Objective To identify histopathologic correlates for the various MRI appearances of breast fibroadenomas.Methods Thirty-eight fibroadenomas in 33 patients(aged 24—57 years)examined with gadolonium-enhanced MR imaging were observed for signal intensity on T_2-weighted images,contrast enhancement,shape,and internal septation,and these findings were correlated with histopathologic findings.All cases underwent surgery and were proved by pathology.Results(1)The lesion shape was lobular,or round in 34 of 38 fibroadenomas(89.5%).(2)The signal intensity on T_1-weighted images was less than or equal to that of fibroglandular tissue in all cases.The signal intensity on T_2-weighted images was highly varible:high T_2 signal intensity was associated with more myxomatous stromal(mean myxoid-sclerotic index value of 1.9),higher stromal cellularity(mean stromal cellularity index value of 2.2); Fibroadenomas with low T_2 signal intensity had stromal that was nearly uniformly sclerotic(mean myxoid- sclerotic index values of 2.8)and low stromal cellularity(mean stromal-cellularity index value of 1.2). Significant differences were found between these two groups,x~2=11.267 and x~2=10.415(P0.05).The degree of contrast enhancement was proved to be related to ages of patients.The enhancement was more intensely in younger patients.(5)Internal septations were identified within nine of 33 enhancing fibroadenomas (27.3%)and appeared to correlated with collagenous bands at histopatholigic analysis.Conclusions Fibroadenomas demonstrate marked histopathologic variability.The resultant variability in the MR appearance correlated with the degree of myxomatous or sclerotic and stromal cellularity.Lobulation and internal septation,which appear to reflect intrinsic growth patterns of fibroadenomas,may provide more reliable information for distinction.Familiarity with the diagnostic features would facilitate to make the differential diagnosis correctly.

Objective To evaluate the b value of diffusion-weighted(DW)MRI in distinguishing between benign and malignant breast lesions.Methods Three diffusion-weighted sequences were implemented with 500,1000 and 2000 s/mm~2 b values respectively on 95 breast lesions in 83 patients.All lesions were confirmed by pathology.The apparent diffusion coefficient(ADC)values and signal intensity (SI)were recorded and compared in different lesions(breast cancer,benign lesion,cyst and normal beast tissue)with the same b value and the same lesions with the different b values.Results(1)The mean ADC value and SI of breast cancer were 1.375?0.378 and 839.713?360.493 respectively with b= 500 s/mm~2,1.176?0.311 and 459.314?229.609 with b=1000 s/mm~2,0.824?0.198 and 243.825? 110.616 with b=2000 s/mm~2.The differences in the mean ADC value were significant between two type lesions(cancer and benign lesion,cancer and cyst,cancer and normal breast tissue)with b values of 500 s/mm~2 and 1000 s/mm~2.But the significant differenee was only seen between cancer and benign lesions when b value was 2000 s/mm~2.(2)The one-side upper limits of 95% confidence interval of mean ADCs were adopted as the point to separate the malignant from the benign lesions,the sensitivity was 70.92%, 70.73% and 69.77%,the specificity was 77.19%,75.70% and 54.76%,the accuracy was 77.12%, 74.32% and 62.35% respectively with b values of 500 s/mm~2,1000 s/mm~2 and 2000 s/mm~2.The areas under ROC eurves were Az_(500)=0.775?0.046(P0.05).Conclusion DWI MRI is useful for the differential diagnosis of breast lesions with b values of 500 s/mm~2 and 1000 s/mm~2.

