Objective To evaluate the diagnostic value of DCE-MRI and breast MR reporting and data system(BI-RADS-MR)in differentiation of breast lesions. Methods Seventy-five patients with 75 pathological-confirmed breast lesions underwent DCE-MRI before treatment and DCE-MRI quantitative analysis. Two senior doc-tors assessed the imaging features blindly by BI-RADS-MR. The pathology results were set as a gold standard. The receiver operating characteristic curve(ROC)interpretation of two physician′s curve analysis was used to evaluate the sensitivity,specificity of BI-RADS classification. Results According to the BI-RADS MR score,38 breast cancer patients were rated as 1 case in grade Ⅰ,0 case in grade Ⅱ,4 cases in gradeⅢ,13 cases in gradeⅣ,20 cases in grade V;37 breast benign tumors were rated as 17 cases in grade Ⅰ,5 cases in grade Ⅱ,12 cases in gradeⅢ,3 cases in gradeⅣandⅤ0 cases. The statistical difference of Tpeak,S max,K1 between benign and malig-nant breast tumors were significant(P<0.05). On ROC,the area under the curve was 0.940,95%confidence in-terval was from 0.887 to 0.994. The sensitivity of BI-RADS in the diagnosis of breast cancer was 94.59%and speci-ficity was 92.11%. Conclusion DCE-MRI combined with BI-RADS-MR classification in diagnosis of benign and malignant breast tumors has an important value and can improve diagnosis and differential diagnosis level.

Objective To investigate the clinical characteristics of radiographic contrast-induced nephropathy(RCIN) in children for improving the knowledge of this disease.Method The clinical data of 6 hospitalized children with RCIN collected from Oct.1998 to Dec.2007 were evaluated retrospectively.Results Of 92 patients who had cardio-angiography,intravenous pyelography,renal arteriography,cerebral angiography,and CT with contrast medium,6 cases(2 girls and 4 boys,aged 2-17 years old) had RCIN.Among the 6 children,5 cases [serum creatinine(Scr) was from 168.3 to 249.7 ?mol/L] showed non-oliguria-type acute renal failure;1 case(Scr was 583.1 ?mol/L) showed oliguria-type acute renal failure,and renal biopsy pathology findings showed that renal tubular epithelial cells were vacuolar degene-ration,striated border fell off,renal tubular epithelial cells were necrotic mulifocally,while the glomeruli were normal.Hematuria in 2 cases with primary disease aggravated;2 cases showed microscopic hematuria;1 case had proteinuria(+),1 case appeared microscopic hematuria and proteinuria(+).Five patients with non-oliguria-type acute renal failure were cured successfully after the medication of 10-21 days.Another case with oliguria-type acute renal failure was well after interrupted hematodialysis for 13 days and medication.Conclusion Children suffering RCIN usually manifest non-oliguria-type acute renal failure,and most of them can be cured by hematodialysis and medication mostly.

Objective To explore the role of eNOS and NF-?B in the cultured endothelial cells apoptosis induced by TNF-? and Ang II.Methods The cultured endothelial cells were treated with TNF-? and Ang II in absence and presence of PDTC(an inhibitor of NF-?B);the mRNA of eNOS was measured by RT-PCR,the protein of eNOS and I?B? were assessed by Western-blot,the activity of NF-?B was evaluated by EMSA,and the apoptosis of cells was detected with Tunel.Results The mRNA and protein of eNOS were significantly decreased in the endothelial cells induced by TNF-? and AngII(P

Kinematical alignment during total knee arthroplasty is an emerging process, and draws more and more attentions from scholars. Knee joint is close to normal joint after TKA through kinematical alighment, which has good clinical results and functional scores, and not increase failure probility. Thus, it may increase joint stress of patella-femur joint, lead to patellar maltracking and increase abrasion. The paper summarized defination and basical principle, operative method, clinical outcomes and deficiency of kinematical alignment during total knee arthroplasty, in order to choose a better way for kinematical alignment during total knee arthroplasty.
Arthroplasty, Replacement, Knee ; methods ; Biomechanical Phenomena ; Humans

Adolescent ; Female ; Humans ; Patellar Dislocation ; physiopathology ; surgery ; Patellar Ligament ; injuries ; physiopathology ; surgery ; Range of Motion, Articular ; Reconstructive Surgical Procedures

Objective To assess the left ventricular(LV) volumes and function acquired by realtime (RT) three-dimensional echocardiography (3DE) versus magnetic resonance imaging (MRI) in elderly patients.Methods A total of 31 patients aged≥60 years [mean (72.1±6.6) years] with various cardiovascular diseases were evaluated by MRI versus RT-3DE on the same day.RT-3DE was performed with a Philips iE-33 echocardiographic system,and LV volumes and function were analyzed with the assistance of TomTec software.The results of LV volumes and function obtained by manual tracing were compared with Signa 1.5-T MRI data.The acquisition of RT-3DE datasets was feasible in all 31 patients.Results The average MRI-detected LV end diastolic volume (LVEDV) was (139.1 ±40.8) ml,LV end systolic volume (LVESV) was (77.8±41.7)ml,LV ejection fraction (LVEF) was (47.9±14.3)％.The average RT-3DE-detected LVEDV was (119.5±37.7) ml,LVESV was (65.5±36.1) ml,LVEF was (47.9± 14.3)％.Compared with MRI values,LVEDV was underestimated by RT-3DE (P＜0.01,r=0.79,y=0.73 x+17.8,SEE=23.5 ml),with a mean difference of (-19.6±25.6)ml; LVESV was also underestimated by RT-3DE (P＜0.01,r=0.89,y =0.77 x+ 5.6,SEE=16.8 ml),with a mean difference of(-12.3± 19.1)ml.Ejection fraction determined by MRI was the same as that by RT-3DE (P＞0.05,r=0.91,y=0.75 x+ 13,SEE=5.61％),with a mean difference of (1.1±7.4) ％.There was good interobserver reproducibility in LV volume detected by RT-3D.Conclusions Compared with MRI,RT-3DE has more accuracy and repeatability in assessment of LV volume and ejection fraction in elderly patients.

