0.05),respectively;the total cost for Group A was significantly higher than in Group B (1 276.54 yuan vs.1 117.57 yuan,P

Objective Differentiation of breast fibroadenoma from breast cancer is of great importance. The purpose of the ar-ticle was to evaluate the diagnostic efficacy of magnetic resonance imaging(MRI) in the differentiation of breast fibroadenoma from breast cancer in DCE-TIC ( dynamic contrast enchancement-time intensity curve) platform type ( typeⅡ) . Methods Between March 2014 and May 2016, 64 patients were included in our study, 19 patients with breast fibroadenoma and 45 patients with breast cancer. All the patients underwent DCE-MRI ( dynamic contrast-enhanced magnetic resonance imaging) examination before operation. Morpho-logic characteristics, hemodynamic characteristics, EER ( early enhancement rate) and ADC ( apparent diffusion coefficient) values were calculated and statistically compared. Results Among 19 cases of breast fibroadenoma, 9 cases were round or ovoid, 8 cases are lobulated, 2 cases were irregular, 15 cases with clear boundary, 14 cases in mammary gland vascular enlargement, 2 cases of slowinflows, 4 cases of moderate inflows, 13 cases of rapid inflows, and the average ADC value was ( 1. 47 ± 0. 38) × 10-3 mm2/s. Low signal separation present in 11 lesions of fibroadenoma. Among the 45 cases of breast cancer, 17 cases were round or ovoid, 7 cases were lobulat-ed, 21 cases were irregular, 11 cases with clear boundary, 38 cases of mammary gland vascular enlargement, 1 case of slow inflows, 5 ca-ses of moderate inflows, 39 cases of rapid inflows, and the averageADC values was (0.98±0.40)×10-3mm2/s. The shape, (χ2=9.176), margin (χ2=16.452), EER(χ2=18.489) and ADC between breast fibroadenoma and breast cancer were of significantly difference. No significant difference was found in the increased and enlarged blood vessels. The success of ADC values in differentation of breast fibroadenoma from breast cancer was statistically significant( P<0.001), and the area under the curve(AUC)of the ROC, sensitivity and specificity of VE were 94.7% and 71.1%. Conclusion Breast fibroadenoma are in fast inflows in the early phase on the DCE-MRI, and there are differences in morphologic characteristics and mass enhancement ways between patients with breast fibroadenoma and breast cancer. Morphologic characteristics combined with inter-nal low signal separation contribute to the differentiation of breast fibroadenoma from breast cancer.

Objective To evaluate the differential diagnostic value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI) and diffusion weighted imaging(DWI) in adenosis of the breast and breast cancer.Methods 30 cases of adenosis and 45 cases of breast cancer with pathological verification were scanned with DCE-MRI and DWI.The MRI features of the lesions were analyzed, including shape,margin,T2WI singal, features of enhancement, time intensity curve(TIC) type, early enhancement rate(EER),peak time, background enhancement and ADC value.Results The irregular margin with or without spiculation and the heterogeneous enhancement were mostly seen in breast cancer (P=0.002,P=0.009, respectively).The TIC type Ⅲ, EER larger than 100% and peak time within 2 minutes were mostly seen in breast cancer(P<0.001).The ADC of breast cancer and adenosis were (1.03±0.24)×10-3mm2/s and (1.34±0.30)×10-3mm2/s respectively(P<0.001).The features of shape,T2WI singal and background enhancement had no statistical significance between adenosis and cancer(P>0.05).Conclusion DCE-MRI combined with DWI will be helpful to the diagnosis of breast lesions.

Kinematical alignment during total knee arthroplasty is an emerging process, and draws more and more attentions from scholars. Knee joint is close to normal joint after TKA through kinematical alighment, which has good clinical results and functional scores, and not increase failure probility. Thus, it may increase joint stress of patella-femur joint, lead to patellar maltracking and increase abrasion. The paper summarized defination and basical principle, operative method, clinical outcomes and deficiency of kinematical alignment during total knee arthroplasty, in order to choose a better way for kinematical alignment during total knee arthroplasty.
Arthroplasty, Replacement, Knee ; methods ; Biomechanical Phenomena ; Humans

Child ; Critical Care ; Humans ; Intensive Care Units, Pediatric ; Medical Records ; Severity of Illness Index

Objective To study the effect of implanted stent or selected operation in patients with acute occlusion of right coronary artery during the emergency coronary arteriongraphy. Methods Forty-three patients with acute occlusion of right coronary artery who underwent the emergency coronary arteriongraphy were divided into two groups: the implanted stent group ( n = 23) during the emergency coronary arteriongraphy and the selected operation group (n =20) during the emergency coronary arteriongraphy . Then we observed the general data, the coronary artery pathological changes, preoperative and postoperative thrombus, the blood flow, remained stenosis and the prognosis. Results The implanted stent group was similar to the control group in general condition, but implanted stent group was significantly different from the control group in the near, intermediate and distal coronary artery pathological changes ( <0.05) . The control group was significantly different from the implanted stent group in the thrombus and slowly blood flow ( <0.05) . After three months, we reviewed coronary arteriongraphy and selected operation, The implanted stent group was significantly different from the control in the remained stenosis and slowly blood flow (<0.05) . But the implanted stent group was similar to the control groug in the thrombus and new proceeding cardiovascular events. Conclusion When thrombus appears in acute occlusion of right coronary artery, we can implant stent during the emergency coronary arteriongraphy if the thrombus is little, or we can select operation after PTCA on the contrary.

