Objective To evaluate the feasibility of MRI-guided vacuum-assisted breast biopsy in domestic clinical prac tice.Methods A total of 45 patients with 45 suspicious breast lesions were examined with MRI-guided vacuum assisted bi opsy.The complications were observed.And the followed-up was performed.Results In 45 suspected breast lesions,43 lesions (43/45,95.56％) were successfully sampled under MRI-guided vacuum-assisted biopsy and the pathologic diagnosis was obtained.For another 2 lesions (2/45,4.44％),the pathology diagnosis were not obtained.The time to perform MRI-guided biopsy was (45.87±8.41)min for one lesion.The 5 malignant lesions (5/45,11.11％) confirmed by biopsy pathology were consistent with postoperative pathological results.For the 38 benign lesions (38/45,84.44％) confirmed by biopsy pathology,there was no malignant performance found in MRI follow-up for 6 months.Because of successful MR imaging-guided core biopsy findings,the clinic treatments were changed in 14 patients (14/45,31.11％).Five cases (5/45,11.11％) with malignant tumors were diagnosed early.The surgical biopsy was avoided in 9 benign cases (9/45,20.00 ％) who suspected as malignant.In all 45 patients,no complications occurred,such as hematoma and infection.Con clusion MRI-Guided vacuum-assisted breast biopsy is sufficient and safe for obtaining histologic proof of lesions,and plays an important role in guiding clinic treatment of some lesions visible only by MRI.

Adult ; Aged ; Autoimmune Diseases ; diagnosis ; metabolism ; Female ; Humans ; Insulins ; metabolism ; Male ; Middle Aged

This study was purposed to detect the expression of transforming growth factor β1 (TGF-β1) and its receptors (TGF-βR) and to investigate their roles in pathogenesis of immune thrombocytopenic purpura (ITP). The expressions of TGF-β1 and their receptors TGF-βRI, TGF-βRII and TGF-βRIII in the peripheral blood of patients with ITP and healthy persons were detected by the real-time PCR, and differences of their expression levels were analysed. The results showed that the expression of TGF-β1 and TGF-βRII mRNA in ITP patients was significantly higher than that in the healthy controls, while the TGF-βRI mRNA expression in ITP patient was significantly lower than that in the controls. The expression of TGF-βRIII was not statistically different between the two groups. It is concluded that TGF-β1 and its receptors including TGF-βRI and TGF-βRII express abnormally in the peripheral blood of ITP patients, which suggests that the TGF-β signaling pathway probably play a vital role in the pathogenesis of the ITP.
Adolescent ; Adult ; Aged ; Case-Control Studies ; Child ; Female ; Humans ; Male ; Middle Aged ; Protein-Serine-Threonine Kinases ; metabolism ; Purpura, Thrombocytopenic, Idiopathic ; metabolism ; pathology ; Receptors, Transforming Growth Factor beta ; metabolism ; Transforming Growth Factor beta1 ; metabolism ; Young Adult

The present study was designed to observe the influence of cerebral ischemia/reperfusion injury on learning and memory in hyperlipidemic rats and estimate the changes of activity of autonomic nervous system. Twenty-three male Wistar rats were randomly divided into three groups, named control group (C group, n=10), hyperlipidemia group (H group, n=6) and hyperlipidemia-ischemia group (HI group, n=7), respectively. The rats in H and HI group were fed a high-fat diet for 2 weeks and the rats in all groups were examined through Morris water maze (MWM) task. The rats in HI group underwent ischemia/reperfusion by 2-vessel occlusion (2-VO) method, and had electrocardiogram (ECG) recording simultaneously. The MWM task and ECG recording were taken again after 7 d of recuperation. The following results were obtained: (1) In the second place navigation performance and probe trial performance, the frequency of memory in quadrant of hidden-platform and memory score decreased significantly in HI group compared to that in C and H groups. (2) The heart rate in HI group decreased slowly after ischemia; the power at high frequency band (HF) reduced gradually, meanwhile the power at middle frequency band (MF) and the ratio of power at MF and HF decreased clearly compared to baseline value. (3) After 7 d of ischemia/reperfusion, the heart rate in HI group was significantly higher than that in H group (P<0.05). While there was no statistical change in the power at MF, the power at HF decreased and the ratio of MF/HF increased significantly (P<0.05). The data demonstrated that ischemia/reperfusion decreased the activity of autonomic nervous system, and the reduction of sympathetic nerve activity was much more than that of vagus nerve activity. The results suggest that the hippocampus neuron injury caused by ischemia induces cognitive disorder and imbalance of vago-sympathetic nerve activity accompanied by vagus nerve suppression.
Animals ; Autonomic Nervous System ; physiopathology ; Brain Ischemia ; etiology ; physiopathology ; Heart Rate ; physiology ; Hippocampus ; physiopathology ; Hyperlipidemias ; complications ; Learning Disorders ; etiology ; physiopathology ; Male ; Memory Disorders ; etiology ; physiopathology ; Random Allocation ; Rats ; Rats, Wistar ; Reperfusion Injury ; pathology ; physiopathology

