Objective To investigate the MRI features and Ki-67 expression and correlation with prognosis in undifferentiated pleomorphic sarcoma (UPS).Methods MRI and clinicopathological data of 34 cases with UPS proved by operation and pathology were analyzed retrospectively(with an average follow-up of 3 years).According to the presence of local recurrence,the data were divided into two groups:no recurrence group (15 cases)and recurrence group(19 cases).Two groups were analyzed according to age,tumor size,location,MRI features (lesions margin,hemorrhage,necrosis,pseudocapsule and perilesional characteristics)and expression of Ki-67.Results The results showed that two groups tumor’s size(P =0.002),location(P =0.025),pseudocapsule(P =0.025 ),peritumoral tissue inva-sion(P =0.008)and expression of Ki-67 (P =0.000)were of statistical correlation with tumor local recurrence.Conclusion Preoper-ative MRI can observe the characteristics of undifferentiated pleomorphic sarcoma,the relationship with the adjacent tissue and local invasive scope,which will be helpful for clinical diagnosis and decision of surgical plan.

Taken Huantiao (GB 30) as breakthrough point, acupuncture manipulations of generating various needling sensations by different physicians are sorted. Types of acupoint needling sensations and conducting directions after acupuncture and all kinds of factors that affect needling sensations are analyzed from new perspectives. It is considered that attention should be paid to acupoint location, postures of patients, manipulation methods, types of needling sensations, transmission lines and duration time of needling sensations, etc.
Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Humans ; Needles ; Sensation

Objective To investigate upper esophageal sphincter (UES)abnormalities in patients with achalasia (AC),and to analyze the correlation between UES abnormalities and clinical symptoms, treatment efficacy.Methods From February 2012 to December 2014,158 patients with AC and received high resolution manometry (HRM)examination were retrospectivly analyzed.According to whether with UES abnormalities,patients were divided into UES normal group and UES abnormal group.Patients of UES abnormal group were sub-divided into UES hypotensive group (UES resting pressure<34 mmHg, 1 mmHg=0.133 kPa),hypertensive group (UES resting pressure>104 mmHg)and impaired relaxation group (residual pressure>12 mmHg).Analysis of Variance,Kruskal-Wallis H test and Chi square test were performed to compare the clinical data and dynamic characteristics of the patients in each group. Results A total of 74 (46.8%)AC patients had UES abnormalities,the majority of whom were impaired relaxation (35 cases,47.3%).The age of patients in hypotensive group ((60.6 ± 10.1 )years)was significantly older than that of hypertensive group ((43.9 ±11 .1 )years)and impaired relaxation group ((46.8±16.3)years),and the disease course (10 years,4 to 30 years)was obviously longer than that of hypertensive group (6 years,1 to 10 years)and impaired relaxation group (8 years,3 to 15 years),and the differences were statistically significant (F = 7.983,H = 13.816,both P < 0.01).There was no correlation between UES abnormalities and clinical symptoms (P >0.05 ).The results of AC subtyping indicated that type Ⅱ AC accounted 55 .7% (88/158).Type Ⅱ AC cases number of UES normal group and abnormal group was 46 and 42 cases,both was majority (54.8% and 56.8%).Among these patients,123 patients finally received peroral endoscopic myotomy (POEM),47.2%(58/123 )of whom had abnormal UES.More than 85 % patients were satisfied at one month after the operation.And Eckardt scores significantly decreased.There was no significant difference in treatment efficacy between the two groups.Conclusions Most AC patients are with UES abnormality,and impaired relaxation is more common.There is no correlation between UES abnormalities and major symptoms.There is no predictive role of UES abnormalities in treatment efficacy of POEM in AC patients.

