Objective To investigate the diagnostic significance of microcalcifications in breast cancer.Methods 120 cases of breast lesions with microcalcifications confirmed by pathology were included in this study,of them,97 cases were breast carcinoma,including infiltrating ductal carcinoma(n=71),invasive lobular carcinoma(n=23),and others 3 cases,23 cases were benign breast diseases.All cases underwent mammography,X-ray features of microcalcification were analysed in comparison with that of pathology.Results (1)The microcalcifications of breast in totally 120 cases could be divided into 3 types according to the density of calcifications,those were high (45/120),middle (34/120) and low (41/120) density.The middle and low dense microcalcifications were more seen in breast cancer(73.19%,71/97),high dense microcalcifications were more seen in benign breast diseases(82.00%,19/23).(2)The malignant calcifications were mostly less than 0.5 mm in diameter.The calcifications appeared as sandy in 68/97,bulky in 18,“Y”,“V”,branch or club in 8 and worm in 3.The benign calcifications were mostly more than 0.5 mm in diameter with regular form and defined margin.(3)Dense or clustered microcalcifications were often seen in breast cancer (82/97),scatter and/or bulky microcalcifications were more seen in benign breast diseases(16/23).Conclusion Microcalcification is important finding in diagnosis of breast cancer,espcially early cancer on macrography,but it should differentiate with benign breast microcalcifications.

Objective To explore the appearances of DSA and therapeutic methods of tanscatheter hepatic artery chomoembolization (THACE) of hepatic carcinoma with arteriovenous fistula(avf).Methods The indirect hepatic portal vein angiography (Superior mesenteric artery angiography) and celiac trunk angiography (common hepatic artery) were performed in 673 cases with hepatic carcinoma confirmed by pathology,then hepatic artery infusion-chemotherapy and/or embolizations were done. Results Heptic carcinoma to be accompanied with arteriovenous fistula(AVF) 151 was totally cases(22.4%),including artery-portal vein fistula 127 cases,artery-vein fistula 15 cases, mixed 9 cases.Of them, hepatic artery embolizations in 131 cases with artery-vein fistula(86.6%) were performed once or more times, in 20 cases due to the embolization of artery-vein fistula couldn’t be performed and/or with tumor embolus inside common portal vein while only arterial infusion-chemotherapy were performed.Conclusion DSA is accurate and direct diagnostic method in hepatic carcinoma with artery-vein fistula. Hepatic artery embolization and infusion-chemotherapy is an effective way for the patients with artery-vein fistula.

Objective To analyze the recurrence rate of intubation and increase of ventilator support rate within 24 hours after using fiberoptic bronchoscopy (FOB) in critically ill patients with hypoxemia complicated with respiratory failure, and to approach the feasibility of FOB in such patients.Methods A prospective study was conducted, including 200 critically ill patients with acute respiratory failure using FOB [oxygenation index (PaO2/FiO2) ≤ 300 mmHg (1 mmHg = 0.133 kPa)] admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Xinxiang Medical College. The rates of intubation and increased ventilatory support and the reasons for bronchoscopy related complications after using FOB 24 hours were recorded, the main risk factors leading to these changes and complications were analyzed and screened by logistic regression analytic method.Results Within 24 hours after using FOB for 200 patients with respiratory failure, an increase in mechanical ventilatory support was required in 68 patients (34%) of that 28 (14%) led to endotracheal intubation. With the extension of time, the rates of intubation and ventilatory support showed a tendency of elevation, the rise in ventilatory support rate being faster. The reasons for bronchoscopy related complications after FOB consisted of cardiovascular disease (41%), coronary artery disease (17%), chronic obstructive pulmonary disease (COPD, 17%), chronic restrictive pulmonary disease (10%), immunity suppression (54%), malignant neoplastic hematologic disorder (20%), acquired immune deficiency syndrome (AIDS, 12%), solid organ transplantation (3%), solid tumor (10%), corticosteroid therapy (25%), immunosuppressive drug (16%), diabetes (15%), chronic renal failure (14%), swallowing nerve injury (37%), anticoagulant therapy (19%), antiplatelet therapy (13%). In the patients with occurrence of COPD or immunosuppression, the rate of invasive ventilation used was significantly higher than that without using invasive ventilation [COPD: 35% (10/28) vs. 14% (24/172),χ2 = 8.081,P = 0.004; immunosuppression: 75% (21/28) vs. 50% (86/172),χ2 = 6.051,P = 0.014]. The logistic regression analysis showed that the occurrence of COPD or immunosuppression was obviously related to whether the intubation being necessary or not [COPD: odds ratio (OR) = 5.200, 95% confidence interval (95%CI) = 1.500 - 17.700,P = 0.006; immunosuppression:OR = 5.300, 95%CI =1.600 - 17.100,P = 0.004].Conclusions In patients with hypoxemia using FOB, they often require addition of mechanical ventilatory support, but the intubation rate is not high. Under the ventilatory support, FOB has certain feasibility for treatment of critically ill patients with hypoxemia and acute respiratory failure.

