Plasma cell mastitis,also known as periductal mastitis or mammary duct ectasia,always occurs in young women.Because of It's Complicated and varied clinical manifestations,it is easily misdiagnosed as breast cancer.Early diagnosis and staging helps to avoid unnecessary surgery.At present,There is no unified understanding to this kind of disease.Modern medicine mainly treated it by surgery while Traditional Chinese medicine believes it shoull be treated internally and externally.Complete resection of the lesion and the cosmetic effect is the focus of current research.This article reviews the progress of research in plasma cell mastitis etiology,pathology,diagnosis and treatment.

Aplastic anemia (AA) is a Tlymphocyte-mediated autoimmune disease. The research on AA was focused on three areas, which were the pathogenesis of immune dysfunction, hematopoietic stem cell damage and abnormal hematopoietic microenvironment. In recent years, more attentions have been paid on abnormal immune mechanisms in the blood. There are complex intracellular cytokine and signal transduction pathway of pathogenesis in AA. And T-bet/IFN-γ signaling pathway plays an important role in development and progression of AA. This article aimed to review T-bet/IFN-γ signaling pathways in AA.

BACKGROUND: Polymethylmethacrylate (PMMA) can ameliorate the condition between vertebral pedicle screws and peripheral bone-matrix interfaces and notably enhance the strength of screw fixation. However, there are several disadvantages during and after operation such as polymerized thermal damaging effect, toxicity and unabsorbable etc. Calcium phosphate cement (CPC) is biocompatible and biodegradable with good biosafty and produce no heat of polymerization, which is a perfect substitute for PMMA.OBJECTIVE: To evaluate the reinforcing effect of CPC on vertebral pedicle screw fixation at biomechanical aspect.DESIGN: Randomized control and repetitive observed measurement.SETTING: Department of Orthopaedics, Second Affiliated Hospital of Nanjing Medical University.MATERIALS: The experiment was conducted in Tongji Medical College of Huazhong University of Science and Technology from August of 2002 to February 2003. ①Two fresh spines from male bodies respectively aged of 52 and 50 years were provided by the Anatomic Department of Tongji Medical College. Ten vertebrae in each spine were obtained (T8-12, L1-5) and taken as 52-year group and 50-year group. Radiographs of these vertebrae were taken to exclude congenital abnormality, fracture, tumor or other pathological changes. Vertebrae in both groups were osteoporoses of grade I and in accordance with experimental requirement.②Main components of solid phase of CPC were micropowder of tricalcium phosphate and tetracalcium phosphate (TTCP) and its main ingredients of liquid phase was citrate solution, which was prepared with solid phase in the ratio of 1g vs 1 mL.Primarily setting-time was 15 minutes and the final setting-time was 12hours with the maximum compressive strength between 45 Mpa and 57 Mpa. ③Diameter of self-made pedicle screws was 5 mm; Length of screw thread segment was 34 mm; Pitch was 2 mm; Depth of screw thread was 0.8 mm.METHODS: ①Biomechanical test of pedicle screw fixation at final solid time of CPC: Vertebrae of 50-year group were taken as testing subjects.Control lateral: vertebral pedicle screws were implanted directly in screw path; Strengthening lateral: vertebral pedicle screws were inserted after fillingwith CPC. After that, specimens were deposited in a thermostated container for twelve hours at 37 ℃. Maximum axial pull-out strength of vertebral pedicle screw was determinated. ②Biomachanical test of vertebra pedicle screw fixation when CPC primarily hardened: specimens in 52-year group were taken as testing subjects. In the same way, vertebral pedicle screw was implanted in the control lateral of vertebral pedicle,while that in the strengthen lateral was implanted after filling of cement,which were placed in the thermostated container for 15 minutes at 37 ℃,the maximum axial pull-out strength of vertebral pedicle in primary setting time were determinated. ③Biomechanical test of CPC in the reinforcement of loose vertebral pedicle screw fixation: vertebrae in 50-year group were selected. Loosened vertebral pedicle screws were re-fixed with CPC for 12 hours. Maximum axial pull-out strength of bilateral screws was tested.MAIN OUTCOME MEASURES: ①Biomechanical testing results of pedicle screw fixation at final solid time of CPC. ②Biomechanical testing results of vertebral pedicle screw fixation when CPC primarily hardened.③Biomechanical testing results of CPC in the reinforcement of loose vertebral pedicle screw fixation.RESULTS: ①Medians of maximum axial pull-out strength of vertebral pedicle screws in control and strengthening laterals in the 50-year group were 620 N and 1 136 N respectively. Compared with control lateral, that in the strengthening lateral increased by 83 % (P ＜ 0.01). Median of anti-cutting stress increased from 1.16 N/mm2 to 2.13 N/mm2 after being strengthened. ②The medians of those in the 52-year group were 554.5 N and 859.5 N respectively and that in the strengthening lateral increased by 55 % in comparison with that in the control lateral (P ＜ 0.01).The median of anti-cutting stress of reinforced bone-screw interface increased from 1.03 N/mm2 to 1.61 N/mm2. ③Maximum axial pull-out strength of vertebral pedicle screws in control and strengthening laterals in the 50-year group of 12 hours after re-fixation were 517 N and 876 N, which respectively increased by 63.6% or 54.2% (P ＜ 0.01) in comparison with median of that of loose screw in the same lateral.CONCLUSION: CPC can enhance vertebral pedicle screw fixation in primary and final setting time, with which loosened screws can be re-fixed.Vertebral pedicle screw in control lateral and strengthening lateral strips from bone-screw interface without peripheral bone and vertebral pedicle being destroyed seriously, which are beneficial to the second insertion of screw.

