Objective To analyze imageology appearance and clinical characteristics of the cystic and solid breast carcinoma.Methods Features of MRI and B-type ultrasonic inspection of 26 patients with the cystic and solid breast carcinoma pathologically confirmed (15 patients with mucinous carcinoma,6 patients with intracystic papillary carcinoma,5 patients with squamous cell carcinoma of the breast) were retrospectively reviewed.Results In terms of clinical appearance,the incidence of the squamous cell breast carcinoma with an average age of 70.1 years old was larger than in youth,while mucinous carcinoma with an average age of 67.7 years old and intracystic carcinoma of breast with an average age of 55.1 years old were contrary.The squamous cell breast carcinoma developed more quickly than mucinous carcinoma and intracystic carcinoma of breast.The squamous cell breast carcinoma often occurred around mammilla (4/5),while the mucinous carcinoma and intracystic papillary carcinoma often occurred upper outer quadrant of breast,which was similar with other breast cancer.The average size of 49.6 mm in the squamous cell breast carcinoma was largest than the average size of 25.1 mm in mucinous carcinoma and the average size of 35.2 mm in intracystic papillary carcinoma.The malignant degree of squamous cell breast carcinoma was higher than mucinous carcinoma and intracystic papillary carcinoma,which intended to occur lymph node metastasis and skin infiltration.The diagnosis probability of mucinous carcinoma was smaller than intracystic papillary carcinoma through preoperative puncture,while squamous cell breast carcinoma was larger.On the MRI imageology appearance,both types of breast cancer had the same shape of rotundity or lobulated.The tumors were low signal on T1WI and partially high signal on T2WI,which were circular enhancement after enhancement.However,the edge of mucinous carcinoma and squamous cell breast carcinoma was rougher than intracystic papillary carcinoma compared with squamous cell breast carcinoma.The bursa wall of mucinous carcinoma was more uniformity,while papillary soft tissue image can be found in intracystic papillary carcinoma,which was enhanced significantly after enhancement.In terms of ultrasonic sound (US),there were low echo signal and high echo signal on the back of tumor compared with other breast tumor.There were shadow beside mucinous carcinoma.Squamous cell breast carcinoma was rich in blood supply,while mucinous carcinoma and intracystic papillary carcinoma were opposite.Conclusion Histological type of cystic and solid breast carcinoma is complex,but the appearances of MRI and US have some characteristics.Histological type and the range of disease could be guessed through the combination of preoperative puncture and clinical appearance,which plays an important role in operation mode and treatment guidance.

Objective To observe the expression of cAMP -response element binding protein (CREB) and N-methyl-D-aspartic acid receptor (NMDA ) after intracochlear electrical stimulation in the auditory cortex and inferior colliculus in infant rats with auditory deprivation .Methods Sixty six SD infant rats were randomly divided into 6 groups (11 rats each group):4 weeks ,and 6 weeks after injection of ototoxic drug ,the control group ,and 3 weeks and 5 weeks after injection of ototoxic drug with intra -cochlear electrical stimulation for one week .Gentami-cin sulphate (350 mg/kg body weight) and frusemide (200 mg/kg body weight) were injected subcutaneously in the skin folds on the lateral abdominal side and the dorsal neck area ,respectively .The expression of CREB and NMDAR1protein were detected by immunohistological staining .Results The results of immunohisto -chemistry revealed that protein expression of CREB and NMDAR1 in 4 week group of injection increased as compared to the control group ,while decreasing as compared to intracochlear electrical stimulation group ,significantly .However ,protein expression of CREB and NMDAR1 in 6 week group of injection decreased as compared to the control group and in-tracochlear electrical stimulation group ,significantly .Conclusion Auditory deprivation could result in the expres-sion of protein of CREB and NMDAR1 in auditory cortex and inferior colliculus increasing in an early stage and then de-creasing in infant rats .Intracochlear electrical stimulation could result in the expression of proteins of CREB and NMDAR 1 in auditory cortex and inferior colliculus increasing in infant rats .The dynamic variation of CREB and NMDAR1 expression in rat auditory cortex and inferior colliculus reflects synaptic plasticity in neurons of auditory pathway .

The market and literature were studied to understand the existing situation of Magnoliae Officinalis Cortex goods, and the collected samples were analyzed, combined with the actual production, a new standard of Magnoliae Officinalis Cortex commercial specification and grade was drafted. Magnoliae Officinalis Cortex goods was divided into two categories according to the source in the old standard. Then each category was divided into four kinds of specifications according to the site. Each kind of specification was divided into several grades according to the length and weight. To judge the quality of Magnoliae Officinalis Cortex goods was mainly based on the appearance quality. In the new standard, the classification of commercial specification and grade is based on the thickness, magnolol and honokiol content. The goods of Magnoliae Officinalis Cortex can be divided into three specifications: Tongpu, Genpu and Doupu. Tongpu is divided into three grades, the remaining two are not graded.
Magnolia ; anatomy & histology ; chemistry

