Objective To evaluate the clinical value of breast localization needle placed via mammary ductoscopy in surgical treatment of patients with intraductal neoplasms. Methods In this study,76 patients with intraductal neoplasms diagnosized by mammary ductoscopy from January 2009 to March 2010 in the Second Affiliated Hospital of Soochow University were randomly divided into two groups.For methylene blue group,ducts with the lesion were marked by methylene blue injection before operation.For localization needle group,ducts were marked by localization needle placed via ductoscopy.The operative time,specimen weight,incision length and diagnostic coincidence rate were compared among the two groups. Results Compared to the methylene blue group,the localization needle group had a significantly shorter operative time (31 ± 8 min vs.42 ± 9 min),lighter specimen weight (1.51 ± 1.36 g vs.2.95 ± 2.07 g),and shorter incision (23.2 ± 7.8 mm vs.34.4 ± 7.1 mm).All the breast cancer cases dianosised by mammary ductoscopy were confirmed by postoperative pathology,but the localization needle group had a higher diagnostic coincidence rate than the methylene blue group (94.7% vs. 76.3%). Conclusion Localization needle under mammary ductoscopy is a reliable technique for localizing intraductal neolasms.The surgical excision guided by localization needle is accurate and less traumatic,and should be a routine method marking the tumor involved duct before operation.

0.05). Regarding to the grade of irradiation mucositis, the majority of patients in the treatment group were at stage Ⅰ-Ⅱ,while those in the control at stage Ⅲ-Ⅳ(P0.05).No adverse drug reaction was observed in both groups during irradiation process.Conclusion:Actovegin can postpone the development of irradiation oropharyngeal mucositis and decrease the incidence of gradeⅢ and Ⅳmucositis.

Objective To investigate the correlation between dose volume histogram(DVH)of tumor targets and organs at risk(OAR)at CT-image based 192Ir brachytherapy and effects and complications for patients with locally advanced cervical cancer. Methods Ten patients with FIGO stage ⅢB cervical cancer received CT image-based 192Ir intracavitary brachytherapy after 54 Gy of three-dimentional four-field pelvic external beam radiotherapy and concurrent weekly cisplatin chemotherapy. Before each brachytherapy,CT images were acquired with applicators in place. Gross tumor volume(GTV), clinical target volume (CTV)and OAR were contoured and inverse treatment planning was designed and optimized by using PLATO treatment planning system. Conventional two-dimensional plans were also designed for comparison.The total intracavitary brachytherapy dose was 30 -42 Gy in 5 -7 fractions. The patients were followed, and the local control and complications were analyzed. The biologically equivalent dose(BED)and biologically equivalent dose in 2 Gy fractions(BED2)for GTV, CTV and OAR were calculated. The minimum dose in the most irradiated tissue volume 2 cm3(D2 cm3)adjacent to the applicator of the sigmoid colon, rectum,bladder and small bowel was determined from the DVH. Results The 1-year local pelvic control rate was 90% and grade 1-2 late complication of sigmoid colon and rectum was 50%. No grade 3 or more complications developed. On CT-image based planning, the BED and BED2 to 90% of the CTV(D90)were 95.50 Gy ± 7. 81 Gy and 79. 73 Gy ± 6. 57 Gy. The BED and BED2 to 90% of the GTV(D90)were 101.86 Gy ± 7.27 Gy and 84. 95 Gy ± 6. 1 Gy. The volume enclosed by 90% of prescribed dose(V90)for GTV and CTV were 92% ±4% and 87% ±7% respectively. The D2cm3 for rectum and sigmoid colon were 74. 97 Gy ±1.64 Gy and 67. 93 Gy ± 4. 30 Gy(EQD2, α/β = 3). Comparing with 2D brachytherapy plans , CT - image based planning has improved D90 and V90 for GTV and CTV with similar dose at point A and rectum reference point. Conclusions Computer tomography-image based 192Ir brachytherapy has resulted in the better dose distribution to the tumor targets with excellent tumor control and acceptable toxicity.

