Objective:To investigate the correlation between MRI features of breast cancer and the expression of CBL-B, AXL and ITGB2, and further to provide new imaging ideas for the early diagnosis of breast cancer, the designation of treatment plan and the preoperative non-invasive assessment of breast cancer prognosis.Methods:204 female patients with breast cancer who visited Linyi Central Hospital from Sep. 2017 to Sep. 2020 and received surgical treatment were selected as research objects. A total of 204 lesions were selected. Scanning was performed using Philips All-digital Ingenia3.0T MRI. Tumor diameter, shape, edge, intensity pattern, time-signal intensity curve (TIC) type, early intensity rate and ADC value were recorded. Immunohistochemical SP method was used to detect the expression levels of CBL-B, AXL and ITGB2 in breast cancer tissues and adjacent tissues.Results:The proportion of patients with low expression of CBL-B, high expression of AXL and high expression of ITGB2 in breast cancer tissues was significantly higher than that in adjacent tissues (All P<0.05) . Univariate analysis showed that tumor diameter, shape, early enhancement rate and ADC value in MRI features were correlated with the expression of CBL-B protein in breast cancer (All P<0.05) . The tumor diameter, shape and TIC typing in MRI features were associated with AXL protein expression in breast cancer. The tumor diameter, TIC typing, early enhancement rate and ADC value in MRI features were related to ITGB2 protein expression. Binary Logistic regression analysis showed that tumor diameter ≥3 cm and early enhancement rate ≥100% were independent risk factors for low expression of CBL-B in breast cancer ( P<0.05) . Tumor diameter ≥3 cm, and irregular shape or burr were independent risk factors for AXL high expression ( P<0.05) . Tumor diameter ≥3 cm, early enhancement rate ≥100%, ADC value ≥1.12×10 -3 mm 2/s were independent risk factors for high ITGB2 expression in breast cancer ( P<0.05) . Conclusion:MRI features of breast cancer can be used to predict the expression of CBL-B, AXL, and ITGB2, so as to provide reference for clinical diagnosis, treatment and prognosis assessment of the disease.

Objective To explore the feasibility of transauricular arterial access for hepatic artery catheterization in rabbits.Methods Thirty healthy New Zealand White rabbits were randomly divided into 5 groups ( n =6 in each group):transauricular vein injection group , transarterial infusion group , transarterial lipiodol group , transarterial gelfoam group and transhepatic puncture group .Every rabbit was prescribed elemene (20 mg/kg) via different access in 6 minutes. All the rabbits of hepatic artery catheterization were divided into two groups according to their serial number :transauricular arterial access group (odd, n=9) and transfemoral arterial access group (even, n=9).The arterial access could be changed each other due to the failure of one technique .The catheterization time , success rate and survival rate were compared between the two groups .Venous blood collection via auricular vein or jugular vein for pharmacokinetics was performed in each rabbit .Results Technical success rates of hepatic artery catheterization were 0% ( 0/9 ) and 88.9%( 16/18 ) for transauricular and transfemoral arterial access , respectively . The time duration of transauricular and transfemoral access groups was 28.4 ±13.6 and 33.9 ±19.6 minutes, respectively (P>0.05).The survival rates of the transauricular and transfemoral access groups were 100%(9/9) and 88.9%(16/18), respectively.Blood samples were collected via auricular vein in 4 and jugular vein in 23 rabbits.Conclusions Hepatic artery catheterization via transauricular arterial access is technically not feasible , while transfemoral access is simple and suitable in rabbits .Blood collection via the jugular vein may be a more reliable and valuable method for pharmacokinetic studies in rabbits .

Objective To investigate the keratin 9 gene mutation in epidermolytic palmoplantar keratoderma (EPPK) and its relationship with clinical manifestations. Methods Three Chinese pedigrees with EPPK were studied. Polymerase chain reaction (PCR) was performed to amplify the seven exons encoded by keratin 9. Denaturing high-performance liquid chromatography (DHPLC), DNA sequencing and allele-specific PCR were used to reveal the sequence variation in the PCR products. Results An insertion-deletion mutation in the exon 1 of keratin 9 497delAinsGGCT, was revealed in all 3 EPPK families, resulting in the keratin 9 change from tyrosine166 to tryptophan and leucine (Y166delinsWL). Allele-specific PCR confirmed that the mutation was not a commonly seen polymorphism, but a novel mutation which has not been reported in The Human Intermediate Filament Mutation Database (http://www.interfil.org). Conclusions A new keratin 9 gene mutation, 497delAinsGGCT, is found in these Chinese EPPK pedigrees, which may be the genetic basis of EPPK.

