Objective To evaluate the value of quantitative 3T dynamic contrast enhanced MRI in the diagnosis of breast lesions. Methods One-hundred and eighteen patients suspected of breast lesions underwent MRI examination. A 3.0 T MR scanner was used to obtain the quantitative MR pharmacokinetic parameters: Ktrans( volume transfer constant), Kep (exchange rate constant) and Ve (extravascular extracellular volume fraction). The mean Ktrans, Kep and Ve of malignant, benign and normal glandular tissues were calculated and compared each other using LSD method. Independent sample t test was used between invasive ductal carcinoma and ductal carcinoma in situ (microinvasion included). Finally, the areas under the ROC curve (AUC) of Ktrans, Kep and Ve between malignant and benign lesions were compared. Results The mean Ktrans, Kep and Ve of malignant lesions (n=87) were (1.010±0.580) min-1, (1.634 ± 1.481) min-1 and (0.735 ±0.273); the mean Ktrans, Kep and Ve of benign lesions (n=23) were (0.331±0.192) min - 1, (0.417±0.324) min - 1 and (0.847±0.291); and the mean Ktrans, Kep and Ve of normal glandular tissues (n =83) were (0.051 ±0.028) min-1, (0.133±0.125) min-1 and (0.597±0.354), respectively. There were significant differences between normal glandular tissues and benign lesions, normal glandular tissues and malignant lesions, benign and malignant lesions in Ktrans (t=9.681, 11.189, 5. 590, respectively, P ＜ 0. 01 ), normal glandular tissues and malignant lesions, benign and malignant lesions in Kep(t =5. 287, 3. 874, P＜0. 05). There were a statistic differences between normal glandular tissues and benign lesions, normal glandular tissues and malignant lesions in Ve(t =2. 932, 2. 562 ,P ＜0. 05). There were no significant differences between normal glandular tissues and benign lesions in Kep, benign and malignant lesions in Ve ( t = 0. 760, 0. 832, P ＞ 0.05 ),invasive ductal carcinoma and ductal carcinoma in situ (microinvasion included) in Ktrans, Kep and Ve(t =0.834,0.075,0.454,P＞0.05). The areas under the ROC curve (AUC) of Ktrans, Kep and Ve between malignant and benign lesions were 0. 934, 0. 941 and 0. 659. The sensitivity of Ktrans, Kep and Ve were 77.01% ,91.95% ,56. 32% and the specificity of Ktrans, Kep and Ve were 95. 65%, 86. 96%, 78.26% for the differential diagnosis of breast lesions if taken the maximum Youden's index as cut-off. Conclusion The differential diagnosis of benign and malignant breast lesions by Ktrans, Kep is applicable.

Objective To analyze the indications,techniques of MR-guided localization and the imaging features of breast lesion.Methods Hook wire localization was performed in 43 patients whose lesions were only detected by MRI,based on a 1.5 T MR scanner and a special MR biopsy positioning frame.The feasibility of operation and accuracy of localization were explored.Lesion features and pathologic findings were analyzed using Fisher exact test.Results A total of 37 patients (86.0％) with 38 lesions underwent MR-guided localization.Of the 6 patients canceled,the lesions were not obvious in 4 patients,and the positioning was difficult in 2 cases.Of the 38 lesions,17 were masses,20 were non-mass enhancement lesions,and one lesion was undetermined enhancement.There were 11 (28.9％) malignant lesions.The distribution of internal enhancement pattern was different between benign and malignant non-mass lesions (P =0.028),while the other morphological features between benign and malignant were not significantly different (P ＞ 0.05).Conclusions MR-guided localization provides an accurate and safe method for localizing the suspicious lesions on MRI.The morphological findings of these lesions are not characteristic for the differentiation of benign and malignant lesions.

