Objective To assess the efficacy of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the breast in the detection of residual lesions of early stage breast carcinoma after lumpectomy. Methods 53 patients with breast masses confirmed to be malignant tumors by pathology after lumpectomy underwent the dynamic contrast-enhanced breast MR imaging and then further surgical treatment by lumpectomy. The DCE MRI-based diagnoses were compared to the results of pathological analyses after the second lumpectomy. Results 17 (32%) cases were detected with abnormal enhancement. 8 cases presented mass-like enhancements , and 6 of them showed tumorous residuals (P < 0.01). 6 presented focal enhancements, taking up 35% and one of them was confirmed pathologically to have tumorous residuals (P < 0.01). 3 cases presented mass-like enhancement, taking up 18% and 2 of them were confirmed with cancerous residuals . MR dynamic enhancement showed 68% of the them presented no abnormal enhancements in the breast and 33 of themhad no residual cancer , taking up 92%. 3 of them were confirmed with tumorous residuals , taking up 8%. The The positive predictive value and negative predictive value of DCE MR imaging for diagnosing residual malignant lesion were 52% and 92%, respectively . Conclusion The dynamic contrast-enhanced MRI of breast is helpful for evaluating residual malignant lesion after lumpectomy and affects positively subsequent treatment.

Objective To study the thalamic metabolic alterations and its correlation with cognitive impairment in patients with cerebral small vessel disease(CSVD).Methods The cognitive function of 34 patients with CSVD and 26 matched volunteers were evaluated by Montreal cognitive assessment(MoCA), and received single voxel 1H-MRS examination to detect the content of NAA,Cho and Cr,and record the ratio of NAA/Cr and Cho/Cr on bilateral thalami.The differences of NAA/Cr, Cho/Cr on bilateral thalami between the two groups were compared, and the correlation between NAA/Cr,Cho/Cr and MoCA total score and its sub-items score in CSVD group were analyzed.Results ①The MoCA of total score as well as its sub-items such as visual space and executive ability,memory,attention and language for CSVD group were significantly lower than that for the control group(P<0.05);②NAA/Cr on bilateral thalami in CSVD group were both lower than that in the control group(left 1.57±0.18,1.68±0.17,t=2.46,P=0.02;right 1.66±0.21,1.78±0.19,t=2.23,P=0.03), the differences were statistically significant (P<0.05);there were no significantly differences in the ratio of Cho/Cr between the two groups(P>0.05);③In CSVD group, the ratio of NAA/Cr on both bilateral thalami were significantly positively correlated with MoCA score (left r=0.83,right r=0.79,P<0.05)as well as visual space and executive ability(left r=0.65,right r=0.46,P<0.05), memory(left r=0.59, right r=0.50, P<0.05), attention(left r=0.42, right r=0.52, P<0.05),language(left r=0.52, right r=0.41, P<0.05), abstraction(left r=0.47, right r=0.40, P<0.05), orientation(left r=0.48,right r=0.42, P<0.05),Cho/Cr were not significantly correlated with MoCA total score and its sub-items(P>0.05).Conclusion The thalamic neuron has been damaged and dysfunctioned in patients with CSVD,and this metabolic abnormality may be related to a wide range of cognitive impairment in CSVD patients.

Objective To investigate the incidence and clinicopathologic significance of MSI in breast caner.Methods 40 paired sporadic invasive breast cancer were collected.Genomic DNA was extracted from live sample.Twelve microsatellites on chromosomes 2p,3p,5q,6q,16q,17q were amplified for MSI,respectively,by polymerase chain reaction(PCR)with designed primers and detecting after polyacrylamide gel electrophoresis.Results MSI in 15 out of 40(35%)of the carcinomas were observed.There was no MSI in benign hyperplasia.MSI was mainly located at D3S1766,D2S2739 and TP53 in the breast cancer.The incidence rate of MSI in breast cancer is associated with the degree of carcinoma differentiation.Conclusions Microsatellite instability might play a role in the early stage during multistep breast carcinogenesis.MSI indicated poor histologic differentiation in breast carcinoma.D3S1766,D2S2739 and TP53 might be the sensitive sites to detect MSI in breast carcinoma transformation.