Objective To compare the image quality of renal artery in-flow inversion recovery MR angiography (IFIR MRA), CTA and contrast-enhanced MR angiography (CE-MRA) and to assess the value of renal artery IFIR MRA. Methods Thirty five patients were prospectively included in this study.Renal artery CTA was performed in 19 patients and renal artery CE-MRA was performed in 16 patients. In addition to renal artery CTA or CE-MRA, all patients underwent renal artery IFIR MRA. Two radiologists separately graded renal artery image quality, renal venous artifact and the visualization of renal artery branches regarding these three different techniques. Wilcoxon signed rank test of paired samples was used to compare the grading results, t test of paired samples was applied to compare the results of renal artery (accessory renal artery) trunk diameter. The consistency evaluation of renal artery image quality and renal venous artifact grades between two radiologists employed Kappa analysis. Results There was no significant difference between IFIR MRA and CTA with renal artery image quality and renal venous artifact (P>0.05). There was significant difference between IFIR MRA and CE-MRA with renal artery image quality and renal venous artifact (P<0.05). The consistency evaluation results of renal artery image quality and renal venous artifact grades between two radiologists were both good. Kappa value were 0.425 to 1.000. CTA of 19 cases depicted 48 renal arteries (38 renal arteries, 10 accessory renal arteries), IFIR MRA depicted them all. The grades of visualization of renal artery branches about IFIR MRA and CTA were (3.7 ± 0.7) and (3.8 ± 0.6) respectively, renal artery trunk diameter of IFIR MRA and CTA were (4.9 ± 1.3) and (5.0 ± 1.4) mm respectively, there was no significant difference between IFIR MRA and CTA (P>0.05).CE-MRA of 16 cases depicted 38 renal arteries (32 renal arteries, 6 accessory renal arteries), IFIR MRA depicted them all. The grades of visualization of renal artery branches about IFIR MRA and CE-MRA were (3.4±0.8) and (2.5±0.9) respectively, and there was significant difference between IFIR MRA and CE-MRA (Z=-4.040, P<0.01). Renal artery trunk diameter of IFIR MRA and CE-MRA were (4.7±1.3) and (4.7±1.2) mm respectively, there was no significant difference between IFIR MRA and CE-MRA (P>0.05). Conclusions The image quality of renal artery IFIR MRA was equal to CTA and superior to CE-MRA. It could be considered as an alternative technique for renal artery angiography.

Objective:To explore the clients' assessment for the ethical behavior of the counselors and psychotherapists.Methods:The main method used in this evaluation was questionnaire,and the self-made questionnaire of the ethical problems in psychotherapy and counseling(for the clients)were used as evaluation tools.Totally 1100 clients,from 12 cities in China,were investigated with 807 questionnaires returned.Results:84.5% of the clients were confident in the treatments,and 89.2% of them gave positive assessment for the ability of their counselors and psychotherapists.15.9% of clients said the counselors and psychotherapists showed impatience or talked to them about their stress sometimes.Besides,59.1% knew about the characters,names and charge of the psychotherapies and counseling,and 53.4% knew the background of the counselors and psychotherapists.91.3% of clients thought the privacy and treatment could be kept secret.7% of clients had intimate relationship with their counselors or psychotherapists,1.5% had sexual relations,and 18.3% made friends in lives.79% of clients could receive timely psychotherapies and counseling.Conclusion:From the assessment of the clients,the vast majorities of the counselors and psychotherapists do well in work ability,confidentiality and time-setting,but not so well in informed-consent and dual relations,which need to be paid attention to and improved.

Data mining technology is called into play to comb and excavate data in the hospital information system(HIS)for the purposes of hospital management and patient safety.Data tables in the electronic medical record system were effectively remodeled as necessary.These measures help build a medical quality surveillance system which is based on the electronic medical record system,with such functions as real-time monitoring and pre-warning.The control framework consists the critical cases control system,surgery and invasive operation control system,overall control system,and TCM strengths application control system.

