Objective To explore the diagnosis value of X-ray breast imaging reporting and data system (BI-RADS) combined with wire-guided localization biopsy for breast microcalcifications in impalpable breast cancer.Methods 192 palpation negative patients with 205 microcalcification lesions were detected by mammography.All lesions were classified according to BI-RADS descriptors for calcification and were categorized by the BI-RADS.The patients with BI-RADS category 4a and above underwent X-ray positioning guide wire-guided biopsy and pathological diagnosis.Results In 205 microcalcification lesions,74 (36.1％) were malignant lesions,131 (63.9 ％) were less than benign lesions.The positive predictive value of malignant breast lesions in clustered,segmental,regional linear branching calcifications were higher [83.3 ％ (5/6),100.0 ％ (11/11),100.0 ％ (1/1)],followed by clustered,linear,segmental,regional pleomorphic calcifications [55.9 ％ (38/68),50.0 ％ (1/2),40.0 ％ (8/20) and 33.3 ％ (4/12),respectively].The positive predictive values of malignant in linear branching calcifications and pleomorphic calcifications were significantly higher than those of coarse heterogeneous calcifications,amorphous or indistinct calcifications (x2 values were 34.44,51.87,16.71,29.86,all P ＜ 0.05).The linear branching calcification had the highest possibility.The proportions of malignant lesions in four different types of glands were extremely dense 40.5 ％ (30/74),heterogeneously dense 39.2 ％ (29/74),scattered areas of fibroglandular density 10.8 ％ (8/74) and fat 9.5 ％ (7/74),respectively.Conclusions BI-RADS categorization for breast microcalcification lesions can improve the detection rate of impalpable breast cancer.Linear branching calcification has higher predictive value for malignant lesions.Dense breast is the risk factors of breast cancer,which should be attached great importance.

Objective To investigate the molecular characteristics of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients receiving antiretroviral therapy (ART) in Guizhou Province. Methods Using a convenience sampling strategy, 8 583 samples were collected in Guizhou and an investigation was conducted including face-to-face questionnaire interview and HIV testing. Results 1 511 cases failed in HIV suppression (viral load, VL>1 000 copies/ml). 1 410 cases (93.31%) were successfully genotyped with HIV pol gene, among which 51.42% were genotyped as CRF01_AE, 26.67% as CRF07_BC and 16.1% as CRF08_BC. Conclusion The subtype changes caused by HIV gene mutation should precede the changes of main transmission routes of HIV through the analysis in recent years. Timely monitoring the changes of HIV subtypes can be one of the main bases for the prevention and control of AIDS.

Mesaconitine was incubated with rat liver microsomes in vitro. The metabolites of mesaconitine in rat liver microsomes were identified by ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method with high resolution power. A typical reaction mixture of 100 mol L-1 Tris-HCI buffer (pH 7.4) containing 0.5 gL-1 microsomal protein and 50 micro molL-1 mesaconitine was prepared. The above reaction mixture was divided into six groups, and the volume of each group was 200 micro L. The incubation mixture was pre-incubated at 37 degrees C for 2 min and the reactions were initiated by adding NADPH generating system. After 90 min incubation at 37 degrees C, 200 micro L of acetonitrile was added to each group to stop the reaction. The metabolites of mesaconitine were investigated by UPLC-MS/MS method. Mesaconitine and 6 metabolites M1-M6 were found in the incubation system. The structures were characterized according to the data from MS/MS spectra and literatures. The metabolic reactions of mesaconitine in rat liver microsomes included the demethylation, deacetylation, dehydrogenation and hydroxylation. The major metabolic pathways of mesaconitine in rat liver microsomes were determined by UPLC-MS/MS on multiple reaction monitoring (MRM) mode combined with specific inhibitors of cytochrome P450 (CYP) isoforms, including alpha-naphthoflavone (CYP1A2), quinine (CYP2D), diethyldithiocarbamate (CYP2E1), ketoconazole (CYP3A) and sulfaphenazole (CYP2C), separately. Mesaconitine was mainly metabolized by CYP3A. CYP2C and CYP2D were also more important CYP isoforms for the metabolism reactions of mesaconitine, but CYP1A2 and CYP2E1 haven't any contribution to MA metabolism in rat liver microsomes.
Aconitine ; analogs & derivatives ; metabolism ; Animals ; Chromatography, High Pressure Liquid ; Cytochrome P-450 CYP3A ; metabolism ; Cytochrome P-450 CYP3A Inhibitors ; Cytochrome P-450 Enzyme Inhibitors ; Cytochrome P-450 Enzyme System ; metabolism ; Enzyme Inhibitors ; pharmacology ; Ketoconazole ; pharmacology ; Male ; Metabolic Networks and Pathways ; Microsomes, Liver ; enzymology ; metabolism ; Quinine ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Sulfaphenazole ; pharmacology ; Tandem Mass Spectrometry