Objective To investigate the value and diagnostic efficiency of the quantitative dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) and intravoxel incoherent motion (IVIM) parameters using three dimention (3D)-histogram analysis for discriminating the Gleason score (GS) of prostate cancer. Methods A total of 53 patients pathologically confirmed as prostate cancer by systemic prostate biopsy who had routine , DCE and DWI-MRI scans were retrospectively analyzed. There were 15 cases for low-risk and 38 cases for intermediate/high-risk prostate cancer. The 3D ROI of all lesions based on T2WI was achieved by image registration to get the quantitative parameters of DCE-MRI and DWI-IVIM. The parameters of DCE-MRI contains: transfer constant (Ktrans), rate constant (Kep) and extracellular-extravascular volume fraction (Ve).The DWI-IVIM related quantitative parameters were ADC, diffusion coefficient (D), diffusion coefficient related to perfusion (D*) and perfusion fraction (f). Then the histogram analysis of these quantitative parameters was performed to get the mean, median, 25th percentile, 75th percentile, Skewness and Kurtosis. Using the Spearman rank correlation analysis to evaluate the correlation of these parameters and GS of prostate cancer. The diagnostic performance of these quantitative histogram parameters related to the GS in identifying low-risk and intermediate/high-risk of prostate cancer was carried by ROC. Results The Kep and Ktrans (mean, median, 25th, 75th) of DCE-MRI were positively correlated with GS (r value was 0.346 to 0.696, P<0.05). The ADC (mean, median, 25th, 75th), D (mean, median, 25th, 75th, Skewness, Kurtosis) and D*(25th) of DWI-IVIM were correlated with GS (r value was-0.544 to 0.428, P<0.05). The DCE-MRI quantitative parameters Kep (25th) had the highest area under curve (AUC, 0.961); The ADC (median) and D (25th) had higher AUC( 0.832, 0.888) in the quantitative parameters of DWI-IVIM, the difference between Kep(25th) and ADC (median) was statistically significant (Z value was 2.212, P value was 0.027). The difference of AUC between Kep (25th) and D (25th), D (25th) and ADC (median) was not statistically significant (Z values were 1.027 and 1.398, P values were 0.162 and 0.304, respectively).Conclusion DCE and IVIM quantitative parameters (Kep, Ktrans, ADC, D) histogram analysis results are correlated with GS, and can be used for distinguishing low-risk from intermediate/high-risk prostate cancer.

Objective To investigate the value of three-dimensional speckle tracking imaging (3D-STI) in assessment of left ventricular (LV) strains. Methods Thirty healthy young adults examined by two-dimensional speckle tracking imaging (2D-STI) and 3D-STI. And the results of LV measurements were compared, which included mean peak systolic longitudinal strains, radial strains and circumferential strains. Also, the time consumption of these two methods was compared. Results The time needed for 3D-STI in acquisition and analysis of the images were (309.3±23.4)s, (305.5±11.2)s, while the time for 2D-STI were (490.6±14.4)s, (1261.4±39.9)s. The differences were signiifcant(t=-21.81, 69.94, both P<0.01). The global mean peak systolic radial strains was (48.59±7.68)%by 3D-STI and (33.25±7.27)%by 2D-STI. The difference was signiifcant(t=9.16, P<0.01). The global mean peak systolic longitudinal and circumferential strains were (-17.66±3.14)%, (-17.13±2.29)% by 3D-STI and (-21.35±2.46)%, (-21.97±3.84)% by 2D-STI. The differences were signiifcant(t=5.33, 5.99, both P < 0.01). The 3D-STI strains were different at different levels of LV. The longitudinal, circumferential and radial 3D-STI strains were largest at middle levels. However, 2D-STI strains didn′ t show such trend. Peak strains measured by 3D-STI and 2D-STI showed high inter-observer and intra-observer agreement in Bland-Altman chart. Conclusion 3D-STI is a novel, convenient and reproducible method to evaluate the strains of LV.

OBJECTIVETo screen phosphopeptide specific for acute leukemia.

METHODSMononuclear cells from bone marrow were collected from 16 newly diagnosed acute lymphoblastic leukemia (ALL) and 20 acute myeloid leukemia (AML) patients. Peptides were extracted and purified, analyzed by immunoprecipitation and liquid chromatography coupled with tandem mass spectrometry (LC-MS).

RESULTS(1) Non-receptor tyrosine kinase family members Fyn, Yes, Src widely expressed in acute leukemia; (2) Some phosphopeptides, including non-receptor tyrosine kinase family members Abl/iso1 and Abl, non-receptor Ser/Thr protein kinase family members Bcr, JNK2, JNK2 iso2, Adaptor/scaffold members Cas-L, Cbl, CrkL CENTD1 (Centaurin delta1) ZO2, transcriptor GFR-1 and phosphatase SHIP-2 were detected in Ph positive ALL, but not in other kinds of ALL. (3) Hck, Lyn and Fgr selectively expressed in AML (except AML-M(3)).

CONCLUSIONSome phosphopeptides were specific for ALL and AML, and may be useful for diagnosis and therapy of acute leukemia.

