Objective To investigate the ultrasound diagnostic value for nipple discharge disease by comparison with fiberoptic ductoscopy. Methods Fiberoptic ductoscopy and ultrasonic inspection were performed on fifty-seven patients with spontaneous nipple discharge,and the results were analysed. Results In all patients, 55 cases (96. 49 % ) were abnormal in high-frequency ultrasound inspection:27 mammary duct expansion(47.36%),19 occupying lesion with mammary duct expansion or cyst (33.33%),6 cystic echo ( 10. 52% ) ,3 only solid echopattern (5.26%) ,and 2 nothing found (3.51% ). In ultrasonic inspection,color and pulse Doppler signal were found in 7 cases. On the other hand, 26 galactophoritis (45.61%), 12mammary duct ectasia (21.05 %), 17 intraductal papilloma (29.82%), 2 breast carcinoma (3.50%) were diagnosed by fiberoptic ductoscopy. In all 19 cases with occupying lesion,ultrasonography's sensitivity was 52. 63% ,specificity was 89. 47%, misdiagnosis rate was 10. 50%, rate of missed diagnosis was 47.36%.Conclusions To nipple discharge disease, high-frequency ultrasound has high sensitivity, easy to find abnormal indication,but is not accurate enough in the diagnosis of smaller occupying lesion.

This study was aimed to create a method for content determination of quercetin, luteolin and kaempferol in flowers of Dimocarpus longan Lour. from different habitats of Guangxi province by HPLC. The samples were sepa-rated on the Hypersil C18 column (250 mm í 4.6 mm, 5 μm) which was eluted with methanol-0.2% phosphoric acid solution (47:53) with detective wavelength at 360 nm, flow rate at 1.0 mL·min-1, and column temperature at 30℃. The results showed that this method had a good linear relationship within the range of 0.18 to 2.88 μg for quercetin, 0.059 to 0.944 μg for luteolin, and 0.024 to 0.384 μg for kaempferol (r = 0.9999). The average recovery rate was 100.06% (RSD = 1.72%), 99.77% (RSD = 1.18%) and 98.67% (RSD = 1.99%, n = 9), respectively. It was conclud-ed that this method is simple, rapid, reliable and with good repeatability, which can be used in the quality control of flowers of Dimocarpus longan Lour.

Objective To investigate the effect of spectral CT monochromatic images for improving imaging quality in hepatic venography.Methods Thirty patients underwent spectral CT examination on a GE Discovery CT 750 HD scanner.During portal phase,1.25 mm slice thickness polychromatic images and optimal monochromatic images were obtained,and volume rendering and maximum intensity projection were created to show the hepatic veins respectively.The overall imaging quality was evaluated on a five-point scale by two radiologists.Inter-observer agreement in subjective image quality grading was assessed by Kappa statistics.Paired-sample t test were used to compare hepatic vein attenuation,hepatic parenchyma attenuation,CT value difference between the hepatic vein and the liver parenchyma,image noise,vein-to-liver contrast-to-noise ratio (CNR),the image quality score of hepatic venography between the two image data sets.Results The monochromatic images at 50 keV were found to demonstrate the best CNR for hepatic vein.The hepatic vein attenuation[(329 ± 47) HU],hepatic parenchyma attenuation [(178 ± 33) HU],CT value difference between the hepatic vein and the liver parenchyma [(151 ± 33) HU],image noise (17.33 ±4.18),CNR(9.13 ±2.65),the image quality score(4.2 ±0.6) of optimal monochromatic images were significantly higher than those of polychromatic images[(149 ± 18) HU],[(107 ± 14) HU],[(43 ±11) HU],12.55 ± 3.02,3.53 ± 1.03,3.1 ± 0.8 (t values were 24.79,13.95,18.85,9.07,13.25 and 12.04,respectively,P ＜ 0.01).In the comparison of image quality,Kappa value was 0.81 with optimal monochromatic images and 0.69 with polychromatic images.Conclusion Monochromatic images of spectral CT could improve CNR for displaying hepatic vein and improve the image quality compared to the conventional polychromatic images.

