Objective To study the value of CT lymphography (CT-LG) in evaluating axillary sentinel lymph nodes (SLN) of rabbit with breast cancer using 3D and curved planar reformation (CPR).Methods CT-LG examinations were completed on the VX2 rabbit models bearing breast cancer established by tumor tissue mass suspension injection.All raw data were transferred to a postprocessing workstation, then the 3D and CPR were used to show lymphatic vessel and lymph nodes.On the CT-LG images, one or several lymph nodes displayed firstly in the lymphatic drainage pathway was defined as the SLN which was then confirmed by the biopsy.Results (1) 20 rabbits bearing tumor underwnet CT-LG examinations, and both SLNs and draining lymphatic vessels were detected using 3D and CPR techniques.70% (14/20) of experimental rabbits had fine images, and 16 SLNs and 7 non-SLNs were demonstrated on 14 rabbits on CT-LG images with good quality.(2) 8 continuous lymphatic vessels displayed well, exhibiting a homogeneous and continuous tube with uniform contrast-medium filling on CPR images.Most lymphatic vessels demonstrated well, and the 14 vessels with local interrupt or fuzzy on 3D images showed continuous tubular contrast-filling with heterogeneous high-density on the CPR images from the injection sites to axillary SLN.Among 6 rabbits with poor images, 3 rabbits showed the SLN but without lymphatic vessels on 3D images, 2 showed only initial segment of lymphatic vessel,and 1 had no lymphatic vessel and SLN.(3) A total 24 SLNs were obtained by SLNB,including 18 metastatic SLNs and 6 negative ones.On CT-LG images, there were statistical differences between the metastatic and negative SLNs in the maximum diameter and filling defect (P=0.041 and P=0.001, respectively).However, the short diameter, shape and margin of SLNs had no statistical differences between the two groups (all P>0.05).Conclusion On CT-LG examinations, 3D and CPR images may show axillary SLNs and lymphatic vessels effectively,and CPR can demonstrate more details than 3D.The maximum diameter and fillingdefect of SLN are helpful for distinguishing metastatic and negative SLNs.

Objective To explore the MSCT manifestations of chromophobe renal cell carcinoma (CRCC)and to improve its accu-racy of preoperative diagnose.Methods Clinical and MSCT finding were retrospectively reviewed in 14 patients with CRCC,which were confirmed by surgical pathology or biopsy.Results (1)On plain scanning,most of the CRCC lesions showed round or oval (86.7%,13/1 5)and isodensity (73.3%,1 1/1 5)mass;and the border of 66.7% (10/1 5)lesions were clear.53.3% (8/1 5)of the lesions were heterogeneous with lamellar cystic low density (8 lesions)and coarse ringed and/or foliated calcifications (4 lesions). (2)On contrast-enhanced sacanning,the CRCC lesions showed mild to moderate (86.7%,13/1 5)and heterogeneous (60%,9/1 5) enhancement,and 73.3% (1 1/1 5)of the lesions were persistent enhanced.(3)According to the pathology,80% (12/1 5)of the le-sions was the typical type,20% (3/1 5)was the eosinophilic type,and 0 was the hybrid type.Conclusion CRCC demonstrates cer-tain characteristics signs at MSCT examination.Lesion mostly shows well-circumscribed round or oval mass in the renal parenchy-ma,mild to moderate,heterogeneous and continuous enhancement on the contrast scanning.The diagnosis of CRCC should be con-sidered especially when the lesion has cystic change and coarse ringed and/or foliated calcifications.

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AIM: To investigate the effect of microRNA (miR)-30c on the viability and migratory ability of human umbilical vein endothelial cells (HUVECs) by targeting plasminogen activator inhibitor-1 (PAI-1).METHODS:The HUVECs were transfected with miR-30c mimic and inhibitor or negative control (NC), and then the expression levels of miR-30c, PAI-1 mRNA and protein were detected by RT-qPCR and Western blot.The viability and migratory ability of HUVECs were measured by CCK-8 assay and wound healing test .After bioinformatic analysis, the assessment of miR-30c binding to PAI-1 3’-UTR was carried out using a luciferase reporter gene assay .RESULTS:miR-30c directly down-regu-lated PAI-1 levels by binding to the 3’ UTR seed sequence of PAI-1 mRNA.Furthermore, transfection of a miR-30c mimic down-regulated the expression of PAI-1 at mRNA and protein levels, leading to enhanced migratory ability and viability of the HUVECs.However, transfection of a miR-30c inhibitor up-regulated the expression of PAI-1 at mRNA and protein le-vels, leading to decreased migratory ability and viability .CONCLUSION:Regulation of miR-30c level changes the migra-tory ability and viability of HUVECs by affecting the PAI-1 expression, indicating the involvement of miR-30c in modulating endothelial function .