BACKGROUND:Open reduction and internal fixation cause big trauma and many complications. With the progression of minimal y invasive concept, percutaneous pedicle screw fixation gradual y showed its obvious superiority. ＜br> OBJECTIVE:To compare clinical outcomes of minimal y invasive percutaneous pedicle screw fixation versus open surgery in the treatment of thoracolumbar fracture. ＜br> METHODS:From October 2012 to January 2014, 50 cases of thoracolumbar fractures, including 25 cases in the minimal y invasive percutaneous pedicle screw fixation group and 25 cases in the open surgery group, were retrospectively analyzed. The differences in length of skin incision, intraoperative blood loss, operation time, postoperation hospital stay, and visual analog scale scores were compared. Serum creatine kinase activity and C-reactive protein levels were measured before surgery and at 24 and 48 hours after operation. Imaging results were used to observe vertebral height and kyphosis Cobb’s angle changes. ＜br> RESULTS AND CONCLUSION:Compared with the open surgery group, the length of skin incision was smal er and intraoperative blood loss was less, operation time, bed time and hospital stay were shorter, and pain of the wound was lighter in the minimal y invasive group. No significant difference was found in serum creatine kinase activity and C-reactive protein levels between the two groups. Serum creatine kinase activity and C-reactive protein levels were higher at 24 and 48 hours after treatment compared with before treatment in both groups. Serum creatine kinase activity and C-reactive protein levels were higher in the open surgery group than in the minimal y invasive group at 24 and 48 hours. There were significant differences in vertebral height and kyphosis Cobb’s angle in both groups after treatment compared with before treatment (P＜0.01). No significant difference in vertebral height and kyphosis Cobb’s angle was detected between the two groups after treatment (P>0.05). Results indicated that minimal y invasive percutaneous pedicle screw fixation and open surgery in repair of thoracolumbar fractures had similar outcomes. However, the trauma of minimal y invasive percutaneous pedicle screw fixation was apparently less than open surgery.