Objective To explore the digital tomosynthesis(DTS)technology application value in children with atlanto-axial joint subluxation inspection.Methods 30 children with torticollis after injury,head and neck activities obstacles or local pain were selected.The consent of patient and family was obtained.At the same time the atlanto-axial joint open mouth,cervical lateral radiographies and DTS scanning were performed,two imaging quality and the diagnosis were compared.Results In all 30 cases,excellent imaging rate was 90% (27/30)on DTS and 53% (1 6/30)on DR respectively.On DTS atlanto-axial sublution were found in 22 cases but on DR atlanto-axial sublution were diagnosed in only 12 cases,suspicious subluxation in 4 cases,and misdiagnosis in 6 cases.Conclusion For diagnosis of atlanto-axial joint subluxation in children,DTS can obtain high quality images,clearly display anatomic structures and pathological morphology of atlanto-axial joint.

Objective To investigate the application value of magnetic resonance enterography (MRE) with multiple sequences in detection of children bowel intestinal diseases .Methods Retrospective analysis of 35 patients with bowel diseases confirmed by clini‐cal results ,surgery and pathology was performed .The patients underwent MRE with multiple sequences including T 1WI ,fat‐suppressed T2 WI ,diffusion weighted imaging (DWI) ,single‐shot fast spin‐echo (SSh‐TSE) sequence ,rapid balance fast field echo (B‐FFE) ,and unenhanced and enhanced fat‐suppressed (FFE‐IP‐SPAIR) scans .Results SSh‐TSE showed the whole intestinal distribution in 34 patients (34/35);DWI showed the lesions with high signal in 29 (29/35);T1WI and fat‐suppressed T2 WI showed hyperintensity on T2WI in 3 ,slight hypointensity on T1WI and T2WI in 2 ,and hyperintensity on T1WI and hypointensity on T2WI in 1 .Enhancement of lesion was found in 28 ,and unenhancement was in 2 .Conclusion MRE with multiple sequences with more information ,sensitivity and non‐ionizing radiation ,can be used as an important method in diagnosis of children intestinal diseases .

Objective To understand the relationship between the dietary patterns and metabolic syndrome among elderly people in Zhejiang province,in order to provide scientific basis and reference for nutrition interventions.Methods Data were obtained from the 2010-2012 Chinese National Nutrition and Health Survey,and factor analysis was used to obtain food patterns among elderly people in Zhejiang province.The Logistic regression was used to explore the association of the food patterns with metabolic syndrome and its components.Results The intakes of bean products,nuts,fruits,eggs,and milk in elderly people were generally low,and the intakes of livestock and poultry meat,cooking oil and salt were relatively high.5 dietary patterns were derived by factor analysis:high-quality protein diet,mediterranean diet,condiments diet,traditional dietary pattern and western dietary pattern.The medical test results in 780 elderly people showed that the standardized prevalence of metabolic syndrome in the elderly was 28.8％,standardized central obesity rate was 41.2％,standardized hypertension rate was 50.3％ and standardized hyperglycemia rate was 39.5％.Logistic regression analysis showed that different dietary patterns had different effects on the metabolic syndrome and its components.Conclusions The prevalence rate of metabolic syndrome and the abnormal rates of its components are high in the elderly in Zhejiang.The intakes of fruits and milk are generally low,and intakes of livestock and poultry meat,cooking oil and salt are relatively high.The relationship between dietary patterns and MS or its components is complicated,so it is necessary to guide the elderly people to adopt reasonable diet by referring to the Diet Pagoda in order to reduce the risk of MS or its components.

Objective To investigate the effect of azelastin nasal spray combined with desloratadine in the treatment of allergic rhinitis .Methods Two hundred patients with allergic rhinitis were selected .According to the digital meter method ,the patients were randomly divided into observation group and control group ,with 100 cases in each group .The control group was treated by azelastin nasal spray , the observation group was given azelastin nasal spray combined with desloratadine .The clinical effects of the two groups were compared .Results The effective rate of the observation group(96.00%) was higher than that of the control group (80.00%),the difference was statistically significant(χ2 =6.235,P<0.05).After treatment,the scores of runny nose,nasal itching,nasal congestion,sneezing and the inferior turbinate swelling in the observation group were (1.1 ±0.2) points,(1.2 ±0.7) points,(1.1 ± 0.3)points,(0.8 ±0.3) points,(0.9 ±0.2) points,respectively,which were significantly lower than those in the control group [(1.4 ±0.9)points,(1.9 ±0.6)points,(1.8 ±0.8)points,(1.7 ±0.7)points,(1.9 ±0.9)points] (t=5.154,5.226,5.154,5.226,5.011,all P<0.05).Conclusion Azelastin nasal spray combined with deslorata-dine tablets in the treatment of allergic rhinitis can quickly relieve the patients 'clinical symptoms,improve the effec-tive rate,and it is safe and worthy of clinical popularization and application .