Objective To describe the radiological features of mastitis.Methods Imaging findings were retrospectively reviewed in 58 women with mastitis,which was confirmed by pathological results.The imaging features were described according to the BI-RADS (breast imaging reporting and data system).All 58 patients had preoperative MRI,while 49 of them were examined with sonograms and 30 with mammograms preoperatively.Results Overall,no remarkable findings were reported on 6 mammography and 2 sonography examinations,but all 58 lesions were identified on MRI in our study.Asymmetrical density (n =16,53.3％) on mammograms and solitary or multiple separated/contiguous hypoechoic mass-like lesions (n =34,69.4％) on ultrasound were the most common signs of mastitis.On enhanced MR images,82.8 ％ (48/58) patients showed non-mass-like enhanced lesions.Multiple,regional enhancement (66.7％,32/48) and separated or contiguous,clumped,rim-like enhancement (63.1％,31/48) were the most common manifestations in non-mass-like enhanced lesions.Of the 58 patients,type Ⅰ and type Ⅱ timesignal intensity curve were detected in 48.3％ and 50.0％ of the patients,respectively.BI-RADS 0 had the highest frequency in reports on mammography (33.3％,10/30),while category 4a was most frequent on sonography (36.7％,18/49) and also on MRI (56.9％,33/58).Conclusion The imaging findings from mammography and US are non-specific for mastitis,therefore,MR can be helpful in the diagnosis,especially in the presence of non-mass-like enhancement that are multiple,regional,separated,or contiguous,clumped,and tim-like.

Objective To establish a carotid siphon aneurysm model in dogs in order to test the mechanical features of a newly-designed Willis covered stent-graft and to investigate the histological reaction of the stent-implanted vessel during a follow-up period of 12 months.Methods Twenty-four saccular sidewall aneurysms were surgically created in twelve dogs(group A)and 12 carotid siphon aneurysms in another twelve dogs(group B).A Willis stent-graft was implanted in each aneurysm.Angiography was performed immediately after the procedure and 1,3,6 and 12 months after the implantation to investigate the aneurysm isolation,endoleak,stent angulation,and the patency or restenosis of the parent artery.Light and scanning electronic microscopy were used to identify aneurysmai sac thrombi,intima hyperplasia and endothelial progress of the stent-loaded arterial segment.Results In group B,postoperative immediate angiography demonstrated that two aneurysms had mild endoleak and three stents became angulated.Follow-up exam 12 months after the procedure revealed that all previous endoleaks disappeared,one parent artery became occluded and three parent arteries developed mild stenosis(＜50%).In group A.occlusion of parent artery was seen in one and mild stenosis(＜50%)in 2 cases.Electronic microscopy revealed new intima formation in all stents,and all aneurysmal sacs were filled with thrombi.In group B.the endothelialization process was not completed until 12 months after the stent implantation,and a marked correlation existed between endothelial cell arrangement and the hemodynamic orientation.Conclusion It is feasible to treat carotid-siphon aneurysm in dog with a Willis stent-graft.The complete endothelialization of the covered stent in tortuous vessel takes longer time than that in rather straight vessel.

Objective Complicated aneurysms located in the cisternal segment of the internal carotid artery(ICA-CSA)present unique therapeutic difficulties.This study is to discuss the feasibility of the Willis stent-graft in treating complicated ICA-CSA by comparing its effect with that of coiling therapy.Methods Willis covered stents were employed in 19 complicated ICA-CSAs(group A),while coils were used in 17 complicated ICA-CSAs(group B).Follow-up angiography was performed to investigate aneurysm recurrence,endoleak and parent artery(PA)stenosis.Kaplan-Meier curves were constructed to compare the recurrencefree and PA stenosis-free rate in both groups.Results Total exclusion was immediately achieved in 13 ICACSAs and minor endoleaks presented in 5 cases in group A.Total or near-total occlusion was achieved in 7 ICA-CSAs.subtotal occlusion in 8 and partial occlusion in 2 cases in group B after coiling.Acute thrombosis occurred in 1 patient in either group and re-hemorrhage happened in 1 patient after coiling.Follow-up angiography in group A revealed that 16 ICA-CSAs were completely isolated,with two parent arteries showing mild in-stent stenosis.Eighteen months after the procedure,Kaplan-Meier analysis showed that the recurrence-free rate was 93.3%and 50%,while the stenosis-free rate of parent artery was 87.5%and 100% in group A and in Group B,respectively.In group A and group B the clinical neurological symptoms were fully recovered in 9 and 9,obviously improved in 3 and 5,unchanged in 2 and 2,and aggravated in one and 0 patients,respectively.Conclusion The implantation of Willis stent-graft is a feasible endovascular therapy for complicated ICA-CSAs.When the parent artery is very tortuous or when the risk that a main collateral branch may be wrongly covered and occluded is present,the implantation of Willis covered stent can not be taken as the treatment of first choice.

