Animals ; Arteritis ; complications ; immunology ; Coronary Artery Disease ; etiology ; pathology ; Coronary Vessels ; pathology ; Models, Animal ; Rabbits

Objective To study the diagnostic value of calcification in differentiating benign and malignant thyroid lesions. Methods CT images of 318 consecutive patients with pathologically proven thyroid lesions were retrospectively reviewed by two radiologists. The following characteristics of calcification on CT images were evaluated: (1) size (≤2 mm indicating microcalcification and > 2 mm or shelly and irregular shape indicating macrocalcification, and both features indicating mixed calcification), (2) number (single or multiple) and (3)location (internal or edge). χ~2 test was used for statistical analysis. Results Oft he 318 cases, 48 were diagnosed as malignant (papillary carcinoma 26, follicular carcinoma 7, medullary carcinoma 3 and microcarcinoma 12) and 270 were benign (nodular goiter 36, adenoma 170, nodular goiter with adenoma 38 and adenoma with Hashimoto's thyroiditis 26). Calcification was found in 60 cases (18.9%). Among them 21 (papillary carcinoma 12,microcarcinoma 6,follicular carcinoma 2 and medullary carcinoma 1) were malignant(43.8%) and 39(nodular goiter 6, adenoma 13,nodular goiter with adenoma 19 and adenoma with Hashimoto's thyroiditis 1) were benign (14.4%) (P < 0.01). Sensitivity and specificity for diagnosing thyroid carcinoma were 43.8% (21/48) and 85.6% (231/270), respectively. Microcalcification was found in 37 cases (malignant 8, benign 29) and macrocalcification was found in 23 cases(malignant 13, benign 10) (P < 0.01) . Sensitivity and specificity of macrecalcification for diagnosing thyroid carcinoma were 61.9% (13/21) and 74.4% (29/39), respectively. Single calcification was found in 31 cases (malignant 13, benign 18) and multiple calcification was found in 29 cases(malignant 8, benign 21) (P >0.05). Internal calcification was found in 15 cases of malignant lesions(71.4%) and 12 of benign lesions(30.8%); Edge calcification was found in 6 cases of malignant and 27 of benign, (P <0.01). Sensitivity and specificity of internal calcification for diagnosing thyroid carcinoma were 71.4% (15/21) and 69.2% (27/39), respectively. Conclusion Internal calcification or(and) macrocalcification of the thyroid lesions may strongly suspect thyroid carcinoma and fine-needle aspiration or surgery should be further performed.

Acute Disease ; Adult ; Ethylene Dichlorides ; poisoning ; Female ; Humans ; Male ; Neurotoxicity Syndromes ; therapy

Objective To detect and analyze the levels of preoperative serum carcino-embryonic antigen (CEA) and CA15-3 in early invasive breast cancer patients and their correlation with pathological parameters. Methods Electrochemical luminescence immunoassay (ECLI) technology was used to detect serum levels of CEA and CA15-3 in 223 cases of early invasive breast cancer patients, 109 patients with benign lesions, and 30 cases of heath control. Immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) were used to detect the estrogen receptors (ER), progesterone recepter (PR), and its HER-2 pathological indicators.Besides, the correlation of serum CA15-3, CEA levels and pathological parameters was analyzed. Results The serum CA15-3 and CEA levels of Breast cancer patients [(22.27±15.11) U/ml, (5.03± 0.49) μg/L] were significantly higher than that of patients in benign lesion group [(14.13±3.04) U/ml, (2.72± 0.11) μg/L] (P< 0.05). CEA level of patients with histological grade Ⅲ was (6.34 ±0.93) μg/L, significantly higher than the level Ⅰ-Ⅱ (4.23±0.50) μg/L (P< 0.05). CA15-3 level was (19.26±15.08) U/ml in T1 tumors, and CA15-3 level was (28.73 ±11.53) U/ml in T2 tumors (P<0.05). The serum levels of CEA and CA15-3 between different histology, pathologic stage, lymph node status, ER, PR, HER-2, pathological characteristics had no significant difference (P>0.05). CEA positive rate of breast cancer group was significantly higher than that of benign lesions(13.5%vs. 3.7%, 26.5%vs. 1.8%, P<0.05). 30 cases of normal control group had no positive one. The joint monitoring sensitivity of CEA and CA15-3 breast cancer group was 9.4 %, the sensitivity was 0 in benign lesion group. There was significant difference (P < 0.05). Conclusion The changes of Serum CA15-3 and CEA levels in breast cancer patients can be considered as the judgment standard for early diagnosis, pathological staging, prognosis and clinical effect monitoring.

