Objective To explore the value of MR dynamic contrast-enhancement in diagnosis and differential diagnosis of infiltrating ductal carcinoma of breast at 3.0T MR magneton.Methods 17 cases of breast infiltrating ductal carcinoma underwent plain MRI and MR dynamic contrast-enhanced scan using 3.0T MR scanners with dedicated breast coil.All cases were confirmed by surgery and pathology.MRI signal intensity,morphology and hemodynamic characteristics of lesions were analysed.Results 17 breast infiltrating ductal carcinomas in 17 cases all appeared as masses,low(8/17)or equal(9/17)signal intensity on T_1WI,high(14/17)or equal(3/17)signal intensity on T_2WI.On morphology,the lesions were irregular and lobulated in shape(82.4%,14/17);undefinite margins(12/17)or non-smooth margins(15/17),glitch sign or astral sign(7/17);the lesions showed non-uniform marked enhancement(10/17)or ring enhancement(5/17)after intravenous administration of contrast agent.82.4%(14/17)of the lesions,the blood vessels could be seen gathering around the lesions on the maximum intensity projection(MIP)image.On hemodynamics,the early enhanced ratio for all cases was over 90%;88.2%(15/17)of the lesions,peak enhancement was less than three minutes;the time-signal intensity curve of the lesions appeared as type Ⅱ was 35.3%(6/17)and type Ⅲ was 58.8%(10/17)mostly.Conclusion Dynamic contrast-enhanced MRI manifestations of breast infiltrating ductal carcinoma are of certain characteristics,which may contribute to the diagnosis and differential diagnosis.

Objective To assess the altered regional homogeneity (ReHo) of local intrinsic cerebral activity within sensorimotor network(SMN) in patients with cervical spondylotic myelopathy (CSM) before or after spinal cord decompression using functional MRI (fMRI). Methods Twenty-one CSM patients who would decompress spinal canal, and 21 healthy volunteers (age, gender and level of education matched) were enrolled from June 2013 to April 2014. All the patients underwent rs-fMRI examination before and 3 months after spinal cord decompression. ReHo measurement was performed statistically within a SMN mask. A second-level random-effect 2-tailed Student's t test was applied to compare the ReHo results between pre-and post-operation CSM patients and healthy volunteers. A second-level paired 2-tailed Student's t test was applied to compare the ReHo results between pre-and post-operation CSM patients. Pearson correlation analysis was performed to assess the correlations between the altered ReHo and clinical evaluation. Results Compared with healthy volunteers, pre-operation patients showed significantly lower ReHo in the left postcentral gyrus/precentral gyrus, together with enhanced ReHo in the right superior parietal lobule (GRF correction, P<0.05). Post-operation CSM patients showed significantly lower ReHo in the right superior parietal lobule comparing with healthy volunteers, as well as enhanced ReHo in the left postcentral gyrus/precentral gyrus comparing with pre-operation (GRF correction, P<0.05). Abnormal ReHo areas in CSM patients demonstrated no significant correlation with clinical measurements (P>0.05) between pre-operation and post-operation. Conclusions Myelopathy in cervical cord may affect intrinsic cerebral activity, as patients with CSM show disrupted regional homogeneity within sensorimotor network. The change of ReHo following decompression suggests that central plasticity may influence functional recovery.

Objective To determine kinetics of TNF-α and miR-146a (microRNA-146a)expressions in lipopolysaccharide (LPS)-induced NR8383 alveolar macrophages (AM) at different intervals and their relationships in order to explore regulatory effect and mechanism of miR-146a on alveolar macrophages inflammatory responses.Methods NR8383 alveolar macrophages were seeded in a 6-well plate,and stimulated with 1 μg/ml of LPS for 0 h,3 h,6 h and 12 h separately after 90 min.Cells were harvested and supernatant were collected 0 h,3 h,6 h and 12 h after incubation.The expressions of miR146a and TNF-α mRNA in cells were detected by real-time qPCR and the levels of TNF-α protein in the supematant of cells were assayed by enzyme-linked immunosorbent assay ( ELISA ).Pearson correlation analysis was used to analyze the correlation between miR-146a and TNF-α mRNA.Results ①The level of TNF-α protein in the supernatant of cell was significantly increased 3 h after LPS challenge ( 359.80 ±57.54) pg/ml (P ＜0.01 ),and peaked 12 h later (729.22 ±50.40) pg/ml (P＜0.01 ) ; ②the expression of TNF-α mRNA peaked 3 h after LPS challenge (67.48 ±24.52) fold,P ＜0.01 ),and then decreased gradually; ③the expression of miR-146a mRNA increased continuously until 6 h or 12 h after LPS challenge 6 h:(5.33 ±0.81) fold,12 h:(8.21 ±1.19) fold,(P＜0.01),and it showed an upward tendency;④ the expression of miR-146a mRNA was negatively correlated with TNF-α mRNA ( r =-0.895,P ＜0.01).Conclusions The miR-146a mRNA showed a negative correlation with TNF-α mRNA present in lipopolysaccharide-stimulated alveolar macrophages,suggesting miR-146a mRNA involved in regulating the inflammatory response of alveolar macrophages.