In recent years,liver transplantation donor shortage as one of world medical problems is paid more attention by domestic and overseas scholars.In view of that,heterotopic auxiliary liver transplantation emerges which transplants the whole or some parts of a donor liver outside the original liver position on the condition that some parts or the whole of the original liver were retained.As for the liver transplantation with poor conditions on portal vein,reconstruction of portal vein has become an aporia.Based on this,some scholars put forward the theory——arterialization of portal vein(PVA),namely a method to increase arterial blood supply or replace portal vein blood perfusion of liver by establishing some pathes among artery and portal vein or its branches.The research background and current situation of heterotopic auxiliary liver transplantation with portal vein arterialization,the transplanting position of donor liver,vessel reconstruction,dynamics mechanism after reconstruction and liver regene-ration are summarized in this review.

Objective To analyze the characteristics and significance of matrix metalloproteinase-9 (MMP-9) expression in the pathophysiological processes of tuberculous meningitis in mice.Methods Sixteen mice were intracerebroventricularly injected with H37RV suspension as the model group.Meanwhile,the other 16 mice were injected with 0.9％ sodium chloride solution as the control group.Thirty days later,all mice were decapitated and the brain tissue were respectively used to for Mycobacterium tuberculosis (M.tuberculosis) incubation,pathological changes observation,MMP-9 activity detection by zymography,blood-brain-barrier permeability and moisture content detection,and immunofluorescence stain of MMP-9,glial fibrillary acidic protein (GFAP) and integrin αM (OX-42).The t test was used to compare the differences between the two groups.Results Every experimental mouse was injected with (1.271±0.111) × 106 colony-forming units (cfu) M.tuberculosis.Thirty days later,the amount of M.tuberculosis in brain tissue homogenates was (4.900± 1.407) × 104 cfu/mL,and the hematoxylin and eosin staining showed dilatation of subarachnoid and ventricular and infiltration of a large number of inflammatory cells.The cumulative absorbance (A) of MMP-9 bands of brain tissue was 47 821 ± 19 932 in the model group and 10 082 ± 3 544 in the control group.The difference was statistically significant (t =3.728,P=0.010).The evans blue (EB) content of brain tissue was (11.8 ± 3.6) μg/g in model group and (4.7 ±3.4) μg/g in control group.The difference was statistically significant (t=2.887,P=0.028).The moisture of brain tissue was 0.849±0.035 in model group and 0.775±0.037 in control group.The difference was statistically significant (t=2.925,P=0.026).The immunofluorescence staining showed that the infected brain tissue expressed high degrees of MMP-9,GFAP and OX-42.And MMP-9 was overlapped with both GFAP and OX-42 obviously.Conclusions The activity of MMP-9 is significantly enhanced in brain tissue of mice suffering from tuberculous meningitis and participates in blood-brain barrier damage,tissue edema and inflammatory cells exudation.Microglia cells-astrocytes network is involved in the secretion of MMP-9.

Radiological evaluation is a key step for donor's preoperative evaluation in living donor liver transplantation(LDLT).There are many powerful functions in multi-slice computed tomography (MSCT)which can suit all-in-one radiological evaluation before donor's operation.By referring to the articles from home and abroad in recent years,from viewpoint of surgeon,this artical reviews the application status of multi-slice CT for preoperative assessment in LDLT,which can help to provide theory support for choice of radiological examination in LDLT donor.

Objective To discuss the diagnostic value of peritoneal effusion detection by emergency-ultrasound in patients with closed abdominal injury. Method From August 2006 to June 2009,212 patients with closed abdominal injury were studied to evaluate peritoneal effusion detection by emergency ultrasound. Results of 212 patients,peritoneal effusion frequency rate was 78.8%( 167/212), meanwhile,abdominal paracentesis confirmation ratio was only 46.2%(98/212). In the follow-up, 13 patients with injuried hollow viscera and 1 patient with rupture of kidney showed peritoneal effusion. The volume of abdominal fluid was increasing in 17 patients,which needed to be managed by surgery. The accuracy rates were respectively 78.3%( 112/143) and 36.1%(13/36) in the solid organs and the hollow organs. Conclusion During the course of diagnosis and treatment in closed abdominal injury,peritoneal effusion monitoring by ultrasound should be used routinely, which can help to decrease the rate of misdiagnosis and avoid delayed treatment.