Objective To investigate the HBV reactivation status and clinic outcomes in the renal allograft recipients with inactive HBsAg carriers,and explore the preventive measures.Methods A retrospective analysis of clinical manifestation was processed in 88 cases of inactive HBsAg carriers before and after renal transplantation.Preoperative liver function in all cases was normal and serum HBsAg positive,HBV DNA＜106 copies/L.Tacrolimus (or cyclosporine A) + mycophenolate mofetil (MMF) + prednisone were given in prevention of rejection after transplantation.In 88 cases,56 cases were given nucleoside analogues (acid) for prophylactic antiviral therapy,in which 31 cases were given lamivudine (LAM) (LAM group),25 cases were given entecavir (ETV) (ETV group) ; The rest 32 cases were not given prophylactic antiviral therapy,only receiving routine liver-protecting therapy (inosine,glucurolactone) (control group).Incidence of HBV re-activation,liver function,response to treatment and the pathological changes of hepatic tissue were observed.Results During the follow-up period,the incidence of HBV reactivation in LAM group and ETV group was 45.2％ and 28.0％ respectively,significantly lower than in control group (84.4％,P＜ 0.05).In prophylactic treatment groups,HBV reactivation occurred later,liver function damage was milder,and HBV DNA load peak was lower (P＜0.05).In LAM group,HBV reactivation occurred in 14 cases,including 10 cases occurred during administration of LAM,and ETV treatment was given for about 2 months,serum HBV DNA levels in 7 cases were under detection line;in the rest 4 cases,HBV reactivation occurred in patients with treatment less than 1 year and noncompliance,who withdrew medicine blindly.After the original scheme of antiviral therapy was done,serum HBV DNA levels in 3 cases were under detection line,and the effect was not obvious in one case.In control group,HBV reactivation occurred in 27 cases.Fourteen cases therefore accepted nucleoside (acid) analogs antiviral therapy,and HBV DNA levels in 10 cases were under detection line.Histological examination revealed the liver with fibrotic cholestatic hepatitis changes in 9 patients,including 8 cases in control group,and 1 case in LAM group due to blind withdrawal of medicine.Conclus(i)on LAM and ETV prophylactic use may decrease the HBV reactivation rate in inactive HBsAg carriers after renal transplantation,reduce the severity of liver damage and the occurrence of fibrotic cholestatic hepatitis.

Objective: To discuss the diagnosis and treatment of infantile congenital subglottic hemangioma. Method:Nine patients with recurrent stridor,feeding difficulties and laryngeal obstruction were diagnosed as con-genital subglottic hemangioma with bronchia endoscopy. The lesions were unilateral in 7 cases and bilateral in 2 ca-ses. Eight cases were treated by intralesional Pingyangmycin injection after tracheotomy. Patients were discharged with metal trachea and were followed up endoscopically 2 weeks thereafter. A second treatment would be required if the tumor reduced in size but not disappeared completely. Plugging tubes and extubation would be done when the tumor disappeared completely. One case with unilateral lesion underwent power-assisted tumor resection with-out tracheotomy. Result: Hemangioma vanished completely in 6 patients with unilateral subglottic hemangioma who were treated with single stage procedure. Tumor size was found reduced significantly after one procedure and van-ished completely after a second procedure in 2 cases with bilateral subglottic hemangioma. All of the 8 cases were extubated successfully. The patient recovered thoroughly in two weeks after power-assisted tumor resection. Con-clusion: Intralesional Pingyangmycin injection after tracheotomy can relief the airway obstruction quickly, shorten the nature course of hemangioma, shorten the period of wearing trachea, has no complication such as subglottic stenosis and is thought to be a safe and effective therapy for large size hemangioma. Power-assisted tumor resec-tion under good total anesthesia without tracheotomy combined with well hemostasis is effective, less injure, and suitable for small size hemangioma.

Objective To evaluate the indications and intraoperative management of nephron-spar- ing surgery (NSS) for renal cell carcinoma (RCC).Methods A total of 53 patients (32 men and 21 women;age range,21 -76 years) with unilateral RCC and a normal contralateral kidney underwent NSS.The disease course ranged from 1 week to 13 months.The unilateral RCCs were detected by B-uhrasonography. Partial nephrectomy was performed on 38 cases of polar RCC and wedge nephrectomy was performed on 15 cases of central RCC.Both renal vein and artery were blocked for 10 - 15 min,and unclamped for 1 -2 min if necessary.The resections were finished within 7 -21 min (mean,12 min).No inosine and regional hypo- thermia were used during operation.Absorbable hemostatic gauze and terylene flake were used to suture renal wound surface.After operation all patients were treated with interferon hypodermic injection of 5 000 000 U every other day for 3 months.Results The diagnosis of RCC with negative cutting margin was confirmed by pathological examination in all patients.The greatest dimension of the renal cancers were＜4 cm except for one of 6 cm.The clinical stage was T_1N_0M_0 in all patients.During the follow-up of 6 -48 months,all pa- tients were alive without recurrence and had normal renal function.Conclusions NSS can be rapidly per- formed for T_1 stage renal cancer＜4 cm or single clearly localized cancer＞4 cm in diameter.The follow-up results are satisfactory.

Objective To assess the effectiveness of absorbable screws and metallic devices for treating tibial plateau fractures.Methods Fifty-seven cases of tibial plateau fractures were treated with internal fixation using absorbable screws(Group A),cannulated screws(Group B)and condylar buttress plates(Group C)in our hospital.According to Schatzker classification,there were 15 cases with typeⅠfractures,21 with typeⅡ,nine with typeⅢand 12 with typeⅣ,who were followed up for 6-51 months. Statistical analysis was performed to compare bone union and functional restoration of the knee between three groups.Results Bone union was achieved in all cases.Based on Merchant scale for knee func- tion,excellence rate was 84%(16/19)for Group A,92%(11/12)for Group B and 85%(22/26) for Group C,with no significant statistical difference.Conclusion Absorbable screws is as effective as metallic devices for treating tibial plateau fractures and has advantages of minimal invasion,few complica- tions and avoiding secondary operation.