Objective To explore the value of high frequency color Doppler ultrasound for the early diagnosis of asymptomatic hyperuricemia in patients with joint disease.Methods Blood pressure,uric acid,total cholesterol,triglyceride and blood glucose were measured in 44 asymptomatic individual with hyperuricemia (the AH group) and 52 healthy persons (the control group),and the joints of the first metatarsalphalan geal,ankles,knees,wrists,elbows and the first metacarpophalangeal joints in the two groups were examined by high frequency and color Doppler ultrasound.T test,Chi-square test,and Fisher exact test were used for statistical analysis.Results ① The incidence rate of hypertension,diabetes and hyperlipidemia in the AH group [43.2％(19/44),22.7％(10/44),13.6％(6/44)] was significantly higher than the control group (x2=27.995,13.129,7.564;P＜0.01);② Double contour sign were found in the first metatarsal-phalangeal,ankles,knees and elbows of the AH group,in contrast to none in the control group (P＜0.05).The incidence of synovial thickening in the first metatarsal-phalangeal [1.5％(8/528)],ankles of the AH group [1.3％(7/528)]was significantly higher than that of the control group [0(0/624),0.2％(1/624)] (x2=9.521,P＜0.01;x2=5.634,P＜0.05).Similar results were found in the two groups in bone erosion in knees [1.7％(9/528) vs 0.3％(2/624)],in knees effusion [6.0％(32/528) vs 0.96％(6/624)] (x2=5.793,P＜0.05;x2=23.623,P＜0.01).The tophi was found in the fight first metatarsal-phalangeal,bilateral knees and the left first metacarpophalangeal 4 joints in 528 joints of the AH group,in contrast to none in the control group (P＜0.05).The difference in hyperechoic spots was no statistically significant between the two groups (P＞0.05).Conclusion Hyperuricemia is related to hypertension,diabetes and high blood lipids.There are some similar specific sonographic findings of gouty arthritis in the asymptomatic individuals with hyperuricemia.Therefore,these findings support that frequent ultrasound examination is a useful tool for the early diagnosis of asymptomatic hyperuricemia with joint disease,especially the screening of the first meta-tarso-phalangeal joint,ankle joint and knee joint.

Objective To investigate the guidance of the endoscopic ultrasonography for the surgery selec-tion of patients with low rectal cancerthrough analyzing the accuracy of endoscopic ultrasonography in preoperative TN staging. Methods Eighty-seven cases with low rectal cancer received preoperative endoscopic ultrasonography examination,the preoperative staging and the postoperative pathologic comparison. The EUS accuracy of preopera-tive staging of rectal cancer was evaluated. Results The preoperative staging with endoscopic ultrasonography for patients with low rectal cancer,100% in T1 stage,96.0% in T2 stage,85.7% inT3 stage,and 100% in T4 stage. The preoperative staging and the postoperative pathologic comparison in T stage were consistent(Kappa = 0.903, P < 0.05). The preoperative staging with endoscopic ultrasonography for patients with low rectal cancer ,87.0% in N0 stage,78.6% in N1 stage,and 100% in N2. The preoperative and the postoperative pathologic comparisons in N stage were consistent(Kappa = 0.768,P < 0.05). Conclusion The endoscopic ultrasonography had a certain advantage in the clinical preoperative evaluation for patients with low rectal cancer ,especially for invasion depth and the judgment of lymph node metastasis ,with a higher accuracy.

Objective To identify the effect of morphology of adult upper and middle thoracic pedicle on security of screw implantation.Methods Five fresh adult cadaveric thoracic spine from T1 to T8 were harvested.Pedicle transverse diameters were measured and compared with the smallest diameter(4.5 mm) of screw used in clinic.The screws were inserted and implant effect was observed.Results The mean transverse diameter of adult thoracic(T1-T8) were T1:4.74(3.85-5.25)mm,T2:4.51(3.45-5.25)mm,T3:4.15(3.60-4.65)mm,T4:3.75(3.10-4.50)mm,T5:4.25(3.70-4.65)mm,T6: 4.53(4.40-4.70)mm,T7:5.38(5.25-5.60)mm,T8:5.55(5.50-5.80)mm.Of all specimens,there were 9 specmen(22.5%) whose tranverse diameters were smaller than 4.5 mm.After implantation,two screws broke through pedicle lateral wall.Conclusion Adult pedicle transverse diameters in T3-T4 are smallest,transpedicular screw placement is difficult in some of these vertebrae,but in most of thoracic vertebrae,pedicle tranverse diameter could permit screw implanting in security.