Background Diabetic retinopathy (DR) is a common microvascular complications of the retina,retinal vascular smooth muscle cells of large conductance calcium-activated potassium channels (BK) is a major factor in regulating vasomotor and hemodynamic.Currently,functional changes of BK channel in retinal artery smooth muscle cells (RASMCs) and its role in DR were rarely reported.Objective This study was to investigate the early vascular damage mechanisms in DR by detecting the changes of BK channels current,calcium concentration and open probability (NP0) of BK channel with different calcium concentration in RASMCs of normal and diabetic rats.Method Fifty SPF SD 8-12 weeks old rats were randomly divided into normal control group and diabetic model group.Forty diabetic rats was intraperitoneally injected with 60 mg/kg streptozotocin to form type 1 diabetic model,10 rats (the normal control group) were injected sodium citrate solution with the same manner.Fluorescent probe was applied to detect calcium concentration in rat RASMCs;RASMCs were isolated by using enzyme digestion,and BK-channel electric currents and calcium concentrations in the RASMCs were measured by whole-cell patch clamp technique and fluorescence assay,respectively.The NP0 of BK channel was measured by single patch clamp technique.Results Diabetic models were successfully established in 36 rats with the success rate 90％.When stimulation voltage is greater than 60 mV,the current density of BK channel in RASMCs of diabetic model group decreased;when stimulating voltage was 100 mV,the BK channel currents of RASMCs in the normal control group and diabetic model group were (100±23) PA/PF and (50 ± 7) PA/PF,the difference was statistically significant (t =19.80,P ＜ 0.05).After adding specific BK channel blocker African scorpion toxin 100 nmol,the BK channel current in the normal control group significantly reduced,and that in the diabetes model group was not significantly changed;the calcium ion concentrations in RASMCs were (123±11)nmol/L and (255± 10)nmol/L in the normal control group and diabetic model group,the difference was statistically significant (t =32.50,P＜0.05).When stimulation voltage was 60 mV,with increasing calcium ion concentration,the NP0 of BK channel increased (F =15.28,P＜0.05).Conclusions The electric current and NP0 of BK-channel are obviously reduced and the calcium concentration is evidently elevated in RASMCs of diabetic rats,suggesting that the abnormal of BK-channel is probably one of the important causes of retinal artery abnormal contraction in diabetic rats.

Objective To evaluate the diagnostic value of MR cholangiopancreatography(MRCP) using three-dimensional fast recovery fast spin-echo(3D FRFSE) in differentiating benign from malignant causes of biliary and pancreatic duct dilatation.Methods 106 cases suspected biliary and pancreatic duct dilatation underwent 3D FRFSE MRCP.The images were prospectively analysed by two skilled radiologists,and the results were compared with that of surgery,biopsy or follow-up.Results MRCP was successful performed at one time in all cases.On MRCP,the visual rate of intra-and extrahepatic bile duct was 100% and that of main pancreatic duct was 93.4%.80 patients had benign lesions: bile duct lithiasis(n=66),papillitis(n=6),descending part of duodenum diverticulitis(n=2),duodenal adenomatoid hyperplasia(n=1) and chronic pancreatitis(n=5).26 patients had malignant lesions: extrahepatic cholangiocarcinoma(n=9),ampullary carcinoma(n=5),gallbladder carcinoma(n=4) and pancreatic head carcinoma(n=8).The sensitivity,specificity and accuracy in differentiating benign from malignant causes of biliary dilatation were 92.3%,96.3% and 95.3%,respectively.Conclusion 3D FRFSE MRCP plays an important role in diagnosis of differentiating diagnosis of the causes of biliary dilatation in clinical practice.

BACKGROUND:Many studies have confirmed that recombinant human bone morphogenetic protein 2 plays a very important role in bone formation and fracture healing, but recombinant human bone morphogenetic protein 2 alone implanted is prone to diffusion and degradation, which is unable to play a persistent role in new bone formation. OBJECTIVE:To explore the effect of recombinant human bone morphogenetic protein 2 composite bone in the rabbit lumbar fusion. METHODS:Thirty New Zealand white rabbits were selected to make posterior lumbar intertransverse fusion models, and then were randomly divided into three groups, in which, L5-6 intertransverse implantation of autologous iliac bone, al ogeneic bone and recombinant human bone morphogenetic protein 2 composite bone (recombinant human bone morphogenetic protein 2 and al ogeneic bone complex) was done respectively. At 6 weeks after implantation, gross observation, X-ray examination and histological observation were performed. RESULTS AND CONCLUSION:Fusion rate and percentage of new bone area were higher in the composite bone group than the autologous iliac bone and al ogeneic bone groups (P<0.05);the tensile strength was lower in the al ogeneic bone group than the other two groups (P<0.05), but there was no difference between these two groups except the al ogeneic bone group. X-ray films showed cal us formation in the implanted region of the three groups. In the autologous iliac bone group, a large amount of cartilage tissues formed along with a smal amount of bone trabeculae and a certain amount of woven bones. In the al ogeneic bone group, the implant was covered with a large amount of fibrous tissues, bone island was seen and there was also a smal amount of bone trabeculae and cartilage tissues. In the composite bone group, a great amount of bone trabeculae and cartilage tissues were visible to form woven bone and cortical bone. These findings indicate that the recombinant human bone morphogenetic protein 2 composite bone can obtain good effect in the rabbit lumbar fusion.