Leaves of Chrysanthemum morifolium were potential medicinal resource. The present study aims to estimate the main bioactive components: total flavonoids (TF), galuteolin (GA), quercitrin (QU), chlorogenic acid (CA) and 3 ,5-O-caffeoylquinic acid ( CQ), which were considered to be the main effective components, in leaves of C. morfolium cultivars in China. The TF content was estimated hy UV-VIS spectrophotometry, while GA, QU, CA, and CQ were quantitatively determined by HPLC. The highest TF content (7. 13% w/w) was found in cultivar Wan Cong (Shexian county). Cultivar Da Bo ( Bozhou county) had the highest GA content (33. 45 mg - g-1); Cultivar Hong Xin (Sheyang county) contained the highest QU content (29.25 mg · g(-1)); Cultivar Chang Ban (Sheyang county) had the highest CA content (13.14 mg ·(-1)). The maximum CQ content (7.35 mg · g(-1)) was observed in culti- r Da Yang ( Tongxiang county). Different cultivars of C. morfolium had significant difference in components, but the leaf and capitulum of C. morifolium. were found to possess similar chemical compositions. The high content of bioactive components in several cultivars suggested the potential utilization of C. morifolium leaves.
China ; Chromatography, High Pressure Liquid ; Chrysanthemum ; chemistry ; growth & development ; Drugs, Chinese Herbal ; analysis ; Plant Leaves ; chemistry

Hepatic encephalopathy is a common metabolic neuropsychiatric syndrome in the development of end-stage liver disease. Since the concept of intestinal-liver-brain axis was proposed, the relationship between the pathogenesis of hepatic encephalopathy and the gut microbiota has been a hot research topic. In recent years, studies have confirmed that gut microbiota is involved in and affects various pathological processes of hepatic encephalopathy. This article combines the latest research progress at home and abroad to elaborate on the research status of regulating gut microbiota and thus interfering with the pathological process of hepatic encephalopathy, hoping to provide new ideas and methods for the intervention of hepatic encephalopathy based on the regulation of gut microbiota.

OBJECTIVE: To investigate the frequency of transfusion transmitted virus (TTV) infection in healthy blood donors in Hangzhou area and the mutation of TTV genomic fragment. METHODS DNA in serum samples of 203 healthy donors was extracted by phenol-chloroform method to detect TTV by semi-nested polymerase chain reaction and nucleotide sequences of partial amplification products were determined after T-A cloning. RESULTS TTV infection rate in 203 cases of blood donors in Hangzhou area was 15.3%. The homology of the amplified products of partial TTV positive samples compared with thereported nucleotide and putative amino acid sequences of TTV TA278 were 63.51% approximate, equals 67.12% and 59.46% approximate, equals 66.22% respectively. CONCLUSIONS TTV infection rate in the blood donors in Hangzhou is relatively high. The TTV infecting blood donors in the area may be a kind of novel genotype.

OBJECTIVETo identify potential mutation responsible for synpolydactyly (SPD) in a large Chinese kindred and to offer genetic counseling and prenatal diagnosis for the members of the family.

METHODSAll family members were examined clinically, and blood samples were obtained for linkage analysis and mutation screening. Ultrasound examinations were conducted at 16-21 weeks. Amniotic fluid sample was obtained by ultrasound-guided amniocentesis at 18 weeks of gestation.

RESULTSA large kindred affected with SPD was identified and characterized. With two short tandem repeat (STR) markers (D2S1238 and D2S1245) flanking the HOXD13 gene, the disease was mapped to 2q31. A heterozygous 27 bp expansion within the imperfect GCN triplet-repeat of exon 1, c. 184_210dup, was identified. The mutation resulted in a gain of 9 alanine residues between the 14th and 15th alanine of the normal 15-amino-acid-long polyalanine tract. On ultrasound examination, all fingers and toes of the fetus appeared to be normal. Linkage analysis and mutation detection confirmed that the fetus did not inherit the mutant allele from his affected mother.

CONCLUSIONHOXD13 gene mutation was responsible for the SPD phenotype in this family. Accurate prenatal diagnosis of SPD was achieved with combined ultrasound and molecular analysis.

Adolescent ; Adult ; Base Sequence ; China ; DNA Mutational Analysis ; Female ; Fingers ; abnormalities ; Genetic Linkage ; Homeodomain Proteins ; genetics ; Humans ; Male ; Middle Aged ; Pedigree ; Pregnancy ; Syndactyly ; diagnosis ; genetics ; Toes ; abnormalities ; Transcription Factors ; genetics ; Ultrasonography, Prenatal ; Young Adult

OBJECTIVETo study the clinicopathological characteristics of synchronous squamous cell carcinoma (SCC) of the renal pelvis and SCC of the ureter.