PURPOSE: To investigate the distribution of CD44+/CD24- cells in breast cancers in relation to tumor size before and after the administration of neoadjuvant chemotherapy. METHODS: CD44+/CD24- tumor cells obtained from breast cancer specimens were characterized in vivo and in vitro using tumor formation assays and mammosphere generation assays, respectively. The distribution of CD44+/CD24- tumor cells in 78 breast cancer specimens following administration of neoadjuvant chemotherapy was also evaluated using immunofluorescence assays, and this distribution was compared with the extent of tumor invasion predicted by Response Evaluation Criteria in Solid Tumours (RECIST). RESULTS: In 27/78 cases, complete remission (CR) was identified using RECIST. However, 18 of these CR cases were associated with a scattered distribution of tumor stem cells in the outline of the original tumor prior to neoadjuvant chemotherapy. After neoadjuvant chemotherapy, 24 cases involved cancer cells that were confined to the tumor outline, and 21 cases had tumor cells or tumor stem cells overlapping the tumor outline. In addition, there were 6 patients who were insensitive to chemotherapy, and in these cases, both cancer cells and stem cells were detected outside the contours of the tumor volume imaged prior to chemotherapy. CONCLUSION: CD44+/CD24- tumor cells may be an additional parameter to evaluate when determining the extent of breast cancer invasion.
Breast ; Breast Neoplasms ; Fluorescent Antibody Technique ; Humans ; Neoplasm Invasiveness ; Neoplastic Stem Cells ; Stem Cells ; Tumor Burden

Objective:To develop rapid screening tools for assessing the risk of mild cognitive impairment(MCI)based on neuropsychological scales and cognitive paradigms.Methods:Two baseline datasets from the Beijing Ageing Brain Rejuvenation Initiative(BABRI)cohort were studied: dataset 1 contained 5 593 subjects, with 1 500 cases with MCI and 4 093 cases with normal cognitive function(the control group); dataset 2 consisted of 588 subjects, with 92 cases with MCI and 496 cases with normal cognitive function(the control group). Dataset 1 was used to simplify the Mini-Mental State Examination(MMSE), and the sub-item combination with the strongest MCI discriminative ability was selected to integrate into the cognitive rapid assessment(BABRI-mini MMSE). Dataset 2 with scores of encoding-recognition episodic memory task was used for further MCI discriminant analysis and was adapted into an episodic memory test(BABRI-EMT). We applied the receiver operating characteristic curve(ROC)for those analyses.Results:The control group and the MCI group showed significant differences in multi-domain cognitive ability and episodic memory task performance( P<0.01). Among sub-items of MMSE measured using dataset 1, MMSE12 and MMSE19 had the highest discriminative accuracy for MCI, and the area under the ROC(AUC)was 0.699 and 0.631, respectively.Dataset 2 was used to investigate the discriminative ability of the episodic memory score in combination with the above two MMSE sub-items for MCI, and the AUC value was 0.732, the sensitivity was 0.731, and the specificity was 0.656. Conclusions:The BABRI-mini MMSE and BABRI-EMT are suitable for the large-scale universal screening of MCI risk.

Migraine is one of the most prevalent and disabling neurological disease, but the current pharmacotherapies show limited efficacy and often accompanied by adverse effects. Acupuncture is a promising complementary therapy, but further clinical evidence is needed. The influence of acupuncture on migraine is not an immediate effect, and its mechanism remains unclear. This study aims to provide further clinical evidence for the anti-migraine effects of acupuncture and explore the mechanism involved. A randomized controlled trial was performed among 10 normal controls and 38 migraineurs. The migraineurs were divided into blank control, sham acupuncture, and acupuncture groups. Patients were subjected to two courses of treatment, and each treatment lasted for 5 days, with an interval of 1 day between the two courses. The effectiveness of treatment was evaluated using pain questionnaire. The functional magnetic resonance imaging (fMRI) data were analyzed for investigating brain changes induced by treatments. Blood plasma was collected for metabolomics and proteomics studies. Correlation and mediation analyses were performed to investigate the interaction between clinical, fMRI and omics changes. Results showed that acupuncture effectively relieved migraine symptoms in a way different from sham acupuncture in terms of curative effect, affected brain regions, and signaling pathways. The anti-migraine mechanism involves a complex network related to the regulation of the response to hypoxic stress, reversal of brain energy imbalance, and regulation of inflammation. The brain regions of migraineurs affected by acupuncture include the lingual gyrus, default mode network, and cerebellum. The effect of acupuncture on patients' metabolites/proteins may precede that of the brain.
Humans ; Migraine Disorders/etiology* ; Brain/diagnostic imaging* ; Acupuncture Therapy/methods* ; Magnetic Resonance Imaging