ObjectiveTo explore the ability of inhibition resistibility of multiple displacement amplification (MDA)in samples with inhibitors. To explain the application and value of MDA in forensic medicine by comparing with using magnetic beads methods(MBM)to purify sample.MethodsDifferent concentra-tions of hemoglobin and humid acid(HA)mixed with DNA samples and then divided the samples into MDA group, MBM group and control group.D3S1358locus was amplified and detected by polyacry-lamide gel electrophoresis detection system and AmpF?STR? IdentifilerTM Plus Kit-capillary electrophore-sis detection system.ResultsWhen hemoglobin concentrations exceed 1 ng/μL or HA concentrations ex-ceed 0.1 ng/μL, amplification products could not be obtained by single-locus system in control group. When hemoglobin concentration exceeds 100 ng/μL or HA concentrations exceed 1 ng/μL, the samples could not be amplified by MBM. Inhibitors in different concentrations were amplified successfully in MDA group without any influence from inhibitors.ConclusionMDA has the capability to remove the inhibi-tion of hemoglobin and HA, which is better than MBM and has a certain value in forensic practices.

Objective:To evaluate the value of synthetic MRI combined with DWI in the diagnosis of benign and malignant breast lesions.Methods:The data of 184 consecutive patients with suspected breast lesions in Yunnan Cancer Hospital from July to September 2019 were prospectively analyzed. All patients were randomly assigned to training group ( n=110) and validation group ( n=74), and underwent conventional MRI and synthetic MRI respectively before and after contrast injection. At the maximum slice of the lesion, the ROI was drawn along the edge and recorded as "tumor". In the solid area with the most obvious tumor enhancement, the second ROI was drawn and recorded as "local". At the same time, ADC values (ADC local and ADC tumor) and relaxation time values (T local and T tumor) were measured. T and T + represented the relaxation time value of the ROI pre-and post-contrast scanning. ΔT% represented the relative change rate in T value between pre-and post-contrast scanning.The rank sum test was used to test the quantitative parameters of benign and malignant breast lesions in the training group and the validation group, and the variables with P<0.05 were included in the binary logistic regression analysis to screen the independent variables and establish the prediction model. The area under ROC curve was used to evaluate the discrimination of parameters and models. The clinical applicability of model was analyzed by decision curve analysis (DCA). Results:In the training group, univariate analysis showed that there were significant differences in T 1tumor, T 1+tumor, ΔT 1% tumor, T 2local, T 2+local, T 2tumor and T 2+tumor, ADC local, ADC tumor between benign and malignant breast lesions ( P<0.05). Multivariate logistic regression analysis showed that T 1+tumor, ΔT 1% tumor, T 2tumor, ADC local, ADC tumor were independent variables in the diagnosis of breast cancer. The relaxation time model (model A: T 1+tumor, ΔT 1% tumor, T 2tumor) and ADC model (model B: ADC local, ADC tumor) established by combining the above variables had the same diagnostic efficiency (AUC=0.905, 0.914, Z=-1.874, P=0.062), and the multi-parameter combination model (model C: T 1+tumor, ΔT 1% tumor, T 2tumor, ADC local, ADC tumor) had the highest diagnostic efficiency (AUC=0.965). DCA analysis showed that when the threshold probability ranges between 21%-99% (training cohort) and 15%-99% (validation cohort), the net benefit of model C was better than model A and B. Conclusion:The multi-parameter combined prediction model established based on the relaxation time value and ADC can identify breast cancer efficiently and can be used as an auxiliary diagnostic tool.

Objective To investigate the value of breast MRI-abbreviated protocol(BMRI-AP)compared with full field digital mammography(FFDM)and breast MRI-full diagnostic protocol(BMRI-FDP)in the diagnosis of early breast cancer with non-calcified.Methods A total of 95 cases patients with early breast cancer with non-calcified(the longest diameter of the lesion≤2 cm,regardless of the size of the carcinoma in situ)were retrospectively included.Clinical,pathological and imaging data of all patients were collected.All patients underwent FFDM and MRI scanning,and three examination regimens,including FFDM,BMRI-AP,BMRI-FDP,were further obtained.Classification was performed according to the breast imaging reporting and data system(BI-RADS)classification standard(fifth edition)developed by American College of Radiology(ACR),and pathological results were taken as the standard.The diagnostic efficacy for early breast cancer with non-calcified were compared among the different three imaging methods.Results The diagnostic accuracy of FFDM,BMRI-AP and BMRI-FDP for early breast cancer with non-calcified was 76.84%,93.68%and 95.79%,respectively,with statistically significant difference among three groups(χ2=20.558,P<0.001).The median(quartile distance)of BMRI-AP and BMRI-FDP scanning time were 478(5)s and 926(13)s,respectively,with statistically significant difference between the two groups(Z=-11.912,P<0.001).Conclusion The diagnostic accuracy of BMRI-AP is significantly better than that of FFDM and similar to that of BMRI-FDP for early breast cancer with non-calcified.In addition,BMRI-AP can significantly shorten the scanning time without reducing the diagnostic accuracy,which is expected to become a new breast cancer screening method.

