Objective To analyze the histological underestimation of stereotactic core needle biopsy (SNCB).and tO attract clinicians' attention.Methods SNCB was performed in 146 patients with 179 lesions from September 2000 to June 2005.and 21 lesions were underestimated histologically.0f 21 nonpalpable breast lesions(NPBL).6 lesions were diagnosed as BI-RADS nl,12 8S BI-RADS Ⅳ,3 as BI-RADS V according to BI-RADS before biopsy.Mammography showed 16 lesions with calicification, 2 cases with masses,1 case with asymmetry density and 2 cases with stellate sign.Results Eleven lesions diagnosed as fibrocystic disease with atypical ductal hyperplasia by biopsy were proved to be ductal carcinoma in situ (DCIS)in 7 lesions and early infiltration in 4 lesions by pathology.3 lesions diagnosed as severe atypical hyperplasia by biopsy were finally proved to be 1 carcinoma in situ and early infiltration in 2 lesions by pathology.3 lesions diagnosed as DCIS by biopsy were invasive carcinoma.4 lesions diagnosed papillary lesions by biopsy and finally were 1 carcinoma in situ,1 early infiltration,1 infiltrating ductal carcinoma and l intraductal papillary adenocarcinoma.Conclusion The histological underestimation of SCNB Was related to the stereotactic location technology,lesion and doctor'S understanding,the radiologist should master the biopsy skills.

Background: The rate of death among people living with HIV/AIDS has decreased significantly as a result of treatment with highly active antiretroviral therapy (HAART). However, the issues of drug induced toxicities and complexity of current HAART regimens has remained of great concern. The aim of this study was to determine factors influencing antiretroviral regimen changes among people living with HIV/AIDS in China. Methods: This retrospective study collected data through face-to-face interviews with people living with HIV/AIDS who were receiving HAART, and gathered relevant information from infectious disease hospitals. The following information were collected: social-demographic characteristics, antiretroviral therapies, CD4 cell counts, virus loads, reasons for changing medication and other related data. Mean and percentages were used to describe the frequency of regimen change among patients, and binary logistic regression was employed to test the factors influencing regimen change. Results: 1,123 people who had experienced regimen change were included in the analysis. On average, patients remained on HAART for 10.2 months before changing regimen, and the average CD4 cell count and viral load (VL) were 383.1 cells/μl and 28,132.4 copies/mL respectively when changing regimen. The reasons for modification were determined as treatment failure (52.5％), adverse reactions (32.3％), and other reasons including pregnancy (15.2％). There are significant differences in regimen change among people with different genders (P<0.001), modes of transmission (P<0.001), duration of HAART (P<0.001) and initial CD4 cell counts (P=0.0024). Males, drug users, people taking long-term medication, and those with lower initial CD4 counts when starting HAART tend to change regimen. Conclusion: Treatment failure was the main reason for the change of HAART regimen. Males, drug users, people on long-term medication and those with lower initial CD4 cell counts when starting HAART were most likely to change regimen.

Objective:To assess the changes of craniomaxillofacial morphology in adolescents with Angle Class II Division 2 malocclusion after orthodontic treatment .Methods:The indexes of lateral cephalometric radiographs of 12 adolescents with Angle ClassⅡ Division 2 malocclusion before and after orthodontic treatment were measured and analyzed .Results:After orthodontic treatment , length of anterior skull base(SN) increased .There was no significant change in maxillary sagittal length .Go‐Gn ,Cond‐Go ,and total length of mandible(Co‐Gn) increased .S‐Go ,N‐Me ,lower facial height ,and upper facial height ,increased .Palatal plane(ANS‐PNS) and mandibular plane(MP) did not rotate significantly .There was no significant change in S‐Go/N‐Me ration .SNA decreased .No significant change happened to SNB .ANB decreased .Y axis angle increased .A significant positive correlation was found between the changes of SNB and those of mandibular length ,Go‐Gn ,and Gond‐Go .There is also a significant inverse correlation between the changes of ANB and those of Cond‐Go and Mandibular length .Conclusions:The orthodontic treatment can effectively improve craniomaxillofacial morphology defects in adolescents with Class II Division 2 malocclusion .The vertical and horizontal direction growth of mandible is conducive to the correction of Angl Class II malocclusion .

Objective:To investigate the efficacy of root canal therapy for periapical periodontitis of maxillary primary incisors accompanied by crown defects .Methods :A total of 114 children patients with periapical periodontitis of maxillary primary incisors (162) accompanied by crown defects ,who were admitted for root canal therapy during January 2010 and December 2012 ,were allocated into the caries group (85 incisors) and the trauma group(77 incisors)according to whether they had trauma history or not .Among them ,there were 75 incisors from 2‐3 years group and 87 incisors from 3‐4 years group .The efficacy analysis were conducted after one year root canal therapy with Vitapex calcium hydroxide paste from J .Morita Corporation . Results :The total cure rate was 62 .35% during one year follow‐up .The cure rate in trauma group was lower than that in the caries group ,and the difference was statistically significant (P<0 .01) .The cure rate of 2‐3 years group was lower than that of 3‐4 years group ,and the difference was statistically significant (P<0 .05) .There was no significant difference regarding cure rate among children with different genders or mobility degrees ,as well as with or without sinus(P>0 .05) .Conclusions :The long term efficacy of root canal therapy for periapical periodontitis of maxillary primary incisors with traumatic history is inferior to that for periapical periodontitis of maxillary primary incisors caused by caries .

