Objective To investigate the optimal combination and the value of functional magnetic resonance imaging in the diagnosis of breast tumors. Methods One hundred and forty patients who had been clinically and pathologically diagnosed as breast tumors in our hospital during the period of 2009 to 2013 were collected. 63 of whom had breast cancer and 77 had benign tumor. All the patients received 1H-MRS, DWI and dynamic enhanced MRI at the same time. The obtained images were analyzed and then compared with the pathological findings. The accuracy, sensitivity, and specificity of MRS combined with DWI or dynamic enhanced MRI, or DwI combined with enhanced MRI in the diagnosis of breast cancer were obtained. Results All the diagnosis were pathologically confirmed. The accuracy, sensitivity, and specificity were 89.8%, 90.1%, and 90.0% for DWI combined with dynamic contrast-enhanced MRI; 77.9%, 77.3% and 79.3% for MRS in combination with enhanced MRI; and 76.3%, 77.8% and 77.1% for DWI combined with MRS. There were significant differences among the three kinds of combination detection in diagnosis of breast cancer , χ2= 9.057, P = 0.011. Conclusions The sensitivity, specificity and accuracy is the highest in DWI combined with dynamic enhanced MRI in the diagnosis of breast tumor , which can be used as the best combination imaging for breast tumor.

Objective To explore the blood-saving and conservation effect and clinical prognosis of extracorporeal circulation circuits designed individually by using medical polymeric materials for adults and infants in cardiac surgical procedures.Methods A total of 41 new extracorporeal circulation circuits designed based on the operation requirements,including 20 for adults and 21 for infants,were applied on adults and infants (body weight less than 10 kg),and the results were compared with that of the conventional circuits on adults (20) and infants (19)respectively.Total priming volume,priming and intraoperative blood products consumption,pump pressure,intraoperative blood hemoglobin (Hb) level,free Hb (f-Hb),platelet (Plt) count,mixed venous oxygen saturation (SvO2),colloid osmotic pressure (COP),lactate (Lac) level,Hb level after modified ultrafiltration,endotracheal intubation time and ICU time were all collected in two groups.Results Priming volume,priming and intraoperative blood consumption and f-Hb level in the blood-saving and conservation circuits group were significantly lower than that of conventional circuits group (P＜0.05).There were no significant differences (P＞0.05) between the two groups in pump pressure,intraoperative blood Hb level,Plt,SvO2,COP,Lac level,Hb level after modified ultrafiltration,endotracheal intubation time and ICU time.Conclusions The minimized blood conservation extracorporeal circulation circuit plays an important role in reducing priming volume and blood transfusion.It maintains a normal level of hemodynamics,oxygenation and tissue perfusion level during cardiopulmonary bypass in cardiac surgery for adults and infants.Red blood cell destruction can be reduced by improving blood compatibility,and physical data are all stabilized intra and post operation.This new circuit is secure,with its better outcome,expected in application.

BACKGROUND: About one fourth of diabetic patients suffer from diabetic retinopathy(DR) and has greatly impacted their quality of life due to the decreased vision. Social support plays important role on rehabilitation of patients.OBJECTIVE: To analyze the relationship between social support and quality of life(QOL) in patients with diabetic retinopathy in order to direct clinical practice and improve the patients' QOL.DESIGN: Cross-sectional study based on patients with diabetic retinopathy.SETTING: Department of Ophthalmology, General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: Totally 81 patients admitted into Department of Ophthalmology, General Hospital of Nanjing Military Area Command of Chinese PLA with diabetic retinopathy during January 2002 to May 2003 were selected. Inclusion criteria: suffer from diabetic retinopathy and willing to attend this study. Exclusion criteria: people with other complications (hypertension, kidney disease) . The patients were divided into two groups according to vision: 28 cases in the group with binocular vision between 0.06 -0. 1; 53 cases in the group with vision less than 0. 05.METHODS: Investigation was conducted to the two groups from three dimensions including objective support, subjective support and usage in order to assess the social support to patients with diabetic retinopathy of different vision. And modified quality of life index (MQLI) was used to assess the QOL in patients with diabetic retinopathy that covered 5 dimensions: somatic health, mental health, social function, self-image and material base.MAIN OUTCOME MEASURES: The total score of social support and QOL of patients with diabetic retinopathy, score of somatic health, mental health,social functions and material base as well as the correlations among them.RESULTS: The total score of social support, score of objective support factor, subjective support factor and usage factor in roup with vision between 0.06 and 0. 1 were much higher than those in group with vision less than 0.05 ( P < 0.01 ). For patients with diabetic retinopathy, the social support had strong correlation with total score of QOL and factor score of other dimensions except of self-image( P < 0.05 or P < 0.01).CONCLUSION: Social support is an important factor that impacts QOL to patients with diabetic retinopathy. It will improve their QOL by reinforcing the social support.

