Objective Ultrasonongraphy and mammography were employed to estimate the pathological response of patients with breast cancer ,who had been accepted neoadjuvant chemotherapy .According to the pres-ent study ,we can provide additional evidence on therapeutic effect on evaluation of neoadjuvant chemotherapy and better selection of regime for breast cancer .Methods One hundred Thirty-six patients who were previously dia-gosed diagnosed with primary breast cancer were included in this study .All subjects were female with clearly pathological detection and accepted neoadjuvant chemotherapy about 4 to 6 cycles regardless of regime .The resid-ual tumor size was evaluated by mammography and /or ultrasonography before operation .Tumor size measured by image were compared with pathological size to predicting the accuracy of two types of imaging .Results Forty one of 116 records were undetectable imaging by mammogram and 19 of 106 records were undetectable by ultrasound which were considered a pathologic complete response .Sixty one(62.24%)of 98 patients who were accepted de-tection of mammogram and ultrasound would be predicted the tumor size by mammogram .Eighty three(84.69%) of 98 patients would be predicted the residual tumor by ultrasound .31 and 59 were accurately evaluated by mam-mogram and ultrasound , respectively .The result indicated that ultrasound was more accurate than mammogram (60.20%vs.31.63%,χ2 =16.11,P<0.001).The correctly rate was 92.85%(91/98)for ultrasound and 68. 37%(67/98) for mammogram.The diagnosis efficiency of ultrasound was more higher than mammogram ,even though there was no different significance between the two methods (χ2 =2.028,P=0.164).Conclusion Ultra-sonongraphy in estimating the residual tumor size after neoadjuvant chemotherapy of patients with breast cancer displays more accurately than mammography .

Multiple primary carcinomas(MPC),also known as multiple cancer,refers to single or multi-ple organ tissues occur more than two primary cancer in the same patient.In this case,it has been found multiple simultaneous cancers within 6 months.It is called metachronous cancer,which multiple cancers come from differ-ent original cancers more than 6 months.It is reported that there is a low incidence rate of multiple primary carci-nomas,which is largely influenced by radiotherapy and chemotherapy.Multiple primary cancers are easy to be confused with metastatic tumors in clinical practice,both of them are quite different in terms of treatment and prognosis.Therefore,it is helpful to improve the survival of patients by timely diagnosis and treatment.This article reported a case of multiple primary carcinomas.

Objective:To explore whether health and wellness coaching can promote healthy lifestyle among highrisk people with stroke.Methods:The highrisk people with stroke admitted to the hospital were randomly divided into a test group (49) and a control group (49) by excel random function method.The control group was given telephone health education once a week, a total of 12 times last 3 months; On this basis, the test group carried out from every week to every months,a total of 8 timeshealth and wellness coaching, measuring the health promotion lifestyle (HPLP-Ⅱ) scale scores of the two groups of subjects at baseline, at the end of the intervention, and 3 months after the end of the intervention.Results:There was no statistical difference in the general demographic data of the two groups of subjects. Repeated measures analysis of variance showed that three months after the intervention, the two groups of subjects had statistically significant differences in nutrition, health responsibilities, physical activity, self-actualization, and health promotion lifestyle scores between the groups, time, and interaction ( F values were 12.131-502.649, P<0.01). There were no statistical differences in interpersonal relationship and stress coping dimensions ( P>0.05). Simple effect analysis found that at the end of the intervention, the two groups of subjects had only statistical differences between the self-actualization dimension and the total score of health promotion lifestyle ( P<0.01). Three months after the end of the intervention, the total scores of nutrition, health responsibilities, sports, self-actualization and health-promoting lifestyles of the two groups of study subjects were significantly different ( P<0.01). Conclusions:Health and wellness coaching can promote healthy lifestyle among highrisk people with stroke.

Background/Aims: Nonalcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease (NAFLD) characterized by hepatic steatosis, inflammation, hepatocellular injury, and fibrosis. We aimed to investigate the usefulness of a key biomarker, lipocalin-2 (LCN2), for the detection of NASH progression. Methods: A mouse NASH model was established using a high-fat diet and a high-sugar drinking water. Gene expression profile of the NASH model was analyzed using RNA sequencing. Moreover, 360 NAFLD patients (steatosis, 83; NASH, 277), 40 healthy individuals, and 87 patients with alcoholic fatty liver disease were recruited. Results: Inflammatory infiltration, focal necrosis in the leaflets, steatosis, and fibrosis were documented in the mouse liver. In total, 504 genes were differentially expressed in the livers of NASH mice, and showed significant functional enrichment in the inflammation-related category. Upregulated liver LCN2 was found to be significantly interactive with various interleukins and toll-like receptors. Serum LCN2 levels were significantly increased in NAFLD patients. Serum LCN2 levels were correlated with steatosis, intralobular inflammation, semiquantitative fibrosis score, and nonalcoholic fatty liver disease activity score. The area under the curve of serum LCN2 was 0.987 with a specificity of 100% and a sensitivity of 93.5% for NASH diagnosis, and 0.977 with almost the same specificity and sensitivity for steatosis. Conclusions LCN2 might be involved in the transition from NAFL to NASH by mediating inflammation. Serum LCN2 levels might be a novel biomarker for the diagnosis of NASH.