Objective To evaluate the pelvic floor function in post-hysterectomy patients. Methods Transperineal pelvic ultrasound was used to observe the pelvic organs in post- hysterectomy patients, and parameters of pelvic floor were measured. Taking the inferior margin of public symphysis as the reference plane,the shape and motion of the proximal urethra and bladder neck were observed at rest and on maximum Valsalva maneuver. Bladder neck-symphyseal distance(BSD) and retrovesical angle were measured. And the bladder neck descent(BND),urethral rotation angle and the rotation angle of the bladder neck were also calculated. Interclass correlation coefficients were calculated to evaluate the consistency of data. Results At rest,the BSD and retrovesical angle were (-2.73±0.37)cm and (119.00±22.40)°, while on maximum Valsalva maneuver was (-0.25±0.67)cm and (114.74±21.50)°,respectively. BND was (2.46±0.59)cm,the urethral rotation angle and the rotation angle of the bladder neck was (70.68±19.91)° and (60.81±17.34) °,respectively. Combined with pelvic ultrasound and clinical manifestations,29 cases of pelvic floor dysfunction after hysterectomy were diagnosed (58.00%, 5 cases of stress urinary incontinence, 8 cases of proctoptoma and 16 cases of bladder prolapse). The consistency was very high in measuring BNS, retrovesical angle at rest and on maximum Valsalva maneuver and BND by different observers. The interclass coefficient was 0.90,0.89,0.91,0.88,0.92,respectively. And the interclass coefficient of urethral rotation angle and the rotation angle of the bladder neck was 0.79, 0.88,respectively. These results showed a good interobserver agreement. Conclusion Transperineal pelvic ultrasound is a simple,reproducible and noninvasive imaging method, which can reveal the position and function of female pelvic organ dynamically and evaluate postoperative pelvic floor function.

Objective To compare the immunostaining of human epidermal growth factor receptor-2(HER-2) among three different clones,and to compare with the results of fluorescence in situ hybridization(FISH) detection,to provide evidences for pathological department to select appropriate antibodies.Methods 268 cases of invasive breast cancer were examined by immunohistochemistry using antibodies for HER-2 of 3 different clones.The results were compared with those done by FISH.Results Immunostaining using antibody clone SP3 showed 3+ reactions in 66 cases;Immunostaining using antibody clone EP3 showed 3+ reactions in 53 cases,while using polyclonal HER-2 antibody,80 cases showed 3+ reactions.There was statistical significance between those groups using different clones(P<0.05).Consistent with the FISH results,the Kappa values are 0.76,0.67,and 0.56,respectively.Conclusion It suggests detection of HER-2 using immunohistochemistry should prioritize selecting monoclonal antibodies,especially clone SP3.

Objective To study the technique of modified multi-slice spiral CT aniography(MSCTA) for displaying the whole length of the carotid arteries and the origin of the vertebral arteries,and to evaluate its clinical value.Methods A total of 152 patients underwent modified MSCTA of extracranial carotid artery which scanned from skull base to aortic arch with contrast medium injected from the femoral vein, the image quality and the detection of lesions were assessed in comparison with that of DSA in a few of cases. Results (1) The jugular vein was displayed in 4 cases, only accounting for 2.63%. (2) The carotid segments including the proximal common carotid artery(CCA), the middle CCA, the carotid bifurcation, the internal carotid artery(ICA) bulb and the distal ICA could be visualized adequately by MSCTA,the showing rates were 97.69%,97.69%,97.69%,95.62% and 97.64%,respectively. Furthermore, moderate or severe stenosis detected by MSCTA in 17 cases was closely corresponding with the results of DSA. Conclusion Modified MSCTA of extracranial carotid artery can display the whole length of extracranial carotid artery and the origin of the vertebral arteries satisfactorily without the interference of the jugular, subclavian and innominate veins, and can improve its clinical application.

