Objective To discuss the clinical significance of the diffuse calcified distribution in diagnosis of benign and malignant breast lesions .Methods 379 patients with different benign and malignant breast lesions confirmed by surgery underwent digital X‐ray mammography .The morphology ,distribution ,number ,diameter ,concentration and density of calcification in lesions ,the maximum range of the calcified area and other accompanied manifestations in benign and malignant breast lesions were analyzed .Results As for the morphology of calcification ,tiny polymorphic calcification was found in 58 .5% of malignant lesions ,meanwhile ,dot‐like one was found in 49 .3% of benign lesions .Fine linear calcification or branched linear one occurred in malignant lesions ,however ,round one occurred in benign lesions .As for the calcification distribution ,regional distribution was found in 43 .9% of malignant lesions , meanwhile the clustered distribution was found in 58 .4% of benign lesions .And all lobar or segmental distribution was seen in malig‐nant lesions .As for the calcification diameter ,the calcification with the diameter less than 0 .5 mm occurred in 71 .6% of malignant lesions ,however ,that with diameter more than 1 .0 cm occurred in 69 .3% of benign lesions .As for the concentration of calcification , lesions with calcification more than 25 were 71 .8% of malignant ones ,whereas those with calcification of 15-25 were 58 .4% of be‐nign ones .As for calcified density ,uneven calcification occurred in 94 .2% of malignant lesions ;however the even one occurred in 63 .4% of benign lesions .The maximum diameter of calcification ranged from 40 mm to 80 mm was found in 59 .0% of malignant lesions , whereas that ranged from 0 mm to 40 mm was in 77 .2% of benign lesions .Conclusion Statistical differences have been found in the morphology ,distribution ,diameter ,concentration ,density and maximum diameter of calcification between the breast benign and ma‐lignant lesions .

Objective To explore the factors for the development of gallstones after gastrectomy. Methods 52 cases of patients with postgastrectumy,were retrospectively analyzed according to their diseases for gastrectomy and operation form. Results Incidence of gallstone in patients of postgastrectomy was higher than in general population. Among which, Billroth Ⅱ type of gastrectomy for carcinoma was the highest (35.5%), then the total gastrectomy (31.5%) and proximate gastrectomy(13.5%). Billroth Ⅰ type operation was 10.3%. Incidence of gallstone in pa-tients of selective vagotomy was lowest (2.5%). Condusion Billroth Ⅱ type of gastrectomy and total gastrectomy were the risk factors of postgastrectomy cholelithiasis. The causes for gallstone formation after Billroth Ⅱ type of gas-trectomy were the restitution of digestive canal and metabolic disorder of bile acid.

ObjectiveTo assess the relationship of filaggrin expression with atopic diathesis and disease severity in patients with alopecia areata (AA).MethodsThirty-seven patients with AA aged (26.3 ± 10.6) years were enrolled in this study.Atopic diseases were noted in 8 of these patients.Clinical data and laboratory test resuhs were reviewed.Immunohistochemical staining was performed to quantify the expression of filaggrin protein in scalp biopsy specimens from all of the 37 patients with AA and from 10 human controls,and fluorescence-based semiquantitative reverse transcription-PCR to detect the expression of filaggrin mRNA in scalp biopsy specimens from 22 patients with AA and 13 healthy controls.Data were statistically analyzed by Mann Whitney U test,chi-square test,and Spearman's rank correlation test.ResultsThe expressions of filaggrin protein and mRNA were significantly lower in patients with AA than in the controls(P ＜ 0.05 or 0.01 ),and the decrease seemed more obvious in patients with large areas of lesions,long duration of disease,and nail abnormalities,but the degree of decrease was unrelated to the complication with atopic diseases.No significant differences were observed in sex ratio,age at onset,disease duration,area of hair loss,the prevalence of family history or incidence of nail abnormalities and increase in serum IgE and eosinophils,between patients with atopic diseases and those without.ConclusionsThe expressions of filaggrin protein and mRNA are decreased in patients with AA,suggesting that filaggrin may participate in the development of AA and is correlated with the severity of AA.

Objective To detect the expressions of apoptosis-related factors and inflammatory cytokines in superficial and deep layers of as well as anagen hair follicles in lesions of early alopecia areata (AA).Methods Scalp biopsy samples were collected from 25 patients with early AA and 15 healthy human controls.Fluorescence-based quantitative PCR was performed to detect mRNA expressions of apoptosis-related genes p53,caspase 3,Fas,survivin and bcl-2,as well as those of inflammatory cytokines interleukin (IL)-4,IL-10,IL-12 and interferon (IFN)-γ.An immunohistochemical assay was conducted to measure the expression of p53 protein in anagen hair follicles.Results Compared with control skin samples,anagen hair follicles in AA lesions showed significantly increased mRNA expression levels (expressed as 2-△△Ct) of pro-apoptotic factors caspase 3,p53 and Fas (6.78,8.01,9.74,respectively,all P ＜ 0.05),but decreased mRNA expression levels of antiapoptotic factors bcl-2 and survivin (0.08 and 0.03 respectively,both P ＜ 0.01),and similar mRNA expression levels of inflammatory cytokines.There was a significant increase in mRNA expression levels of Th1 cytokines IFN-γ and IL-12 (2.75 vs.1.00,P ＜ 0.05; 85.67 vs.1.00,P ＜ 0.01),but a significant decrease in the expression level of the Th2 cytokine IL-10 (0.002 vs.1.000,P ＜ 0.01) in superficial layers of AA lesions compared with those of normal control skin.The degree of changes in mRNA expression levels of IL-10 and IL-12 was significantly higher in superficial layers than in deep layers of AA lesions (P＜0.01 and 0.05 respectively).The immunohistochemical assay showed that the number of p53-positive cells per 100 cells in anagen hair follicles of AA lesions was higher than that in those of control skin (t =23.79,P ＜ 0.01).Conclusions Anagen hair follicles in AA lesions exhibit high expressions of pro-apoptosis factors,but low expressions of antiapoptotic factors,suggesting that apoptotic factors play a role in the occurrence of AA.

