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

Traditional Chinese medicine market is a typical market with information asymmetry, which may lead to "lemons" problem. Third-Party Certification is efficient path to solve the problem of information asymmetry. For this reason geo-authentic and commodity classes certification seems to be very important. But as we know, information asymmetry happen in the stages of traditional Chinese patent medicines market. So a signaling transfer mechanism, which can deliver the quality signal, is badly needed in TCM market. This paper analysis and design of signaling transfer mechanism based on Third-Party Certification, which called quality prestige index of TCM enterprises (QPITCM). QPITCM can display quality information as a signal run through the TCM market.
Certification ; Drugs, Chinese Herbal ; economics ; standards ; Medicine, Chinese Traditional ; economics ; standards ; Quality Control

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

Objective To identify the threshold of percentage of body fat (BF％) associated with diabetes mellitus,hypertension and dyslipidemia in an elderly Chinese population.Methods An individual was considered as a subject if they exhibited any one of the three cardiovascular disease risk factors:diabetes mellitus,hypertension or dyslipidemia.A total of 1 140 subjects were recruited from the Physical Examination Center of Tianjin Hospital,China (male 511,female 629,aged ≥60 years).Questionnaire interview,physical examination,body composition measurement,blood biochemistry measurement,muscle strength measurement and other measurements were performed for each subject.Receiver operating curves (ROC) were created to determine the optimal percentage of body fat cutoff points,with the presence of diabetes mellitus,hypertension or dyslipidemia as outcome variable.Results The percentage of subjects with at least one of the following conditions (diabetes mellitus,hypertension or dyslipidemia) was 62.8％ for men and 73.9％ for women.Increased percentage of body fat was associated with an increased occurrence of diabetes mellitus,hypertension or dyslipidemia in the elderly,particularly among women.The ROC curve shows that the threshold of fat percentage in men and women was 28.2％ and 36.6％,respectively.Conclusion The risks of diabetes,hypertension and dyslipidemia is closely related to elevated body fat mass in the elderly.The percentage of body fat mass is an important indicator of obesity,threshold of BF ％ can provide reference for clinical obesity intervention in elderly patients.It also can provide reference for the treatment and prevention of cardiovascular disease.

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 clinical features and therapeutic strategies of one patient with meningioangiomatosis ( MA ) complicated with intracranial aneurysm formation. Methods The clinical data of one patient with aneurysm-formed MA admitted to the Department of Neurosurgery,the First Affiliated Hospital of Sun Yat-sen University was analyzed retrospectively. The patient received emergency craniotomy and middle cerebral artery aneurysm clipping and evacuation of intracranial hematoma. The meningeal tissue around the aneurysm was taken for pathological examination. Results Microscopy revealed meningeal thickening in the patient with MA accompanied with intracranial aneurysm. Spindle cells around the meninges and perivascular tissue of cortical hyperplasia formed an annular and fence-like structure. The results of immunohistochemistry showed the hyperplastic vessels and perivascular fibroblast like spindle cells diffuse vimentin-positive;the hyperplastic vascular endothelial cells CD99,CD34 were positive;and the residual glial cells in the lesions showed glial fibrillary acidic protein positive. Conclusion MA complicated with intracranial aneurysm is rare. The vascular condition is poor. The shape of aneurysm is irregular,and the risk of bleeding is high. Excise the involved meningeal tissue and clip the aneurysm with microsurgical operation is the resonable treatment.

Objective To assess the accuracy and repeatability of real-time three-dimensional eehoeardiography (RT-3DE) for the measurements of left ventricular (LV) mass in elderly patients compared with magnetic resonance imaging (MRI).Methods A total of 31 patients (26 men) aged ≥60 years (72.1±6.6) years with various cardiovascular diseases were evaluated by MRI and RT- 3DE on the same day.RT-3DE was performed with a Philips iE-33 echocardiographic system, and LV mass was analyzed with the assistance of TomTec software.The results of LV mass 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 A good correlation was observed between RT-3DE data with manual border detection and MRI for LV mass (r=0.869, y=0.943 x+11.69, SE= 19.09 g, P< 0.01), with a mean difference of (4.7±37.7)g.The average LV mass was (123.9±35.0)g (74.4-208.1 g) evaluated by MRI, and was (128.6±37.9)g (67.0-222.9 g) evaluated by RT-3DE.There was good inter- or intra-observer correlation between RT-3DE by two sonographers for LV mass.Conclusions The assessment of LV mass from RT-3DE data is feasible in elderly patients.The mass can be determined with high accuracy and low interobserver variability in elderly patients with adequate eehocardiographic image quality.