Objective To investigate the role of homocysteine(Hcy)and homocysteine thiolactone(HcyT)in the development of macrovascular complications in patients with type 2 DM.Methods A total of 160 subjects were recruited in this study:40 healthy controls,120 with type 2 DM.Plasma Hcy levels were measured by Polarization Immunoassay(FPIA),and HcyT concentrations were monitored using high-performance liquid chromatography(HPLC)on a reversephase C18 column with ultraviolet detection.Plasma folic acid and Vitamin B12 levels were measured with radioimmunoassay method.Results Plasma Hcy and HcyT concentrations in type 2 DM patients were significantly higher than healthy controls[Hcy:9.28(7.51～11.82)?mol/L vs 5.64(5.17～8.00)?mol/L,P

Objective To study the effect of Radix Salviae Miltiorrhizae (RSM), a kind of Chinese Traditional Medicine which can dissolve stasis by activating blood circulation, on proliferation, invasion, adhesion, migration and metastasis of B16-BL6 metastatic mouse melanoma cells and discuss its functional mechanism. Methods The proliferation, adhesion, invasion and migration capacity of B16-BL6 metastatic cells was evaluated by MTT assay, adhesion assay and reconstituted basement membrane invasion and migration assay in vitro respectively. Mouse spontaneous melanoma model was used to study the effect of RSM on metastasis in vivo. Results The extract of RSM bidirectionally adjusted the multiplication of B16-BL6 cells, promoted prominently the adhesion of B16-BL6 to Laminin, inhibited significantly B16-BL6 invading reconstituted basement membrane and the migration of B16-BL6. In the mouse spontaneous melanoma model, it suppressed significantly the volume of lung metastatic nodes but had little effect on the number of lung metastatic nodes. Conclusion The extract of RSM can alleviate the degree of the metastasis of B16-BL6 metastatic mouse melanoma cells, which may be related with inhibiting the B16-BL6 cells invading the extracellular matrix and reducing the migration of B16-BL6 cells.

Objective To compare the lymph node dissection of left chest single incision and neck-right chest-abdomen incision in esophageal cancer surgery,and to explore the reasonable range of lymph node dissection in esophageal cancer surgery.Methods We retrospectively analyzed the clinical data of 72 patients with esophageal cancer radical surgery.According to the surgical approach,the patients were divided into left chest single-incision group (32 cases) and three-incision group (40 cases).The surgery time,number of lymph node resected,drainage tube time,length of hospital stay,lymph node dissection status and incidence of postoperative complications were analyzed.Results In left chest single-incision group and three-incision group,the operative time [(225.44 ± 11.98) min vs (265.42 + 13.15) min],lymph node dissection number[(8.031 ± 1.153) vs (11.821 ± 1.138)],length of stay [(13.212 ± 1.294) d vs(15.691 ± 1.404) d] and other aspects had statistically significant differences (t =24.201,25.302,14.010,all P ＜ 0.05).There were no significant differences between two groups in the chest tube indwelling time and the incidence of postoperative complications (P ＞ 0.05).Conclusion Both surgical radical resection of esophageal cancer have their own characteristics in terms of surgical difficulty,risks,efficacy and complications.In clinical,these must be carefully evaluated in patients with lesions and body affordability flexibility to choose the surgical approach in order to achieve the best therapeutic effect.