Objective To evaluate MRI in the diagnosis of the bone contusion of the knee joint and its clinical significance.Methods Using special coil for knee joint,coronal,sagittal,axial and oblique sagittal plane scanning with fast spin-echo sequence(T_1WI,T_2WI,PDWI+FS)was performed on knee joint in 205 patients in three days after injury.According the distributing bone marrow edema and injury mechanism,bone contusion were classified five types as pivot shift injury,clip injury,dashboard injury, hyperextension injury and lateral patellar dislocation.Results One hundred and forty-five cases of the 205 patients were found bone marrow edema without fracture on X-ray films.Among them,pivot shift injury was found in 43 cases accompanied with anterior cruciate ligament rupture in 30 cases,tear of the posterior horn of the lateral or medial meniscus in 12 and tears of the medial collateral ligament in 8 cases;clip injury in 53 cases accompanied with anterior cruciate ligament rupture in 10 cases,tear of the posterior horn of the lateral or medial meniscus in 15 and tears of the medial collateral ligament in 38 cases;dashboard injury 40 cases accompanied with posterior cruciate ligament rupture in 16 cases,hyperextension injury 9 cases accompanied with anterior cruciate ligament rupture in 2 cases,posterior cruciate ligament rupture in 5 cases.No lateral patellar dislocation was found.Forty-eight of 145 patients had undergone arthroscopy, 43 cases(89.6%)of them were in accordance with MRI diagnosis.Bone contusion were defined as geographic regions of abnormal signal intensity,that is,low signal intensity in T_1-weighted images and high signal intensity in PD-weighted or T_2-weigeted images with fat saturation.Conclusion MRI can accurately display the location and area of bone contusion of the knee joint as well as its adjunctive structure injury and deduce their injury mechanism.MRI should be used routinely for knee trauma.

OBJECTIVETo evaluate the outcome of Titanium elastic intramedullary nailing (TEN) for the treatment of displaced midclavicular fractures.

METHODSBetween February 2010 and February 2013, 62 patients with displaced midclavicular fractures were treated by TEN, including 27 males and 35 females with an average age of 37.6 years old ranging from 15 to 67 years. The course of disease was from 1 to 9 days (means 2.7 days). Thirty-nine cases were treated by closed reduction and 23 cases by assistant small incision. Based on OTA (the Orthopaedic Trauma Association classification) classification, 31 cases of simple fractures involved 5 cases of 06-A1,15 cases of 06-A2,11 cases of 06-A3; 31 cases of wedge fractures involved 4 cases of 06-B1,12 cases of 06-B2,15 cases of 06-B3. Postoperative pain relief were evaluated by VAS score,and operation time,fracture healing time were recorded. After 6 weeks and after removing internal fixation shoulder joint function was evaluated by Constant score, and shoulder joint function were assessed by Herscovici score after 6 weeks.

RESULTSExcept 2 cases were lost to follow-up, 2 cases did not remove internal fixation, 3 cases' fractures were nonunion, the remaining 55 patients received follow-up for an average time of 11.4 months. The average preoperative VAS score was 5.20±0.71, and it turned to be 1.550.59 at 3 days after operation. The average operative duration was 40 min (15 to 65 min). The average bone healing time was (2.71±0.54) months (2 to 5 months). No difference about bone healing time was found between simple fractures and wedge fractures,and between the patients treated by closed reduction and assistant small incision. According to Herscovici standard, the shoulder function was excellent in 49 cases, good in 4, fair in 1, and poor in 1. Simple fractures achieved better Constant score than wedge fractures at 6 weeks postoperatively, whereas no difference was found at 4 weeks after fixation removal.

CONCLUSIONTitanium elastic nails (TEN) for treatment of displaced midclavicular fractures has advantages of good clinical effect,rapid pain relief,fast recovery of shoulder joint function. For OTA classification type B patients with comminuted fracture can replace steel to achieve very good effect, but to grasp the appropriate.

Adolescent ; Adult ; Clavicle ; injuries ; surgery ; Female ; Fracture Fixation, Intramedullary ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged

Objective To report and analyze the renal function improvement in a case with ad-vanced bilateral renal cell carcinoma after targeted therapy. Methods The patient was a 60-year-old man who complained of lower back pain for 1 month. Ultrasound and CT scan detected bilateral renal masses, left lesion was 11.0 cm×9.4 cm×8.5 cm, and the right one was 3.5 cm×4.3 cm×4.1 cm. X-ray examination showed metastatic lesions in liver and lower right lung. GFR was 20.39 ml/min of left kidney, 25.40 ml/min of right kidney. The renal biopsy confirmed renal clear cell carcinoma. Sorafenib was administrated 400 mg twice or once daily for 12 weeks. Results After the targeted therapy, the decreased bilateral kidney tumor sizes were identified by CT scan. There was liquid nec-rosis in the tumor, and no new metastatic lesion detected. The kidney function was improved as well. The total GFR increased to 71.38 ml/min. Left kidney GFR increased to 31.57 ml/min, right kidney GFR increased to 39.81 ml/min, respectively. Conclusion Targeted therapy could improve renal function in advanced renal cell carcinoma cases by controlling tumor development.