Chromatography, High Pressure Liquid ; Humans ; Immunoprecipitation ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; Neoplasm Proteins ; analysis ; Phosphopeptides ; analysis ; Phosphorylation ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; metabolism ; Proteomics ; Tandem Mass Spectrometry

The clinical efficacy of acupuncture and moxibustion for post-stroke constipation was systematically reviewed. By computerized and manual retrieval of clinical research literature regarding acupuncture and moxibustion for post-stroke constipation, the randomized control trials (RCTs) that met the inclusive criteria were collected. Cochrane systematic review method was used and Revmen 5.2 software was adopted to perform this Meta analysis. Totally 8 articles were included, involving 610 cases of post-stroke constipation. As a result, the total effective rate and cured rate of acupuncture and moxibustion for post-stroke constipation were significantly superior to those of the control group [total effective rate: OR = 2.10, 95% CI (1.25, 3.54), Z = 2.78, P = 0.005; cured rate: OR = 2.37, 95% CI (1.57, 3.58), Z = 4.10, P < 0.0001]. This result indicated that acupuncture was effective for post-stroke constipation and had some advantages compared with other therapies. But the quality of included RCTs was low, and high-quality, large-sample and multi-center RCTs were needed to perform further verification.
Acupuncture Therapy ; Constipation ; etiology ; therapy ; Humans ; Moxibustion ; Randomized Controlled Trials as Topic ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo compare the clinical results of early and delayed intramedullary nailing and locked plating for the treatment of multi-segments tibial fractures of type AO/ASIF-42C2.

METHODSBetween January 2010 and January 2013,45 patients with multi-segments closed tibial fractures of AO/ASIF-42C2 were treated by early primary intramedullary nailing and locked plating in 20 cases as early group and delayed in 25 cases as delayed group. In early group,20 cases included 13 males and 7 females with an average age of (37.9±14.3) years old ranging from 20 to 56 years;according to soft tissue injury Tscherne classification, 8 fractures were frade I,12 were grade II. In delayed group, 25 cases included 17 males and 8 females with an average age of (38.7±17.2) years old ranging from 24 to 55 years,4 fractures were grade I ,19 were grade II ,2 were grade III. The operative time, blood loss, hospital stay,fracture healing time and complications were recorded. At final follow-up, the Johner-Wruhs score were used to evaluate functional efficacy, and the posterior-anterior and lateral X-ray to evaluate fracture reduction and alignment.

RESULTSAll the patients were followed up for (12.5±2.5) months in early group and (13.2±2.8) months in delayed group (P>0.05). No wounds infections were happened. At the last follow-up, the mean range of knee joint was 10°-0°-120°. According to Johner-Wruhs scoring,there were 15 cases in excellent,3 in good,fair in 2 in early group; 21 in excellent,2 in good,2 in fair. The average operative time,blood loss had no significant differences between two groups (P>0.05), but hospital stay in early group was significantly shorter than those in delayed group(P<0.05). Average fracture healing time of early group and delayed group were (5.3±2.6) months and (6.0±2.9) months, respectively (P>0.05).

CONCLUSIONFor multi-segments tibial fractures of type AO/ASIF-42C2 with preoperative minor soft tissue injuries lighter of Tscherne grade I or II, early primary intramedullary nailing and locked plating does not significantly increase the postoperative incidence of soft tissue complications for patients. The early and delayed primary intramedullary nailing and locked plating for treatment of AO/ASIF-42C2 proximal third tibial fractures can get similar curative effect.

Adult ; Bone Plates ; Female ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

OBJECTIVETo evaluate protective effects of Rheum tanguticum polysaccharides (RTP) on traumatic brain injury (TBI) in rats.

METHODThe polysaccharides (RTP) were extracted from Tanguficum Maxim. 120 rats were divided into 15 groups, with 8 rats in each group. RTP at 100, 200 and 400 mg x kg(-1) were administrated orally once a day for five days, and model of brain injury was made by dropping weight method.

RESULTRTP reduced water content and malondialdehyde (MDA) levels, and increased total SOD activity and Na+-K+ ATPase activity after injuried.

CONCLUSIONThe polysaccharides may be one of the effective comptents in Rheum tanguticum, showing significant neuroprotective effects.

Animals ; Brain Injuries ; enzymology ; metabolism ; pathology ; Cerebral Cortex ; enzymology ; ultrastructure ; Male ; Malondialdehyde ; metabolism ; Neuroprotective Agents ; pharmacology ; Plants, Medicinal ; chemistry ; Polysaccharides ; isolation & purification ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Rheum ; chemistry ; Sodium-Potassium-Exchanging ATPase ; metabolism ; Superoxide Dismutase ; metabolism