Objective To evaluate MR and CT imagings of desmoplastic fibroblastoma(DF) and aggressive fibromatosis(AF) in neck and shoulder girdle, and to emphasis upon the MRI findings with pathological correlation. Methods MR and CT appearances of DFs(4 cases) and AFS(3 cases) confirmed by surgical and pathologic findings were retrospective analysed, which were correlated to the pathologic features. Four cases of DF were male patients, with a median age at 48 years. Two cases of AF were female (20,29 years respectively), and another AF patient was male (79 years). Results (1) Four DFs were round mass located in the intermuscle space of neck, and the margins were mostly well-circumscribed. Envelope was seen in one lesion on MRI. On unenhanced CT, the masses showed homogeneous low attenuation (2 cases) or slightly low attenuation with several heterogeneous areas in it (1 cases). Enhancement was not obvious on post-contrast CT images. MRI studies were done in two patients. Signal intensity (SI) on MR was homogeneous and heterogeneous one lesion respectively on unenhanced T_1-weighted images. Mixed SI as low or high SI nodes within isointense compared with muscle on T_2-weighted images. No evident enhancing was noted after administration of gadopentetate dimeglumine. (2) All three lesions of aggressive fibromatosis arose from musculoaponeurotic structures. The masses were irregular margin and appeared elongated, which oriented in the direction of the muscle bundle. On unenhanced CT examination, the masses had poorly defined and isodense relative to adjacent musculature (2 cases). On T_1-weighted images, three masses consisted of poor margination and isointensity relative to adjacent muscle. On T_2-weighted images, two lesions were heterogeneity of signal, which predominantly slightly high in SI with strip- or node-shape low SI, and one lesion had homogeneous high SI. On post-contrast T_1-weighted images, all lesions showed marked enhancement, heterogeneity of signal and irregular margin appeared distinctly. Of them, two masses had claw-shape invasive margin. Conclusion Both DF and AF, the age range of affected persons different, were fibroblastic origin soft-tissue neoplasms. The distinct imaging characteristics of these two disorders were related to their different [JP3]pathologic features. Concerning the effect of diagnose and differential diagnose, MRI was predominance over CT. [JP]

Objective To describe the CT appearance of recurrent laryngeal nerve paralysis,discuss the anatomic and pathologic basis of this paralysis,and evaluate CT diagnosis.Methods 32 cases of recurrent laryngeal nerve paralysis clinical confirmed were analyzed retrospectively.All of these patients had the CT scans from the level of hyoid bone to the upper thorax,the slice and interval are 5 mm.Results CT findings of recurrent laryngeal nerve paralysis included: oblique of aryepiglottic fold,dislocation of arytenoids cartilage and cricoarytenoid joint,dilation and relaxation of piriform sinus for 27 cases (84.4%);wide and asymmetrical ventricle of larynx for 16 cases(50.0%);asymmetrical and fix of vocal fold for 11 cases(34.4%) et al.Conclusion The recurrent laryngeal nerve innervate all the intrinsic muscles of the larynx except cricothyroid muscle,paralysis of the nerve leads to atrophy of related muscles.CT scan demonstrate the larynx morphologic changes of recurrent nerve paralysis and is helpful to identify the etiology.

ObjectiveTo analyze the MRI features of aggressive fibromatosis (AF) in order to improve its diagnostic accuracy.Method The clinical files and MRI appearances of 66 AF patients (primary 19 cases,recurrent 47 cases) were reviewed and compared with the postoperative pathological findings.ResultsThe median age of all patients was 31 years( range,11—60 years) with a male-to-female sex ratio of 1 ∶ 3.4.Eighty tumors were discovered.There were 5 superficial fibromatosis and 75 deep fibromatosis in which 2 lesions were intraabdominal,6 lesions in the abdominal wall and 67 lesions extraabdominal.The average long diameter of all lesions was ( 8.7 ± 5.4 ) cm,of superficial lesions ( 5.7 ±2.8) cm,of deep lesions ( 8.9 ± 5.5 ) cm.Of the 80 tumors,79 were displayed as space-occupying intramuscular lesions; 47(58.8％ ) were ovoid or lobulated and 22( 27.5％ ) were infiltrative in shape; 48 (60％) lesions had a well-defined margin,of which 4 formed a pseudocapsule as they enlarged by compressing normal tissue.To compare with the muscle signal intensity on MRI,75 lesions demonstrated isointensity,mild hyperintensity or hypointensity on T1 WI,heterogeneous high intensity on T2 WI,and avid heterogeneous enhancement after contrast administration.There was no necrosis or surrounding edema in all lesions.Tumors destroyed bone in 2 cases.ConclusionAggressive fibromatosis has characteristic features on MRI,and MRI is valuable in diagnosising AF and evaluating the extend of lesion and involvement of adjacent structures.