Objective To investigate the change of plasma visfatin in patients with coronary heart disease and its clinical significance.Methods A total of 310 patients with coronary heart disease (ACS group:n =217; SAP group:n =93) and of 90 healthy subjects with a matched age and gender were included in this study.The plasma concentration of visfatin of each subject was measured using ELISA assay,and each patient underwent selective coronary angiography examination.A total of 85 cases of patients in CHD group underwent 64-slice CT coronary imaging to evaluate the main plaque within the coronary.Results The visfatin,LDL,BMI,blood glucose levels was significantly higher in CHD group[ ( 128.18 ± 13.86)ng/ml,(3.63 ± 1.48) mmol/L,( 26.18 ± 1.82) kg/m2,(7.25 ± 2.03 ) mmol/L] than in control group [ (75.96 ± 10.27 )ng/ml,(2.64 ± 0.53 ) mmol/L,( 23.51 ± 0.89 ) kg/m2,(5.11 ± 1.53 ) mmol/L,P ＜ 0.05 ],respectively.The visfatin level in the ACS group [ ( 145.57 ± 19.95 ) ng/ml ] was significantly higher than the SAP group [ (110.79 ±7.78)ng/ml,P ＜0.05].The visfatin concentration gradually increased with the aggravation of the complexity of coronary lesion types and severity of coronary lesions( P ＜ 0.05).The plasma visfatin concentrations in Soft plaque group and the fibrous plaque group were significantly higher than calcified plaque (P ＜ 0.05).HDL-C and Gensini score of coronary lesions were negatively correlated ( r =- 0.055,P ＜0.05) ; LDL-C,Glu,and visfatin was positively correlated with coronary lesions Gensini score ( r =0.464,0.279,0.531,P ＜ 0.05 ),respectively.Conclusions The plasma visfatin level in patients with Coronary heart disease increased and affected its lipid metabolism.It may be an important inflammatory factors promoting arterial atherosclerosis occurs and development,which has a certain value to the judgment of coronary lesions and plaque stability combined with 64-slice spiral CT examination.

Objective To establish the quality standard for Haijinhuwei powder. Methods Corydalis Rhizoma, Angelicae Dahuricae Radix, Angelicae Sinensis Radix were identified by TLC. The content of tetrahydropalmatine was determined by HPLC. Results TLC spots were clear and specific.There was a good linear relationship between peak area and concentration of tetrahydropalmatine at the range of 10.78-107.8μg.mL-1(r=0.999 9).The average recovery rate was 96.57% and RSD was 1.40%(n=6). Conclusion All these results indicated that the developed TLC-HPLC method was proved to be reliable, accurate and specific, which could be used for the quality control of Haijinhuwei powder.

Objective A retrospective analysis were conducted to identify the effect of bypassing the emergency department on 30-days outcomes of patients with acute myocardial infarction undergone primary percutaneous coronary intervention ( PPCI) . Methods From June 2014 to April 2015, 187 patients underwent PPCI in Kunming General Hospital were included. 13 patients were excluded owing to their incomplete follow-up data. The total 174 patients were divided into two groups: the control group (n =59) who did not bypass the emergency department, and the bypass group ( n = 115) who bypassed the emergency department and directly received PPCI. The data of all patients were collected and analyzed. Results There were no significant differences in baseline characteristics and PPCI related data (including percentage of thrombus aspiration catheter used, length or diameter of stents applied between two groups (all P ﹥ 0. 05) . The bypass group had shorter door-to-ballon ( D2B) than the control group [ (67. 7 ± 21. 5) min vs. (89. 4 ± 23. 6) min, P ﹤ 0. 001] . There were no significant differences in 30-days all-cause mortality, re-myocardial infacrtion and target ressel revascularization (TVR) between the two groups (P ﹥ 0. 05) . Total MACEs rate in the bypass group was lower than in the control group (10. 2% vs. 1. 7% , P = 0. 012) . Logistic regression analysis showed that age, diabetes, pain-to-door (PTD) time and CK peak value were the main influencing factors for 30-day MACEs rate of patients receiving PPCI ( P ﹤0. 05) . Conclusions Bypassing the emergency department can shorten D2B time and reduce 30-days MACEs post-PPCI, but reducing the total ischemic time will be more beneficial to patients with acute myocardial infarction.

0.05,respectively).But most inte-restingly,the MMP-9 showed a positive relevance(r=0.686,P