AIM:To investigate the ameliorative effect of ischemic postconditioning (I-postC) on pia mater microcirculation in rats subjected to cerebral ischemia reperfusion (I/R) and its mechanisms. METHODS:Thirty-two male Wistar rats were randomly divided into sham,I/R,I-postC,and ischemic preconditioning (IPC) groups. The global cerebral I/R injury was induced by shunting carotid artery in rats. Pia mater microcirculation and cerebral microcirculatory perfusion were measured after reperfusion. The content of soluble intercellular adhesion molecule-1 (sICAM-1) in plasma was detected using enzyme linked-immunosorbent assay (ELISA). Myeloperoxidase (MPO),malondialdehyde (MDA),and superoxide dismutase (SOD) in cerebral tissue were detected. The expressions of vascular endothelial cell cadherin (VE-cadherin) and NF-?B p65 in cerebral tissue were assayed by Western blotting. RESULTS:(1) The disturbance of the blood flow in microvessel induced by I/R was improved significantly by I-postC. In addition,I-postC alleviated significantly the decrease in diameters of microvesseles,cerebral microcirculatory perfusion and cerebral VE-cadherin content induced by I/R (P

Objective To investigate ~1H-MRS findings of brain tumor and the clinical application of ~1H-MRS.Methods 80patients with brain tumors clinically or pathologically-proved underwent ~1H-MRS.Normal opposite hemispheres in 30 cases were used as control group.Single voxel spectroscopy(SVS) or 2D-MRS imaging was performed with excited echo sequence.The mean ratio of metabolisms with difference was compared.Results Compared with control group,NAA of tumor decreased in certain degree(P

Objective To predict the risk of acute myocardial infarction with 64-row CT and left ventricular function analysis.Methods Both 64-row CT coronary angiograhphy and 64-row CT left function in 289 patients were analysed. All the patients were divided into four groups according to the degree of stenosis of their coronary arteries. Mean left ventricular myocardial mass( LVMM ) , left ventricular ejection fraction(LVEF) and left ventricular end diastolic volume(LVEDV) of each group were calculated and compared with their clinical materials.Results LVMM, LVEDV as determined with 64-row corrected well with the occurrence of the myocardial ischemia proved by clinical evidence(r≈0.82,0.76),while LVEF showed a negative correction(r≈-0.74).Conclusion It is not accurate enough to predict the acute myocardial infarction with only the degree of narrow of the coronary artery. 64-row CT provides not only the degree of stenosis of the coronary artery , but also the functional features of the left ventricular as well. Both of them are of much importance to predict the risk of the acute myocardial infarction.

Objective To investigate the effects of ω-3 fatty acids on inflammation and coagulation function in hepatocellular carcinoma (HCC) patients after partial hepatectomy.Methods In this prospective randomized controlled trial,80 HCC patients were randomly divided into two groups based on the parenteral nutrition (PN) scheme that was provided 5 days after partial hepatectomy:fish oil group:20％ fish oil and 80％ mediumlong fatty acid; and control group:100％ medium-long fatty acid.The inflammation,liver function,blood coagulation indicators,and prognosis were compared between two groups.Results After 3 days of hepatectomy,the serum C-reactive protein levels in the control and fish oil groups were (119.6 ± 57.3) mg/L and (97.1 ± 46.1) mg/L(P =0.016),respectively; and on day 6 after surgery,C-reactive protein levels of two groups were (54.9 ± 26.1)and (40.7 ±21.8) mg/L,respectively (P =0.018).The plasma fibrinogen level in the fish oil group was significantly lower than that in the control group 3 days [(3.4 ± 1.1) vs.(4.1 ± 1.3) g/L,P ＜ 0.001] and 6 days [(3.3 ± 0.9) vs.(3.8 ± 1.2) g/L,P ＜ 0.001] after surgery.The retention rate of indocyanine green at 15 minutes on the 7th postoperative day were 8.6％ ±4.9％ and 9.2％ ±7.3％ in the control and fish oil groups,respectively (P=0.179).The recurrent rate (40.63％ vs.44.12％,x2 =0.082,P =0.774) and survival rate in the fish oil and control groups (90.62％ vs.88.24％,x2 ＜0.001,P =1.000) also showed no significant difference after 6 months of follow-up.Conclusion ω-3 fish oil emulsion can reduce postoperative inflammatory response and prevent thrombosis.

AIM: To investigate the ameliorative effect of water extract of propolis (WEP) preconditioning on mesenteric microcirculation of rats subjected to small intestinal ischemia reperfusion (I/R). METHODS: Thirty-two male Wistar rats were randomly divided into sham, I/R and WEP (100, 200 mg/kg) preconditioning groups. Model of small intestinal I/R injury was made by clamping super mesenteric artery for 45 min followed by 120 min of reperfusion in rats. Mesenteric microcirculation was detected at the end of reperfusion. The degree of small intestinal injury was The content of soluble intercellular adhesion molecule-1 (sICAM-1) in plasma and myeloperoxidase (MPO) activity in intestinal tissue were detected using enzyme linked-immuno-sorbent assay (ELISA) and spectrophotometer, respectively. RESULTS: (1) WEP preconditioning alleviated significantly the pathologic lesion in small intestine, and wet/dry ratio, compared to those in I/R group (P<0.01). (2) The disturbance of the blood flow in microvessel induced by I/R was improved significantly by WEP. In addition, WEP preconditioning alleviated significantly the decrease in diameters of microvessels and microcirculatory blood velocity (P<0.05 vs I/R group) and inhibited the adherence of leukocytes to venule (P<0.01 vs I/R group) in a dose-dependent manner. SICAM-1 content in plasma and MPO activity in intestinal tissue were decreased in WEP preconditioning group, compared to those in I/R group (P<0.05 or P<0.01). CONCLUSION: WEP preconditioning ameliorates mesenteric microcirculation of rats subjected to small intestinal I/R through suppressing the activation of polymorphonuclear neutrophils mediated by ICAM-1.

