PURPOSE: The purpose of this study is to illustrate MR patterns of bone marrow of calvarium and vertebral body in normal subjects according the age distribution and to understand the course of the fatty replacement from red marrow. METHODS AND MATERIAL: We retrospectively evaluated MR examinations of the calvaria(n=71), cervical spine(n=71), thoracic spine(n=65), Imbar spine(n =68) in subjects without bone marrow abnormality whose age ranged 3 weeks to 74 years. Three distinctive patterns were categorized on Tl-weighted images of the skull. In pattern 1, uniformly low signal intensity with or without very small areas of high intensity in frontal and occipital bones is noted. In pattern 2, frontal and occipital bones have uniformly high signal intensity, and patchy area of high intensity appears in parietal bone. In pattern 3, the entire skull has uniformly high signal intensity. In the spine, four patterns were categorized on Tl-weighted MR images. In pattern 1, the vertebral body has uniformly low signal intensity except for linear areas of high intensity superior and inferior to basivertebral vein. In pattern 2, bandlike and triangular areas of high signal intensity are found in the periphery. Pattern 3 and 4 have diffusely distributed areas of high signal intensity; pattern 3 consist of numerous indistinct dots measuring a few millimeter or less, and pattern 4 consist of fairly well marginated areas ranging in size from 5 to 1.5cm. RESULT:In the calvaria, 73% of pattern 1 were younger than 20 years, pattern 2 were evenly distributed, and 86% of pattern 3 were older than 40 years. In the spine, 87% of pattern 1 were younger than 40 years, 72% of pattern 3 were in 40 to 50 years, and 87% of pattern 4 were older than 50 years. Pattern 2 were evenly distributed in the cervical and thoracic spine, but in the thoracic spine 62% were younger than 30 years. CONCLUSION:It is concluded that younger age group shows mainly pattern 1, whereas elderly group has pattern 3 or 4 in the calvarial and vertebral body marrow. This suggests that conversion to fatty marrow begin locally and progress diffusely with age.
Age Distribution* ; Aged ; Bone Marrow* ; Humans ; Occipital Bone ; Parietal Bone ; Retrospective Studies ; Skull* ; Spine ; Veins

An ipsilateral supraclavicular lymph node recurrence of breast cancer after surgery has been considered a predecessor to distant metastases. There still is a debate as to whether breast carcinoma patients with the isolated supraclavicular lymph node recurrence should be considered to have disseminated disease or if aggressive treatment, with curative intent, is justified. We report two cases of an isolated ipsilateral supraclavicular lymph node recurrence following modified radical mastectomy, and multimodality treatments with modified radical neck dissection, systemic chemotherapy and involved field radiotherapy. These patients have lived without locoregional recurrence or distant metastases for 3 and 2 years, respectively. Conclusively, we recommend aggressive combined multimodality treatments, including surgery, such as modified radical neck dissection or complete excision of the involved lymph nodes, systemic chemotherapy, and involved field radiotherapy, in patients with isolated supraclavicular lymph node recurrence, but with no other evidence of distant metastases.
Breast Neoplasms ; Drug Therapy ; Humans ; Lymph Nodes ; Mastectomy, Modified Radical ; Neck Dissection ; Neoplasm Metastasis ; Radiotherapy ; Recurrence