OBJECTIVE:To evaluate the curative efficacy of granulocyte macrophage colony stimulating factor (GM-CSF) as an adjunctive therapy for the treatment of acute myeloid leukemia (AML). METHODS: Randomized controlled trials (RCTs) of GM-CSF in the treatment of AML were retrieved from PubMed,EMBase,Cochrane Library,CBMdisc and CNKI database by computer as well as from the leukemia-related journals manually for a quality evaluation of the methodology and Meta analysis using RevMan5.0 software. RESULTS: A total of 10 RCTs were included,of which,3 RCTs were graded as A,5 as B and 2 as C. The results demonstrated that there were no significant differences of indexes among groups as complete remission (CR) rate,relapse rate,infection rate and length of hospital stay,etc. CONCLUSION: The available clinical research results showed that GM-CSF adjunctive therapy could neither increase CR rate,nor decrease the relapse rate,infection rate or length of hospital stay.

Objective To summarize the application of ATP bioluminescence assay in surveillance of terminal disinfection of effects ,so as to provide the basis for intervention of disinfected effects .Methods ATP bioluminescence assay were employed to randomly test the surfaces of operating objects in therapeutic rooms and beside tables in wards ,total 144 object surfaces ,of each clinical departments in the whole hospital .The values of ATP bioluminescence assay were read on‐site ,0-250 RLU was recognized as qualification ,while disqualification when >250 RLU .The disqualified object surfaces were performed on‐site intervention that all of them were re‐disinfected ,the results were compared .Results Both the surfaces of operating objects and beside tables were dis‐qualified before disinfection ,and the values of ATP bioluminescence assay were 780 ± 10 .34 RL and 853 ± 13 .29 RLU respectively . The pass rates of ATP bioluminescence assay was 61 .97% of operating surfaces and 79 .45% of beside table surfaces the first dis‐infection .The disqualified sites were retested following on‐site intervention .The values of ATP bioluminescence assay were 431 .02 ± 0 .53 before intervention and 1 .43 ± 0 .59 after intervention ,and the difference was statistically significant .Conclusion ATP bi‐oluminescence assay can get more immediately ,simple and timesaving in evaluating the effect of disinfection and estimate the effi‐ciency of disinfection timely ,which can also provide the scientific basis on on‐site intervention so as to improve the execution power of hospital infection management .

OBJECTIVETo explore the clinical effects of Dynesys system for the treatment of multiple segment lumbar degenerative disease.

METHODSA total of 28 patients with lumbar degenerative disc disease treated with Dynesys system from December 2008 to May 2011 were retrospectively reviewed. There were 16 males and 12 females, aged from 27 to 75 years old with an average of 49.1 years. Thirteen patients with multiple segmental lumbar intervertebral disc protrusion, including L3-L5 in 7 cases, L2-L4 in 1 case and L4-S1 in 5 cases. Fifteen patients with multiple segmental lumbar spinal stenosis, including L3-L5 in 10 cases, L4-L5 in 4 cases and L2-S1 in 1 case. The symptoms of lumbago and (or) intermittent claudication in all patients were treated with conservative treatments for more than 6 months and these methods did not work. Visual analogue scale (VAS) was used to analyze the lumbar and leg pain, imaging data were used to measure the intervertebral space height and intervertebral motion of fixed segment and upper adjacent segment, Oswestry Disability Index (ODI) was used to evaluate the clinical effect.

RESULTSAll operations were successful and the patients were followed up from 38 to 65 months with an average 50.6 months. At final follow-up, ODI and VAS of the low back pain and leg pain were (25.10±6.52)%, (1.25±0.70) points and (1.29±0.89) points, respectively and were decreased compared with preoperative (P<0.05). Postoperative intervertebral space heights were increased and intervertebral motions were decreased in fixed segment compared with preoperative (P<0.05). There were no significant differences in intervertebral space heights and intervertebral motions of upper adjacent segment between preoperative and postoperative (P>0.05).

CONCLUSIONDynesys system may obtain long-term clinical curative effect in treating multiple lumbar degenerative disease. It can partially preserve the intervertebral motions of the fixed segments, have little effect on adjacent segments. The long-term clinical effect of Dynesys still need longer time follow-up observation.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; pathology ; surgery ; Joint Instability ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Visual Analog Scale

OBJECTIVETo evaluate the levels of bone morphogenetic protein-15 (BMP-15) in human follicular fluid (FF) and its association with response to ovarian stimulation.

METHODSWestern blotting was performed to determine the levels of BMP-15 in FF obtained from follicle aspirates in 70 patients undergoing IVF treatment. According to the response to ovarian stimulation the patients were divided into poor responder group and normal responder group.

RESULTBMP-15 levels in FF of poor responders were significantly higher than those in normal responders (1.01 +/- 0.34 vs 0.77 +/- 0.24, P<0.01).

