Objective To evaluate the b value of diffusion-weighted(DW)MRI in distinguishing between benign and malignant breast lesions.Methods Three diffusion-weighted sequences were implemented with 500,1000 and 2000 s/mm~2 b values respectively on 95 breast lesions in 83 patients.All lesions were confirmed by pathology.The apparent diffusion coefficient(ADC)values and signal intensity (SI)were recorded and compared in different lesions(breast cancer,benign lesion,cyst and normal beast tissue)with the same b value and the same lesions with the different b values.Results(1)The mean ADC value and SI of breast cancer were 1.375?0.378 and 839.713?360.493 respectively with b= 500 s/mm~2,1.176?0.311 and 459.314?229.609 with b=1000 s/mm~2,0.824?0.198 and 243.825? 110.616 with b=2000 s/mm~2.The differences in the mean ADC value were significant between two type lesions(cancer and benign lesion,cancer and cyst,cancer and normal breast tissue)with b values of 500 s/mm~2 and 1000 s/mm~2.But the significant differenee was only seen between cancer and benign lesions when b value was 2000 s/mm~2.(2)The one-side upper limits of 95% confidence interval of mean ADCs were adopted as the point to separate the malignant from the benign lesions,the sensitivity was 70.92%, 70.73% and 69.77%,the specificity was 77.19%,75.70% and 54.76%,the accuracy was 77.12%, 74.32% and 62.35% respectively with b values of 500 s/mm~2,1000 s/mm~2 and 2000 s/mm~2.The areas under ROC eurves were Az_(500)=0.775?0.046(P0.05).Conclusion DWI MRI is useful for the differential diagnosis of breast lesions with b values of 500 s/mm~2 and 1000 s/mm~2.

Objective To study the effect of bromocriptine(BRC) on the activation of T lymphocyte stimulated by phytohemagglutinin(PHA).Methods After CD4+ T cell line Jurkat E6-1 cells were stimulated by PHA,prolactin(PRL) and BRC,respectively,the expression of linker for activation of T cells(LAT) and zeta-chain T cell receptor associated protein kinase 70 000(ZAP-70) mRNA of T lymphocytes were checked by RT-PCR.The expression of PRL mRNA of T lymphocytes was detected by Real time PCR.The expression of CD25(cluster of differentiation) as a marker of early activation on the surface of T lymphocytes was detected by flow cytometry,and the activation of nuclear factor-?B(NF-?B) was detected by luciferase reporter system.Results 1.BRC inhibited the expression of ZAP-70 as the common signal molecules both in the T lymphocyte activation pathway and PRL-prolactin-prolactin receptor(PRLR) signal transduction pathway,and decreased the expression of PRL mRNA produced by activation T lymphocytes.2.BRC enhanced the expression of LAT mRNA as another important signal molecular on the T lymphocytes and CD25 on the surface of the T lymphocytes.3.The activation of NF-?B of T lymphocytes was decreased.Conclusions BRC might inhibit the activation of T lymphocytes by inhibiting the expression of ZAP-70,the common signal molecules between T lymphocytes activation and PRL-PRL pathway,and PRL mRNA,the like-T lymphocyte growth factor.

Adolescent ; Adult ; Altitude ; External Fixators ; Female ; Follow-Up Studies ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibial Fractures ; pathology ; physiopathology ; surgery ; therapy ; Treatment Outcome ; Young Adult

When the glomerular mesangial cells of rats were cultured in vitro at high glucose concentration,the activity of extraeellular signal-regulated kinase(ERK),the expression of transforming growth factor-?_1(TGF-?_1)mRNA and the content of typeⅣcollagen in the supematant were higher than those at normal glucose concentration.These effects were inhibited by fluvastatin.The results showed that the activation of ERK signal transduction pathways appeared to play a role in the onset and progression of diabetic nephropathy. Furthermore,fluvastatin could protect the kidney by inhibiting ERK signal transduction pathway and TGF-?_1 expression.

OBJECTIVETo summarize the methods and results of the surgical treatment of patients with multiple pressure sores.

METHODSTwenty-one patients with 56 multiple pressure sores, hospitalized from January 2001 to May 2007, were treated with transfer of various skin flaps together with skin grafting. The pressure sores were respectively located in sacrococcygeal region (21 wounds), ischial tuberosity (14 wounds), greater trochanter of femur (13 wounds) and other sites (8 wounds). All the patients were given systemic supporting treatment in perioperative period and early debridement . The wounds were repaired with flaps, fascio-musculocutaneous flaps, or free skin grafts according to their size, depth, position and the condition of adjacent skin and soft tissue. Continuous irrigation, negative pressure suction, regular posture changes in turning frame after operation were also emphasized.

RESULTSTwenty-five wounds were repaired by fascio-cutaneous flap or myocutaneous flap with healing rate of 90%. Thirteen wounds were repaired by adjacent regional flap with healing rate of 85%. Eight wounds were treated with direct suturing,among which 6 healed completely. Ten wounds were treated with free skin grafting,among whom 7 healed completely. Among 9 delayed healing wounds, 4 wounds healed after debridement and suturing or free skin transplantation for second time, 4 wounds healed by dressing change in a short time, and in the last a chronic sinus remained. Follow-up over 6 months, multiple pressure sores recurred in 3 patients.