No abstract available.
Pregnancy*

Objective To study the therapeutic effect of recombinant adeno-associated virus carrying human endostatin gene therapy on endometriosis in mice model. Methods Recombinant adeno-associated virus vector carrying human endostatin gene and enhanced green fluorescent proteins gene (rAAV2-endostatin-EGFP) was constructed. Endometrium was from 12 patients with leiomyoma undergoing hysterectomy in Second Hospital, Tianjin Medical University between November and December 2008. Endometriosis models of nude mice were established by transplanting human endometrial fragments intooperitoneal surface. After 1 week, those 60 mice were divided into 3 groups: treatment group including 20 mice injected with rAAV2-endostatin-EGFP to ectopic lesion, control group including 20 mice injected with rAAV2-EGFP to ectopic lesion and blank control group including 20 mice injected with phosphate buffered saline (PBS) to the ectopic lesion. At 1, 2 and 3 weeks after treatment, those mice underwent laparotemy to observe the location and size of ectopic lesion in abdominal cavity. The expression of endostain protein, number of gland, microvessel density (MVD) and vascular endothelial growth factor (VEGF) were measured in ectopic lesions. The serum level of estradiol and progesterone were detected in nude mice among every groups. Results (1) All endometriosis of nude mice models were established successfully through peritoneum transplanting. After 1 week's treatment, flat lesion nodes, decreased gland number and narrow and atrophy glandular cavity were observed by light microscope. (2) The endostatin gene was transferred into nude mice successfully and expressed effectively. It was observed that endostatin protein expression was shown with enhanced green fluorescent proteins in ectopic lesion. (3) Glands number of ectopic lesion in rAAV2-endostatin-EGFP group(7.8±1.9,7.0±1.5 and 5.5±1.7) were significantly less than 10.1± 1.7, 10.2±2.0 and 9.8±2.4 in rAAV2-EGFP control group and 10.2±2.2,10.0±2.0 and 9.7±2.2 in PBS control group at 1,2 and 3 weeks after treatment(all P<0.05). Glands number of ectopic lesion in rAAV2-endostatin-EGFP group at 3 weeks was significantly less than those at 1 and 2 weeks after treatment (P<0.05). (4) MVD of ectopic lesion in rAAV2-endostatin-EGFP group (12.2±1.5,11.4±2.1 and 9.0±1.4) was significantly less than those at rAAV2-EGFP control group (16.5±1.7,16.5±1.9 and 16.9±1.9) and PBS control group (16.2±1.6,16.0±1.6 and 16.3±1.7) at 1,2 and 3 weeks after treatment (all P<0.05) . MVD of ectopic lesion in rAAV2-endostatin-EGFP group at 3 weeks was significantly less than those at 1 and 2 weeks after treatment(P<0.05). (5) The rate and density of VEGF expression at ectopic lesion in rAAV2-endostatin-EGFP group (35%, 30%, 25% and 1.60±0. 43,1.33± 0. 30,1.03±0.36) were significantly less than those at rAAV2-EGFP control group (80% ,75% ,85% and 2.43±0.53,2.43±0.29,2.66±0.45) and PBS control group (85% ,90% ,90% and 2.36±0.53,2.64± 0.57,2.53±0.52) at one 1, 2 and 3 ,weeks after treatment (all P<0.05). The expression of VEGF at ectopic lesion in rAAV2-endostatin-EGFP group at 3 weeks was significantly less than those at 1 and 2 weeks after treatment (P<0.05). (6) The level of estradial and progesterone in serum of nude mice of rAAV2-endostatin-EGFP group [ E_(2)> : (48±7 ) pmol/L, P: (61±8 ) nmol/L ] did not reach statistical difference when compared with those at rAAV2-EGFP control group [ E_(2): (50±9) pmol/L, P: (60±10) nmol/L] and PBS control group [E_(2):(48±7)pmol/L,P: (58±10)nmol/L,P>0.05]. Conclusions The recombinant adeno-asseciated virus carrying human endostatin gene therapy could inhibit angiogenesis at endometriotic lesions and not influence steroid level. The antiangiogenic gene therapy might become a novel option for endometriosis.

Objective:Scope review of exercise-related research in patients with inflammatory bowel disease (IBD), while pointing out the limitations of existing research, and providing references for future studies in this area.Methods:We searched PubMed, EMBASE, Web of science, Cochrane databases, China Biology Medicine, Chinese National Knowledge Infrastructure, Wan Fang Data, and Chinese Science Journal Database for studies related to exercise intervention in patients with IBD from January 1974 to July 2020. We extracted data from the included studies. Then we summarized and presented the results.Results:16 articles were finally included, of which 14 were randomized controlled trials and 2 were quasi-experimental studies. Results show that exercise methods can be divided into four categories: aerobic exercise, resistance exercise, flexibility exercise and mixed exercise. The intensity of exercise was mostly low to moderate. The frequency of exercise was mostly 3 times/week, lasting for 30-60 minutes per session. The results showed that exercise had positive effects on physical fitness, bone density, anxiety and depression, quality of life among patients with IBD. However, the effect of exercise on disease activity are diverse.Conclusion:exercise is beneficial to the mental and physical health among this group, but the existing studies have small sample sizes, short exercise intervention period, neglect of individualization in exercise prescription design, low exercise compliance, non-uniformity of exercise effect evaluation indicators.

Self-disclosure is a simple and effective intervention to improve the health outcomes of patients. Foreign scholars have paid attention to it and applied it in the self-management of patients with chronic diseases widely. However, there are few domestic related studies in China. This article reviewed the definition, significance, assessment tools, and summarized the influencing factors and intervention studies of self-disclosure in patients with chronic diseases. It would provide references for research of self-disclosure, further improving the self-management and mental health of patients with chronic diseases.