CONCLUSIONIncreased levels of BMP-15 in FF may be associated with poor response to ovarian stimulation.

Adult ; Blotting, Western ; Bone Morphogenetic Protein 15 ; Female ; Follicle Stimulating Hormone ; administration & dosage ; Follicular Fluid ; drug effects ; metabolism ; Gonadotropin-Releasing Hormone ; administration & dosage ; analogs & derivatives ; Growth Differentiation Factor 9 ; Humans ; Infertility, Female ; metabolism ; Intercellular Signaling Peptides and Proteins ; biosynthesis ; Ovary ; drug effects ; metabolism ; Ovulation Induction

Objectiv e:To investigate the effect of different culture conditions on the differentiation of Treg and Th17 to lay a foundation for exploring the methods to reverse the immune tolerance induced by tumor microenvironment.Methods:The IL-6 gene was cloned and stablely transferred into the tumor cell line expressing TGF-β.The conditioned mediums ( CM) were prepared by collecting the culture supernatants of tumor cell lines with or without IL-6 expression and used in the in vitro culture of peripheral blood mononuclear cells ( PBMC ) .The changes of Treg and Th17 in PBMC treated with different CM were detected with flow cytometry ( FCM) .Results:The expression of TGF-βin BEL-7402 was higher than that in HepG2.Thus the BEL-7402 was selected for preparation of cell line stablely transfected with IL -6 gene.ELISA detection confirmed the effective expression of IL -6 by the identified cell lines.It was showed that the Treg increased in PBMC treated with culture supernatants of tumor cells .However,the presence of IL-6 reversed the increase of Treg and promoted the differentiation of Th 17.Conclusion: The culture supernatants of tumor cells increases the proportion of Treg.However,the presence of IL-6 in this CM can reverse the increase of Treg and raise the proportion of Th 17.

Objective To evaluate the value of ultrasound elastography in the diagnosis of breast tumor ,and compared with imaging analysis .Methods To collect the image data of 160 patients ,confirmed by pathology ,a total of 182 ,preoperative ultra-sound elasticity imaging and DWI ,ultra sonic elastography diagnosis by five points method ,DWI on the basis of the measured ADC value in the diagnosis of lesions ,respectively compared with pathology .Results Ultrasound elastography diagnosis of 89 malignant tumors ,of which the correct diagnosis of 78 malignant tumors ,7 misdiagnosis ,11 benign misdiagnosed as malignant diagnosis;93 benign tumors ,86 of correct diagnosis ,11 misdiagnosis ,7 malignant misdiagnosed as benign ,sensitivity was 87 .6% ,specificity of 92 .5% ,the Accuracy was 93 .9% ;ultrasound elastography and DWI combined imaging diagnosis of 86 malignant tumors ,81 correct diagnosis of malignant tumors ,4 misdiagnosis ,5 from the benign misdiagnosed as malignant diagnosis ,96 benign tumors ,92 correct diagnosis ,5 misdiagnosis ,the sensitivity was 94 .1% ,specificity of 95 .8% ,the accuracy was 97 .2% .Conclusion Ultrasound elas-tography in breast benign and malignant tumor diagnosis with higher sensitivity and specificity ,accuracy ,joint DWI can significantly improve the sensitivity and specificity of breast benign and malignant tumor diagnosis ,accuracy .

ObjectiveTo recognize the normal CT appearances of adult pterygoid hamulus and increase the ability to recognize pterygoid hamulus abnormalities.Methods The pterygoid hamulus of 108 normal adults ( male:53 cases,female,55 cases) were studied with MIP and VR reconstructive images by 64-slice spiral CT in order to observe its normal shape,to measure its length,diameter,vertical height,horizontal width,abduct angle in coronal position and post-abducent angle in anteroposterior position.The differences between genders,two sides and age groups were compared,respectively.ResultsThe normal pterygoid hamulus had a wide basal body and a pillar caudomedial part with round or intumescentia extreme.In coronal position,the distal end towards outer direction in 214 sides and 2 sides in inner direction. In anteroposterior position,the distal end towards posterior direction in 190 sides and anterior direction in 26 sides.The pterygoid hamulus length,vertical height,and horizontal width of adult males were (8.18 ± 0.94) mm,(7.23 ±0.92) mm,(4.27 ±0.81 ) mm,respectively.They were larger than the adult females (7.31 ± 1.01) mm,(6.26 ±0.90) mm,(3.97 ±0.82) mm,and the difference was statistically significant (t values were 6.56,7.86,2.72 respectively,P ＜ 0.05).The pterygoid hamulus vertical height of age group over 60 years old (7.13 ± 1.35) mm exceeded the age groups of 18-39 (6.55 ±0.86) mm.The difference was statistically significant ( F =4.95,P ＜ 0.05 ).Conclusions64-slice spiral CT could display the shape,length and angle of pterygoid hamulus in full. It could help to recognize correlated pterygoid hamulus diseases.