Objective To investigate the diagnostic value and therapeutic implication of breast imaging reporting and data system (BI-RADS)in non-palpable breast lesions detected by imaging.Methods 21 7 patients,who were found clinical non-palpable suspi-cious lesions in breast by X-ray examination,were enrolled in our study.All patients underwent general mammography (including craniocaudal view and mediolateral oblique view)and mammographic spot view in some patients,then were biopsied using 3D wire guided location biopsy.The predictive value of BI-RADS was analyzed by compare the imaging diagnosis with pathological results. Results Of the 21 7 cases,98 cases were diagnosed of grade Ⅲ,81 cases of grade Ⅳ and 38 cases of grade Ⅴ using BI-RADS.All cases were confirmed by surgery.All lesions were excised completely according to the preoperative 3D wire guided location biopsy. 75 lesions were malignant (34.6%,75/21 7),including 39 cases of carcinoma in situ (52.0%,39/75);142 lesions were benign.1 1 cases of grade Ⅲ,29 cases of grade Ⅳ and 35 cases of grade Ⅴ were malignant.The positive predictive value of BI-RADS for gradeⅢ,grade Ⅳ and grade Ⅴ was 1 1.2% (1 1/98),35.8% (29/81)and 92.1% (35/38)respectively.The positive predictive value of BI-RADS Ⅳ for premenopausal and postmenopausal women was 24.5% (13/53)and 57.1% (1 6/28).Conclusion BI-RADS can improve the resection rate and biopsy rate of non-palpable breast lesions by 3D wire guided location biopsy,and the detection rate of early breast cancer.

Objective:To investigate the effects of total flavonoids from Cycas Revolute on expression of vascular endothelial growth factor (VEGF),basic fibroblast growth factor (bFGF),Hypoxia inducible factor-1α (HIF-1α) and nuclear factor-κB(NF-κB) in model mice of Lewis lung cancer.Methods: The expressions of VEGF,bFGF,HIF-1α and NF-κB in tumor tissues were detected by immunohistochemistry and Western blot.The expression of VEGF,VEGF and NF-κB in tumor tissues were detected by fluorescent quantitative PCR.BFGF,HIF-1α and NF-κB mRNA were detected by immunohistochemistry.Results: The results of immunohis-tochemistry,Western blot and Real-time PCR showed that the results were basically the same,compared with model group,the expression of VEGF,bFGF,HIF-1α,NF-κB mRNA and the expression of VEGF,bFGF,HIF-1α and NF-κB were decreased,the difference was highly significant (P<0.05).Conclusion: The mechanism of total flavonoids from Cycas Revolute in the treatment of lung cancer may be through inhibition of the expression of VEGF,bFGF,HIF-1α,NF-κB in invasion and metastasis,and further inhibit the expression of VEGF,bFGF,HIF-1α and NF-κB in invasion and metastasis-related proteins,thus play a role of anti-lung cancer invasion and metastasis.

Objective To evaluate the influnce of atrial fibrillation(AF)/atrial flutter on the mortality and prognosis of patients with AMI. Methods A total of 297 consecutive patients were studied from Jan.2001 to Dec. 2005 and were categorized into 2 groups according to the presence or absence of AF/atrial flutter. The 30 d and 6 mo mortalities, Killip Grades, cardiogenic shock, arrhythmia and left ventricular ejectory functional (LVEF) 6 months after AMI with Doppler US between the 2 groups were compared. Results The incidence of AF/atrial fluttler was 12.5% with older age, higher Killip Gorade, higher CPK peak, higher rates of previous myocardial infarction and multivascular involvement than those without AF/atrial flutter. The short and medium-term mortalities in AF/atrial flutter group were both significantly higher than those of non-AF/atrial flutter group(P

Objective To establish the prediction model for ischemic stroke recurrence. Methods Consecutive patients with ischemic stroke from January 1st, 2008 to December 31st, 2009 were followed up until June 30th, 2010. The rate of recurrence were described with Kaplan-Meier curve, and the factors associated with recurrence were analyzed with monovariant and multivariate Cox's proportional hazard regression. Results There were 79 cases relapsed during the follow-up. The independent risk factors associated with recurrence were age(X),history of hypertension (X2), family stroke history (X3), total cholesterol (X4), disease progression (X5), total scores of Essen stroke risk score (X6). The personal prognosis index (PI) for predicting recurrence was as: PI=0.025X1+0.681X2+0.973X3+0.395X4+0.636X5+0.283X6. As the receiver operating characteristic (ROC) curve showed, when the cut-off point of PI was 2.289, the sensitivity of the model was 0.731 and specificity was 0.795. Conclusion The model for predicting recurrence of ischemic stroke was established.