Objective To compare the molluscicidal effects between“Luo-wei”(TDS),a plant molluscicide in 4 percent, and metaldehyde and niclosamide(MNSC)in the field. Methods A natural ecological environment with Oncomelania hupensis was selected as the test area,the test concentrations of TDS and MNSC were 2.5 g/m3 and 2 ml/m3 respectively by the immersion method;the test doses of TDS and MNSC were 3 g/m2 and 2 ml/m2 respectively by the spray method;the doses of WPN in a control group were 2 g/m3 and 2 g/m2 respectively by the two methods above-mentioned. The molluscicidal effects between TDS and MNSC were compared by using the synchronous design method and parallel comparative method. Results In the TDS group,the death rate of snails was 90.70%by immersion for 24 hours,reached to 81.40%after spraying for 7 days,and there were no significant differences among the observation time points in molluscicidal effects(P>0.05). One day after the spraying,the death rate of snails was less in the TDS group compared with that in the MSCN group(P<0.01),but the death rates of snails were similar in both groups 3 days after the spraying(P>0.05). In the MSCN group,the death rate of snails was 99.17%by immersion for 24 hours,reached to 66.07% by spraying for 1 day. In the WPS group,the death rate of snails was 97.15% by immersion for 24 hours,reached to 71.43%after spraying for 1 day,and there were no significant differences(both P>0.05). Conclusion TDS has a good molluscicidal activity and stable efficacy,and the molluscicidal effect of TDS is similar to that of MSCN in the filed, but the molluscicidal sensitivity of TDS is lower than that of MSCN.

Objective:To investigate the effect of different concentrations of human adipose-derived mesenchymal stromal cells (hADMSCs) derived exosome-mimetic nanovesicles (NVs)and exosomes (EXOs) on the biological function of human umbilical vein endothelial cells (HUVECs) .Methods:(1) Through hydrodynamic liposuction, adipose tissue was obtained from the thighs of 10 women (aged 18-65 years) in Fujian Medical University Union Hospital from June 2019 to August 2020. The hADMSCs were isolated by enzymatic hydrolysis, cultured to passage 4 and induced into adipocytes and osteocytes. The surface protein markers were identified by flow cytometry. (2) hADMSCs-NVs and hADMSCs-EXOs were prepared and observed under an electron microscope. Their surface protein markers were analyzed with particle size analyzer, particle size was analyzed with nanoparticle tracker. Protein quantitative analysis and nanoparticle tracking were used to detect the total protein and particle number of NVs and EXOs produced by 1×10 6 hADMSCs. (3) The control group (DMEM basic medium), 40, 60, 80 μg/ml NVs groups and 20, 40, 60 μg/ml EXOs groups were set to compare the proliferation, migration and angiogenesis of HUVECs through CCK-8 proliferation test, cell scratch test and angiogenesis test respectively. Graphpad Prism 7.0 was used for statistical analysis, and the measurement data were expressed as Mean±SD. Repeated measurement analysis of variance was applied to the comparison between multiple groups, and Tukey test was applied to pairwise comparison. P<0.05 represented statistical significance. Results:(1) The fourth generation of hADMSCs were slender spindle-shaped cells under optical microscope. After 21 days of adipogenesis induction, the transparent lipid droplets inside the cells were stained red by oil red O staining. After 14 days of osteogenesis induction, a large proportion of brown black staining area was observed by alkaline phosphatase calcium cobalt staining. The surface protein markers CD90 and CD29 of hADMSCs were positive. (2) Under transmission electron microscope, the structures of hADMSCs-NVs and EXOs were similar, both were discoid vesicles. The expression levels of CD9, CD81 and IgG were similar between NVS and EXOs. The particle sizes of NVs and EXOs were about the same, which were (72.0 ± 21.51) nm and (81.27±22.37) nm. The total protein content of NVs produced by 1×10 6 hADMSCs was (140.7±5.1) μg, about 100 times that of EXOs, which was (1.3±0.3) μg. The number of NVs [(644.5 ± 17.1)×10 8/ml] particles was about 90 times that of EXOs [(7.1±0.1)×10 8/ml]. (3) In CCK-8 proliferation assay, at 12, 24 and 48 hours after culture, the growth trend of HUVECs in the groups were generally consistent, and the difference in absorbance value was statistically significant ( P<0.01); at 48 hours after culture, the absorbance values of 60 μg/ml NVs and 40 μg/ml EXOs were higher than those in the control group (all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). At 8 and 24 hours after cell scratch assay, the changes of scratch width in each group were different, and the difference was statistically significant ( P<0.01); at 24 hours after scratch, the change of scratch width in 60 μg/ml NVs and 40 μg/ml EXOs groups were greater than that in the control group (all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). In the angiogenesis assay, the number of branch points and the length of blood vessels in each group were different, and the difference was statistically significant ( P<0.01). The number of capillary branches formed by HUVECs in 60 μg/ml NVs and 40 μg/ml EXOs groups were higher than that in the control group (all P<0.01), but there was no significant difference between the two experimental groups (all P>0.05). The capillary length of 60 μg/ml NVs and 40 μg/ml EXOs groups were longer than that of the control group ( all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). Conclusions:The shape and size of NVs were similar to EXOs, while the total protein content of NVs was about 100 times that of EXOs. The effects of hADMSCs-NVs and EXOs on the biological functions of HUVECs are similar and the optimum concentrations of NVs and EXOs are 60 μg/ml and 40 μg/ml, respectively.