Objective To explore the association between moxibustion sensation and therapeutic efficacy during moxibustion treatment. Methods By applying Taiyi moxa stick to Shiqizhui (EX-B 8) to treat primary dysmenorrhea, the association between the change of Visual Analogue Scale (VAS) score and the topical moxibustion sensation and transmission types during the 30 min moxibustion treatment was observed. Besides, the occurrence time of transmission, and the transmission distance, width, depth, and direction were recorded. Results Superficial moxibustion sensation occurred in forty patients, of whom, the VAS score changed by (38.50±14.38) mm; heat-penetrating moxibustion sensation occurred in 18 patients, and the VAS score changed by (38.89±12.43) mm; heat-expanding sensation occurred in 6 patients, and the VAS score changed by (45.00±14.10) mm; distant transmission happened in 13 patients, and the VAS score changed by (41.54±13.90) mm. Patients with 4 types of moxibustion sensation had the highest VAS scores both before and after treatment, followed by 3 types, 2 types, and 1 type moxibustion sensation. In comparing the changes of VAS score between 10 min and 20 min treatment and between 20 min and 30 min treatment, the patients with 4 types of moxibustion sensation had the most significant change. Conclusions Different moxibustion sensations occur at different frequencies, and the occurrence of moxibustion sensation is related to the severity of disease condition. The number of moxibustion sensation type can affect the remission process of disease, but can merely influence the treatment result. The single moxibustion sensation (superficial heat only) works faster, usually taking 0~10 min; while the other forms of moxibustion sensation (heat penetrating, heat-expanding, and distant transmission) works slower, usually taking over 20 min.

OBJECTIVETo assess the clinical value of contrast-enhanced ultrasonography (CEUS) in early diagnosis of breast cancer.

METHODSCEUS was performed in 107 cases of ultrasound BI-RADS(®) category 3 or category 4 small breast tumors (diameter no greater than 10 mm) before surgery. The range, type and patter of enhancement of the tumor and the surrounding tissues were observed, and the time-intensity curve (TIC) was analyzed for TIC curve type, basic and peak intensity, enhancement intensity, rising slope, and enhancement intensity. The results were analyzed comparatively between benign and malignant tumors.

RESULTSThe peak intensity, enhancement intensity index and peak time in CEUS were statistically significant between benign and malignant breast tumor (t=-2.310, -2.592, -2.127, P=0.021, 0.010, 0.033), and the intensity difference and rising slope also differed significantly (t=-3.422, -3.388, P=0.001, 0.001). TIC curve type, enhancement pattern, enhancement types and enhancement range were statistically significantly between benign and malignant breast tumor (P<0.001).

CONCLUSIONBenign and malignant BI-RADS(®) category 3 or 4 small breast tumors differ in the peak intensity, enhancement intensity index and peak time in CEUS. More nodular hyperplasia showed no enhancement in CEUS, and 97.8% of the lesions without enhancement are benign. In enhanced breast nodules, malignant breast lesions show more quick wash-in and wash-out type and quick wash-in and slow wash-out type, and the latter is more common; benign lesions often show a slow wash-in and slow wash-out type. In CEUS, the range of enhancement in malignant nodules is wider than that in two-dimensional ultrasound.

Objective: To compare the therapeutic effects of two different moxibustion methods both with tai-yi moxa stick in treating primary dysmenorrhea. ＜br> Methods: Forty-three patients were randomized into two groups by the random number table according to their treatment orders. The causalgic group was intervened by causalgic stimulation with tai-yi moxa stick while the tepid group was treated by mild thermal stimulation with tai-yi moxa stick. Shiqizhui (EX-B 8) was selected for both groups. Visual analogue scale (VAS) was used for observation before and during the treatment by every 10 min to compare the clinical efficacies between the two groups. ＜br> Results: Before treatment, there was no statistically significant difference in pain intensity between the two groups (P>0.05). After treatment, both groups achieved significant improvements in pain intensity (P＜0.05), but the inter-group difference in pain intensity was still statistically insignificant (P>0.05), but the difference was enlarged comparing with that before treatment. The pain relief during the first 10 min of treatment was slower in the causalgic group than that in the tepid group. However, during the later 20 min, the pain relief in the calsalgia group gradually outpaced that in the tepid group. ＜br> Conclusion: The two moxibustion methods with tai-yi moxa stick both have a good instant analgesic effect in treating primary dysmenorrhea. For patients with primary dysmenorrhea, if 30 min is regarded as the treatment time, mild stimulation was suggested to be used for the first 10 min, and causalgic stimulation for the later 20 min to achieve a better curative effect.