Background/Aims: Nonalcoholic steatohepatitis (NASH) is a progressive form of nonalcoholic fatty liver disease (NAFLD) characterized by hepatic steatosis, inflammation, hepatocellular injury, and fibrosis. We aimed to investigate the usefulness of a key biomarker, lipocalin-2 (LCN2), for the detection of NASH progression. Methods: A mouse NASH model was established using a high-fat diet and a high-sugar drinking water. Gene expression profile of the NASH model was analyzed using RNA sequencing. Moreover, 360 NAFLD patients (steatosis, 83; NASH, 277), 40 healthy individuals, and 87 patients with alcoholic fatty liver disease were recruited. Results: Inflammatory infiltration, focal necrosis in the leaflets, steatosis, and fibrosis were documented in the mouse liver. In total, 504 genes were differentially expressed in the livers of NASH mice, and showed significant functional enrichment in the inflammation-related category. Upregulated liver LCN2 was found to be significantly interactive with various interleukins and toll-like receptors. Serum LCN2 levels were significantly increased in NAFLD patients. Serum LCN2 levels were correlated with steatosis, intralobular inflammation, semiquantitative fibrosis score, and nonalcoholic fatty liver disease activity score. The area under the curve of serum LCN2 was 0.987 with a specificity of 100% and a sensitivity of 93.5% for NASH diagnosis, and 0.977 with almost the same specificity and sensitivity for steatosis. Conclusions LCN2 might be involved in the transition from NAFL to NASH by mediating inflammation. Serum LCN2 levels might be a novel biomarker for the diagnosis of NASH.

OBJECTIVETo evaluate the clinical feasibility of dual-source computed tomographic urography using dual-energy virtual non-enhanced CT.

METHODSTotally 240 patients received dual-source CT, which included true non-enhanced CT (TNCT) , nephrographic phase scanning with dual-energy mode (100kVp/230mAs and Sn140kVp/178mAs) , and excretory phase scanning. A contrast bolus injection of 100 ml (370 mgI/ml) contrast agent was applied (4.5ml/s) , followed by 100ml normal saline (4.5ml/s) . Virtual non-enhanced CT (VNCT) image sets were reformatted from 'Liver VNC ' software. The mean CT number, noise, signal to noise ratio (SNR) , image quality, and radiation dose were compared between TNCT and VNCT image sets.

RESULTSThere was no significant difference in mean CT numbers of all organs (P>0.05) . However, VNCT images had significantly lower noise and higher SNR than TNCT images (both P<0.05) . Image quality of VNCT was lower than that of TNCT without significant difference (P>0.05) . Radiation dose of nephrographic phase with dual-energy mode was significantly higher than that of TNCT and excretory phase scanning (P<0.05) .

CONCLUSIONDual-energy VNCT requires less radiation dose and therefore has a potential to replace TNCT in the dual-source CT urography.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Radiation Dosage ; Radiography, Dual-Energy Scanned Projection ; methods ; Reproducibility of Results ; Sensitivity and Specificity ; Signal-To-Noise Ratio ; Tomography, X-Ray Computed ; methods ; Urography ; methods ; Young Adult

OBJECTIVETo investigate the role of specificity protein 1 (Sp1) in regulating radiosensitivity of cervical cancer cell lines.

METHODSWe analyzed Sp1 expression in 6 different cervical cancer cell lines (SiHa, HeLa, Caski, Me180, Ms751, and C33a) using Western blotting and real-time PCR. Clonogenic survival assay and curve fitting were used to assess the changes in radiosensitivity of Me180 cells transfected with lentivirus-mediated shRNA vector targeting sp1 and HeLa cells transfected with sp1 over-expression vector.

RESULTSIn the 6 cell lines tested, the cellular expression levels of Sp1 decreased gradually in the order of Me180, Caski, C33a, SiHa, Ms751, and HeLa. SP1 knockdown with lentivirus-mediated shRNA significantly lowered the survival rate of Me180 cells following radiation exposure (P<0.05), and obviously lowered the values of SF2, D0 and Dq but significantly increased α/β of the cells. Compared with the cells transfected with the mock vector, HeLa cells with sp1 over-expression showed a significantly increased survival following radiation exposure (P<0.05) with obviously increased values of SF2, D0 and Dq but significantly lowered α/β.