Background:This study aimed to investigate the changes in the clinical indicators and influencing factors of treatment duration among human immunodeficiency virus (HIV) patients in whom antiretroviral therapy (ART) was unsuccessful.Methods:In this retrospective study,a total of 9,418 HIV patients who failed in ART during 2004-2016 were included and divided into two treatment groups-Group 1 (treatment time ≤ 3 years,n1 =5,218) and Group 2 (treatment time ＞ 3 years,n2 =4,200).Patient follow-up data,including age,cluster of differentiation 4 (CD4) count,and viral load,glucose,creatinine,and triglyceride levels,were extracted from electronic health record databases.Covariance analysis for repeated measures was used to analyze the biochemical indicators,and multiple logistic regression modeling was used to compare relevant data extracted from the Group 1 and Group 2 HIV patient cohorts with different treatment time.Results:The median initial CD4 count was 175.0 cells/μl (interquartile range,77.0-282.0),while the initial CD4 counts for Group 1 were lower than those for Group 2 (P ＜ 0.05).A significant interaction between group and time effects was observed (P ＜ 0.05) in total cholesterol (TC).Changes in hemoglobin level among HIV patients were also significantly associated with treatment time (P =0.001).The initial CD4 count (odds ratio [OR] =0.756),female sex (OR =0.713),Zerit (d4T) (OR =1.443),TC (OR =1.285),and aspartate aminotransferase level (OR =1.002) were significantly associated with the survival time of dead patients with HIV (P ＜ 0.05).Additionally,the initial CD4 count (OR =1.456),age (OR =1.022),time interval (OR =0.903),patient's living status (OR =0.597),d4T (OR =2.256),and triglyceride (OR =0.930) and hemoglobin levels (OR =0.997) were significantly associated with the treatment time of HIV patients with drug withdrawal (P ＜ 0.05).Conclusion:The initial biochemical parameters can affect the survival and treatment time of HIV patients.With a comprehensive understanding of the physiological and biochemical indicators of patients,we can reduce the probability of drug withdrawal and prolong the survival time of HIV patients.

Objective To study the prevalence,treatment policy and control of hypertension in patients with maintenance hemodialysis, and to analyze the influencing factors of hypertension control.Methods We studied the current status of 1382 patients with maintenance hemodialysis in 11 dialysis centers in Shanghai, among them 809 were male, and 573 were female.Hypertension was defined as systolic blood pressure(SBP) ≥ 140 and/or diastolic blood pressure (DBP) ≥90 mm Hg ( 1 mm Hg = 0.133 kPa).Those who had a history of hypertension and requiring antihypertensive therapy were also diagnosed as hypertension though their blood pressure was within normal range during the survey.Hypertension control was defined as blood pressure ＜ 140/90 mm Hg before each dialysis session.Results The prevalence of hypertension in the hemodialysis patients was 86.3%.The treatment rate and control rate in those patients were 96.8% and 25.5% respectively.More than half (50.4% ) of patients were treated with only one kind of anti-hypertensive drug, and 34.4% with 2 kinds, 14.2% with 3 kinds, 1.0% with 4 kinds or more.Calcium channel blocker (CCB) was the most frequently prescribed drug (61.0%), followed by angiotensin Ⅱ receptor blockers ( 56.4% ), centrally acting anti-hypertensive agent ( 26.4% ), beta blockers and alpha, beta-blockers( 14.0% ).The control rate of hypertension in those hemodialysis people was aggravated by the existence of coronary artery disease.The patients who need more kinds of antihypertensive agents have a poorer control rate of hypertension.The hypertension control rate elevated significantly with the adequate hemodialysis.Conclusions There is a very high prevalence of hypertension in maintenance hemodialysis patients.Although the treatment rate is high, the control rate is unsatisfactory.So the control of hypertension in hemodialysis patient is still a clinical challenge.Appropriate dialysis adequacy, reasonable use of erythropoietin, treatment of heart disease and judicious use of antihypertensive drugs may be helpful to improve the clinical outcome.

Objective To analyze the effect of edaravone combined with statins on levels of serum homocysteine (Hcy),C-reactive protein (CRP) and total cholesterol (TC),triglyceride (TG),high-density lipoprotein HDL),low-density lipoprotein cholesterol (LDL-C) in patients with ischemic stroke.Methods A total of 63 patients with ischemic stroke in our hospital were divided into two groups,27 cases in control group were given atorvastatin,and 36 patients in the observation group were given edaravone treatment in addition.The levels of Hcy,TG,TC,HDL and low LDL-C were detected.At the same time,stroke scale of NIHSS,Barthel index of daily living ability,Self Anxiety Scale (SAS) and Self Depression Scale (SDS) were recorded at 14 days before and after treatment.Results The observation group had lower Hcy,CRP and LDL-C levels,while higher HDL level.Total effective rate in the observation group was significantly higher than the control group (88.89％ vs.77.78％,P ＜0.05).The observation group had higher Barthel index and lower SAS,SDS scores than the control group (P ＜ 0.05).Conclusion Edaravone combined with atorvastatin can significantly improve patients' treatment outcomes,and improve prognosis and life ability.

