Objective To explore the application value of non coherent diffusion weighted imaging(IVIM) model in magnetic resonance body element for differentiating benign and malignant breast cancer.Methods Compar-ison of dynamic enhanced magnetic resonance (DCE -MRI)was conducted in 60 patients with breast occupying lesions,all patients were not treated with biopsy or needle biopsy before MRI scan.The lesions were obtained by oper-ation or biopsy after MRI scan,confirmed by pathology,39 benign lesions(benign group),28 malignant lesions(malig-nant group).IVIM-DWI parameters of two lesions group(D value,D* value and F value)were compared,analyzed IVIMDWI model parameters(D value,D* value and F value)diagnostic efficiency of diagnosis of benign and malig-nant breast lesions.Results Compared with two lesions groups,in the IVIM DWI model parameters,the D value of the malignant group was (0.95 ±0.19)×10 -3 s/mm2 ,which was significantly lower than (1.33 ±0.25)×10 -3 s/mm2 of the benign group (t =3.89,P <0.05),the F value of the malignant group was (8.97 ±2.01)%,which was significantly higher than (7.01 ±2.13)% of the benign group (t =3.93,P <0.05),there was no significant differ-ence in D* values between the two groups (P >0.05).IVIM DWI model in differential diagnosis of breast lesions had high diagnostic efficiency.Conclusion IVIMDWI model in the diagnosis of benign and malignant breast cancer is highly effective,and it has high clinical value.

Objective To observe the therapeutic effect of Jiaji point needling for the treatment of gastroesophageal reflux disease (GRD) with liver-stomach stagnated heat type. Methods Sixty GRD patients were randomly divided into Jiaji point group and conventional point group, 30 cases in each group. Jiaji point group was given needling on bilateral T5 to T10 Jiaji points, and conventional point group was given acupuncture mainly on Zusanli, Zhongwan and Neiguan points, once a day for 10 continuous days. Before and after treatment, the scores of clinical symptoms and gastroscopy results were observed, and then the therapeutic effect and recurrence rate of GRD were evaluated. Results (1) The total effective rate of Jiaji point group was 86.7％, and that of the conventional point group was 83.3％, the difference being insignificant (P > 0.05). (2) After treatment, the scores of clinical symptoms of the two groups were decreased (P < 0.01 compared with those before treatment), and the decrease in Jiaji point group was superior to that in the conventional point group (P < 0.05). (3) After treatment, the mean R value of gastroscopy results in the two groups was lower than that before treatment (P <0.01) , but the difference of the mean R value of gastroscopy results in the two groups was insignificant (P >0.05). (4) After treatment for 2 months, the recurrence rate of Jiaji point group was 23.5％ and that of the conventional point group was 42.9％, the difference being insignificant between the two groups (P > 0.05).Conclusion The short-term effect of Jiaji point needling for the treatment of GRD with liver-stomach stagnated heat type is superior to that of conventional point needling.

Objective To investigate the effect of pioglitazone on oxazolone-induced colitis and to clarify the mechanism of apoptosis by Fas/Fas ligand(FasL). Methods Eighteen BALb/c mice of ulcerative colitis induced by oxazolone enema were equally allocated into 3 groups. The mice in group 1 were sacrificed 3 days after enema,lamina propria mononuclear cells(LPMC) were isolated from freshly obtained colonic specimens and treated in vitro with pioglitazone (40 ?mol/L),the annexin-V-FITC was used for detection of apoptosis,and Fas/FasL expression was assayed by flow cytometry. Meanwhile,untreated mice were served as normal controls. Mice in group 2 (control group) and 3 (experiment group) were treated with methylcellulose or pioglitazone(20 mg?kg -1 ?d -1 ) 3 days after enema and were administrated for consecutive 7 days. The colonic inflammation including disease activity index (DAI),macroscopic and histological changes,myeloperoxidase(MPO) activity and levels of interleukin (IL)-4,IL-5 were evaluated. Results Apoptosis of LPMC,expression of Fas and FasL in normal and colitis mucosa were 12.89?1.23,70.63?6.24,8.59?5.47 and 4.25?0.84,62.60?5.85,23.75?10.23,respectively. After treated with pioglitazone,both apoptosis of LPMC and expression of Fas increased,while FasL expression decreased (40.58?10.32,83.98?11.38 and 10.04?5.21 respectively). In group 2 and group 3,the macroscopic and microscopic score,MPO activity,IL-4 and IL-5 level were 2.50?0.55,8.83?0.75, 3.81?0.17,216.46?34.32,102.28?25.74 and 0.33 ?0.52,4.00?0.63,1.25?0.16,179.36?18.15,61.65?17.45,respectively. Conclusion The results indicate that pioglitazone treatment can significantly attenuate colonic inflammation,and it might be related to the apoptosis of LPMC through Fas and FasL.