METHODSThe clinical data of two cases of synchronous SCC of the renal pelvis and SCC of the ureter were retrospectively reviewed and analyzed. In case 1, a 68-year-old man with hematuria for a month, imaging modalities revealed a right renal pelvis tumor and a right distal ureter tumor. The patient underwent nephroureterectomy and excision of the bladder cuff. Case 2, a 60-year-old man with the complaint of lower abdominal pain and left flank pain for a month, was diagnosed as left distal ureteral stone in another hospital. Ureterolithotomy was performed and a ureteral tumor was found at the lower site of the stone intraoperatively. The pathological report demonstrated SCC, and the patient was transferred to our hospital for further treatment. We found a left renal mass invading the left hemicolon during surgery, and nephroureterectomy was performed with a bladder cuff excision, left hemicolon resection, and also complete lymph node dissection. Neither of patients received adjuvant radiotherapy/chemotherapy.

RESULTSModerately differentiated SCC was reported in both of renal pelvis and ureter in case 1 and the tumor invaded the subepithelial connective tissue in the renal pelvis and superficial muscle in the ureter. In case 2, moderately differentiated SCC of the left renal pelvis with colon metastasis and poorly differentiated SCC of the ureter was reported with two retroperitoneal lymph node metastases. The two patients died from tumor recurrence and metastasis 5 and 6 months after the surgery, respectively.

CONCLUSIONSynchronous SCC of the renal pelvis and SCC of the ureter are rare and has high likeliness of early recurrence and metastasis, often with poor prognosis.

Aged ; Carcinoma, Squamous Cell ; complications ; pathology ; Humans ; Kidney Neoplasms ; complications ; pathology ; Kidney Pelvis ; pathology ; Male ; Middle Aged ; Ureteral Neoplasms ; complications ; pathology

OBJECTIVETo clone tpn17 and tpn47 genes of Treponema pallidum and then construct their prokaryotic expression systems,to establish ELISAs based on rTpN17 and rTpN47 as antigens and to evaluate the sensitivity and specificity of the ELISAs for detection of serological diagnosis of syphilis.

METHODSThe whole length of tpn17 and tpn47 genes was amplified by PCR and then their prokaryotic expression systems were constructed. SDS-PAGE was used to measure the expression of the target recombinant proteins rTpN17 and rTpN47. Ni-NTA affinity chromatography was applied to extract rTpN17 and rTpN47, while Western blot was performed to determine the specific immunoreactivity of rTpN17 and rTpN47. By using rTpN17 and rTpN47 as the coated antigen, respectively, ELISAs (rTpN17-ELISA and rTpN47-ELISA) were established to detect serum samples from 200 healthy individuals, 25 RA patients, 17 SLE patients and 211 syphilis patients. The detection effects of the ELISAs were compared to those of TRUST and TPHA.

RESULTThe sequence similarity of the cloned tpn17 and tpn47 genes was 100 % compared with the corresponding sequences in GenBank. The expression outputs of rTpN17 and rTpN47 were approximately 37.2 % and 26.8 % of the total bacterial proteins, respectively. Both the extracted rTpN17 and rTpN47 could take place remarkable conjugation reactions to the sera with positive antibody against Treponema pallidum.The positive detection rate of TPHA (99.1%) was the highest (P<0.001). The positive detection rates of rTpN17-ELISA (85.3 %) and rTpN47-ELISA (84.3 %) were similar (P>0.05). The positive detection rates of TRUST (72.5 %) was lower than that of rTpN17-ELISA (P=0.001) but similar to that of rTpN47-ELISA (P=0.014). The detection results of all the serum samples from healthy individuals, RA patients and SLE patients were negative, whereas 7.1 % (3/42) of the samples from RA or SLE patients were positive.

CONCLUSIONrTpN17 and rTpN47 are still maintaining their original immunoreactivity. The ELISAs using rTpN17 or rTpN47 as the antigen are rapid, simple and convenient, higher sensitivity and specificity methods for serological screening and detection of syphilis.