ObjectiveTo investigate the effects of Ginkgo-Dipyidamolum on nerve symptom, sign and the nerve conduction velocity of patients with diabetic peripheral neuropathy (DPN).Methods60 patients with DPN were divided randomly into observation group and control group with 30 patients in each group. Routine therapy was conducted in control group. On the basis of routine therapy as control group, Ginkgo-Dipyidamolum was used by intravenous infusions in observation group for 4 weeks. The symptoms and physical sign of patients, and nerve conduction velocity (NCV) were observed.ResultsAfter treatment, clinical symptoms, signs and NCV in observation group improved and were significantly different from that before treatment ( P<0.01), also significantly different from control group ( P<0.01).ConclusionGinkgo-Dipyidamolum can improve the nerve symptoms and signs of patients with DPN, and enhance NCV.

Objective: To analyze the effect of Argon-Helium cryosurgery (AHCS) on CD4+ CD25+ regulatory T cells (Treg) and its implication in patients with advanced renal carcinoma.Methods:,Peripheral venous blood samples were ob-tained from 32 patients with advanced renal cell carcinoma before and after AHCS.The proportions of Treg cells and T lym-phocyte subsets (CD3+ T, CD4+ T, CD8+ T, CD4+ T/CD8+ T, and NK cells) in the peripheral blood were measured by flow cytometry.Enhanced CT or enhanced MRI was used to observe the necrosis of tumor at 1 month after AHCS.The areas with no imaging enhancement in tumor were regarded as tumor necrosis.The necrosis rate was measured by Cavalieri method and the tumor burden was evaluated.Results: At 3 months after AHCS, the percentages of Treg cells were gradual-ly decreased from 4.18%±1.58% to 1.96%±0.54%, with a significant difference (P=0.001).At 3 months after AHCS, the pro-portions of CD3+ T, CD4+ T, NK and CD4+ T/CD8+ T were gradually increased from 19.26%±7.52%, 43.54%±12.99%, 1.15%±0.57%, and 17.49%±8.36% to 30.83%±5.69%, 49.58±10.76%, 1.84%±0.12%, and 27.63%±8.20%, with a statistical significance (P=0.000, P=0.003, P=0.02, and P=0.001).The proportion of CD8 + T was decreased from 40.86%±8.89% to the lowest ratio (26.74%±4.29%) at 3 months after AHCS, with a significant difference (P=0.000).At 3～6 months after cryo-therapy, there was only a slight change in the proportions of CD3 + T, CD4 + T, CD4 + T/CD8 + T, NK, CD8 + T, and Treg cells, with no significant difference (P>0.05).Correlation analysis showed that the decrease in tumor burden was positively correlated with the decrease of the proportion of Treg cells (r=0.793, P<0.01).Conclusion: After AHCS, the distribution of T-lymphocyte subsets can be improved and the anti-tumor immune response was strengthened.The percentage of Treg cells is correlated with tumor burden.

Objective To analyze the clinical and pathological factors which can influence the occurrence of the recurrent occlusion of metallic stents in patients with malignant biliary obstruction. Methods The clinical data of 50 patients with malignant biliary obstruction, who suffered repeated metallic stents obstruction and were admitted to authors" hospital during the period of March 2006-September 2008, were retrospectively analyzed. Of 50 patients, liver carcinoma was diagnosed in 12, pancreatic carcinoma in 17 and carcinoma of bile duct in 21. The relevant factors which might bear a relation to the occurrence of repeated metallic stents obstruction were evaluated. Results Single factor analysis of variance indicated that the denomination of carcinoma, clinical stage of carcinoma, location of obstruction, whether infection being accompanied or not, and the anti-tumor therapy after biliary stenting treatment were the significant factors closely linked to the occurrence of repeated metallic stents obstruction in patients with malignant biliary obstruction, Logistic regression analysis demonstrated that clinical stage of carcinoma, location of obstruction and whether infection being accompanied or not were the important factors that determined the occurrence of repeated metallic stents obstruction. Conclusion Clinical stage of carcinoma, location of obstruction and whether infection being accompanied or not are important reference factors for judging the occurrence of occlusion of metallic stents in malignant biliary obstruction.