Objective: To investigate the clinicopathologic characteristics, immunophenotype, differential and diagnostic features of atypical spindle cell lipomatous tumor (ASLT). Methods: Three cases of ASLT were collected from January 2010 to March 2017 at Zhejiang Provincial People′s Hospital. The clinical and imaging features, histomorphology, immunophenotype and prognosis were analyzed. Fluorescence in situ hybridization (FISH) was used to detect MDM2 gene amplification, and relevant literature was reviewed. Results: All three patients were adult males, aged 38, 43 and 54 years, respectively. One tumor originated in the subcutaneous soft tissue in the head and neck, one was located in the left primary bronchus and one in the latissimus dorsi muscle. Grossly, all three tumors were circumscribed and ranged from 4.0 to 5.8 cm in size. Microscopically, all showed a focally infiltrative front. These tumors were composed of variable proportions of spindle-shaped and adipocytic cells in a background of variable fibrous and edematous matrix. Scattered lipoblasts were easily seen. One tumor was composed predominately of spindle tumor cells, one of adipocytic cells, and one of equally mixed cell populations. The spindle tumor cells were generally bland-appearing with focal nuclear enlargement and hyperchromasia noted in one case. Mitosis was not seen in neither the spindle cells nor the adipocytic cells. By immunohistochemistry, diffuse and strong reactivity to CD34 of the spindle cells was noted in all cases, definite loss of Rb expression was noted in one of three cases, and S-100 protein was expressed only in the adipocytic cells. INI-1 was intact and Ki-67 index was 1% to 3%. All other markers including CDK4, MDM2, STAT6, SOX10, CD99, bcl-2, β-catenin, CD117, GFAP, CK, EMA, SMA and desmin were negative. FISH of MDM2 was done in two cases, and both showed no amplification. The ASLT in the head and neck had two recurrences during 17 months of follow-up, whereas the tumor in the latissimus dorsi was free of disease during 33 months of follow-up. Conclusions ASLT is a rare subtype of low-grade adipocytic neoplasm and is distinctive from atypical lipomatous tumor/well-differentiated liposarcoma. The histomorpholgy of ASLT has significant heterogeneity and forms a continuous spectrum. ASLT needs to be distinguished from a series of benign and malignant soft tissue tumors.

Objective To assess the influence of different interventional injection routes of raltitrexed on the liver function, histology and pharmacokinetics in experimental rabbits, and to discuss the feasibility, safety and advantages of local application of raltitrexed. Methods A total of 25 New Zealand white rabbits were randomly and equally divided into 5 groups with 5 rabbits in each group: group A (using peripheral intravenous injection), group B (employing hepatic arterial infusion), group C (adopting hepatic artery embolization with Lipiodol), group D (hepatic artery embolization with gelfoam particles), and group E (direct puncture of liver and injection). Clinical equivalent dose (0. 17 mg/kg) raltitrexed injection was given to each experimental rabbit. At 5, 15, 30, 60, 120 and 180 min after the treatment, venous blood sample was collected for pharmacokinetic analysis. At 6 h and one week after administration of drug, liver functions were tested, and histological specimens of liver tissues were made at the same time. Results The peripheral blood drug concentrations at 5 and 60 min in group A were 0. 91 μg/mL and 0 μg/mL respectively, at 5 and 180 min in group B were 1. 73 μg/mL and 0. 37 μg/mL respectively, at 5 and 180 min in group C were 0. 82 μg/mL and 0. 08 μg/mL respectively, at 5 and 180 min in group D were 0. 94 μg/mL and 0. 08 μg/mL, and at 5 and 60 min in group E were 0. 39 μg/mL and 0. 13 μg/mL respectively. Six hours after administration of drug, the serum levels of AST, ALT in group C, group D and group E were significantly increased (P＜0. 0l), which returned to normal levels in one week after the treatment. The severity of liver tissue degeneration and necrosis detected in each group varied, in a severity - decreasing order, from group E, group C, group D, group B and group A. In group E, the surrounding normal liver tissue had no obvious necrosis. Conclusion The rabbit' s liver has no significant first pass elimination effect to raltitrexed. The equivalent dose of raltitrexed administered through the hepatic artery can cause obvious hepatocellular injury. Direct puncture and injection produce limited liver injury. Clinically, the dose of raltitrexed can be adjusted based on the degree of super selective catheterization condition and tumor size. (J Intervent Radiol, 2018, 27:247-251)