Objective:To investigate the effects of oleanolic acid on the growth and migration of keloid fibroblasts.Methods:Keloid tissue samples from 9 patients in the Department of Plastic Surgery of General Hospital of Northern Theater were collected and fibroblasts were cultured in vitro. Fibroblasts were treated with different concentrations of oleanolic acid and divided into three groups: control group added 0.9% NaCl; 5 μmol/L oleanolic acid group added 5 μmol/L oleanolic acid; 10 μmol/L oleanolic acid group added 10 μmol/L oleanolic acid. MTT assay was used to detect cell proliferation; flow cytometry was used to detect cell cycle. Annexin V propidium iodide (AV-PI) staining was used to detect cell apoptosis. Transwell assay was used to detect the migration of oleanolic acid. Western blotting and real-time PCR were used to detect the expression of related proteins and mRNA activity. Each group was made in triplicate. Analysis of variance was used to compare the data among the three groups. LSD- t test was used for pairwise comparison, and P<0.05 was considered to be statistically significant. Results:MTT result showed that oleanolic acid could inhibit the proliferation of cells. After 24 hours, the proliferation of cells in 5 μmol/L oleanolic acid group and 10 μmol/L oleanolic acid group were 0.660±0.020 and 0.460±0.020, respectively, compared with 0.780±0.001 in the control group, F=114.4, P<0.001. Compared with the control group, the difference was statistically significant ( t=5.94, P<0.001, t=15.60, P<0.001); flow cytometry showed that the cell cycle G1/S phase transduction was blocked, 5 μmol/L oleanolic acid group and 10 μmol/L oleanolic acid group were significantly inhibited. The percentage of G1 phase cells in the 5 μmol/L oleanolic acid group was significantly higher than that in the control group ( t=3.14, P=0.030, t=6.38, P< 0.001). AⅤ-PI staining showed that the number of apoptotic cells in the 5 μmol/L oleanolic acid group (0.9%) and 10 μmol/L oleanolic acid group (3.4%) was significantly higher than that in the control group (0.4%), and the difference among the three groups was F=119.6, P<0.001. Transwell assay showed that the migration number of cells in 5 μmol/L oleanolic acid group (57.13 ± 2.65) and 10 μmol/L oleanolic acid group (42.15 ± 2.55) was significantly lower than that in control group (72.27± 3.32), F=101.3, P<0.001. Compared with the control group, the difference was statistically significant ( t=6.50, P<0.001, t=14.41, P<0.001). Western blotting showed that oleanolic acid could inhibit the expression of Cyclin D1, Bcl-2, Bax and MMP2. Compared with the control group, 5 μmol/L oleanolic acid t=8.70, P<0.001, t=5.00, P=0.040, t=12.41, P<0.001, t=10.46, P<0.001; compared with the control group, 10 μmol/L oleanolic acid t=31.61, P<0.001, t=23.17, P<0.001, t=12.11, P<0.001, t=44.52, P<0.001. Real-time PCR reaction showed that the mRNA activity levels of Cyclin D1, Bcl-2, Bax, MMP2 were also inhibited. Compared with the control group, 5 μmol/L oleanolic acid t=5.42, P< 0.001, t=3.11, P=0.040, t=16.11, P<0.001, t=11.71, P<0.001; compared with the control group, 10 μmol/L oleanolic acid t=51.78, P<0.001, t=30.89, P<0.001, t=10.64, P<0.001, t=17.10, P< 0.001. Conclusions:Oleanolic acid (5 μmol/L and 10 μmol/L) can inhibit the proliferation and migration of keloid fibroblasts and induce apoptosis of keloid fibroblasts after treating keloid fibroblasts for 24 hours, which can inhibit the growth of keloid and be used for the prevention and treatment of keloid.