Objective To analyze the effect of edaravone combined with statins on levels of serum homocysteine (Hcy),C-reactive protein (CRP) and total cholesterol (TC),triglyceride (TG),high-density lipoprotein HDL),low-density lipoprotein cholesterol (LDL-C) in patients with ischemic stroke.Methods A total of 63 patients with ischemic stroke in our hospital were divided into two groups,27 cases in control group were given atorvastatin,and 36 patients in the observation group were given edaravone treatment in addition.The levels of Hcy,TG,TC,HDL and low LDL-C were detected.At the same time,stroke scale of NIHSS,Barthel index of daily living ability,Self Anxiety Scale (SAS) and Self Depression Scale (SDS) were recorded at 14 days before and after treatment.Results The observation group had lower Hcy,CRP and LDL-C levels,while higher HDL level.Total effective rate in the observation group was significantly higher than the control group (88.89％ vs.77.78％,P ＜0.05).The observation group had higher Barthel index and lower SAS,SDS scores than the control group (P ＜ 0.05).Conclusion Edaravone combined with atorvastatin can significantly improve patients' treatment outcomes,and improve prognosis and life ability.

Objective To compare the phenylalanine(Phe)concentration in the sample of dried blood spot,measured by four different methods:fluorescence assay,tandem mass spectrometry(MS/MS), including MS/MS Derivatized,MS/MS Non-Derivatized and MS/MS-Standard Curve.Methods A total of 204 dried blood spot(DBS)samples of phenylketonuria(PKU)patients from Shanghai Xinhua Hospital were collected in this study.Phe concentration in DBS was measured by fluorescence assay and MS /MS assay,including MS/MS Derivatized, MS/MS Non-Derivatized and MS/MS-Standard Curve.The samples were divided into low, middle and high concentration groups according to Phe concentration, which were under the 360 μmol/L,between 360 and 600 μmol/L,and over 600 μmol/L respectively.The differences among the groups were analyzed by consistency check and non-parametric test.Results The within-day and between-day precisions of MS/MS-Standard Curve assay were 4.0%-7.2%,the recoveries were 93.2%-97.3%.Consistency check showed that less than 8.1%of Phe value were out of the 95%limit of agreement among these four methods.In the low and middle concentration groups,the quartile of Phe value measured by fluorescence assay,MS/MS Standard Curve and MS/MS Derivatized were 176(118,251)μmol/L,174 (94,273)μmol/L,153(94,242)μmol/L; and 540(478,578)μmol/L,485(414,529)μmol/L,466(402,513)μmol/L,respectively.Phe value measured by fluorescence assay was significantly higher than that by MS/MS Standard Curve,the difference was 4.8%-9.0%,(Z=-3.787 to -2.674,P<0.01). Phe value obtained from MS/MS Non-Derivatized was less than that by MS/MS-Standard Curve, the difference was 3.9%-5.2%,(Z=-7.474 to -5.747,P<0.01).In the high concentration group,the quartile of Phe value measured by MS/MS-Standard Curve, MS/MS Derivatized, MS/MS Non-Derivatized and fluorescence assay were 807(695,924)μmol/L,700(575,785)μmol/L,680(623,771)μmol/L and 711(674, 794)μmol/L, respectively.Phe value obtained from MS/MS Standard Curve was significantly higher than those from the other methods and the difference was 10.9% -16.2%,(Z=-4.458 to-4.356,P<0.01).Conclusions The MS/MS Standard Curve assay showed good specificity and accuracy.These four assays displayed good agreement.Although there was difference in measuring the Phe concentration among these methods, they could be used in blood Phe concentration monitoring for PKU patients.

Three new thionic compounds, ()-2-(2-carboxyl-2-hydroxyethylthio)-ferulic acid (), ()-2-methoxy-4-(3-(methylsulfonyl)prop-1-en-1-yl)phenol (), and thiosenkyunolide C (), together with two new aromatic glycosides ( and ) were isolated from the rhizome of Hort. Two known compounds ( and ) were also obtained. Their structures were elucidated based on extensive spectroscopic data (UV, IR, 1D and 2D NMR, and HR-ESI-MS). Furthermore the absolute configurations were established by comparison of their calculated and experimental circular dichroism spectra and by a dimolybdenum tetraacetate [Mo(AcO)]-induced circular dichroism procedure. All compounds were evaluated against lipopolysaccharide (LPS)-induced NO production in BV2 cells, and compounds and showed strong inhibitory activities with IC values of 2.03 and 3.09 µmol/L, respectively (positive control curcumin, IC = 6.17 µmol/L). In addition, compound showed weak proteintyrosine phosphatase-1B (PTP1B) inhibitory activity.