OBJECTIVETo explore effective approaches of treating elderly patients with distal tibiofibular fractures.

METHODSFrom August 2008 to October 2012,175 elderly patients with distal tibiofibular fractures were treated with locking compression plate (LCP) through anterior tibial. There were 112 males and 63 females with an average of 71.3 (ranged 60 to 83) years old. Of them,89 cases were treated by anterior tibial tension reduced incision with LCP,including 62 males and 27 females with a mean age of (71.8 +/- 6.4) years old. Eighty-six patients were treated by distal tibial incision with LCP,including 58 males and 28 females with a mean age of (70.3 +/- 6.7) years old. Swelling time, operation time, intraoperative blood loss, hospital stay, healing time, complications and AOFAS scores were compared between two groups after operation.

RESULTSSwelling time in anterior tension reduced incision with LCP and distal tibial incision with LCP was (5.6 +/- 1.3) and (9.7 +/- 2.1) days, healing time was (4.2 +/- 1.4) and (5.4 +/- 1.9) months,and complications were found 3 in tension reduced incision and 10 in distak tibial incision respectively;and all data shown statistically significant differences between two groups (P < 0.05). At 12 months after operation,AOFAS score was 89.0 +/- 9.7, 87.9 +/- 9.4; and there was no statistically significant difference between two groups (P > 0.05).

CONCLUSIONTension reduced incision through anterior tibial combined with locking compression plate fixation in treating elderly patients with distal tibiofibular fractures can provide good clinical effects with quick fracture healing and low complications.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Female ; Fibula ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Treatment Outcome

This paper introduces remote Computed Tomography van, telemedicine and telecommunication vehicle.
Computer Communication Networks ; Humans ; Image Processing, Computer-Assisted ; methods ; Lung Neoplasms ; diagnosis ; Mass Screening ; Telemedicine ; instrumentation ; methods ; Telemetry ; instrumentation ; methods ; Tomography, X-Ray Computed ; instrumentation ; methods

Head ; surgery ; Humans ; Neck ; surgery ; United States

Objective To observe the microstructural changes in lesions of alopecia areata (AA) with dermoscopy and to evaluate their correlation with clinicopathological manifestations. Methods The area of alopecia of 62 patients with AA and 44 patients with other types of hair loss were observed by using a noncontact polarized dermoscope (Dermlite, USA). Clinical data on and laboratory findings from these patients were collected. Pathological examination was carried out with scalp biopsy specimens from the alopecia area of 15 AA patients. Results Characteristic dermoscopic signs of AA included yellow dots, black dots, broken hairs, exclamation mark hairs, short vellus hair and newly-grown short hairs. Among these signs, yellow dots showed the highest prevalence (83.9%). Exclamation mark hairs, black dots and broken hairs were rather specific signs for AA, and the prevalence of the three signs was positively correlated with disease activity and positivity rate of hair-pull test. A positive correlation was also noted between the prevalence of elevated thyroid peroxidase antibody levels and positivity rate of hair-pull test (r = 0.269, P ＜ 0.05 ) as well as prevalence of broken hairs (r = 0.445, P ＜ 0.05), and between the prevalence of yellow dots and that of keratinous plug in follicular orifice. There was a negative correlation between the prevalence of newly-grown short hairs and perifollicular mast cell infiltration and between the prevalence of black dots and the anagen/catagen ratio. Conclusions Yellow dots can serve as a preliminary screening marker for AA. Exclamation mark hairs, black dots and broken hairs are highly sensitive for the confirmation of diagnosis of AA, and often predict progressive AA.Dermoscopic signs are well correlated to the histopathology features of AA, and may be useful for the evaluation of disease severity and guidance on the treatment of AA.