Objective To retrospectively assess diagnostic accuracy of magnetic resonance imaging (MRI)in preoperative assessment of local extent of breast ductal carcinoma in situ(DCIS)and DCIS with small invasive foci,compared with the mammography and ultrasonography(US)imagings.Methods Results of MRI,mammography,and US imaging from 17 consecutive women with known breast DCIS and DCIS with invasive foci were analyzed,and then compared with pathologic examination.Results(1) Fourteen lesions showed enhancement on dynamic breast MRI,of which 11 lesions were no-mass-like enhancement.Six of 11 lesions appeared segmental enhancement,and 2 were regional enhancement.Ductal and multiple focal areas enhancement were 1 case respectively.Symmetric diffuse enhancement in bilateral breast was showed in 1 patient.Ductal dilation was visible in ipsilateral breast on pre-contrast MRI in 2 cases,which manifested bloody nipple discharge in clinical examination,and duct enhanced on post- contrast imaging in one of them.Two lesions appeared mass enhancement with irregular shape and homogeneous signal.Linear enhancement surrounding the oval homogeneous mass with smooth margin found in 1 case.(2)Thirteen of 17 patients underwent bilateral mammography.There were various findings in mammograms,including microcalcifications(6 cases),normal mammograms(2 cases),calcifications with other appearance(2 cases),and non-calcification abnormity(3 cases).In 8 lesions with calcifications, 5 were noted higher probability of malignancy calcifications and 3 intermediate concern calcifications. Calcifications distributed clustered(5 cases),regional(2 cases)and diffuse(1 case)shape.(3)Sixteen of 17 patients were performed breast US examination.Eleven lesions,which were correct diagnosed, appeared higher echo spots within irregular lower echo area.One lesion diagnosed benign and 4 were negative on US examination.(4)Regarded the size measured on pathologic examination as golden standard, accordance of lesion extent was 13 of 17 case in MRI,7 of 13 in mammography,and 7 of 16 in US.There were 2 lesions overestimation of extent in MRI,3 in mammography,and 2 in US.Underestimation of extent showed 1 case and 3 cases in mammography and US imaging respectively.The difference was not significant (P = 0.161).Conclusion The MR imaging features of DCIS and DCIS with small invasive loci were characteristic.The combination of MRI and mammography could improve diagnostic accuracy.

Objective To investigate the feasibility of determining the breast cancer extension with diffusion-weighted imaging(DWI)and the apparent diffusion coefficient(ADC).Methods Fifty-nine lesions(57 patients)were studied by using DWI and ADC measurement before surgical excision.The cancer extension was investigated on ADC maps with different b values(b=500 and 1000 s?mm~(-2))according to the threshold values discussed before.The lesion extension on dynamic enhanced images and on DWI was used for comparison.The tumor extension was determined by calculating two lines.Line one:the maximum diameter of lesion.Line two:perpendicular line crossing the midpoint of line one.All measurement was compared with the pathologic specimen.Results(1)There were 48 invasive ductal carcinomas,6 ductal carcinomas in situ with small invasive foci,3 mucinous carcinomas,and 2 medullary carcinomas.(2)The low ADC value on ADC maps at b=500 and 1000 s?mm~(-2)was described as cancer extension.The measurement results were compared to pathologic figures and the pattern of correlation was categorized into 3 groups:Group 1,the area of low ADC values was almost the same as the pathological tumor extension; Group 2(overdiagnosis),the area of low ADC values was wider and more than 20% larger than the area of tumor extension;Group 3(false negative),no area of low ADC value was observed.There were no significant difference between DWI with b of 500 and b of 1000 s?mm~(-2)(X~2=0.160,P=0.689;X~2= 0.172,P=0.679)in Groups 1 and Group 3.There were 2 lesions in Group 2,which were consistent in DWI with b of 500 and b of 1000 s?mm~(-2).There were 14 misdiagnosed lesions,including overdiagnosis in 2 lesions and false negative in 12 lesions.Eight lesions measured at DWI with b of 500 and b of 1000 s? mm~(-2)were not consistent.Five lesions were diagnosed correctly at DWI with b of 500 s?mm~(-2),three of them were duetal carcinomas in situ with small invasive foci.(3)The extension of lesion on dynamic enhanced imaging was measured at 4 minutes after enhancement,and was compared with the extension measured at the same slice on DWI map.Pathologic figures were regarded as the gold standard.The extension of 47 lesions(80%)on enhanced images accorded with DWI.The abnormal area on DWI,which was consistent with pathologic figures,was wider than the area on enhanced images in 8 lesions.Of them,3 lesions were mucinous carcinomas and 5 lesions were grade 3 invasive ductal carcinomas.Conclusion DWI and ADC value have the potential in evaluating the cancer extension.The accuracy of extension measured on DWI map was better than that on dynamic enhanced images for some kinds of breast cancers.