Objective:To explore the efficacy of a 3D printed personalized composite template in the high tibial osteotomy for genu varum.Methods:A retrospective analysis was conducted of the 12 patients with genu varum who had been treated by high tibial osteotomy assisted by a 3D printed composite template at Department of Orthopaedics, The Third Hospital of Changsha between May 2016 and March 2019. They mere 2 men and 10 women, with a mean age of 55.1 years(range, from 46 to 65 years). Before operation, 3D printing technology was used to design and print a personalized composite osteotomy template for each patient. All patients underwent knee arthroscopy before osteotomy. The personalized 3D printed composite template was used to assist the high tibial osteotomy. The therapeutic outcomes were evaluated by comparison of posterior tibial slope angle (PTS), patellar height (Insall-Salvatti index), femorotibial angle, weight-bearing line (WBL) and medial proximal tibial angle (MPTA) on X-ray radiographs, American Hospital for Special Surgery (HSS) knee score and visual analogy scale (VAS) between pre-operation and 12 months after operation.Results:The 12 patients were followed up for 15 to 36 months after operation, with an average of 14.7 months. All wounds healed at the first stage after operation with no complications like infection, nerve injury, deep vein thrombosis at lower limbs, delayed fracture union or nonunion. Follow-ups revealed no such complications as plate breakage or internal fixation loosening. The values of femorotibial angle (181.09°±3.94°), WBL (19.11%±17.61%), MPTA (81.20°±1.15°), HSS (87.6±7.1) and VAS[0(0, 1)] at 12 months after operation were significantly improved compared with those before operation[171.79°±2.77°, 61.71%±2.14%, 88.06°±1.44°, 64.6±12.9 and 4 (3,5) , respectively] (all P<0.05). There was no significant difference in PTS or Insall-Salvatti index between pre-operation and 12 months post-operation ( P>0.05). According to the HSS scores at the last follow-up, the efficacy was excellent in 10 knees, good in one and fair in one. Conclusion:A 3D printed composite osteotomy template can lead to precise correction of alignment of lower limbs in the high tibial osteotomy for genu varum, resulting in good short-term outcomes.

Objective To establish a kind of animal model and methods for neuroendoscope training. Methods With rat abdominal cavity hypothesized as cerebral ventricle, a set of programs for neuroendoscopic operative skill training were designed, including endoscopic techiniques, electronic coagulation, suction, flush, biopsy and balloon dilatation, and so on. Results Simulation operation was performed on rat abdomen under neuroendoscope. The procedure helped to practice the endoscopic manipulation, get to know well how to perform endoscope, coagulation, suction, flash instruments, be familiar with the usage of electric coagulation in the liquid condition. The emphasis was put on the basic skills of pure neuroendoscopic operation such as balloon dilatation, electric coagulation, cutting off,forcep biopsy and flush. Conclusions The rat model can provide a way to train pure neuroendoscopic operation. The trainer can get basic experience with regard to endoscopic manipulation, balloon dilatation, electric coagulation, suction, flush and biopsy under endoscope. The method can be an important part of neuroendoscopic laboratory training.

Objective To undersyand the genetic characteristics of Enterovirus Type 71 (EV 71 )isolated from clinical specimens of children with hand-foot-mouth disease (HFMD)in Shaoxing city from 2012 to 2013.Methods RNA was extracted from specimens collected from stool,throat swab and vesicle from children with HFMD,and EV 71 were identified by reverse transcriptase polymerase chain reaction (RT-PCR).Ten positive samples were isolated and were amplified by segmented PCR,then,they were spliced into a full-length after sequenced according to the reference strains. Homology analysis on region VP1 and phylogenetic tree were carried out based on nucleotide sequence and amino acid sequence.Results The results indicated that the ten isolated strains were all EV 71 positive.Sequence alignment of VP1 showed that the nucleotide and amino acid homogeneity of these 10 strains were related to C4a genotypes,with 95.06%-97.87% and 93.60%-98.99% respectively.Phylogenetic tree based on VP1 indicated that these 10 strains all belonged to C4a genotype.Conclusion The identified EV 71 strains isolated from HFMD children in Shaoxing city belong to genotype C4a.

OBJECTIVETo evaluate the efficacy of intraoperative magnetic resonance imaging (iMRI) and multimodal navigation in surgical resection of glioblastoma.

METHODSBetween February 2009 and July 2010, 76 glioblastoma patients underwent surgical resection guided by iMRI and multimodal navigation. The cohort consisted of 43 male and 33 female patients, with a mean age of 49 years (range: 14-79 years). Rates of gross total resection (GTR) and extent of resection (EoR) were calculated at first and final iMRI scans.Pearson χ(2) test was used to compare the rates of GTR.

