Objective To evaluate the efficacy of ultrasonically guided radiofrequency (RF) thermal ablation of hepatic carcinoma (HC) with a clustered electrode. Methods Clinical records on 245 consecutively admitted HC patients who underwent RF tissue ablation therapy were analyzed. The tumor supplying blood flow, changes of tumor size, clinical manifestation, and AFP level were analyzed. Results AFP value decreased significantly in 50% of patients one week after ablation. Tumors less than 5*!cm in diameter became avascularized 1 to 6 months after the therapy, and it was noted that all tumors shrank in size after the therapy. For tumors more than 5*!cm in diameter, RF ablation was used in conjunction with intraarterial chemotherapy and embolization. Conclusion Ultrasound guided RF thermal ablation is an effective, safe, minimally invasive technique for treating malignant hepatic tumors.

OBJECTIVE: To analyze the uncertainty of determination of western medicine composition illegally added into Chinese patent drug and find out the effect factors of uncertainty in order to provide scientific basis for evaluating test report. METHODS: Antler tablets were tool as example. Qualitative analysis of additive composition was carried out using HPLC-MS method and the content of sildenafil citrate in each tablet was determined. Uncertainty of test was evaluated according to the regulation specified in Evaluation and Expression of Measurement of Uncertainty (JJF1059-1999). RESULTS: The uncertainty of the test is 0.10 mg in each tablet. CONCLUSION: The uncertainty of the experiment is mainly caused by non homogeneity of sample.

Objective Comparing the enhancement of contrast-enhanced ultrasound(CEUS) with the intensity of the blood signals of breast masses, and producing the parameter of peak intensity (PI), to determine whether they can reflect the differentiation of the benign breast masses from the malignant ones.Methods Fifty patients with the breast masses (25 benign,25 malignant) were implemented the contrastenhanced ultrasound inspection.The blood signals of the masses could be got before performing the CEUS,then the CEUS was performed.The enhancement of the masses was divided into 4 grades according to the enhancement of breast which was around the mass (no enhancement, low enhancement, equal enhancement,and high enhancement as well).The PIs of all masses and high enhanced massed were calculated by software in machine,then them were compared according to "the groups which had been classified by their maximal diameters.Results Forty-one of 50 cases showed an obvious enhancement using CEUS compared with the routine CDFI.Malignant masses were more obviously than that of benign ones ( P＜0.05).In the 50 cases,the no enhanceed ones( n = 2) and equal enhanced ones( n = 5) were benign,and 1 case of the low enhanced masses( n = 9) was malignant.The high enhanced masses ( n = 34) were malignant or benigh.About the high enhanced masses, there were statistics meanings using the parameter of PI for the masses whose maximal diameters＜2 cm( P＜0.05),and no statistics meanings when their maximal diameters≥2 cm(P＞0.05).Conclusions The CEUS of breast can improve the appreance of the tumor' s blood vessel obviously, especially for malignant masses.The PI of the breast benign masses are different from the malignant ones.Combination of them can help to discriminate benign masses from malignant ones.The parameter of PI is useless for differentially diagnosing the breast masses if their maximal diameters≥2 cm and the blood flow grade Ⅲ before CEUS.

In this study, a recurrent massive phyllodes tumor of the breast was surgically removed and the grafting was used to repair the local skin defects. A 29-y female patient had recurring breast phyllodes tumor of extremely large size in the chest wall after the excision of a previous tumor. The massive phyllodes tumor was eliminated by completely removing the layers of the skin and tissues above the costal bones with incisal margin being 2 cm away from the tumor lesion. The latissimus dorsi myocutaneous flap, lateral thoracic skin flap, and rectus abdominis myocutaneous flap were grafted to replace the lost tissues due to the surgery. Anti-infection and anticoagulation treatments were used after the surgery. The graft flaps had sufficient blood supply and good blood circulation, and the incisions mostly healed. The outcome of the surgery was acceptable. For the surgical treatment of the massive phyllodes tumor in the chest wall, it is an alternative of choice to use latissimus dorsi myocutaneous flap, lateral thoracic skin flap and rectus abdominis myocutaneous flap in combination for skin grafting.
Breast Neoplasms/*surgery ; Mastectomy ; Neoplasm Recurrence, Local/*surgery ; Phyllodes Tumor/*surgery ; Surgical Flaps

