Objective To evaluate the value of 64-slice spiral CT angiography in diagnosing diabetic leg arteriosclerosis obliterans(DLASO).Methods 64-slice spiral CT angiography was done in 90 patients with diabete and suspected vascular disorders of lower limb.Images were analyzed on the basis of the transverse CT source data including the maximum intensity projection(MIP),volume rendering(VR),multiplanar reconstruction(MPR) and curved planar reconstruction(CPR).Results 64-slice spiral CT angiography could exactly show the space relationship and anatomical detail of aortoiliac and lower extremity arteries.Arteriosclerostic obliterans was found in variant degree in 67 cases(67/90),of them,49(56.3%) were slight to medium arteriostenosis,18(20.7%) were obvious arteriostenosis and 7 were complete obstructed with collateral circulation.Conclusion 64-slice spiral CT angiography is of significant value in the assessment of arteriosclerosis obliterans of lower extremity arteries in the patients with diabetes.

Objective To determine the technological conditions for the purification of the total alkaloid from the Corydalis Rhizoma (CR) by macroporous adsorption resin. Methods Total alkaloids of CR were determined by acid dye colorimetry, palmatine hydrochloride, dehydrocorydaline, tetrahydropalmatine, and corydaline were determined by HPLC. Six macroporous adsorption resins were investigated with the absorption rates, elution rates, and the content of the total alkaloid and four alkaloids of CR by static and dynamic adsorbing experiments. The purification process conditions of the total alkaloid of CR were optimized by the loading amount and volume flow of sample, the type and volume of the impurity removal of solvent and elution solvent and so on. The stability of the purification process was investigated by 5, 10 times enlargement. Results D141 type macroporous adsorption resin was the best choice for the purification of the total alkaloid from CR, the optimized parameters were as follows: Drug concentration was 0.6 g/mL of medicinal material and was added to the D141 macroporous resin column that the ratio of diameter to height range from 1:5 to 1:9 at a flow rate of 2 BV/h to 2 BV, 1.3 BV of purified water was used to remove impurities, and then 6 BV 95% ethanol was used as eluent at a flow rate of 2 BV/h. The purity of the total alkaloid of CR was up to 68.19% after purification, and the content of palmatine hydrochloride, dehydrocorydaline, tetrahydropalmatine, and corydaline was 1.95%, 11.74%, 4.93%, and 6.36%, respectively. The purity of the total alkaloid of the CR can reach more than 65% by 5 times and 10 times enlargement. Conclusion The purity of the total alkaloids can reach more than 65% after verification test, and the transfer rate of total alkaloids and four alkaloid monomers of CR can reach more than 85%, indicating that D141 macroporous adsorption resin can effectively purify total alkaloids from CR, and can be applied to industrial production.

Objective To assess the efficacy of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the breast in the detection of residual lesions of early stage breast carcinoma after lumpectomy. Methods 53 patients with breast masses confirmed to be malignant tumors by pathology after lumpectomy underwent the dynamic contrast-enhanced breast MR imaging and then further surgical treatment by lumpectomy. The DCE MRI-based diagnoses were compared to the results of pathological analyses after the second lumpectomy. Results 17 (32%) cases were detected with abnormal enhancement. 8 cases presented mass-like enhancements , and 6 of them showed tumorous residuals (P < 0.01). 6 presented focal enhancements, taking up 35% and one of them was confirmed pathologically to have tumorous residuals (P < 0.01). 3 cases presented mass-like enhancement, taking up 18% and 2 of them were confirmed with cancerous residuals . MR dynamic enhancement showed 68% of the them presented no abnormal enhancements in the breast and 33 of themhad no residual cancer , taking up 92%. 3 of them were confirmed with tumorous residuals , taking up 8%. The The positive predictive value and negative predictive value of DCE MR imaging for diagnosing residual malignant lesion were 52% and 92%, respectively . Conclusion The dynamic contrast-enhanced MRI of breast is helpful for evaluating residual malignant lesion after lumpectomy and affects positively subsequent treatment.

Objective To investigate clinical efficacy and safety of endoscopic multiband mucosec-tomy(EMBM)for esophageal submucosal tumors(SMTs).Methods Data of 51 patients with SMTs diag-nosed between Jan 2012 and Aug 2014 were retrospectively studied.Of the 51 patients,33 patients(34 le-sions)received EMBMand 18 patients received endoscopic submucosal resection(ESMR).The operation success rates,complete resection rates,procedure time,complications and the follow-up of group EMBMand group ESMR were compared.Results All of 51 cases had successful endoscopic treatment with no perfora-tion,infection or obvious bleeding.Follow-up showed no recurrence after operation.Compared with group ESMR,group EMBM had higher complete resection rate [97.1% (33 /34)VS 61.1% (11 /18 ),P =0.010],shorter operation time[(6.3 ±1.8)min VS (21.4 ±3.8)min,P =0.001]and lower complication rate[6.1%(2 /33)VS 27.8%(5 /18),P =0.024].Conclusion EMBM is simple,safe and effective for treating SMTs originating from muscularis mucosa or submucosa which are less than 2.0 cm in diameter.

Objective To evaluate the clinical value of fiberoptic ductoscopy in diagnosis and treatment of patients with galactophoritis or mammary duct ectasia. Methods From November 2005 to March 2008, fiberoptic ductoscopy were performed in 120 women with nipple discharge. The duct of 95 cases as non-malignant lesion were insufflated and perfusioned with entamycin and dexamethasone. Results Ninty-five of 120 cases were non-malignant disease,which contained one side 81 and two sides 14; the discharge was bloody,ivory, stramineous in 21, 17, 57 patinents, respectively; and the dignosis were 17 mammary duct ectasia, 53 galactophoritis, and 25 mammary duct ectasia with galactophoritis. Of the 95 cases, hich were intradutal insufflated and perfusioned with gentamycin and dexamethasone, the nipple discharge were decreased or disappeared in 81 cases, the effective rate was 85.3%. Conclusion Fiberoptic ductoscopy is a convenient,safe, accurate method in diagnosis and treatment of patients with galactophoritis or mammary duct ectasia.