OBJECTIVETo compare the early clinical outcomes of primary total knee arthroplasty in the valgus knee between mobile-bearing prosthesis and fixed-bearing prosthesis.

METHODSFrom January 2011 to December 2013, 17 patients (23 knees) treated by the same surgeon were selected for a retrospective study in the First Hospital of Jilin University, including 2 males and 15 females with a mean age of 61.5 years old (48 to 75 years). The pre-operative diagnosis included osteoarthritis (14 patients, 19 knees) and rheumatoid arthritis (3 patients, 4 knees). The patients with valgus deformity were divided into group A and group B. The patients in group A were treated with the fixed-bearing prosthesis (9 patients, 12 knees), and the patients in group B were treated with the mobile-bearing prosthesis (8 patients, 11 knees). The Knee Society Score (KSS), Hosptial for Special Surgery (HSS), Western Ontario MacMaster (WOMAC), the range of motion (ROM) and femorotibial angle were collected at pre-operation and post-operation follow-up for statistical analysis.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 36 months (mean 25 months). The valgus deformity was corrected in all patients, and there were significant differences for all patients between pre-operation and post-operation at the latest follow-up with regard to the KSS knee score, function score, HSS score, WOMAC score, ROM and femorotibial angle (P<0.01). There were no significant differences in KSS knee score, function score, HSS score, WOMAC score, improvement in ROM and femorotibial angle between two groups at the latest follow-up. However there were significant differences in ROM (P<0.05) between fixed-bearing group (101.8±8.8)° and mobile-bearing group (108.4±7.2)° at the latest follow-up. No case with spin-out of mobile bearing was observed. There were no complications in any patient, such as infection, common peroneal nerve injury, dislocation and instability. The X-ary imaging showed no osteolysis or implant loosening.

CONCLUSIONThe early clinical outcomes of primary total knee arthroplasty by using mobile-bearing prosthesis and fixed-bearing prosthesis are satisfactory for the treatment of the valgus knee, and the short term clinical outcomes of mobile-bearing TKA and fixed-bearing TKA are similar.

Aged ; Arthritis, Rheumatoid ; physiopathology ; surgery ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Joint Deformities, Acquired ; surgery ; Knee Joint ; surgery ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; Range of Motion, Articular ; Retrospective Studies

OBJECTIVETo improve the method for monitoring sleep state and respiratory rhythm of SD rats, providing a solution for rats' chewing on the wires, signal loss and instability problems in the animal model of sleep apnea syndrome (SAS).

METHODSWe improved monitoring electrodes of both electrocorticogram (ECoG) and electromyogram (EMG), signal circuit and animal operation.

RESULTSOperation time was shortened and wound exposure time was reduced, which made it easier for postoperative recovery. The ECoG and EMG signals were more stable with sharp image, and signal circuit lines had better conductivity and material durability, achieving continuous monitoring for a long time and high success rate. We could precisely distinguish the sleep wake state and the sleep apnea events in rats according to these signals.

CONCLUSIONThe improved method is more reliable and practical to test the small animal model of SAS, and is more easily to operate and the signals are more stable.

Animals ; Electroencephalography ; methods ; Electromyography ; methods ; Models, Animal ; Monitoring, Physiologic ; methods ; Rats ; Respiration ; Sleep ; Sleep Apnea Syndromes ; diagnosis

Objective To evaluate the feasibility and effect of three-points ablation approach in in treatment of typical atrial flutter guided by CARTO. Methods Twenty-six patients with typical atrial flutter diagnosed by ECG and electrophysiological study (EPS) were enrolled in this study. Activation sequence mapping and linear ablation were performed in 11 patients (conventional group) . Three-points guided linear ablation with CARTO system was performed in another15 patients (three-points group) . Results There was no significant difference in the success rate between the two groups. Both the procedure and fluoroscopic time in three-points group were significantly shorter than that in conventional group [(72.66±29.82) vs (102.52±32.61) min;(4.26±2.76) vs (7.32±3.16) min] . Conclusions The three-points ablations approach is as safe and effective as conventional ablation approach in treatment of typical atrial flutter;however,the former can significantly shorten the procedure time and fluoroscopy time.

CTB protein possessed mucosal adjuvant immunoactivity. The CTB gene was amplified by PCR method from a strain V. cholerae. The nucleotide sequence of CTB gene was 375 bp and shared 96.0%~99.2% homology with other 6 CTB genes. The recombinant plasmid pTWIN1-CTB transformed E. coli strain BL21(DE3) expressed with 0.8 mmol/L IPTG. The molecular weight of expression products was identical with expectative weight by SDS-PAGE electrophoresis. The CTB fusion proteins mainly assembled inclusion bodies and the outputs of proteins were approximately 20% of the total bacterial proteins. The CTB proteins possessed mucosal immunoactivity by GM1-ELISA assay.