Objective: To investigate the clinicopathologic and differential diagnostic features of glomus tumor of the kidney. Methods: Four cases of glomus tumor of the kidney were collected from the archives of Peking University Third Hospital, the Second Hospital of Tianjin Medical University, Ningbo Yinzhou Second Hospital and Zhejiang Provincial People′s Hospital between January 2012 to June 2017; the clinical and radiologic features, histomorphology, immunohistochemistry, ultrastucture and prognosis were analyzed and the relevant literature was reviewed. Results: Patients consisted of 2 men and 2 women with ages ranging from 37 years to 66 years (mean 55 years). Three patients had history of hypertensive disease (grade Ⅱ, 3 to 10 years). The tumors measured in maximum diameter from 3.0 cm to 4.0 cm (mean 3.6 cm) and showed gray-white to yellow and tan on cut surface. Macroscopical examinations showed all tumors were circumscribed but non-encapsulated. Histologically, 1 tumor presented as glomus tumor with extensive myxoid change, 1 as cellular and solid pattern glomus tumor, 1 as glomangioma with focal myopericytoma-like pattern and 1 as symplastic glomus tumor with areas resembling myopericytoma. The tumor cells in two cases showed scant cytoplasm and uniform, bland-appearing nuclei without mitoses. In one case, the tumor cells were epithelioid with abundant eosinophilic cytoplasm and relatively well-defined cell borders. There was an increased mitosis of 4/50 HPF; however, no evidence of atypical mitosis or nuclear atypia was noted. In the symplastic glomus tumor the tumor cells showed frequently nuclear pleomorphism without mitoses. By immunohistochemistry, all tumors showed strong and diffuse reactivities to at least 3 of the 4 muscle-associated markers (SMA, h-Caldesmon, MSA and Calponin), 3 tumors strongly and diffusely expressed collagen Ⅳ, 2 expressed CD34 and 1 focally expressed desmin; whereas markers including epithelial, neuroendocrine, nephrogenic, melanoma-associated, STAT6, S-100 protein, CD117 and β-catenin all were negative in all the 4 tumors. Ultrastuctural analysis was done in 2 cases and showed prominent cytoplasmic actin bundles and pericellular basement membrane, and lacking of rhomboid renin crystals in both tumors. The hypertension persisted after surgical resection for all the 3 patients with this medical history. Follow-up information (range: 6-64 months, mean: 44 months)showed that no evidence of local recurrence or distant metastasis was identified in all 4 patients. Conclusions Glomus tumor rarely occurs in the kidney and usually has a good prognosis. Careful attention to its morphology with the judicious use of immunohistochemistry and ultrastuctural analysis can be helpful for its diagnosis and differential diagnosis.

Objective To study clinical characteristics of type 2 diabetic(T2D)patients with metabolic syndrome(MS)and its components in Beijing urban communities.Methods Totally,3295 T2D patients involved in a combined prospective diabetic management study from 15 urban communities in Beijing were classified as four groups, according to 2004 Chinese Diabetes Society's definition of MS, i. e, isolated T2D, T2D with one component of MS, T2D with two components of MS and T2D with three components of MS. Their clinical characteristics were analyzed. Results ( 1 ) Among 3295 T2D patients, 155 (4. 7% )were isolated T2D, 107 (32.6%) T2D with one component of MS, 1386 (42.1%) T2D with two components of MS and 679 (20.6%) T2D with three components of MS, with an overall 62.7% (2065/3295) of T2D patients complicated with MS. (2) In these T2D patients, the more components of MS they had, the higher body mass index (BMI), waist circumference, waist to hip circumference ratio (WHR),systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting serum levels of insulin and triglyceride (TG) and the lower level of high-density lipoprotein-cholesterol (HDL) were presented (P <0. 01 ). (3) Percentage of isolated T2D in women increased from 49. 0% (76/155) to 61.9% (420/679)of those with three components of MS ( P < 0 01 ), with increasing of components of MS. (4) Multiple logistic regression analysis showed that BMI, history of hypertension, decreased HDL, increased TG,increased blood pressure, all were risk factors for T2D patients complicated with MS. Conclusions Among T2D patients in urban communities of Beijing, 95.3% (3140/3295) of them complicated with one or more components of MS, and 61.9% (420/679) of them complicated with MS. So, community diabetic management must be implemented in an all-round way, including control of blood pressure, blood lipids,body weight and so on, in addition to control of blood sugar.