Objective:To investigate the effect of different concentrations of human adipose-derived mesenchymal stromal cells (hADMSCs) derived exosome-mimetic nanovesicles (NVs)and exosomes (EXOs) on the biological function of human umbilical vein endothelial cells (HUVECs) .Methods:(1) Through hydrodynamic liposuction, adipose tissue was obtained from the thighs of 10 women (aged 18-65 years) in Fujian Medical University Union Hospital from June 2019 to August 2020. The hADMSCs were isolated by enzymatic hydrolysis, cultured to passage 4 and induced into adipocytes and osteocytes. The surface protein markers were identified by flow cytometry. (2) hADMSCs-NVs and hADMSCs-EXOs were prepared and observed under an electron microscope. Their surface protein markers were analyzed with particle size analyzer, particle size was analyzed with nanoparticle tracker. Protein quantitative analysis and nanoparticle tracking were used to detect the total protein and particle number of NVs and EXOs produced by 1×10 6 hADMSCs. (3) The control group (DMEM basic medium), 40, 60, 80 μg/ml NVs groups and 20, 40, 60 μg/ml EXOs groups were set to compare the proliferation, migration and angiogenesis of HUVECs through CCK-8 proliferation test, cell scratch test and angiogenesis test respectively. Graphpad Prism 7.0 was used for statistical analysis, and the measurement data were expressed as Mean±SD. Repeated measurement analysis of variance was applied to the comparison between multiple groups, and Tukey test was applied to pairwise comparison. P<0.05 represented statistical significance. Results:(1) The fourth generation of hADMSCs were slender spindle-shaped cells under optical microscope. After 21 days of adipogenesis induction, the transparent lipid droplets inside the cells were stained red by oil red O staining. After 14 days of osteogenesis induction, a large proportion of brown black staining area was observed by alkaline phosphatase calcium cobalt staining. The surface protein markers CD90 and CD29 of hADMSCs were positive. (2) Under transmission electron microscope, the structures of hADMSCs-NVs and EXOs were similar, both were discoid vesicles. The expression levels of CD9, CD81 and IgG were similar between NVS and EXOs. The particle sizes of NVs and EXOs were about the same, which were (72.0 ± 21.51) nm and (81.27±22.37) nm. The total protein content of NVs produced by 1×10 6 hADMSCs was (140.7±5.1) μg, about 100 times that of EXOs, which was (1.3±0.3) μg. The number of NVs [(644.5 ± 17.1)×10 8/ml] particles was about 90 times that of EXOs [(7.1±0.1)×10 8/ml]. (3) In CCK-8 proliferation assay, at 12, 24 and 48 hours after culture, the growth trend of HUVECs in the groups were generally consistent, and the difference in absorbance value was statistically significant ( P<0.01); at 48 hours after culture, the absorbance values of 60 μg/ml NVs and 40 μg/ml EXOs were higher than those in the control group (all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). At 8 and 24 hours after cell scratch assay, the changes of scratch width in each group were different, and the difference was statistically significant ( P<0.01); at 24 hours after scratch, the change of scratch width in 60 μg/ml NVs and 40 μg/ml EXOs groups were greater than that in the control group (all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). In the angiogenesis assay, the number of branch points and the length of blood vessels in each group were different, and the difference was statistically significant ( P<0.01). The number of capillary branches formed by HUVECs in 60 μg/ml NVs and 40 μg/ml EXOs groups were higher than that in the control group (all P<0.01), but there was no significant difference between the two experimental groups (all P>0.05). The capillary length of 60 μg/ml NVs and 40 μg/ml EXOs groups were longer than that of the control group ( all P<0.01), but there was no significant difference between the two experimental groups ( P>0.05). Conclusions:The shape and size of NVs were similar to EXOs, while the total protein content of NVs was about 100 times that of EXOs. The effects of hADMSCs-NVs and EXOs on the biological functions of HUVECs are similar and the optimum concentrations of NVs and EXOs are 60 μg/ml and 40 μg/ml, respectively.