Objective To evaluate the application values of diffusion tensor tractography (DTT) combined with neuronavigation in microsurgery of insular gliomas. Methods The clinical data of 27 patients with insular gliomas, admitted to our hospital from March 2013 to October 2017, were analyzed retrospectively. All DTT images were transferred to the neuronavigation system, and the three-dimensional location of tumors and pyramidal tracts were re-constructed. Surgical approaches were designed and excision scopes were defined before the surgery. Techniques on how to distinguish and protect the key blood vessels and pyramidal tracts were discussed. The treatment efficacies were analyzed. Results Total lesion resection was achieved in 22 patients (81.5％), subtotal resection in 4 (14.8％ ), and partial resection in one (3.7％ ). Postoperative pathology indicated 7 were oligodendrogliomas, and 20 were astrocytomas, including WHO grade I in one, grade II in 18, and grade III in one. One patient had transient aphasia (recovery after two weeks), 2 experienced worsened hemiplegia on opposite side of their bodies (normal after one month), and the left 24 patients remained intact function after operation. Conclusions The combination of DTT and neuronavigation is safe and effective in surgical treatment for insular gliomas, which can protect the brain function at greatest degree and maximize lesion resection, and improve the postoperative quality of life.

Helicobacter pylori (Hp) is a Gram-negative bacterium selectively colonized in gastric mucosa, and is one of the main factors inducing chronic gastritis and even gastric cancer. Recent studies have shown that Hp infection induces various stress responses, including oxidative stress, nitrosative stress and endoplasmic reticulum stress. Hp can stimulate neutrophils, macrophages and gastric epithelial cells to express reactive oxygen species and reactive nitrogen species, resulting in excessive accumulation of reactive oxygen species and reactive nitrogen species, aggravating inflammation and damage to gastric mucosa. Such long-term inflammation and oxidative stress may increase the risk of cancer. In addition, Hp induced endoplasmic reticulum stress plays an important role in the early stages of precancerous lesion formation. This article reviewed the research progress of role of stress response induced by Hp infection in gastric mucosal diseases.

Objective: Symptomatic intracranial hemorrhage (sICH) is one of the severe complications of ischemic stroke thrombolysis. Several prognostic scales have been developed to predict the risk of sICH. The performance of seven scales was compared in a single center cohort. Methods: Data of patients with consecutive ischemic stroke who received 0.9 mg/kg intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis within 4.5 h time window from stroke onset were collected. Seven scales that can provide an estimate of risk of sICH were identified and evaluated: Hemorrhage After Thrombolysis (HAT), blood Sugar, Early infarct signs, (hyper) Dense cerebral artery sign, Age, National Institutes of Health (NIH) Stroke Scale (SEDAN), Stroke Prognostication using Age and NIH Stroke Scale (SPAN)-100, Safe Implementation of Thrombolysis in Stroke (SITS), Total Health Risks In Vascular Events (THRIVE), Glucose at presentation, Race (Asia), Age, Sex (male), systolic blood Pressure at presentation, and Severity of stroke at presentation (NIH Stroke Scale; GRASPS) and Multicenter Stroke Survey (MSS). The area under the receiver operating characteristic curve (AUROC) was calculated and Logistic regression and the Hosmer-Lemeshow test were also performed. Results: The current study included 293 patients, of whom 7.85% (23/293) had sICH by National Institute of Neurological Disorders and Stroke (SICH_NINDS), 5.46% (16/293) by Europe Cooperative Acute Stroke Study Ⅱ (SICH_ECASSⅡ) and 4.44% (13/293) by Safe Implementation of Thrombolysis in Stroke (SICH_SITS) criteria. SEDAN had the highest AUROC for predicting sICH: sICH_NINDS: AUROC=0.843, OR=3.167, 95%CI 2.106-4.762, P<0.01; sICH_ECASSⅡ: AUROC=0.797, OR=2.509, 95%CI 1.652-3.812, P<0.01; sICH_SITS: AUROC=0.784, OR=2.172, 95%CI 1.405-3.357, P<0.01. And SPAN-100 had the lowest AUROC among all the seven scales and was only associated with risk of SICH_NINDS in regression analysis. Furthermore, when sub-grouped the cohort into anterior circulation infarction and posterior circulation infarction, regression analysis suggested that all the seven scales were however not associated with sICH risk in patients with posterior circulation infarction. Conclusions SEDAN constantly had the highest predictive power, SPAN-100 had the worst. The seven scales studied could not predict sICH in posterior circulation infarction.