Objective ToanalyzetheCTimagingfeaturesofatypicalpulmonaryhamartomas,soastounderstandthecausesof misdiagnosisandimprovetheaccuracyofdiagnosis.Methods 18caseswithatypicalpulmonaryhamartomasconfirmedbypathology inourhospitalwerecollectedretrospectively,including9 malesand9females.18caseswereexaminedbychestCTscans,among which,2caseswithplainscans,and16caseswithenhancedscans.TheresultsofCTimagingwereanalyzedbytwoassociatechief radiologistswithdoubleblindmethod,observingthelesionlocation,size,edge,border,density,enhancementfeatures,theremaining lungtissue,theageofonset,history,andclinicalmanifestations.Results Inall18cases,3caseswereendotracheallesion,ofwhich1 casewasinleftmainbronchus,theothertwowereinrightmiddleandupperbronchusrespectively,showingcalcificationdensityand subsequentatelectasis;15caseswereperipherallesions,including7casespresentingrightpulmonarynodulesand8casespresenting leftpulmonarynodules.Allperipheralcasesweresolitarypulmonarynoduleswithoutcalcificationandfatdensity.Thediameterof nodulesrangedfrom0.3cmto2.1cm.5casesshowedsmoothroundisolatednodulesand10casesshowedshallowlobulatednodules. In16casesofenhancedscan,1lesionshowedremarkableenhancement,6lesionsshowedslightlyenhancement,and9lesionsshowed nosignificantenhancement.Conclusion PulmonaryhamartomaislackofcharacteristicofCTimaging,whichisthemainreasonof misdiagnosis.Recognizingitsdiverseimageperformancesincludingshallowlobulation,roughedge,remarkableenhancementandetc. helpsusavoidmisdiagnosis.

Objective:To investigate the detection rate of motoric cognitive risk(MCR)syndrome and explore the possible risk factors at different age groups.Methods:A total of 561 patients from geriatric outpatient clinic of Hubei Provincial Hospital of Traditional Chinese Medicine from November 2018 to December 2019 were divided into two age groups under 70 years old(n=241)and 70 years old and above(n=320). The general information, Pittsburgh Sleep Quality Index, Geriatric Depression Scale-15(GDS-15), 4-meter walking test, Mini-Mental State Examination and Morse Fall Scale were collected.Patients with MCR were screened out according to the MCR diagnostic criteria.Logistic multiple regression analysis was used to analyze the associated risk factors.Results:7 cases(7/241, 2.9%)met the MCR diagnostic criteria in age<70 years group, and 34 cases(34/320, 10.7%)in age ≥ 70 years group.The proportion of hearing impairment complaints and GDS-15 scores of MCR patients were higher than those of the non-MCR group in age<70 years group, and the Morse Fall Scale of MCR patients was higher than that of the non-MCR group in age ≥70 years old group( P<0.05). After adjusting for associated confounding factors, multiple logistic regression analysis showed that hearing impairment complaints( OR=26.394, P<0.05)and GDS-15( OR=1.385, P<0.05)were independent risk factors for MCR in age<70 years group.And female( OR=0.445, P<0.05)was a protective factor for MCR in age ≥70 years old group. Conclusions:Motoric cognitive risk syndrome has different risk factors in different age groups, which may indicate that the causes and predictive significance of MCR in these two different age groups are different.

【Objective】 To explore the surgical characteristics and clinical efficacy of percutaneous endoscopic visualization trephine for thoracic spinal stenosis. 【Methods】 We made a retrospective analysis of 37 patients with single-segment thoracic spinal stenosis treated with percutaneous endoscopic visualization trephine from January 2019 to June 2020. Among them， there were 14 males and 23 females； their age ranged from 31 to 82 years old， with an average of （57.6±11.8） years old. Their posture， length of hospital stay， length of operation and blood loss were recorded. The visual analogue scale （VAS）， Oswestry disability index （ODI） and the modified Japanese Orthopaedic Association （JOA） score were used to evaluate the preoperative and final conditions of patients and calculate the improvement rate. 【Results】 The operation was successfully completed in all the patients， and no patients developed epidural hematoma， incision infection or postoperative paralysis. Among the 37 patients， 24 ones with ossification of ligamentum flavum （OLF） were in the prone position， and 13 patients had lateral surgery. Among them， thoracic disc herniation （TDH） occurred in 3 cases， OPLL in 5 cases and OLF+OPLL in 5 cases. The hospital stay was （7.2±1.6） days， the operation time was （96.5±20.0） min， and the blood loss was （41.9±10.8） mL. VAS score decreased from （7.0±0.9） to （1.9±0.8）； ODI improved from （41.7±2.1） to （16.1±1.7）； and JOA score increased from （5.8±1.4） to （8.6±1.4）. The preoperative and postoperative differences were statistically significant （P<0.05）. 【Conclusion】 Percutaneous endoscopic visualization of thoracic spinal stenosis is treated by choosing different positions according to the type of compression. The spinal canal is fully decompressed. The surgical method is safe and minimally invasive， and the postoperative effect is satisfactory.