Objective To investigate current status of use of oral hypoglycemic drugs and insulin among adult patients with type 2 diabetes mellitus (T2DM) in urban community of Beijing.Methods In total,3297 T2DM patients aged more than 20 years from 15 urban communities of Beijing were studied.Their body weight,height,fasting plasma glucose level and glycosylated hemoglobin Alc (HbAlc) were measured.A door-to-door questionnaire survey on use of oral hypoglycemic drugs and insulin was conducted for them.All the T2DM patients surveyed were divided into four groups based on their received intervention.Results ①Of 3279 T2DM patients,454 (13.8％) received lifestyle intervention,971 (29.5％) used only one oral hypoglycemic drug,1179 (35.7％) with combined oral hypoglycemic drugs,and 693(21.0％) with insulin.②There was significant difference in average HbAlc among the four groups of T2DM patients with lifestyle intervention,only one oral hypoglycemic drug,combined oral hypoglycemic drugs,and insulin,with HbAI c of (7.0 ± 1.9) ％,(7.1 ± 1.5) ％,(7.4 ± 1.5 ) ％,and (7.5 ± 1.5 ) ％for them,respectively ( F =15.1,P ＜ 0.01 ).Proportions of the T2DM patients with HbAlc equal to or higher than 7.0％ were 32.2％,39.4％,52.1％ and 59.5％ for the four groups,respectively ( x2 =117.7,P ＜ 0.01 ).③In the T2DM patients with lifestyle intervention,32.2％ (146/454) of them with HbA1 c equal to or higher than 7.0％ were untreated with any oral hypoglycemic drug.In those with only one oral hypoglycemic drug,39.4％ (383/971) of them with HbAlc equal to or higher than 7.0％ were not treated with combined oral hypoglycemic drugs and/or insulin.In those with combined oral hypoglycemic drugs,52.1％ (614/1079) of them with HbAlc equal to or higher than 7.0％ were not received combined insulin treatment.④ Fasting plasma glucose level,treatment strategies,postprandial 2-h blood glucose level and length of the illness were independent risk factors for HbAlc level equal to or higher than 7.0％,with odds ratio (OR) of 1.757,1.256,1.175 and 1.031,respectively.⑤ In 2843 T2DM patients with oral hypoglycemie drugs and/or insulin treatment,1494 (52.6％ ) received biguanides and 693 received (24.4％ )insulin,respectively.Conclusions More than half of adult patients with T2DM do not meet the target of glycemic control of HbAlc less than 7.0％ in urban communities of Beijing,due to not active use of oral hypoglycemic drugs,and not timely adoption of combined use of oral hypoglycemic drugs and insulin therapy.

Objective To investigate the prevalence of dyslipidemia in subjects with type 2 diabetes mellitus in Beijing urban communities.Methods Total 3316 subjects with type 2 diabetes (age 20-80 years) were recruited from 15 urban community health centers in Beijing using a multi-stage random sampling approach.Dyslipidemia was diagnosed according to Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults:2007 version.Results Among 3316 diabetic subjects (1329 malesand 1987 females),75.6％ (2506/3316) had dyslipidemia,the prevalence was 72.5％ (964/1329)in men and 77.6％ (1542/1987) in women.The prevalence of hypertriglyceridemia and hypercholesterolemia was 41.9％ (1388/3316) and 48.1％ (1595/3316),respectively.31.5％ (1043/3316) subjects had high levels of low-density lipoprotein cholesterol (LDL-C) and 21.2％ (703/3316) had low high-density lipoprotein cholesterol (HDL-C).Among all subjects with dyslipidemia only 22.9％ (575/2506) took hypolipid agents.The overall blood lipid control rates of triglyceride (TG),total cholesterol (TC),LDL-C and HDL-C in 1393 subjects with dyslipidemia history were 48.0％ (669/1393),17.4％ (242/1393),30.9％ (430/1393) and 75.8％ (1056/1393),respectively.Diabetics with dyslipidemia had higher body mass index,waist circumference,blood pressure,plasma glucose and hemoglobin A1c.The prevalence of dyslipidemia in the overweight and uncontrolled-glucose group were 79.0％ (1678/2125),78.9％ (1756/2227),respectively.Logistic regression analysis showed that gender,age,body mass index and hemoglobin A1c were associated with dyslipidemia.Conclusions The prevalence of dyslipidemia in diabetic subjects in Beijing urban communities is high and less than one quarter patients take hypolipid agents.Age,body mass index and hemoglobin A1c are the risk factors of dyslipidemia in type 2 diabetic patients.