Objective To study the value of ultrasound-guided fine needle aspiration (FNA) in the diagnosis of axillary lymph node metastasis in breast cancer,and to compared with conventional ultrasound in the diagnosis of metastatic lymph nodes of breast cancer.Methods Five hundred patients were enrolled into study prospectively from our hospital.The set of standard for patients into study:patients were diagnosed by BI-RADS and classified into class 4 or class 5 preoperative,the maximum diameter of the tumor was less than 2 cm,and there was no case of distant metastasis.Ultrasound guided FNA was performed in each case,and the results were compared with conventional ultrasound diagnosis results,using pathological findings as gold standard.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy in the diagnosis of axillary lymph node by conventional ultrasound were 60.6%,67.6%,77.2%,48.7%,and 63.1%,respectively,and by ultrasound-guided FNA were 78%,100%,100%,71.6%,and 85.6%,respectively.There were significant differences between the two diagnostic methods statistically(χ2=113.2,P<0.001).Conclusions Ultrasound-guided FNA can effectively reduce the number of sentinel lymph node biopsy,which displays a certain clinical value.

Objective To evaluate set-up errors by megavoltage cone-beam CT in head and neck cancers treated with precision radiotherapy. Methods From April 2007 to March 2008, 22 patients with nasopharyngeal carcinoma (15 patients) ,parotid carcinoma (4 patients) and brain glioma (3 patients) were enrolled, among whom 7 patients underwent three-dimensional conformal radiotherapy (3DCRT) and 15 received intensity modulated radiotherapy (IMRT). The radiation dose was 56. 0 -70.4 Gy in 28 -32 fractions within 6 -7 weeks. Megavoltage cone-beam scan was performed weekly before treatment. The isocenter displacement was calculated by comparing megavoltage cone-beam CT and planning CT in left-right (LR), cranio-caudal (CC), and anterior-posterior (AP) directions. Results Totally 129 sets of megavoltage cone-beam CT images were obtained for 22 patients. The frequency of isocenter shift more than 0. 3 cm,0. 4 cm and 0. 5 cm were 28,15 and 9, respectively. The maximum mean set-up error was found in CC, which was about 0. 1 cm more than that in LR and AP. The frequency of isocenter shift direction was almost identical in LR and CC, which was more frequent (about 75%) in the posterior direction. Conclusions During the course of radiation of brain tumor and head and neck cancer, the enlarging tendency of set-up errors has been found in all the three directions. The isocenter shift in AP was more frequent to the posterior direction.

Objective To explore the ideal choice of feeding artery which is used for regional arterial infusion (RAI) in severe acute pancreatitis. Methods Forty-five patients with SAP were treated with RAI. The ideal feeding artery was that can supply entire pancreas according to arteriography and can maximize concentration of drug at pancreatic tissue. The pancreatic arteriography was considered as the final objective evidence for choice. Results (1)Gastroduodenal artery was chosen as feeding artery in forty-four cases, and superior mesenterlc artery was chosen in only one case because of vascular abnormity. (2)According to splenic arteriography, blood of splenic artery was supplied to spleen chiefly, and only partial tail of pancreas was applied by splenic artery. (3)According to celiac trunk arteriography, blood of celiac trunk could be supplied to entire pancreas, but a considerable proportion of the total blood was supplied to spleen through splenic artery and liver through hepatic artery proper.Therefore, the drug utilization index was lower. (4)According to gastroduodenal arteriography, blood of gastroduodenal artery could be supplied to entire pancrea, and almost all of the blood that contains drug flowed into pancreas. Therefore, the drug utilization index was higher. Conclusions Gastroduodenal artery is the ideal choice of artery which is used for regional intra-arterial infusion in sever acute pancreatitis. Pancreatic arteriography should be applied routinely when yever acute pancreatitis was treated with RAI.

Adenoviridae ; genetics ; Calcium-Binding Proteins ; genetics ; metabolism ; Cells, Cultured ; Female ; Genetic Vectors ; Humans ; Microfilament Proteins ; genetics ; metabolism ; Myocytes, Smooth Muscle ; metabolism ; Myometrium ; cytology ; metabolism ; RNA, Small Interfering ; genetics ; Recombinant Fusion Proteins ; genetics ; metabolism ; Transfection

Adolescent ; Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Exercise Therapy ; Female ; Humans ; Male ; Phytotherapy ; Spondylitis, Ankylosing ; therapy ; Transcutaneous Electric Nerve Stimulation

Objective:To investigate the imaging features of breast solid papillary carcinoma(SPC) by ultrasonography.Methods:The ultrasonic images of 218 breast SPC patients confirmed by pathology in Fudan University Cancer Center from December 2012 to January 2020 were retrospectively reviewed. The manifestations were preliminarily classified into 6 types, and the ultrasonic imaging features were summarized.Results:There were 22 cases with negative ultrasound findings. The cases of solid mass, nodular with ductal dilatation, cystic-solid mass, intraductal abnormal echo, simple ductal dilation and non-ductal flaky hypoechoic area or structural disorders were 79(36.2%), 33(15.1%), 29(13.3%), 30(13.8%), 20(9.2%) and 5(2.3%), respectively, and the diagnostic rates of ultrasound were 70.9%, 24.2%, 75.9%, 20%, 0 and 0, respectively.Conclusions:The ultrasonic manifestations of breast SPC are diverse, while cystic-solid findings can be seen as a clue of breast SPC.