No Abstract Available.
Mass Screening*

The gastrointestinal mesenchymal tumors (GIMTs) form a heterogenous group with controversy centering on both the cell of origin and the prediction of clinical behavior. They include a small group of tumors with mature smooth muscle or Schwann cell differentiation and a larger group with inconsistent or no evidence of differentiation. Tumors in the latter are now referred to as gastrointestinal stromal tumors (GISTs). A clinicopathologic and immunohistochemical study was performed on 53 cases of GIMTs to identify cellular differentiation and predictors of clinical behavior. Fifty three cases of GIMTs could be histologically and immunophenotypically divided into three categories, 6 leiomyomas (11.3%), 4 schwannomas (7.6%), and 43 GISTs (81.1%). All leiomyomas (SMA desmin ) and schwannomas (S-100 ) were located in stomach and negative for CD34 and CD117. Thirty nine cases of GISTs were either CD34 (n=26) or CD117 (n=23) immunoreactive. Of these 39 GISTs, 26 were negative for myoid (SMA, desmin) and neural marker (S-100), 10 SMA desmin-S-100-, two SMA-desmin-S-100 , and one SMA desmin-S-100 . Two out of 4 GISTs, which were negative for CD34 and CD117, were immunohistochemically considered leiomyosarcoma (SMA desmin ). GISTs of small intestine had a tendency to be malignant than those of stomach. Pathologic grade of GISTs was not correlated with cellular differentiation. In 29 GISTs with clinical follow-up information, tumor size, mitotic counts, Ki-67 labelling index, tumor necrosis, mucosal invasion, and CD34 expression were significantly correlated with metastasis/recurrence.
Cell Differentiation ; Desmin ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Intestine, Small ; Leiomyoma ; Leiomyosarcoma ; Muscle, Smooth ; Necrosis ; Neurilemmoma ; Stomach

Urinary stones are rarely seen in the urethra and are usually encountered in men with urethral stricture or diverticulum. The case of a 52-year-old woman presented, who consulted for weak stream associated with repeated urinary infections. The diverticulum was approached via vaginal route and the extraction was successful. The patient has been well, with no dysuria, dyspareunia, incontinence for 3-month follow-ups.
Calculi ; Diverticulum ; Dyspareunia ; Dysuria ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rivers ; Urethra ; Urethral Stricture ; Urinary Calculi

PURPOSE: To know the differences of proton MR spectroscopic features between recurrent rectal cancer and fibrosis in post-operative period, and to evaluate the possibility to discriminate recurrent rectal cancer from post-operative fibrosis by analysis of proton MR spectra. MATERIALS AND METHODS: We evaluated the proton MR spectra from 25 soft tissue masses in perirectal area that developed in post-operative period after operation for the resection of rectal cancer. Our series included 11 cases of recurrent rectal cancer and 14 of fibrotic mass. All cases of recurrent rectal cancer and post-operative fibrosis were confirmed by biopsy. We evaluated the spectra with an attention to the differences of pattern of the curves between recurrent rectal cancer and post-operative fibrosis. The ratio of peak area of all peaks at 1.6 -4.1ppm to lipid (0.9 - 1.6ppm) [P (1.6 -4.1ppm)/P (0.9 -1.6ppm)] was calculated in recurrent rectal cancer and post-operative fibrosis groups, and compared the results between these groups. We also evaluated the sensitivity and specificity for discriminating recurrent rectal cancer from post-operative fibrosis by analysis of 1 H-MRS. RESULTS: Proton MR spectra of post-operative fibrosis showed significantly diminished amount of lipids compared with that of recurrent rectal cancer. The ratio of P (1.6 -4.1ppm)/P (0.9 -1.6ppm) in post-operative fibrosis was much higher than that of recurrent rectal cancer with statistical significance (p < .05) due to decreased peak area of lipids. Mean (standard deviations of P (1.6 -4.1ppm)/P (0.9 -1.6ppm) in post-operative fibrosis and recurrent rectal cancer group were 2.71 +/-1.48 and 0.29 +/- 0.11, respectively. With a cut-off value of 0.6 for discriminating recurrent rectal cancer from post-operative fibrosis, both the sensitivity and specificity were 100% (11/11, and 14/14). CONCLUSION: Recurrent rectal cancer and post-operative fibrosis can be distinguished from each other by analysis of proton MR spectroscopic features, and 1 H-MRS can be a new method for differential diagnosis between recurrent rectal cancer and post-operative fibrosis.
Biopsy ; Diagnosis, Differential ; Fibrosis* ; Magnetic Resonance Spectroscopy* ; Protons* ; Rectal Neoplasms* ; Sensitivity and Specificity