Objective To compare the simple cases of hand-foot-mouth disease(HFMD) with HFMD patients complicated with encephalitis and HFMD cases complicated with pulmonary edema (PE). To explore predictor factors of disease progression and unfavorable prognosis. Methods Forty-one EV71-infected children admitted to the Fuyang First People's Hospital in Anhui Province from March to May in 2008 were investigated in the research, who were classified as encephalitis-complicated cases ( encephalitis group, n = 15 ), PE-complicated cases ( PE group, n = 15 ) and simple cases (simple group, n= 11 ). Their clinical manifestation, laboratory findings, and immunophenotypes of peripheral blood lymphocyte were analyzed to find predictors associated with disease progression and unfavorable outcomes. Results The mortality rate in PE group was 66.7%, which was significantly higher than that in encephalitis group. Ninty-three point three percent cases in PE group and encephalitis group were younger than 3 years old, with statistic difference compared to simple group. Patients in PE group had higher total blood white cell (WBC) counts and higher absolute neutrophil counts and tended to have higher breathing rate, heart i'ate and glucose level than encephalitis group. The percentages of T cells and natural killer (NK) cells were significantly lower among patients complicated with encephalitis than simple HFMD patients.Conclusions PE is one predictor for poor prognosis. Factors correlated with unfavorable outcome include high WBC, high absolute neutrophil counts; elevated breathing rate, heart rate and glucose level. The immunophenotypes of peripheral blood lymphocytes can also predict the disease progression.

Objective To investigate the correlation between wholeGorgan MRI score (WORMS)and pain in patients with knee osteoarthritis (OA).Methods 1 1 9 patients with knee OA were enrolled,and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)was used to estimate the pain.Knees of all the subj ects underwent scanning with sagittal,coronal,transverse TSEG T2 WIGFS and sagittal 3DGFLASHGWE sequences at 3.0T MR.The pathological changes of knee cartilage lesions,subarticular bone marrow edema (BME),bone cysts,bone attrition,osteophytes,meniscal inj ury,ligament inj ury,synovial thickening and joint effusion were evaluated according to the WORMS.The correlations between the above pathological changes and the pain were analyzed.Results There were significant and positive correlations between articular cartilage lesions and osteophytes,articular cartilage lesions and BME,BME and cyst,bone attrition and osteophytes,and BME and osteophytes,with the correlation coefficients of 0.6 70,0.5 9 8,0.5 1 8,0.5 1 4 and 0.505 ,respectively (P＜0.05 ).Multiple regression analysis showed that BME,bone attrition,synovial thickening and joint effusion were the main factors affecting the severity of pain after adj usted for age and BMI (P＜0.05).Conclusion The source of OA pain is multifactorial.The severity of BME,bone attrition,synovial thickening and joint effusion are the main factors associated with joint pain.As a nonGinvasive examination method,MR can make a comprehensive evaluation of the pathological changes of knee OA.

Objective To study the value of MSCT in the diagnosis of neonatal type (Ⅲ) congenital esophageal atresia.Methods MSCT data of 25 cases with neonatal type (Ⅲ) congenital esophageal atresia confirmed by surgery and pathology were analyzed retrospectively.The full preparation before examination and the image post-processing function were checked,and MSCT data were compared with the findings of surgery.Results By full preparation and application of M PR,SSD technology after scanning,the esophageal proximal blind end,and the distance between the two esophageal blind ends were clearly displayed,furthermore,the opening position,morphology and diameter of the distal tracheoesophageal fistula were also showed,and bronchial tree morphology and inflammation in the lung can be visible.Conclusion MSCT full preparation and application of image post processing function are potential to the clinical diagnosis of congenital esophageal atresia and tracheoesophageal fistula.