection of pancreatic cancer.Methods:Data of 15 patients undergoing laparoscopic surgery for pancreatic cancer in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Wannan Medical College from June 2022 to March 2023 were retrospectively analyzed, including 13 males and 2 females, aged (67.0±8.6) years. ICG were intraoperatively injected to visualize the lesion and guide surgical resection. The surgical methods, postoperative pathology, ICG fluorescence imaging and tumor margins were reviewd.Results:Among the patients, seven underwent laparoscopic pancreaticoduodenectomy, seven underwent laparoscopic radical antegrade modular pancreaticosplenectomy, and one conversed to open pancreaticoduodenectomy due to combined superior mesenteric vein reconstruction. Postoperative pathology confirmed pancreatic moderately differentiated adenocarcinoma in nine cases, pancreatic moderately-low differentiated adenocarcinoma in four cases, pancreatic follicular cell carcinoma in one case, and inflammatory lesion in one case. Negative surgical margins were confirmed in all cases. Pancreatic lesion were visualized in 14 cases (fluorescent delineation of the tumor capsule) but not well visualized in one case (with moderately differentiated adenocarcinoma). In the case of inflammatory disease, the lesion parenchyma were visualized.Conclusion:ICG injection in laparoscopic surgery enables visualization of pancreatic tumor, which facilitates tumor localization and margin determination.

Objective:To evaluate the efficacy of a modified continuous penetrating-suture pancreaticojejunostomy (PPJ), also known as a continuous PPJ with a U-shaped reinforcement of pancreatic section (U-PPJ), in patients with high risk of clinically relevant postoperative pancreatic fistula (CR-POPF).Methods:Clinical data of 33 patients with pancreatic tumors undergoing pancreatic surgery in the Department of Hepatobiliary Surgery, the First Affiliated Hospital of Wannan Medical College from August 2017 to December 2023 were collected, including 22 males and 11 females, aged (64.9±8.6) years old. According to the fashion of pancreaticojejunostomy, patients were divided into two groups: U-PPJ group ( n=11) and PPJ group ( n=22). The general data, incidence of CR-POPF, abdominal bleeding and other clinicopathological data were collected. Results:All patients underwent pancreatic surgery successfully and were discharged from the hospital uneventfully. Intraoperative blood loss in U-PPJ group was 200.00 (100.0, 200.0) ml, postoperative hospitalization was 13.0 (11.0, 18.0) d, and the drain removal time was 17.0 (12.0, 21.0) d, and no CR-POPF occurred. The intraoperative blood loss, postoperative hospitalization days, drain removal time, and incidence of postoperative biochemical leakage were comparable between the groups (all P>0.05). The incidence of CR-POPF in U-PPJ group was lower than that in PPJ group [0 vs. 22.7% (5/22), P<0.05]. Conclusion:U-PPJ is safe and effective in patients with pancreatic tumors and might reduce the incidence of CR-POPF.