Animals ; Bone Matrix ; pathology ; Bone and Bones ; pathology ; Collagen Type I ; metabolism ; Collagen Type III ; metabolism ; Disease Models, Animal ; Humans ; Muscle, Skeletal ; metabolism ; pathology ; Osteoblasts ; pathology ; ultrastructure ; Osteoclasts ; pathology ; Osteocytes ; pathology ; Osteogenesis Imperfecta ; classification ; metabolism ; pathology ; Skin ; pathology

Objective:To investigate the correlation between the breast cancer MRI schedule of reinforcement and the shrinkage pattern of tumor after neo-adjuvant chemotherapy, and its clinical significance in the guidance of formulating operation plan. Methods:Dynamic contrast-enhanced MRI scan was performed before chemotherapy and before surgery after a whole-range N-Acety-L-Cysteine (NAC) treatment in 55 patients with loco-regionally advanced breast cancer who received the neo-adjuvant chemotherapy. MRI sched-ule of reinforcement and the shrinkage pattern of tumor after neo-adjuvant chemotherapy were obtained in the treatment, and the corre-lation between the two was analyzed. Results:Of the 55 patients, the unilateral breast mass was found in 54 and the bilateral lesion in 1. There were 56 neo-plastic foci in these patients. The mass-like enhanced image was seen in 24 of the total cases (43%), of which 23 presented with a centripetal shrinkage, 1 with an annular decline, (P<0.01). Multifocal mass-like enhancement image was found in 13 of the total cases, (23%), of which 2 centripetal shrinkages were the singular mass, 11 remained a multifocal lesion after the tumor shrinkage (P<0.01). The mass with peripheral non-tumor-like enhancement image was seen in 8 of the total cases (14%), of which 4 showed a centripetal shrinkage and another 4 a honeycombed multifocal decline (P>0.05). There were 11 of the total cases with non-tu-mor-like enhancement (20%), in which 4 assumed a centripetal shrinkage and 7 a honeycombed multifocal shrinkage (P<0.01). Conclu-sion:The tumor shrinking pattern and its accurate radiological image evaluation are the keys to the selection of breast-conserving sur-gery and the control of local recurrence after treatment of NAC regimen. We can predict the shrinking pattern through the type of the le-sion on baseline before NAC, which is important for the patients and surgeon to get a reasonable expectation in the subsequent treat-ments.

Objective To evaluate the efficacy and safety of the unilateral and bilateral drainage in hilar malignant biliary obstruction with a meta?analysis of relevant studies. Methods A systematic electronic search with keywords “ biliary stent”, “hilar tumor” and “malignant biliary obstruction” was independently performed by two reviewers in major electronic databases of Pubmed, EMBASE, Cochrane Library and Web of Science. A meta?analysis was conducted using Revman 5?? 1 software. Results Six studies were included with a total number of 558 patients, of whom 307 patients underwent unilateral biliary drainage and 251 pa?tients bilateral drainage. There was no significant difference in early complications ( OR = 1?? 03,95% CI:0?? 58?1?? 81,P = 0?? 93), later complications (OR = 0?? 98,95%CI:0?? 46?2?? 07,P = 0?? 95), operation success rate (OR= 1?? 42,95%CI:0?? 76?2?? 66,P = 0?? 28),drainage efficacy or median survival time between the two groups. Compared with unilateral biliary drainage, bilateral biliary drainage had a longer time of stent patency (MD = - 29?? 12,95% CI:- 38?? 55?- 19?? 70,P< 0?? 001). Conclusion Both unilateral and bilateral biliary drainage are safe and effective for hilar malignant biliary obstruction, but more high quality clinical researches are needed.

Objective To observe the effects of intensive lower extremity motor control training on the motor function of lower extremity, balance and walking capability of stroke patients. Methods 40 stroke patients were randomized into the intervention group (n=20) and control group (n=20). Both groups received the routine rehabilitation, while the intervention group accepted the lower extremity motor control training in addition for 6 weeks. Before and after 6 weeks of treatments, they were assessed with Fugl-Meyer Assessment of lower extremity (FMA-L), Berg Balance Scale (BBS), Holden Functional Ambulation Category (FAC); their gaits were analysesd with footprint. Results Both groups improved significantly in scores of FMA-L, BBS, FAC and average step length, stride width, walking velocity (P<0.01) after treatment, and improved more in the intervention group than in the control group (P<0.05). Conclusion Intensive motor control training of lower extremity may promote the recovery of motor function of lower extremities, balance and walking ability of stroke patients.

Objective To evaluate the using of either 225 or 150 microgrammes of mifepristone combined with misoprostol for termination of second-trimester gestation(16～24 weeks).Methods 180 women requesting voluntary induced abortion during gestation 16～24 weeks were randomised to three groups,group 1:oral mifepris- tone 225rag,group 2:oral mifepristone 150mg,and group 3:injected 100rag rivanot by amniocentestis.The total suc- cess rate,once success rate,the interval of having-medicine to uterine-constraction,the volume of bleeding within 2 hours after labour and cervical laceration rate were observed.Results The once success rate of induced labour in group 1 was higher than that in group 2 and group 3(P