Objective:To explore the relationship between iodine and hypothyroidism.Methods:Patients with primary hypothyroidism (hypothyroidism group) and healthy people (control group) from Linfen City who first came to the Affiliated Hospital of Shanxi Institute for Endemic Disease Prevention and Treatment in 2017 and 2018 were selected as the research subjects. One random urine sample and fasting venous blood sample were collected from the research subjects. The levels of urinary iodine, blood iodine and serum total triiodothyronine (TT 3), total thyroxine (TT 4), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (TgAb) and anti-thyroid peroxidase antibody (TPOAb) were detected. According to the results of TSH level, hypothyroidism group was divided into hypothyroidism Ⅰ group (TSH≥10.00 mU/L) and hypothyroidism Ⅱ group (4.20 mU/L < TSH < 10.00 mU/L), and they were compared with control group (0.27 mU/L≤TSH≤4.20 mU/L). Results:A total of 97, 96 and 175 research subjects were included in hypothyroidism Ⅰ group, hypothyroidism Ⅱ group and control group, respectively. There was no significant difference in urinary iodine levels among the three groups ( H = 0.631, P > 0.05). The blood iodine levels [(40.70 ± 21.08), (58.59 ± 14.55), (59.50 ± 11.89) μg/L] in the three groups were significantly different ( F = 50.559, P < 0.01), and the blood iodine level in hypothyroidismⅠgroup was lower than that in hypothyroidism Ⅱ group and control group ( P < 0.01). The levels of TT 3 [median (interquartile range): 1.59 (0.99, 2.05), 2.25 (1.98, 2.59), 2.14 (1.89, 2.49) nmol/L], TT 4 [35.18 (16.06, 70.23), 105.68 (83.38, 133.19), 107.18 (89.92, 128.30) nmol/L], FT 3 [3.48 (1.94, 4.52), 5.01 (4.57, 5.50), 5.02 (4.64, 5.55) pmol/L] and FT 4 [7.14 (3.12, 10.76), 15.31 (13.87, 17.11), 16.69 (14.87, 18.20) pmol/L] in the three groups were significantly different ( H = 66.197, 142.461, 94.508, 166.557, P < 0.01). After further pairwise comparison, the levels of TT 3, TT 4, FT 3, and FT 4 in hypothyroidism Ⅰ group were significantly lower than those in hypothyroidism Ⅱ group and control group ( P < 0.01). The levels of TgAb and TPOAb in the three groups were significantly different ( H = 85.507, 101.726, P < 0.01). After further pairwise comparison, the levels of TgAb and TPOAb in hypothyroidismⅠgroup were significantly higher than those in hypothyroidism Ⅱ group and control group ( P < 0.01); and the levels of TgAb and TPOAb in hypothyroidism Ⅱ group were significantly higher than those in control group ( P < 0.01). The correlation analysis showed that urinary iodine was positively correlated with blood iodine ( r = 0.170, P < 0.05); blood iodine was positively correlated with TT 3, TT 4, FT 3, and FT 4 levels ( r s = 0.484, 0.594, 0.383, 0.509, P < 0.01), and it was negatively correlated with TSH level ( r s = - 0.373, P < 0.01). Conclusion:Hypothyroidism patients with TSH≥10.00 mU/L may have low blood iodine level.

Objective To investigate the empathic abilities and the association between empathic abilities and executive function in schizophrenic patients. Methods Empathy with the Interpersonal Reactivity Index-C (IRI-C) and executive function with Wisconsin Card Sorting Test (WCST) , Stroop Color-Word Task (Stroop), Spatial n-back Task (n-back) were applied to 74 schizophrenic patients and 69 healthy controls. Results Compared with healthy controls, schizophrenic patients showed significantly lower total scores ((46. 8 ± 10. 0) vs (51.5 ±9.7), P<0.01),and subscores in Perspective Taking ((9.5 ±4.2) vs (12.2 ±3.9) , P<0. 01), Fantasy ((12.5 ±4.2) vs (15.5 ±3.8), P<0.01) and Empathic Concern((15. 9 ±4.2) vs (17. 3 ±3.4), P< 0.05) ,but higher subscore((8.8 ±5. 1) vs (6.5 ±3.7), P<0.01) in personal distress of IRI-C. A significant difference(P<0.01) were fund on the scores of WCST, Stroop task and n-back task between schizophrenic patients and healthy controls. Pearson correlation analysis showed that the total scores of IRI-C was negatively correlated with the response administered (Ra), the number of responses errors (Re) and non-perseverative errors (nRpe) of WCST (r= -0.293, r= -0.253, r= -0.272, P<0.05) respectively, that empathic concern sub-score of IRI-C was negatively correlated with Ra, Re, perseverative responses (Rp) and perseverative errors (Rpe) of WCST (r= -0.326, r= -0.300, r= -0.294, r= -0.287, P<0.01 -0.05) respectively , but positively correlated with Rfp. of WCST (r=0.279, P<0.05), and that the fantasy subscore of IRI-C was negatively correlated with the reaction time of B part(r= -0.299, P<0.01) and C part (r= -0.322, P<0.01) of the Stroop task. Conclusion Schizophrenics have a general impairment of empathy and executive function,and affective empathy is related to the executive function, suggesting that the impairment of executive function maybe the one of pathological mechanism for the empathic deficit of patients with schizophrenia.