ObjectiveTo investigate the prognostic factors of non-small cell lung cancer (NSCLC) after resection.MethodsClinical data of 131 NSCLC patients who underwent resection were reviewed and divided into chemotherapy group(86 cases) and non-chemotherapy group(45 cases) according to the treatment method.Survival rate was calculated by Kaplan-Meier method.The prognosis was analyzed by Cox proportional hazards model.ResultsThe median survival time (MST) of squamous cell carcinoma (76 cases),bronchial alveolar cell carcinoma( 8 cases),adenocarcinoma( 35 cases ),adenosquamous carcinoma (12 cases) was 60,54,34,24 months respectively (P＜0.05).For the patients of stage Ⅰ B,the MST of chemotherapy group and non-chemotherapy group was 75 and 76 months respectively(P ＞ 0.05 ).Multivariate analysis showed that tumor size,T stage,N stage,chemotherapy were independent prognostic factors (P =0.080,0.002,0.000,0.029).Conclusions Squamous cell carcinoma and bronchial alveolar cell carcinoma have better prognosis than adenocarcinoma,adenosquamous carcinoma.For the patients of stage Ⅰ B,the survival time can't be prolonged through platinum-based chemotherapy.Tumor size,T stage,N stage,chemotherapy are independent prognostic factors.

Background and purpose:Histological grade of DCIS is an important factor in the prognosis, high nuclear grade have higher inifltration trend and recurrence rate. This study aimed to evaluate the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast, then analyze its relations with nuclear grade. Methods:Of the 94 patients, 97 lesions were proved DCIS by pathology. The morphology, maximum size, time-intensity curve of lesion were recorded or measured. Statistic was performed to identify MR imaging features that optimally discriminated HNG from non-HNG DCIS. Results:There were 49 non mass-like enhancement lesions, and 48 masses enhancement lesions. Among 49 non mass-like lesions, 29 were segmental enhancement (59.18%). Dynamic enhanced performance:50 exhibited plateau curves and 27 were washout curves. BI-RADS categories:22 BI-RADS 4A, 19 BI-RADS 4B, 29 BI-RADS 4C, and 27 BI-RADS 5. HNG lesions exhibited larger mean maximum lesion size (non-mass-like enhancement: P=0.01; mass: P=0.03), time- intensity curve was variable to approach signiifcance (P=0.01), and BI-RADS can help to discriminate the nuclear grade (P=0.02). There were no differences in lesion morphology (P>0.05). Conclusion:The preliminary ifndings suggest that DCE MR imaging features may aid in identifying patients with high risk DCIS.

Background and purpose: Ductal carcinoma in situ (DCIS), is precursor lesions of invasive breast cancer, belongs to non-systemic ductal lesions, which is similar to other ductal lesions on imaging. This study aimed to investigate the differential diagnostic value of MRI in DCIS between DCIS with microinvasion (DCIS-MI) and breast intraductal papilloma (BIDP). Methods:All the cases were surgico-pathologically conifrmed. Twenty-four patients were DCIS, 9 patients were DCIS-MI, and 20 patients were BIDP. The MRI charateristics of DCIS, DCIS-MI and BIDP were analyzed and compared. Results:DCIS and DCIS-MI’s performance in the form of MRI is dififcult to differentiate (P<0.05). Compared with BIDP, the ductal and segmental enhancement, typeⅢtime-signal intensity curve (TIC), and the red pseudo-color image were associated with the DCIS. The local area enhancement, typeⅡTIC, and no-red pseudo-color image were associated with BIDP. Conclusion:MRI is a useful for differentiate between DCIS and BIDP, but is dififcult for DCIS and DCIS-MI.

Objective To investigate the influence of glycosylated hemoglobin A1c (HbA1c) standard value (2007 and 2010 Chinese Diabetes Prevention Guide) on glycemic control and treatment of type 2 diabetic patients in Chinese cities.Methods A cross-sectional study was carried out in type 2 diabetes mellitus from outpatients in selected hospitals all over China in 2009 and 2012.Patients treated with oral antidiabetic drugs (OADs),insulin or OAD combined with insulin were enrolled.A questionnaire including general characters,therapy,complications and blood glucose was completed by trained surveyors.Results A total of 30 853 patients were enrolled in 2009,and 48 232 patients in 2012.The distribution of HbA1c ＜6.5％,6.5％-＜7.0％,7.0％-＜8.0％,8.0％-＜9.0％,9.0％-＜ 10.0％ and ≥ 10.0％ was 20.35％,12.59％,35.50％,18.94％,6.46％ and 6.16％ in 2012; 14.81％,27.72％,14.55％,6.55％ and 8.36％ in 2009,respectively.The top three OAD were biguanides,sulfonylureas and thiazolidine.The most common treatment options for combined therapy are metformin combined with sulfonylurea in both 2009 and 2012.Conclusions There is an increase in the proportion of patients with good and general blood glucose control in 2012.With the generalization of Chinese Diabetes Prevention Guide,a steady tendency is presented in blood glucose control.