CONCLUSIONSilencing Sp1 can increase the radiosensitivity while Sp1 overexpression enhances the radioresistance of cervical cancer cell lines, suggesting an important role of Sp1 in radiotherapy for cervical cancer.

OBJECTIVETo analyze the expression of MAP2K4 and vimentin in human endometrial carcinoma (EC) and their association with the clinicopathological features and prognosis of the patients.

METHODSMAP2K4 and vimentin expressions were detected immunohistochemically in paraffin-embedded tissue sections from 128 patients with EC, and the correlation of MAP2K4 and vimentin expressions with the clinicopathological factors of the patients was analyzed.

RESULTSMAP2K4 and vimentin proteins were positively expressed in 49 (38.3%) and 83 (64.8%) of the patients, respectively. A positive expression of MAP2K4 was negatively correlated with FIGO stage of the tumor (P=0.010) and lymph node status (P=0.016); a positive expression of vimentin was positively correlated with FIGO stage of the tumor (P=0.025), histological grades (P=0.017), depth of myometrial invasion (P=0.044) and lymph node status (P=0.032). MAP2K4 was inversely associated with vimentin expression in EC(r=-0.598, P<0.001). Patients positive for MAP2K4 tended to have a higher overall survival rate (P=0.002), and those positive for vimentin tended to have a lower overall survival rate (P=0.007); patients positive for MAP2K4 but negative for vimentin had the longest survival time, while those negative for MAP2K4 and positive for vimentin had lowest survival rate (P=0.004).

CONCLUSIONDetection of MAP2K4 and vimentin might help in early diagnosis and prognostic evaluation of patients with EC.

Endometrial Neoplasms ; metabolism ; pathology ; Female ; Humans ; MAP Kinase Kinase 4 ; metabolism ; Prognosis ; Survival Rate ; Vimentin ; metabolism

OBJECTIVETo investigate the expression of phosphoglycerate kinase 1 (PGK1) and its prognostic value in endometrial carcinoma (EC).

METHODSThe expression of PGK1 was detected immunohistochemically in 30 normal endometrium and 130 EC specimens. The relationship between PGK1 protein expression and the clinicopathological features of the patients was evaluated.

RESULTSImmunohistochemical analysis revealed low PGK1 expression in 55.4% (72/130) and high PGK1 expression in 44.6% (58/130) of the EC specimens, as compared with the rates of 90% (27/30) and 10% (3/30) in normal endometrium, respectively (P<0.001). PGK1 expression was significantly correlated with FIGO stage (P<0.001), histological grade (P=0.002) and lymph node metastasis (P<0.001). Kaplan-Meier survival analysis indicated that patients with a high PGK1 expression had a shorter overall survival rate than those with a low PGK1 expression (P<0.001). Multivariate analysis showed that a high PGK1 expression was not the independent predictor of the prognosis of EC (P=0.077).

CONCLUSIONA high expression of PGK1 is associated with aggressive and metastatic behaviors of EC, and detection of PGK1 provides assistance in evaluating the prognosis of patients with EC.

Objective To determine the safety and efficacy of intra-arterial urokinase in the treatment of acute cerebral infarction (ACI) patients with computed tomography perfusion-based selection within a 6-9 h window.Methods Fifty-two ACI patients,with computed tomography perfusion imaging (CTPI) identifying thresholds for salvageable penumbra,were randomly assigned to intra-arterial thrombolysis with urokinase (group A) and conventional anti-platelet aggregation (group B) within a 6-9 h window.Whole brain digital subtraction angiography (DSA) was done at pre-and post-treatment to observe the recanalization of occlusive vessels in group A.The National Institutes of Health Stroke scale (NIHSS) 24 h and 7 d after treatment,and modified Rankin Scale (mRS) and Barthel Index (BI) 90 d after treatment were used to evaluate the efficacy.Results In group A,15 patients showed successful recanalization (thrombolysis in myocardial infarction [TIMI] index:grade Ⅲ in 9 and grade Ⅱ in 6) and 12 patients showed unsuccessful recanalization (TIMI index:grade Ⅰ in 6 and grade 0 in 6) with a successful recanalization rate of 55.56％.More obvious NIHSS improvement 24 h and 7 d after treatment in group A was observed than that in group B (P＜0.05),and more patients with favorable outcomes based on mRS and BI in group A were noted than those in group B (P＜0.05).In addition,the incidence of cerebral hemorrhage within 24 h of treatment between the two groups was similar (P＞ 0.05).Conclusions Intra-arterial thrombolysis with urokinase is safe and effective for ACI patients within a 6-9 hour window under the guidance of CTPI.