BACKGROUND: Appropriate direction and angle of traction for the vertebral artery type cervical spondylosis(CSA)make significant effect.Selective angiography is recognized as"gold standard"to diagnose the vascular disease.Although magnetic resonance angiography as a non-invasive examination,there exist shortcomings such as a longer time checking,vulnerable to man-made factors,a certain aggressive feature.OBJECTIVE: Through the use of color Doppler flow imaging(CDFI)and transcranial Doppler sonography(TCD)adding the test of turning neck,to analyze the change of blood current parameter before and after the tractions from different directions and angles.METHODS: 240 cases suffering CSA were selected and divided into groups according to anatomy angle of lesion parts(upper cervical segments,lower cervical segments,mixed type)and traction mode,angel(anteversion sitting position 1°-10°,11°-20°,21°-30° groups,posterior extension sitting position 1°-10°,11°-20°,21°-30° groups,neutral position sitting position group).Local massage served as control group.The indexes of vertebral artery of neck part including inner diameter(D)of narrowest location,peak systolic velocity and average velocity of blood were measured by CDFI adding the test of turning neck.The indexes of left vertebral artery,right vertebral artery and basiiar artery including peak velocity(Vp)of period of contraction and mean velocity(Vm)of blood were measured by TCD adding the test of turning neck.RESULTS AND CONCLUSION: ①We determined vertebral artery type of cervical spondylosis on the base of anatomic site. On the basis of diseased region,we divided cervical syndrome into 3 types.They were superior part(C1-C3),inferior part (C4-C6) and commixture.it offers clinical guidance for traction therapy from spondylous morphous and mechanics.② We determined the gbest angle of traction.The therapeutic efficacy in posterior extension sitting position occupying 11-20～was better in upper hind neck;the therapeutic efficacy in anteversion sitting position occupying 11-20° was better in inferior neck; the therapeutic efficacy in anteversion sitting position occupying 1-10° was better in neutral position sitting position.③ We knew that CDFI and TCD are the convenient,non-invasive,safe and reduplicative methods to guide traction therapy in vertebral artery type of cervical spondylosis.

Objective To investigate the relationship between RAD51 135G ＞ C polymorphism and prognosis in triple-negative breast cancer patients by retrospective analysis.Methods The clinical data of 62 triplenegative breast cancer patients were collected.The 62 cases underwent standard chemotherapy and radiotherapy after tumor resection from Jan.2004 to Dec.2010 in Affiliated Cancer Hospital of Zhengzhou University.RAD51 135G ＞ C polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RELP) technology.The survival curve about progress free and overall survival time were then made.Results The median progress free and overall survival time in triple-negative breast cancer patients with or with-out RAD51 135G ＞ C polymorphism were(77.00 ±5.55)and(89.00 ± 10.40) months vs(99.00 ±4.26)and (103.00 ±4.30) months.The difference had statistical significance(P =0.039 and 0.015 respectively).Conclusion RAD51 135G ＞ C polymorphism is related with prognosis of triple-negative breast cancer patients,which might be a prognostic factor for breast cancer.

Objective To discuss the protein level of hypoxia-inducible factor 1-alpha(HIF-1α),glucose transporter-1 (Glut-1)and vascular endothelial growth factor(VEGF) in breast cancer tissue in diabetic patients and its significance.Methods HIF-1α,Glut-1 and VEGF protein levels were measured by immunohistochemical staining in 112 cases of primary breast cancer tissues.CD31 labeled vascular endothelial cells were used to evaluate micro vascular density (MVD).The correlation between the effect of blood sugar control and clinicopathological parameters was analyzed.Results The expression of HIF-1α,Glut-1 and VEGF protein in breast cancer tissues of diabetic patients was significantly higher than that in breast cancer tissues of non-diabetic patients(t =2.255,P =0.030; t =2.154,P=0.038; t =2.225,P =0.032).HIF-1α was positively correlated with Glut-1 and VEGF in diabetic patients with breast cancer (r =0.561,P =0.003 ; r =0.435,P =0.014).The level of MVD in breast cancer tissues of diabetic patients was obviously higher than that in the non-diabetic patients with breast cancer(t =9.458,P =0.000).The effect of blood sugar control was significantly correlated with lymph node metastasis and tumor stage in diabetic patients with breast cancer(x2 =4.689,P =0.030; x2 =5.051,P =0.025).Conclusion Hypoxia-related factors including HIF-1α,Glut-1 and VEGF and MVD are upregulated in diabetic patients with breast cancer,and the effect of blood sugar control is correlated with lymph node metastasis and tumor stage,suggesting diabetes mellitus may promote tumor progression through high glucose and hypoxia in breast cancer.