Objective To investigate the association between the HLA-DRB1 gene polymorphisms and susceptibility of pulmonary tuberculosis (TB) in patients with type 2 diabetes mellitus in North China. Methods A 1∶1 matched case-control study was adopted. Polymerase chain reaction-sequence-specific primers techniques (PCR-SSP) and restriction fragment length polymorphism (RFLP) was used to type polymorphisms (DR15, DR16, DR1, DR11). Information on environmental-related risk factors and pathological changes of tuberculosis was collected using a pre-tested standard questionnaire. Variance analysis, Chi-square, univariate and multivariate conditional Logistic analysis were conducted with SPSS 12.0 for Window. Results A sample of 124 pairs of cases and controls was studied. Univariate analysis demonstrated that DR15 mutant increased the risk of susceptibility of pulmonary tuberculosis (OR＝2.461, 95%CI: 1.363~4.444, P=0.002),and it would further increased if DR16 mutant occurred together (OR=4.904, 95%CI: 1.554~15.476). In multivariate analysis, DR15 mutant also associated with susceptibility of pulmonary tuberculosis (OR=2.996, 95%CI: 1.51~5.945). Conclusion Polymorphism of DR15 genotype might be a susceptible genotype of TB patients with type 2 diabetes mellitus in North China.

Since the establishment of eight-year clinical medicine specialty, in line with the princi-ple of "eight-year consistency and fusion of the bachelor and doctor degree", the training mode of "strength-ening the foundation, focusing on quality, overall optimization, facing the clinical" has been implemented. In order to reach the standard of professional doctorate, a series of courses of professional doctorate need to be fused in limited time and designed carefully by medical schools. However, grasping proper teaching time and opportunity is particularly important for students' learning and development. By collecting the courses information of 11 medical colleges and universities offering eight-year clinical medicine specialty, we have analyzed the teaching time, methods and course categories of scientific research training courses and graduate degree courses, aiming to find the appropriate teaching program.

Objective:To elucidate the effects of andrographolide (AG) against acute pancreatitis (AP)-associated kidney injury and explore the potential mechanism.Methods:Thirty-two C57BL/6 mice were divided into control group, AP group, AG treatment group and AG control group. In AP group, AP model was established by intraperitoneal injection of L-arginine and LPS. AG treatment group was intravenously injected with AG 8 h before the model establishment. The control group was intraperitoneally injected with an equal volume of normal saline. The AG control group was intravenously injected with AG 8 h before the intraperitoneal administration of normal saline. Venous blood of inner canthus in mice was collected, and the levels of amylase, creatinine (Scr) and urea nitrogen (BUN) in serum were detected. Pancreatic and double kidney tissues were also collected. Pancreatic myeloperoxidase (MPO) activity was detected by colorimetry. Histopathological changes of pancreas and kidneys were observed under light microscope and pathological score was evaluated. Ultra-high-performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry was used to analyze metabonomics in renal tissue.Results:Compared to the control group, the levels of amylase, Scr and BUN in serum and pancreatic MPO activity in the AP group were obviously increased [(13.78±6.01)U/L to (0.23±0.04)U/L, (79.81±24.03)μmol/L to (9.02±2.87)μmol/L, (34.76±14.53)mmol/L to (8.52±2.55)mmol/L, (16.55±4.23)U/g pro to (2.32±0.55)U/g pro]; histopathologic scores of pancreas and kidney in the AP group were also increased (2.70±0.26 to 0.20±0.12, 3.00±0.35 to 0.30±0.12), and the differences were statistically significant (all P<0.05). The levels of amylase, Scr and BUN in serum and pancreatic MPO activity in the AG treatment group were decreased than the AP group [(8.26±3.87)U/L to (13.78±6.01)U/L, (55.42±17.25)μmol/L to (79.81±24.03)μmol/L, (20.66±10.30)mmol/L to (34.76±14.53)mmol/L, (11.51±3.29)U/g pro to (16.55±4.23)U/g pro]; histopathologic scores of pancreas and kidney were also decreased in the AG treatment group than those in the AP group (1.40±0.19 to 2.70±0.26、1.70±0.26 to 3.00±0.35), and the differences were statistically significant (all P<0.05). Metabonomics analysis detected a total of 31 metabolites. Most of metabolites were involved in amino acid and fatty acid metabolism, and a few of them were also involved in glucose, nucleotide, vitamin and bile acid metabolism. Conclusions:AG exerts protective effects on AP-associated kidney injury by altering the levels of multiple metabolites.