Objective To evaluate the value of narrow band imaging(NBI) in the diagnosis of early squamous esophageal cancer and precancerous lesions.Methods Four thousand and fifty-six patients were examined by routine endoscopy,NBI and iodine chromoscopy,one hundred and fourteen lesions in 82 patients were screened.Of all lesions were detected by NBI with magnification and targeted biopsy.The differences among routine endoscopy,NBI and iodine chromoscopy,and the consistency between IPCL and histological findings were assessed.Results Compared to NBI and iodine chromoscopy,especially flat lesions,there was a high missed diagnosis rate in diagnosis of early squamous esophageal cancer and precancerous lesions by routine endoscopy.With NBI and iodine chromoscopy,the incidence rate of lesions was 78.0% and 79.8%,respectively.For iodine staining,85.7% Grade Ⅰ was high grade intraepithelial neoplasia(HGIN),and 66.0% Grade Ⅱ/Ⅲ was low grade intraepithelial neoplasia(LGIN).For NBI,80.4% Grade Ⅰ was HGIN,but there was no specificity in diagnosis LGIN.In appearance of IPCL,92.9% Type Ⅳ/Ⅴ was HGIN,89.4% Type Ⅱ/Ⅲ was LGIN,and it has a relatively better consistency in IPCL with histological findings.Conclusion There is a high detection rate in diagnosis of early squamous esophageal cancer and precancerous lesions by Lugoul's iodine staining and NBI endoscopy.It's probably that IPCL patterns by NBI with magnification can provide scientific basis for both the endoscopic theraphy of early esophageal cancer and the omen of postoperative recurrence.

Objective To evaluate the clinical efficacy of transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization in the treatment of hepatic metastases from colorectal carcinoma.Methods Sixty-eight cases with hepatic metastases from colorectal carcinoma were equally and randomly divided into two groups.The patients in study group were treated with transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization,while the patients in control group were treated with conventional(normal temperature) transcatheter hepatic arterial chemotherapy lipiodol embolization.Results The effective rate of study group and control group was 65%(22 / 34) and 32%(11 / 34) respectively,the difference between two groups was statistically significant(P

0.05).While compared with the control,the permeation enhancement effects of 5% concentration of Lecithin,Oleic acid,Menthol,Limonene,and Azone were 1.37,2.25,3.71,6.75,and 10.15 times,respectively.CONCLUSION: Compared with Simomenine Hydrochloride,Simomenine free base had excellent transdermal characteristics,and was more suitable for the development of new transdermal preparation.

The Six Meridians inTreatise on Exogenous Febrile Diseases were once thought the same with the six meridians ofThe Inner Canon of Huangdi. With this theory was overthrown, similarities and differences and the correlation between them have gradually been studied. In this paper, we take the Taiyang Median as an example to explain the similarities and differences from two aspects, including clinical symptoms and the understanding of the same disease with different treatment.

Spindle cell carcinoma of the breast (SpCC) is a very rare variant of breast cancer characterized as large tumor size,high histological grade and high negative expression of hormone receptors and HER2/neu protein.It has a high tendency for local recurrence and distant metastasis,while the axillary lymph node metastasis is less common occured,which leads to poor outcomes.Given the relatively low incidence,our knowledge about SpCC is limited.The main unsolved obstacles are the early dection and diagnosis,and the improvement in treatments.Herein,this article reviewed the clinicopathologic characteristic,diagnosis,treatment and prognosis of the spindle cell carcinoma of breast.

Objective: To explore the clinical effcacy and short-term survival rate of partial cardiac auto-transplantation for treating the patients with giant left atrium.
Methods: A total of 7 patients with rheumatic heart disease received partial cardiac auto-transplantation in our hospital from 2012-08 to 2013-05 were retrospectively studied. The patients were at the age of (54.9±5.0) years including 3 male, all of them combined with giant left atrium and pre-operative atrial ifbrillation (AF), 6 of them received radio-frequency ablation. All patients were monitored for their baseline condition, operative status, peri-operative mortality and complication occurrence for clinical analysis.
Results: All 7 patients received mitral valve replacement, 5 had aortic valve replacement and 2 had aortic valve-plasty, the mean aortic cross clamp time was (271.7±29.0) min. The average left atrial diameter decreased from (91.7±3.5) mm to (64.8±8.1) mm, left ventricular ejection fraction (LVEF) improved from (38.3±6.5) % to (47.4±6.1) % at discharge, allP<0.05; 4 patients recovered to sinus rhythm and no peri-operative death occurred. The patients were followed-up for (20.7±3.9) months, 1 year post-operational survival rate was 100%, 1 patient died at 17 months after operation and the average left atrial diameter was (56.3±3.4) mm in rest 6 patients at the last examination during follow-up period.
Conclusion: Partial cardiac auto-transplantation may obviously reduce left atrial diameter with good clinical effect in certain patients with giant left atrium.

Objective To investigate the correlation between the expression of P-SAPK/JNK and neuronal apoptosis in the striatum during permanent middle cerebral artery occlusion (pMCAO) in rats.Methods Fifty-four male Sprague-Dawley rats were randomly divided into sham operation group and pMCAO 1-,3-,6-,12-,and 24-hour groups (n =9 in each group).Apoptotic neurons in the striatum during cerebral ischemia were detected by TUNEL assay,the nuclear translocation of P-SAPK/JNK in the striatum by immunohistochemical staining expressions of P-SAPK/JNK protein by Western blot.Results The numbers TUNEL- and P-SAPK/JNK-positive cells in the striatum at 1 hour after pMCAO increased significantly (P =0.000 1),and reached the peak at 6 hours.The numbers of TUNEL-positive cells decreased at 12 hours,however,it still higher than the sham operation group (P =0.000 2).Western blot analysis showed that the expression of P-SAPK/JNK after pMCAO increased significantly,and the time-course change was in accord with the result of immunohistochemical staining Neuronal apoptosis in the striatum was significantly positively correlated with the expression of P-SAPK/ JNK (r =0.984,P =0.000 4).Conclusions Cerebral ischemia may induce neuronal apoptosis in the striatum through the activation of P-SAPK/JNK.