AIM: To prepare and characterize a mouse anti-human CD40 mutant monoclonal mAb. METHODS: Female BALB/c mice of 6-8 weeks old were immunized with CD40 mutant transfectant (L929-CD40mu) as immunogen. The spleen B cells of the mice were fused with Sp2/0 myeloma cells. The hybridoma cells were screened with CD40 mutant transfectant (L929-CD40mu) by FCM. Faststrip analysis was performed to identify Ig subclass of this mAb. The epitope recognized by this mAb was detected by Bio-5C11 competitive assay. Western blot technique was adopted to identify the mAb. The proliferation of tumor cells in vitro was analyzed by MTT assay and apoptosis of tumor cells in vitro was analyzed by PI-annexin V assay. RESULTS: One hybridoma cell line named 10C5 was obtained, which had the property of secreting anti-human CD40 mutant monoclonal antibody continuously and steadily. This mAb specifically recognized human CD40 mutant molecule and induced the apoptosis of tumor cells in vitro. CONCLUSION: One hybridoma cell line which can secret a mouse anti-human CD40 mutant mAb has been prepared successfully. This mAb can inhibit the growth of tumor cells expressing CD40 mutant and induce their apoptosis in vitro.

Objective To verify the association between common breast cancer susceptibility loci which have been confirmed in European and Asian populations and breast cancer susceptibility in sporadic breast cancer among the Han nationality in Henan province , and to analyze their genotypes in the internal type of breast cancer . Methods In 253 breast cancer patients ( the case group ) and 343 patients who had benign breast lesions ( the control group), rs2046210(6q25.1), rs2981582(EGFR2), rs889312(MAP3K1), and rs3803662(TOX3/TNRC9)were genotyped by SNP im-LDR technique.According to estrogen receptor(ER), progesterone receptor (PR), human epidermal growth factor receptor 2(HER2)and Ki67, breast cancer are divided into 5 types:Lu-minal A, Luminal B, HER2-enrich, Luminal HER2, and triple negative breast cancer ( TNBC).Results rs2046210(6q25.1), rs2981582(EGFR2), rs889312(MAP3K1)had no statistical differences between the case group and the control group(P=0.421, 0.459, and 0.468), but the genotype of rs3803662(TOX3/TNRC9)in the case group and the control group had statistical difference (P=0.037).The allelic frequencies of rs3803662 between the case group and control group were different in codominant inheritance ( OR=2.19, 95%CI:1.19-4.02)and recessive genetic models (OR =2.06,95% CI:1.15 -3.70).Compared with AA and GA, GG in-creased the risk of breast cancer ( P =0.012, 0.015 ).The genotypes of rs2046210 ( 6q25.1 ), rs2981582 (EGFR2), rs889312(MAP3K1), and rs3803662(TOX3/TNRC9)had no difference in different types of breast cancer.Conclusions Four common breast cancer susceptibility loci from GWAS are not entirely associated with breast cancer risk among the Han nationality in Henan province .Only rs3803662(TOX3/TNRC9)is confirmed to increase the risk of breast cancer .Different genotypes of 4 loci distribute equally in different types of breast cancer .