Objective To investigate the difference between the early phases and delay phase of three-phase bone scintigraphy on hemiplegic patients with earlier complex regional pain syndrome (CRPS).Methods Twenty-nine stroke patients with hemiplegia complicating CRPS received three-phase bone scintigraphy after intravenous injection of 99Tcm-methylene diphosphonate (MDP). The region of interest (ROI)technique was used to obtain the radioactive counts of involved joints and contralateral sites on wrists,metacarpophalangeal,proximal interphalangeal and distal interphalangeal joints. The total counts of these four sites in each patient were then obtained and the total uptake ratios of involved joints/contralateral joints for each phase were calculated to compare the difference among the three phases. Wilcoxon test and ANOVA were used in data analyses. Results The involved joints of hemiplegic side displayed higher tracer uptake.There were significant differences of the radioactive counts between involved joints and uninvolved ones in the perfusion,pool and delay phase (Wilcoxon test,Z:-4.73 to -2.10,P＜0.05). There was no significant difference of total uptake ratios of involved joints/contralateral joints among the three phases ( ANOVA,F = 0. 807,P ＞ 0.05 ). Conclusions Due to higher bone seeking agent accumulation on three-phase bone scintigraphy,both early phases and delay phase imaging showed similar value in stroke patients with hemiplegia complicating earlier CRPS.

Objective:This study aimed to analyze the feasibility, safety, and efficacy of cryoablation in treating pain caused by malignant paravertebral and mesenchymal tumor. Methods:Cryoablation was performed in 31 patients with unresectable and painful malignant paravertebral and mesenchymal tumors whose pain was poorly controlled by conventional treatment methods. Tumors ranged in size from 3 cm to 20 cm. Pain experienced by the patient was assessed using the Brief Pain Inventory (BPI) at 0, 1 day, 1 week, 1 month, and 3 months post-cryoablation. Results:BPI scores were divided into two categories, i.e., the influence and the se-verity of pain. Both categories showed downward trend after cryoablation. Pain severity score significantly decreased (P=0.001, t=3.862;P=0.031, t=2.261) 1 day and 1 month after cryoablation. Pain influence score also significantly decreased (P=0.016, t=2.566;P=0.036, t=2.195) 1 day and 1 week after cryoablation. Two patients (6.45%) had mild complications, and no serious complication was ob-served. Conclusion:Cryoablation is a low-risk and well-tolerated topical treatment for pain caused by unresectable malignant paraverte-bral and mesenchymal tumors.

In temporomandibular disorders (TMD), pain takes place when neuropeptides stimulate synovial tissue to produce several cytokines such as interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α, which activate neurons and glia of synovial membrane at the bilaminar regions of temporomandibular joint (TMJ). It has been reported that, after neurogenic differentiation, the synovial mesenchymal stem cells (SMSCs), deriving from TMJ, possess the same cytological features as the neuronal cells. This study examined the ability of substance P (SP) and calcitonin gene-related peptide (CGRP) to stimulate SMSCs and neurogenic SMSCs secreting inflammatory cytokines during TMD, evaluated the mutual effects of inflammatory cytokines and neuropeptides and tested the analgesic effect of hyaluronic acid (HA). The levels of IL-1β, IL-6 and TNF-α in SMSCs and neurogenic SMSCs in the presence of neuropeptides were measured by ELISA. SP and CGRP produced by SMSCs and neurogenic SMSCs were determined by RT-PCR and Western blotting. The results showed that the expression of SP and CGRP was significantly enhanced in the neurogenic SMSCs in response to IL-1β, IL-6 and TNF-α, and the effect was remarkably inhibited by HA. IL-1β, IL-6 and TNF-α, in return, could be enhanced in the neurogenic SMSCs upon stimulation by SP and CGRP. Neuropeptides and inflammatory cytokines might work mutually on the TMD pain. The HA-mediated analgesic effect may be implicated in the inhibition of SP and CGRP expression in neurogenic SMSCs.

Objective To investigate the hepatoprotective effect of silybin-phosphatidylcholine complex(SPC) in sepsis rats.Me-(thods) Fifty Wistar immature rats were randomly divided into 3 groups:normal control(10 cases),septic group(30 cases) and interfe-(rence) group(10 cases).In septic group and interference group,rats were treated by cecal ligation and puncture(CLP).Meanwhile,the interference group was given SPC before 2 hours of CLP and after 2 hours of CLP.Blood of rats was taken from all groups to determine the levels of serum tumor necrosis factor-?(TNF-?),interleukin-1(IL-1),alanine aminotransferase(ALT) and aspartate aminotransferase(AST) at varying intervals.Results The levels of serum TNF-?,IL-1,ALT and AST after CLP were significantly elevated in septic group compared with the normal control group(P