Objective:To explore the influence on inflammation cytokines for anti-IL-1βand TNF-αIgY intranasal treatment in guinea pigs with allergic rhinitis.Methods:The allergic rhinitis model in guinea pigs was established using ovalbumin(OVA).Hartley guinea pigs were randomly divided into the control group(group C,n=17),the allergic rhinitis model group(group M,n=27),the 0.1%anti-IL-1βand TNF-αIgY treatment group(group Z1,n=21)and the fluticasone propionate treatment group(group Z2,n=21). At 2 h,4 h and 8 h after the last treatment,blood was got by heart puncture,as well as nose was lavaged using 0.9% saline and the nasal lavage fluid( NLF) was collected.The level of cytokines was examined using ELISA kits.Results: In the peripheral blood, the levels of IL-1β,IL-5,IL-9,IL-13,IL-18,IL-33 and TGF-β1 from 2 h to 8 h;TNF-αand OVA-specific IgE from 2 h to 4 h;and IL-22 from 4 h to 8 h were significantly decreased in the 0.1%anti-IL-1βand TNF-αIgY treatment group compared with the allergic rhinitis model group(P<0.05).In the NLF,the levels of IL-1β,IL-5,IL-9,IL-13,IL-22,IL-33,TNF-α,TGF-β1 and OVA-specific IgE from 2 h to 8 h;and IL-18 at 2 h were significantly decreased in the 0.1% anti-IL-1βand TNF-αIgY treatment group compared with the allergic rhinitis model group ( P<0.05 ) .Conclusion: Anti-IL-1βand TNF-αIgY intranasal treatment can significantly reduce inflammation cytokine levels in allergic rhinitis guinea pigs.

Objective To evaluate the therapeutic effect of segmental hepatectomy for intrahepatic bile duct stones.Methods In this study, 414 patients suffering from intrahepatic bile duct stones underwent hepatectomy from Jan 1981 to Dec 2001. Stones distribution, operation modality,postoperative complication and therapeutic effect were evaluated. Results Postoperative complications occurred in 72 cases(17.4%), mortality was 0.7%. A follow up of 2 to 22 years was achieved in 305 patients (73.7%), with excellent or good result in 88.9%, residual stone in 15.7%,and stone recurrence in 4.6%.Conclusion Appropriate use of hepatectomy is effective for the treatment of intrahepatic bile duct stones.

Objective:To analyze the features and clinical significance of damages to non pulmonary organs like the heart,kidney and peripheral blood in SARS patients.Methods:SPSS 11.0 and SDAS software packages were used to retrospectively analyze the damages to the heart,kidney and peripheral blood in 330 clinically confirmed SARS cases.Results:(1)The heart damage occurred within 1 week after SARS onset in mild cases; the rates of LDH,HBDH,CK and CK MB returning to normal were 74.2%,80.6%,100% and 100%,respectively.In severe cases,the heart damage usually occurred 1 week after SARS onset; the rates of LDH,HBDH,CK and CK MB returning to normal were 32.2%,29.5%,55.2% and 44.4%,respectively.Ten patients whose CK MB didnot return to normal died.(2) The changes of RBC count appeared after an average of 1 week (1 10 d) in 54.2% of the patients.It returned to normal in all the mild SARS cases after an average of 12.5(4 21) d but didnot in 18.4% of the severe cases ( P

ObjectiveTo explore the relationship among dream threat level,life events and childhood trauma in obsessive-compulsive patients.Methods 59 obsessive-compulsive patients and 57 healthy controls were tested with Dream Threat Questionnaire (DTQ),Childhood Trauma Questionnaire ( CTQ ) and Life Events Scale (LES).The dream threat level were compared between the two groups,and correlation and regression analysis were used to research the relationship of the variables for patients’ data.ResultsCompared with the healthy controls,patients had significantly higher DTQ score ( 1.40 ± 2.23 vs 3.31 ± 3.04,P ＜ 0.01 ),CTQ total score (34.21 ± 8.47 vs 43.02 ± 10.78,P ＜ 0.01 ),LES total score ( 16.88 ± 16.42 vs 45.39 ± 46.01,P ＜ 0.01 ) and its negtive life events subscore ( 14.14 ± 14.61 vs 39.56 ± 42.94,P ＜ 0.01 ).Correlation analysis showed that dream threat level,negative life events and childhood trauma were significantly positively correlated each other( r =0.326 ～0.402,P ＜ 0.05 ～0.01 ).Regression analysis indicated that childhood trauma directly predicted dream threat level (β =0.104,P ＜ 0.05 ) and completely mediated the relationship between negative life events and dream threat level.ConclusionObsessive-compulsive patients have higher dream threat level,more childhood trauma experience and life events.Childhood trauma experience is a significant factor influencing dream threat level,and as a complete mediation by which life events influence dream threat level.