Objective To evaluate the clinical results of indirect reduction and fixation with the self-manufactured external fixator as a viable alternative in the surgical treatment of intraarticular calcaneal fractures.Methods From May 2006 to May 2009,a total of 30 patients undergone surgical treatment of intraarticular calcaneal fractures were analyzed,including 20 males and 10 females with an average age of 36 years (range,15-53).According to Sanders classification based on the computed tomography scan of intraarticular calcaneal fractures,16 patients were classified as type-Ⅲ,and 14 type-Ⅳ in this series.All fractures were treated first with the external fixator as indirect reduction and fixation device on the whole,which can enlarge the interspace of the subtalar joint significantly.Then,posterior articular facet of calcaneus was exposed and reduced through a small lateral incision.The calcaneal's length,breadth,thalamus height,maximum vertical displacement of the post-articular surface,and B(o)hler angle were measured preoperatively,3 days and 6 months after operation in X-ray film.Reduction results were evaluated by CT scan according to the standard of Buckley.Results The average follow-up time of all patients was 29 months (range,4-45).Lateral and axial roentgenograms showed satisfactory restoration of the calcaneal's anatomical structure.There were significant differences between preoperative values and those 3 days or 6 months postoperatively.There were no significant differences between values 3 days postoperatively and those 6 months postoperatively.The reduction results of posterior articular facet were evaluated by CT scan.Twenty-seven patients obtained anatomical reduction,3 patients obtained uneven articular facet within 2 mm.Conclusion This selfmanufactured external fixator is a vialbe alternative in the treatment of intraarticular calcaneal fractures,which has advantages of minimal invasion,practicality and less complications.

Objective:To explore the method of predicting high lymph node load in patients with early breast cancer to avoid unnecessary sentinel lymph node biopsy.Methods:The clinicopathological and thoracic multi-slice spiral CT (MSCT) data of 2620 patients with early (cT1~2N0M0) breast cancer treated in the Affiliated Cancer Hospital of Zhengzhou University from January 1, 2014 to August 1, 2018 were collected. According to the postoperative pathological results, the patients were divided into the group with axillaryhigh lymph node burden (HNB) and the non-HNB group. The influencing factors of axillary lymph node burden in patients with early breast cancer were determined by univariate and multivariate analysis, and the diagnostic model of MSCT to HNB was established. The best cutoff value for the diagnosis of HNB was determined through analyzing the receiver operative characteristic (ROC) curve, and the consistency between MSCT diagnosis and pathological diagnosis was evaluated by Kappa test. Results:Among the 2 620 patients, 168 were diagnosed of HNB. Univariate analysis showed that the tumor size, the status of human epidermal growth factor receptor 2 (HER-2), the number of abnormal lymph nodes showed in MSCT, the ratio of the length to the diameter of the maximum abnormal lymph node as shown in MSCT, the condition of the maximum abnormal lymph node door, and the parenchyma of the maximum abnormal lymph node were related to axillary lymph node burden in patients with early breast cancer ( P<0.05). Multivariate analysis showed that the number of abnormal lymph nodes showed in MSCT was an independent influencing factor of axillary HNB in patients with early breast cancer. Compared with patients without abnormal lymph nodes, the OR values of patients with 1, 2, 3 or more abnormal lymph nodes displayed by MSCT and in axillary HNB status were 3.305, 9.379, 126.163 and 780.953, respectively. Using 3 or more abnormal lymph nodes detected by MSCT to predict the area under the ROC curve of axillary HNB in patients with early breast cancer, the area was 0.928, the sensitivity was 82.1%, the specificity was 95.4%, and the accuracy was 94.5%. Kappa test showed that the consistency between MSCT diagnosis and pathological diagnosis was relatively high ( Kappa=0.629, P<0.001). Conclusions:The number of abnormal lymph nodes showed in MSCT is an independent influencing factor of axillary HNB in patients with early breast cancer. Taking 3 or more abnormal lymph nodes showed in MSCT as the threshold can help to predict the axillary HNB status of early breast cancer patients and exempt some of them from unnecessary sentinel lymph node biopsy.