RESULTSiMRI and multimodal navigation were successfully implemented in all cases. Rates of GTR were misestimated by neurosurgeons in 24 cases (31.6%), which were confirmed by first iMRI. Total tumor resection were achieved in 20 cases (26.3%) as a result of iMRI scan, increasing the rates of gross total resection from 52.6% to 78.9% (χ(2) = 11.692, P = 0.001). Extent of resection in 28 patients who underwent further tumor resection were increased from 81.5% to 98.1%, leading to the overall extent of resection improved from 92.3% to 98.4%. At 3-month follow-up, 3 cases (3.9%) developed permanent neurologic deficits. The mean clinical follow-up was 15.6 months (range 3.0-45.0 months). The 2-year overall survival rate was 19.7%. The median progression-free survival of gross total resection group was 12 months (95% CI: 10.1-13.9 months), compared with 9 months (95%CI: 7.9-10.1 months) of the subtotal resection group (χ(2) = 4.756, P = 0.029). The overall survival of gross total resection group was 16 months (95% CI: 13.7-18.3 months), compared with 12 months (95% CI: 9.7-14.3 months) of the subtotal resection group (χ(2) = 7.885, P = 0.005).

CONCLUSIONCombined with multimodal navigation, iMRI helps maximize surgical resection of glioblastoma, preserving neurological function while increasing progression-free survival and overall survival.

Adolescent ; Adult ; Aged ; Brain Neoplasms ; surgery ; Female ; Glioblastoma ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods ; Neuronavigation ; Young Adult

Pseudoallergic reactions occured after the first administration of patients, and the pathogenic mechanisms of them were different from the allergic reactions which needed excitation after antigen sensitization. To provide a basis for evaluation, clinical use and drug development of pseudoallergic reactions, the models were established by two kinds of Chinese herbal injections (CHI) both on different strain or gender mice. With the use of ICR, Kunming, BALB/C, C57 mice, pseudoallergic tests of two CHI were conducted to compare the sensitivity of four strains mice, and compared the differences in male and female animals. Test substances contain 0.8% Evans blue (EB) were intravenously injected into different strain and gender mice. Scores of ear blue staining and quantitation of ear EB exudation were the parameters for pseudoallergic reaction. Results of strain difference indicated that both CHI A and B could cause severe pseudoallergic reactions indicated by obvious vascular hyperpermeability on ICR mice. The pseudoallergic reactions in ICR mice are more obvious under the the same dose of injection, which stated the sensibility of ICR mice. And the reactions of KM mice and BALB/C mice were slightly reduced which compared to ICR mice, even alomost nothing on C57 mice. Comparison results of gender difference showed that one CHI was not have significant difference in male and female animals, but male animals were more susceptible than females on another CHI. Therefore, ICR mice were preferable experimental strain on the model of pseudoallergic reactions induced by CHI A and B. Because of female animals were easily influenced by estrous cycle, the pseudoallergic reactions induced by CHI A and B select and use male mice befittingly.
Animals ; Drug Hypersensitivity ; etiology ; Drugs, Chinese Herbal ; adverse effects ; Female ; Injections ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred ICR ; Sex Characteristics ; Species Specificity

Objective To explore the molecular mechanism of pituitary growth hormone adenoma cell proliferation.Methods Functional growth hormone-secreting pituitary adenoma(fGH-PA)tissue samples were collected from 12 patients with acromegaly.The exchange protein 1 directly activated by cAMP(Epac1)mRNA expression levels in fGH-PA tissues and rat RGC-5,MMQ and GH3 cells were determined by qPCR.The expression levels of Epac1 in fGH-PA tissues were determined by immunohistochemistry.Western blot was used to determine the expression levels of Epac1 in MMQ and GH3 cells.Overexpression or knockdown of Epac1,or knockdown of cAMP response element-binding protein(CREB)in GH3 cells,cell cycle changes were determined by flow cytometry,cell proliferation ability was determined by CCK-8 assay,and the expression levels of p-CREB,CREB,Cyclin D1,CDK2 and p21 in cells were determined by Western blot.Results qPCR and immunohistochemistry results showed that the expression levels of Epac1 mRNA and protein in fGH-PA tissues were significantly higher than those in adjacent normal tissues(P<0.05).qPCR and Western blot results showed that compared with RGC-5 cells,the expression levels of Epac1 mRNA and protein in MMQ and GH3 cells were significantly increased(P<0.05).After overexpres-sion of Epac1 in GH3 cells,compared with the Control group,the proportion of cells in G0/G1 phase and S phase in the Epac1-OE group were significantly reduced(P<0.05),and the proportion of cells in G2/M phase were significantly increased(P<0.05);the cell prolifera-tion ability were significantly enhanced(P<0.05);the expression levels of p-CREB and Cyclin D1 in cells were significantly increased(P<0.05),the expression levels of CDK2 and p21 were significantly decreased(P<0.05),while there was no significant change in the expression level of CREB between the two groups(P>0.05).After knockdown of Epac1 or knockdown of CREB in GH3 cells,all of the above results were reversed(P<0.05).Conclusion The overexpression of Epac1 in pituitary growth hormone adenoma cells can up-regulate the levels of p-CREB in cells,and promote adenoma cells to pass through G1/S phase checkpoint,resulting in cell cycle checkpoint disorder and massive proliferation,but it does not affect the expression levels of CREB.