BACKGROUND: Studying the relationship between flexibility and body composition of college students is of great significance for enhancing the levels of physical health and sports. OBJECTIVE: To investigate the relationship between sit-and-reach and body composition of college students in Guangxi Zhuang Autonomous Region and differences between sexes. METHODS: Totally 2 175 students from a Guangxi university were randomly selected. Body composition was determined by the MC-180 body composition tester. The students were divided into four groups: ≤ 12.10 cm group,＞ 12.10-16.40 cm group,＞ 16.40-20.70 group and＞ 20.70 group according to quartile of sit-and-reach measured in accordance with the National Physical Health Test Standard. All data were processed by SPSS 22.0 software. RESULTS AND CONCLUSION: Sit-and-reach was significantly correlated with body mass index, percentage of body fat, fat-free mass index, upper limb lean mass and lower limb lean mass (P ＜ 0.05), and percentage of body fat was negatively correlated with sit-and-reach (P ＜ 0.05). The body mass index, fat-free mass index, upper limb lean mass and lower limb lean mass in the ≤ 12.10 cm group were significantly lower than those in the other groups. Fat-free mass index and upper limb lean mass were correlated with sit-and-reach in male college students (P ＜ 0.05). The fat-free mass index and upper limb lean mass in the＞ 16.40-20.70 cm group were significantly higher than those in the ≤ 12.10 cm group. Therefore, there is a positive correlation between the flexibility and fat-free mass index and upper limb lean mass in college students.

Cutaneous sterile pustulosis is categorized as a non-infectious and non-follicular impetigo, with a low prevalence and difficulty in the treatment.Deficiency of interleukin(IL)-36 receptor antagonist (DITRA) is an auto inflammatory disease featured by the decreased interleukin-36 receptor antagonist (IL-36Ra) activity caused by IL36 RN mutation.Functional or structural defects of IL-36Ra increase the secretion of inflammatory and pro-inflammatory factors by keratinocytes, macrophages and dendritic cells.Upregulation of IL-36 receptor agonists induce type 17 helper T lymphocytes to secrete IL-17, which is essential for the onset of multiple subtypes of aseptic pustulosis.Research on the relationship between DITRA and cutaneous sterile pustulosis is important for developing targeted therapies.

Objective:To investigate the influence of trimethylamine N-oxide(TMAO)on the development of early neurological deterioration(END)in diabetic patients with acute ischemic stroke.Methods:In this cross-sectional study, 108 type 2 diabetes patients with acute ischemic stroke treated at the Department of Neurology in the Affiliated Wuxi People’s Hospital of Nanjing Medical University between October 2019 and November 2020 were consecutively recruited.END was defined as an increase in the National Institutes of Health Stroke Scale(NIHSS)≥ 2 points and exclusion of intracranial hemorrhage or bleeding transformation in cranial imaging evaluation within 5 days of initial deterioration of neurological dysfunction.The patients were divided into 2 groups, an END(n=36)group and a non-END group(n=72). Fasting plasma TMAO was measured using isotope dilution liquid chromatography coupled to tandem mass spectrometry.Results:Of the 108 patients, 36(33.3%)were diagnosed with END, and their plasma TMAO levels were significantly higher compared with patients without END( Z=-3.500, P<0.001). For prediction of END, the area under the ROC curve for plasma TMAO levels was 0.707(95% CI: 0.603-0.811, P<0.001). The frequencies of END in subjects grouped via tertiles of TMAO were 22.2%, 19.4% and 58.3%, respectively, with significant differences between the 3 groups( χ2=14.979, P=0.001). Univariate analysis showed that elevated TMAO( OR=1.160, 95% CI: 1.050-1.282, P=0.004)was associated with END.A multivariate logistic regression model further confirmed the association between TMAO and END( OR=1.145, 95% CI: 1.033-1.269, P=0.010). Conclusions:Increased plasma TMAO levels are associated with END in diabetic patients with acute ischemic stroke.