Antibodies, Bacterial ; Antigens, Bacterial ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; methods ; Female ; Humans ; Male ; Syphilis ; diagnosis ; Syphilis Serodiagnosis ; Treponema pallidum ; chemistry ; immunology ; isolation & purification

Objective To investigate the etiology of acute recurrent pancreatitis (ACP) and de-termine how to further enhance its level of treatment.Methods The clinical data of 33 patients with ACP treated in Ruijin Hospital from 2003 to 2007 were retrospectively analyzed.Results Of the 33 patients with an average age of 55 (22-86), 18 (55%) were male and 15 (45%) female.ACP occurred once in 26 patients, twice in 4 and 3 times in 3.The disease appeared whithin 1 year in 29 patients, 1-2 years in 2, 2-3 years in 1 and 3 years in 1 after being dischared from hospital.For its etiology, it was of biliary origin in 29 patients, hyperlipidemia in 1, pancreatic tumor in 1 and unknow reasons in 2.Twenty-four patients were treated with operation or endoscopy.Two patients died and the mortali-ty was 9.1%.Conclusion ACP is mainly due to biliary origin in China.Operative intervention at an appropriate opportunity can effectively reduce the recurrence of biliary-origin pancreatitis.

OBJECTIVETo construct prokaryotic expression systems of ltB/ctB-lipL41/1 fusion genes, identify immunogenic and adjuvant activities of the products as well as to understand the frequencies of lipL41 gene that carrying and expressing in L. interrogans wild strains and specific antibody levels in sera from patients with leptospirosis.

METHODSPolymerase chain reaction (PCR) with linking primer was applied to construct the fusion genes ltB-lipL41/1 and ctB-lipL41/1. By routine molecular biological techniques, prokaryotic expression systems of the two fusion genes were constructed. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) was used to examine expression of the target recombinant proteins rLTB-rLipL41/1 and rCTB-rLipL41/1. Both western blot and Ganglioside-enzyme linked immunosorbent assay (GM-ELISA) were used while immunogenic and adjuvant activities of rLTB-rLipL41/1 and rCTB-rLipL41/1 were measured. PCR and MAT were performed to detect lipL41 gene and expression of the gene in 97 wild strains of L. interrogans, respectively. Antibodies against product of lipL41 gene in serum samples from 228 leptospirosis patients were detected by ELISA.

RESULTSIn comparison with reported corresponding sequences, the similarities of ltB-lipL41/1 and ctB-lipL41/1 fusion genes to nucleotide and putative amino acid sequence were 99.6%-99.9% and 99.8%-100%, respectively. Expression outputs of both rLTB-rLipL41/1 and rCTB-rLipL41/1, mainly presenting with inclusion body, consisting approximate 10% of the total bacterial proteins. Both rLTB-rLipL41/1 and rCTB-rLipL41/1 could combine rabbit anti-rLipL41/1 serum as well as bovine GM1, respectively. 87.6% of the L. interrogans wild strains(85/97) having lipL41 gene while 84.5% (82/97) of the wild strains with rLipL41/1 or rLipL41/2 antiserum were positive for MAT with titers of 1:4-1:128. 84.6% (193/ 228), 78.5% (179/228) from the patients' serum samples were positive for rLipL41/1 and rLipL41/2 antibodies, respectively.

CONCLUSIONltB-lipL41/1 and ctB-lipL41/1 fusion genes and their prokaryotic expression systems were successfully constructed in this study. The two expressed fusion proteins showed qualified immunogenic and adjuvant activities. lipL41 gene was extensively distributed and frequently expressed in different serogroups of L. interrogans. rLTB-rLipL41/1 or rCTB-rLipL41/1 seemed to have had good potential to serve as an antigen in L. interrogans genus-specific vaccine.

Amino Acid Sequence ; Animals ; Antibody Specificity ; Antigens, Bacterial ; biosynthesis ; chemistry ; genetics ; immunology ; Cattle ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli Proteins ; genetics ; Genetic Engineering ; methods ; Humans ; Leptospira interrogans ; genetics ; physiology ; Leptospirosis ; immunology ; Polymerase Chain Reaction ; Recombinant Fusion Proteins ; biosynthesis ; chemistry ; genetics ; immunology ; Sequence Analysis, DNA