CONCLUSIONEnhancing systemic supporting treatment in perioperative period, using fascio-cutaneous flap or myocutaneous flap to repair multiple sores, followed by continuous irrigation and negative pressure suction after operation, and regular postural change on turning frame, contribute a rate of success for management of multiple pressure sores.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pressure Ulcer ; surgery ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; Wound Healing ; Young Adult

OBJECTIVETo investigate the optimal operation method for the management of various chronic wounds in legs and feet.

METHODSFifty-one chronic wounds were evaluated according to infection, inflammatory response, and distribution in different areas of the leg and foot. Preoperative treatment was given accordingly, then transposition of skin flap, skin grafting, or amputation was performed. The healing rate after single session operation and average hospitalization were statistically analyzed.

RESULTSThe wound healing rate after single session operation was 86. 3% , the average hospital stay was (17. 8 +/- 2. 1) days, and the appearance and function of the leg and foot after operation was satisfactory.

CONCLUSIONThe appropriate preoperative treatment and operation method conforming to the wound location and evaluation are of vital importance in the management of chronic wounds in the leg and foot. Operation is one of the most effective ways to repair chronic wounds in the leg and foot, and it can shorten the wound healing process and restore the function.

Adult ; Chronic Disease ; Foot Ulcer ; pathology ; surgery ; Humans ; Leg Ulcer ; pathology ; surgery ; Longevity ; Male ; Surgical Flaps ; Wound Healing

Adult ; Aged ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery ; Young Adult

Aim To investigate the protective role of salvianolic acid B ( Sal B ) on cardiac hypertrophy in type 2 diabetes mice , and to explore its influence on peroxisome proliferator activated receptors-α( PPARα) .Methods The type 2 diabetes melitus ( T2DM) mouse model was established by 4 weeks ' high fat diets feeding and one time STZ intraperitoneal injection .The animals were randomly divided into:control, T2DM, T2DM+SalB(100 mg· kg -1 · d-1 ) and Sal B(100 mg· kg -1 · d-1 ) groups.Eight weeks later, heart weight, tibial length, cross section area of cardiomyocytes , protein expression of PPARαin heart tissue were recorded .In vitro, high glucose and high insulin ( HGI ) were used to induce hypertrophic growth in cultured neonatal rat cardiomyocytes ( NRC-Ms) .And cell surface area , 3 H-leucine incorporation , 3 H-D-glucose uptake and PPARαprotein level were measured to observe the effect of Sal B and MK 886, a PPARαinhibitor.Results In T2DM model mice, Sal B could lower heart weight/tibial length and cross sec-tion area of cardiomyocytes , while PPARαprotein level in hearts were improved .In cultured cardiomyocytes , Sal B ( 10 ～100 μmol · L-1 ) ameliorated the in-creased levels of cell surface area ,3 H-leucine incorpo-ration and improved the decreased 3 H-D-glucose up-take and PPARαexpression induced by HGI . But those function could be abolished by MK 886.Conclu-sion Sal B ameliorates cardiac hypertrophy in T 2DM mice, which may be related to its function on PPARαactivation .

The paper described the professional approach of Shanghai Hospital Development Center(SHDC)in developing a professional team of public hospital directors by such means as operation and management-autonomy,fixed tenures system,performance appraisal,part-time job control and income distribution. Recommendations raised include an organic unity of management functions of investors and power of management of the directors to motivate them in their management;building a comprehensive investor management system and strict cadre management mechanism to enhance supervision of the directors.

Objective To look for more serum biomarkers supporting the diagnosis of multiple system atrophy ( MSA) and providing more evidence for early treatment.Methods All patients and healthy controls were enrolled from January 2011 to March 2015 in the First Affiliated Hospital of Zhengzhou University.Demographic features and biochemical examination results were collected.The t test was used to compare the lipid levels between MSA patients and controls.LSD-t test was used to compare the lipid levels among subtypes of MSA patients.Multivariate Logistic regression analysis was conducted to analyze the influencing factors.The relevance between lipid levels and onset age, disease duration and Hoehn & Yahr stage was calculated by Spearman correlation coefficients.Results Participants included 195 MSA patients and 195 age-and gender-matched controls with no neurological diseases.The levels of total cholesterol ((4.33 ±0.90) mmol/L), triglyceride ((1.27 ±0.71) mmol/L), low-density lipoprotein (LDL;(2.70 ±0.76) mmol/L) were significantly lower in patients than in controls ((4.52 ±0.85), (1.47 ± 0.86), (2.85 ±0.71) mmol/L ,t=2.056,2.528 and 2.149 respectively, all P<0.05).The levels of total cholesterol ((4.28 ±0.96) mmol/L) and triglyceride ((1.20 ±0.64) mmol/L) were significantly lower in MSA-P patients than in control group ((4.52 ±0.85), (1.47 ±0.86) mmol/L;LSD-t=1.983, 2.566, both P<0.05).After adjusting for age, gender and histories, the odds ratio ( OR) was 0.31 (95%CI 0.15-0.65, P =0.002 ) for MSA patients in the highest quartile of triglyceride and 0.38 (95%CI 0.17 -0.83,P=0.016) for those in the highest quartile of high-density lipoprotein (HDL), compared with the lowest quartiles.And HDL level was in a significantly positive correlation with onset age (r=0.15, P=0.039).Conclusion Our data suggest that triglyceride and HDL may be associated with the prevalence of MSA, and the lower levels of HDL, the earlier onset of MSA.