Objective:To observe the efficacy the application of endoscope assisted temporoparietal fascia flap harvest for the second-stage operation in auricular reconstruction of Nagata’s technique for microtia.Method:In this retrospective study, the clinical data were collected from the patients who received microtia reconstruction with autologous rib cartilage at the Department of Burns and Plastic Surgery, General Hospital of Northern Theater Command from January 2015 to January 2022. According to the surgical procedure, patients were divided into endoscopic group and open surgery group. In endoscopic group, endoscope-assisted temporoparietal fascia harvest were performed for the second-stage operation in auricular reconstruction of Nagata’s technique. In open surgery group, temporoparietal fascia flaps were harvested in open surgery for the second-stage operation in auricular reconstruction of Nagata’s technique. Regular follow-up was conducted to observe the survival of the fascia flaps, complications, patient satisfaction, and surgical scars. The patient satisfaction questionnaire for auricular reconstruction was used to assess patient satisfaction, and the patient and observer scar assessment scale (POSAS) was used to evaluate scar formation in the surgical area. Data analysis was performed using SPSS 26.0 statistical software. The measurement data were expressed by Mean ± SD, and the counting data were expressed as cases (%). The T-test was used to compare the age difference, length of hospital stay, intraoperative blood loss, scar length, patient satisfaction, and POSAS scores between the two groups. Chi-square test was used to compare the gender composition and incidence of complications between the two groups. P<0.05 was considered statistically significant. Results:A total of 51 patients were included, with 26 in the endoscopic group (14 men and 12 women) and 25 in the open surgery group (12 men and 13 women). The age of the patients in the endoscopic group was (9.8±2.9) years (ranging from 7 to 17 years), while in the open surgery group was (10.3±3.8) years (ranging from 7 to 17 years). The postoperative follow-up period was (15.4±3.4) months (1 to 2 years), and all fascia flaps survived without any severe complications. There were no statistically significant differences between the two groups in terms of age difference, length of hospital stay, intraoperative blood loss, postoperative satisfaction, sex composition ratio, and postoperative complications ( P>0.05). The scar quality in the endoscopy group was superior to that in the open surgery group, and POSAS scores of endoscopic group were lower than those in the open surgery group, and the difference was statistically significant ( P<0.05). Conclusion:Endoscope assisted temporoparietal fascia flap harvest for the second-stage operation in auricular reconstruction of Nagata’s technique for microtia can minimize scarring, improve the postoperative appearance and is not statistically associated with the appearance of reconstructed auricles or complications.

Objective To assess the clinical value of contrast-enhanced ultrasonography (CEUS) in early diagnosis of breast cancer. Methods CEUS was performed in 107 cases of ultrasound BI-RADS? category 3 or category 4 small breast tumors (diameter no greater than 10 mm) before surgery. The range, type and patter of enhancement of the tumor and the surrounding tissues were observed, and the time-intensity curve (TIC) was analyzed for TIC curve type, basic and peak intensity, enhancement intensity, rising slope, and enhancement intensity. The results were analyzed comparatively between benign and malignant tumors. Results The peak intensity, enhancement intensity index and peak time in CEUS were statistically significant between benign and malignant breast tumor (t=-2.310,-2.592,-2.127, P=0.021, 0.010, 0.033), and the intensity difference and rising slope also differed significantly (t=-3.422,-3.388, P=0.001, 0.001). TIC curve type, enhancement pattern, enhancement types and enhancement range were statistically significantly between benign and malignant breast tumor (P<0.001). Conclusion Benign and malignant BI-RADS? category 3 or 4 small breast tumors differ in the peak intensity, enhancement intensity index and peak time in CEUS. More nodular hyperplasia showed no enhancement in CEUS, and 97.8%of the lesions without enhancement are benign. In enhanced breast nodules, malignant breast lesions show more quick wash-in and wash-out type and quick wash-in and slow wash-out type, and the latter is more common;benign lesions often show a slow wash-in and slow wash-out type. In CEUS, the range of enhancement in malignant nodules is wider than that in two-dimensional ultrasound.