Objective To study the efficacy of L-3,5-diiodotyrosine (DIT) and inorganic iodine (KIO3) in iodine-deficiency Wistar rats.Methods Sixty Wistar rats,weighting about 160-180 g,were divided into two groups according to body weight by the random number table method:iodine-deficiency model (40 rats) was fed with low-iodine food (the iodine content was 35.9 μg/kg);optimal-iodine model (20 rats) was fed with low-iodine food and given with KIO3 water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day.Model was established for 3 months.Iodine-deficiency model was subdivided into low iodine (LI) group,KIO3 group and DIT group,eight,nine,ten rats in each group;from optimal-iodine model,nine rats were randomly selected as optimal iodine (NI) group.LI group was fed with low-iodine food;KIO3 group was fed with low-iodine food and given with KIO3 water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day;DIT group was fed with low-iodine food and given with DIT water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day;NI group was fed with low-iodine food and given with KIO3 water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day.After 3 months,24-hour urine of the rats was collected.According to the method for determination of iodine in urine by As3 +-Ce4+ catalytic spectrophotometry (WS/T 107-2006),iodine content in urine was detected.Rats were anesthetized intraperitoneally with 25％ urethane,blood from abdominal aortic was collected to determinate the serum thyroid hormone [total triiodothyronine (TT3),total thyroxine (TT4),free triiodothyronine (FT3),free thyroxine (FT4)] level in rats by automatic electrochemical luminescence immunoassay.All the rats were sacrificed to analyze the thyroid weight.Results ① The urine iodine showed significant differences in the four groups (x2 =25.24,P ＜ 0.05).The median of urine iodine concentration in the LI,NI,KIO3 and DIT groups were 3.00,286.14,223.37,214.33 μg/L,respectively.The urine iodine concentration in LI group was significantly lower than those of other three groups (all P ＜ 0.05).② The serum TT3,TT4,FT3,FT4 levels showed significant differences in the four groups (F =63.48,140.73,130.20,365.27,all P ＜ 0.05).And the hormone levels in KIO3 group were lower than those of the DIT group [TT3:(1.57 ± 0.20) vs.(1.97 ± 0.18) mmol/L,TT4:(51.23 ± 4.90) vs.(71.94 ± 5.27) mmol/L,FT3:(5.34 ± 0.45) vs.(6.98 ± 0.33) pmol/L,FT4:(26.18 ± 2.30) vs.(35.47 ± 2.28) pmol/L,all P ＜ 0.05].③The color of thyroid in KIO3 and DIT groups became pale pink.The absolute and relative thyroid weight showed significant differences in the four groups (F =225.05,345.40,all P ＜ 0.05).The absolute thyroid weight [(31.76 ± 1.75) mg] and relative thyroid weight [(11.69 ± 3.47) mg/100 g] in DIT group was lower than that of the KIO3 group [(36.31 ± 5.23) mg,(12.83 ± 4.38) mg/100 g,all P ＜ 0.05].Conclusion Animal experimental results show that DIT has a better iodine-supplementing efficacy than that of KIO3.