Objective To evaluate the effects of branched-chain amino acids-enriched early parenteral and enteral nutrition on the liver function and serum aminograms in cirrhotic rats after partial hepatectomy. Methods In this prospective randomized controlled study, 24 cirrhotic rats, induced by thioacetamide, were randomized into three groups: enteral nutrition (EN) group, EN + branched-chain amino acid (BCAA) group, and parenteral nutrition (PN) + BCAA group. After receiving partial hepatectomy, rats in all three groups were nutritionally supported with equal amount of calorie and nitrogen contents from the 1st postoperative day ( PO day 1 ) to PO day 5. On PO day 6, parameters including body weight, liver functions, prealbumin, transferring, and serum aminograms were measured or determined, and the level of liver albumin mRNA was detected by reversal transcription-polymerase chain reaction and morphological examinations such as HE staining and immunohistochemical staining, which were assessed by index of Ki67 protein index. Results Body weight was significantly decreased in all three groups on PO day 6 (P ＜0.05 ). Compared with EN + BCAA group, serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase after partial hepatectomy were significantly higher in PN + BCAA group (P ＜0.05 ). Serum alkaline phosphatase level was significantly higher in PN + BCAA group than in EN group ( P ＜0. 05). The level of prealbumin was significantly lower in PN + BCAA group when compared with EN group or EN +BCAA group ( both P ＜ 0. 05 ), although no such significant difference was noted in terms of transferrin ( P ＞0. 05 ). The levels of leucine and isoleucine elevated while those of tyrosine, phenylalanine, arginine and tryptophan declined in PN + BCAA group or EN + BCAA group when compared with EN group ( P ＜ 0. 05 ). Aminograms were not significantly different between EN + BCAA group and PN + BCAA group ( P ＞ 0. 05 ). Levels of total amino acid and aromatic amino acid (AAA) were significantly lower while BCAA and ratio between BCAA and AAA (BCAA/AAA) were significantly higher in PN + BCAA group or EN + BCAA group than in EN group (P ＜ 0. 05 ).Significantly lower level of albumin mRNA and index of Ki67 were observed in PN + BCAA group than in EN group or EN + BCAA group (P ＜ 0.05 ) on PO day 6. Conclusions BCAA-enriched EN or PN reverses amino acid disequilibrium and restores BCAA/AAA in cirrhotic rats after partial hepatectomy. Compared with PN, EN is superior in improving postoperative liver function, promoting protein synthesis, and speed up tissue regeneration in the postoperative liver. However, it still can not restore serum albumin in a short term.

Objective:To investigate the correlation between the breast cancer MRI schedule of reinforcement and the shrinkage pattern of tumor after neo-adjuvant chemotherapy, and its clinical significance in the guidance of formulating operation plan. Methods:Dynamic contrast-enhanced MRI scan was performed before chemotherapy and before surgery after a whole-range N-Acety-L-Cysteine (NAC) treatment in 55 patients with loco-regionally advanced breast cancer who received the neo-adjuvant chemotherapy. MRI sched-ule of reinforcement and the shrinkage pattern of tumor after neo-adjuvant chemotherapy were obtained in the treatment, and the corre-lation between the two was analyzed. Results:Of the 55 patients, the unilateral breast mass was found in 54 and the bilateral lesion in 1. There were 56 neo-plastic foci in these patients. The mass-like enhanced image was seen in 24 of the total cases (43%), of which 23 presented with a centripetal shrinkage, 1 with an annular decline, (P<0.01). Multifocal mass-like enhancement image was found in 13 of the total cases, (23%), of which 2 centripetal shrinkages were the singular mass, 11 remained a multifocal lesion after the tumor shrinkage (P<0.01). The mass with peripheral non-tumor-like enhancement image was seen in 8 of the total cases (14%), of which 4 showed a centripetal shrinkage and another 4 a honeycombed multifocal decline (P>0.05). There were 11 of the total cases with non-tu-mor-like enhancement (20%), in which 4 assumed a centripetal shrinkage and 7 a honeycombed multifocal shrinkage (P<0.01). Conclu-sion:The tumor shrinking pattern and its accurate radiological image evaluation are the keys to the selection of breast-conserving sur-gery and the control of local recurrence after treatment of NAC regimen. We can predict the shrinking pattern through the type of the le-sion on baseline before NAC, which is important for the patients and surgeon to get a reasonable expectation in the subsequent treat-ments.