Objective:To investigate the effects of oleanolic acid on the growth and migration of keloid fibroblasts.Methods:Keloid tissue samples from 9 patients in the Department of Plastic Surgery of General Hospital of Northern Theater were collected and fibroblasts were cultured in vitro. Fibroblasts were treated with different concentrations of oleanolic acid and divided into three groups: control group added 0.9% NaCl; 5 μmol/L oleanolic acid group added 5 μmol/L oleanolic acid; 10 μmol/L oleanolic acid group added 10 μmol/L oleanolic acid. MTT assay was used to detect cell proliferation; flow cytometry was used to detect cell cycle. Annexin V propidium iodide (AV-PI) staining was used to detect cell apoptosis. Transwell assay was used to detect the migration of oleanolic acid. Western blotting and real-time PCR were used to detect the expression of related proteins and mRNA activity. Each group was made in triplicate. Analysis of variance was used to compare the data among the three groups. LSD- t test was used for pairwise comparison, and P<0.05 was considered to be statistically significant. Results:MTT result showed that oleanolic acid could inhibit the proliferation of cells. After 24 hours, the proliferation of cells in 5 μmol/L oleanolic acid group and 10 μmol/L oleanolic acid group were 0.660±0.020 and 0.460±0.020, respectively, compared with 0.780±0.001 in the control group, F=114.4, P<0.001. Compared with the control group, the difference was statistically significant ( t=5.94, P<0.001, t=15.60, P<0.001); flow cytometry showed that the cell cycle G1/S phase transduction was blocked, 5 μmol/L oleanolic acid group and 10 μmol/L oleanolic acid group were significantly inhibited. The percentage of G1 phase cells in the 5 μmol/L oleanolic acid group was significantly higher than that in the control group ( t=3.14, P=0.030, t=6.38, P< 0.001). AⅤ-PI staining showed that the number of apoptotic cells in the 5 μmol/L oleanolic acid group (0.9%) and 10 μmol/L oleanolic acid group (3.4%) was significantly higher than that in the control group (0.4%), and the difference among the three groups was F=119.6, P<0.001. Transwell assay showed that the migration number of cells in 5 μmol/L oleanolic acid group (57.13 ± 2.65) and 10 μmol/L oleanolic acid group (42.15 ± 2.55) was significantly lower than that in control group (72.27± 3.32), F=101.3, P<0.001. Compared with the control group, the difference was statistically significant ( t=6.50, P<0.001, t=14.41, P<0.001). Western blotting showed that oleanolic acid could inhibit the expression of Cyclin D1, Bcl-2, Bax and MMP2. Compared with the control group, 5 μmol/L oleanolic acid t=8.70, P<0.001, t=5.00, P=0.040, t=12.41, P<0.001, t=10.46, P<0.001; compared with the control group, 10 μmol/L oleanolic acid t=31.61, P<0.001, t=23.17, P<0.001, t=12.11, P<0.001, t=44.52, P<0.001. Real-time PCR reaction showed that the mRNA activity levels of Cyclin D1, Bcl-2, Bax, MMP2 were also inhibited. Compared with the control group, 5 μmol/L oleanolic acid t=5.42, P< 0.001, t=3.11, P=0.040, t=16.11, P<0.001, t=11.71, P<0.001; compared with the control group, 10 μmol/L oleanolic acid t=51.78, P<0.001, t=30.89, P<0.001, t=10.64, P<0.001, t=17.10, P< 0.001. Conclusions:Oleanolic acid (5 μmol/L and 10 μmol/L) can inhibit the proliferation and migration of keloid fibroblasts and induce apoptosis of keloid fibroblasts after treating keloid fibroblasts for 24 hours, which can inhibit the growth of keloid and be used for the prevention and treatment of keloid.