Objective To evaluate the value of MSCT in the diagnosis of extrahepatic cholangiocarcinoma.Methods The MSCT appearances of extrahepatic cholangiocarcinoma confirmed by pathology in 27 cases were analyzed retrospectively.Among them,20 patients underwent plain and four-phase dynamic contrast-enhanced CT scans including early arterial phase,late arterial phase,portal phase and delay phase,7 patients only underwent contrast-enhanced CT scans.Results 15 lesions were located in the hilar and 12 lesions were located in the common bile duct.CT features of cholangiocarcinomas in this group were varied with its position and growth pattern.Besides the direct sign such as delay enhancement,the indirect findings were also specific such as hepatic lobe atrophy,dilated bile duct,etc.Conclusion MSCT is of great value in diagnosis of extrahepatic cholangiocarcinoma.

ObjectiveTo investigate the effect of different cyclic strengths on expressions of phospholipase A2 (PLA2) and cyclooxygenase (COX) in human tenocytes.MethodsHuman tenocytes were uniaxially stretched with different stretching intensity (4％, 8％ and 12％) under 0.5 Hz for four hours.Non-stretched tenocytes were applied to the control group.The expressions of cytosolic PLA2(cPLA2), COX1 and COX2 were measured by Western blot and RT-PCR.The secretion of secretory PLA2 (sPLA2) was measured by ELISA.Results The mRNA expressions of cPLA2, COX1 and COX2 in control group, 4％, 8％ and 12％ stretch groups showed an increase trend.But protein expressions of cPLA2 and COX1 in 4％ stretch group were increased insignificantly compared with the control group (P ＞ 0.05).Protein expressions of cPLA2 and COX1 in 8％ and 12％ stretch groups were increased more significantly compared with the control group (P ＜ 0.01).The COX2 expression in 4％,8％ and 12％ stretch groups showed statistical difference compared with that in the control group (P ＜0.01) and the difference increased with stretch intensity.There was no different expression of sPLA2 between 4％ stretch group and control group (P = 0.260).However, expression of sPLA2 was increased markedly in 8％ and 12％ stretch groups (P ＜ 0.01).ConclusionsThe expressions of human tendnocytes PLA2, COX1 and COX2 in vitro are positively correlated with stretch intensity.PLA2/COX system may be a new molecule target in clinical treatment of tendinopathy.

ObjectiveTo evaluate the clinical results of minimally invasive ankle arthrodesis with percutaneous cannulated screws.MethodsBetween April 2005 and October 2010, 12 patients with the ankle arthrodesis for unilateral severe arthritis (Kellgren-Lawrence class Ⅲ) were prospectively analyzed, including 2 cases of rheumatoid arthritis, 8 cases of post-traumatic arthritis, and 2 cases of osteoarthritis. There were 7 males and 5 females with an average age of 42.0 years(range, 25-7 1). The average disease duration was 7.3 years (range, 1-21). The anterior median incision of 3.0-5.0 cm was made to explore the ankle joint.The cartilage of tibial-talus joint was completely debrided. Two guide pins were inserted from posterosuperior to anteroinferior, and cannulated screws were implanted to fix ankle joint. All patients were physically examined with an extended protocol of questionnaires and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot Scales. Ankle fusion in all patients was evaluated by clinical examination, and conventional radiography including anterior-posterior, lateral and mortise views of the ankle. ResultsAll 12 patients were followed up postoperatively for an average of 21.5 months(range, 6-55), and were proved be bone union by clinical examination and radiology with a mean of 13.5 weeks (range, 9-21). The AOFAS rating scale improved from a mean of 42.8±8.6 points at pre-operation to a mean of 66.6±5.4 points at post-operation 6 months,showing significant difference(t=-3.075, P=O.012), and to a mean of 72.3±4.6 at the final follow-up, also showing significant difference with pre-operation (t=-8.595, P=-0.006). There was no infection,local skin necrosis, screw loosing, and so on. ConclusionThe minimally invasive ankle arthrodesis with percutaneous cannulated scews is a recommend procedure, with mini-invasion, short surgery time, high fusion rate, good clinical outcomes, few complications.