Objective To explore the method of demonstrating main operative section of facial recess approach with multi-slice CT by using double oblique muttiplanar reconstruction.MethodsSimilarly as surgical procedure of facial recess approach,30 (60 eras) normal temporal bones in cadavers were reconstructed to observe main operative sections and anatomical marks.Main images of operative section of facial recess approach were reconstructed using double oblique multiplanar reconstruction on multislice CT.With the reference of operative anatomical marks,the ratios of visibility of anatomical marks on the transverse plane,coronal plane,sagittal plane and double oblique were calculated and compared.The degree,of which major anatomical landmarks were displayed on the same plane ( axial,coronal,sagittal,or doubleoblique sagittal plane),was classified using the following criteria: level 4: 100％ of anatomical landmarks were presented in the same plane; level 3: 90％ to 99％ of anatomical landmarks were presented in the same plane; level 2: 80％ to 89％ of anatomical landmarks were presented in the same plane; level 1: 70％ to 79％ of anatomical landmarks were presented in the same plane ; level 0: ＜ 70％ of anatomical landmarks were presented in the same plane.Classification data were tested by chi-square test.Results Four key operative section were involved in facial recess approach,which were of oblique sagittal orientation.The central mark of the first key operative section was semicircular canal by using double oblique multi-planar reformation.On reconstructed images of the first key operative section,horizontal reference line was short process of incus,and the angle adjusting the reference line on the transverse plane was 22.15° ±5.22°.On the reconstructed images of the first key operative section,coronal reference line was tympanic segment of facial canal,and the angle adjusting the reference line on the coronal plane was 14.35° ± 4.02°.On the reconstructed images of the second key operative section,the central mark was fossa incudis,the horizontal reference line was short process of incus and the angle was 20.15° ± 5.52°,while the coronal reference line was tympanic segment of facial cana,and the angle was 13.15° ± 3.33°.On the reconstructed operative images of the third key section,the central mark was pyramidal eminence,the horizontal reference line was the horizontal portion of the facial nerve and the angle was 32.53° ±5.22°,while the coronal reference line was the tympanic segment of facial nerve,and the angle was 15.05° ± 4.43°.On the fourth reconstructed images of the key operative section,the central mark was the posterior border of round window,the horizontal reference line was the superior border of oval window,and the angle was 50.15° ± 8.02°,while the coronal reference line was the tympanic segment of facial nerve,and the angle was 15.25° ± 4.12°.For the four planes (double-oblique sagittal,axial,coronal,or sagittal plane),the results of the degree to which they could include the major anatomical landmarks in the same layer of the first section were: level 4 in 60 sides,level 2 in 12 sides and level 3 in 48 sides,level 2 in 15 sides and level 3 in 45 sides,level 3 in 10 sides and level 4 in 50 sides,respectively.The results of the second section were: level 4 in 60 sides,level 2 in 11 sides and level 3 in 49 sides,level 2 in 13 sides and level 3 in 47 sides,level 3 in 11 sides and level 4 in 49 sides,respectively.The results of the third section were: level 4 in 60 sides,level 2 in 10 sides and level 3 in 50 sides,level 2 in 11 sides and level 3 in 49 sides,level 3 in 9 sides and level 4 in 51 sides,respectively.The results of the fourth section were: level 4 in 60 sides,level 2 in 9 sides and level 3 in 51 sides,level 2 in 8 sides and level 3 in 52 sides,level 3 in 5 sides and level 4 in 55 sides,respectively.The four planes differed significantly in the degree to which they could include the major anatomical landmarks in the same layer ( x2 =123.3200,121.4231,122.4011,125.4213,all,P ＜ 0.05 ).The visibility ratio of every section is 100％ (60/60).Conclusion Double oblique multi-planar reformation is a new method to demonstrate landmarks of operative section of facial recess approach in one slice.The reconstructive images of operative section with double oblique multi-planer reconstruction may provide valuable information for operation.

ObjectiveTo evaluate the association between Cyclin D1 G870A polymmphism and risk of colorectal cancer.MethodsExtensive searches of relevant studies on datebase like PubMed,EMCC and CNKI were performed.Case control studies involving unrelated subjects and genotype frequencies in control group consistent with Hardy-Weinberg equilibrium were included for the meta-analysis.Twenty-three case-control studies with 6 344 cases and 9 018 controls were analyzed by the fixed-effect or random-effect meta-analysis method.The metaanalysis was applied with RevMan 5.0 software for heterogeneity test.AA and GA were compared with those with GG genotype.Pooled OR value and 95％ confidence interval (CI) were calculated.ResultsThere were statistical differences between AA & GA and GG.The pooled OR value was 1.10 (95％CI:1.01-1.19,P =0.02).The values were analyzed hierarchically according to different populations.The pooled OR value of Asian was 1.11 (95％ CI:0.98-1.26,P=0.11).The pooled OR value of American was 1.13(95％CI:0.97-1.32,P=0.12).The pooled OR value of European was 1.06(95％CI:0.89-1.25,P =0.52).The pooled OR value of Oceanian was 1.05(95％ CI:0.80-1.38,P=0.73).The values were analyzed hierarchically according to the comparison basis.The pooled OR value of hospital-based was 1.07 (95％ CI:0.95-1.20,P =0.28).The pooled OR value of population-based was 1.13 (95％CI:1.01-1.26,P=0.04).ConclusionThe Cyclin D1 G870A polymorphism is correlated with the susceptibility of colorectal cancer risk at the aggregate level analysis.Analysis by different methods:according to different populations,every group don't support the correlation.According to comparison basis,there has no correlation in hospital-based group,but there has correlation in population-based group.