ObjectiveTo optimize the b-value of breast diffusion-weighted MRI (DW-MRI) at 1.5T by applying a range of b values and comparing the apparent diffusion coefficient (ADC) and signal-to-noise ratio (SNR) on a phantom,disease-free breast tissues,and benign and malignant lesions.Methods A phantom and 32 women with pathologically confirmed malignant ( 18 ) and benign ( 14 ) lesions were examined using EPI-DWI with different b values on a 1.5 T MR scanner.The b-value of EPI-DWI was 0,50,100,200,400,600,800,1000,1200,1400,1600,1800,2000,2200,2400,and 2600 s/mm2,respectively.The SNR and ADC values of the phantom,disease-free breast tissues,and benign and malignant lesions were measured.The correlation between the b-value and ADC or SNR of each image was analyzed.ResultsThe SNR of DWIdecreased as the b-valueincreased,showing aninversecorrelation (r =-0.802,P ＜0.01 ).The ADC values of benign and malignant lesion decreased as the b-value increased (r =-0.923 and -0.855,P ＜0.01 ).The maximum difference in ADC between malignant and benign lesions was observed when the b-value is between 800 and 1000 s/mm2 and diminished when the b-value was greater than 1400 s/mm2.ConclusionFor good image quality and valid differentiation between malignant and benign lesions,the optimized b-value of DWI at 1.5 T is between 800 s/mm2 and 1000 s/mm2.

Objective To investigate the value of apparent diffusion coefficient(ADC)of breast carcinoma before and one course after neoadjuvant chemotherapy,and to predict the response of breast carcinoma to neoadjuvant chemotherapy.Methods Twenty female patients with 21 breast carcinoma lesions were examined with diffusion weighted imaging(DWI)and contrast-enhanced MRI within 7 days prior to neoadjuvant chemotherapy(adriamycin + taxinol),during 18-21 days after the first couse of therapy and within 7 days prior to the surgery resection.The tumors were divided into response group and relative nonresponse group by change of the tumor.The difference of ADC between the two groups before and after 1st course of chemotherapy was compared.Results In chemotherapy response group with 15 lesions,the mean ADC was(0.98±0.15)×10-3 mm2/s before chemotherapy and increased to(1.22±0.23)×10-3 mm2/s after 1 st course of chemotherapy(P＜0.05),while in nonresponse group with 6 lesions,the mean ADC before and after chemocherapy was(1.09±0.08)×10-3 mm2/s and(1.11±0.07)×10-3 mm2/s,respectively,with no statistical difference(P>0.05).The mean ADC of response group prior to chemotherapy was significantly lower than that of nonresponse group(P＜0.05).A significant negative correlation(r=-0.51,P＜0.05)was observed between the ADC prior to treatment and change of ADC after the first couse therapy.Conclusion Preliminary results revealed the initial ADC of the tumor in patient with breast carcinoma and the changes of ADC after 1 st couse treatment may predict response to neoadjuvant chemotherapy.

PurposeTo investigate a multi-parametric protocol for breast MRI examination and lesions assessment correlated to the American College of Radiology (ACR) breast imaging reporting and data system (BI-RADS) categorization, and to improve the management of the breast lesions.Materials and Methods 301 pathologically confirmed lesions on 278 patients were retrospectively included. The scan protocol used a dynamic contrast enhancement sequence (DCE) of 1 mm×1 mm×1 mm spatial resolution, 120 temporal resolution and a diffusion weighted imaging (DWI) of b=1000 s/mm2. The malignant morphological features on the early-enhanced images, type II or III time intensity curve and the apparent diffusion coefficient (ADC) value less than benign/malignant threshold was equally weighted. Each was given 1 point when present malignant features and treated different on mass and non-mass-like enhancement lesions. When the sum of score was ≥2 points, the lesion was categorized as BI-RADS 5. When the sum of score was 1 point, the lesion was categorized as BI-RADS 4. When the sum of score was <1 point, the lesion was categorized as BI-RADS 3. The other specific benign findings were categorized as BI-RADS 2. No abnormality on DWI, DCE, T2WI and T1WI was categorized as BI-RADS 1. The final categories were correlated to the pathological grades as benign (B), high risk (HR) and malignant (M).Results When grouped HR as malignant (M+HR), the area under curve (AUC) of the ROC was 0.860. When grouped HR as benign (B+HR), the AUC of the ROC was 0.876, and the optimized sensitivity, specificity and accuracy was 85.3%, 86.8% and 85.1%, respectively, which were better than the other grouping. If the management of HR lesions could be lumptoectomy or short-term follow-up, the positive predictive value (PPV) of BI-RADS 5 for excisable lesions (M+HR) was 93.2%, the PPV of BI-RADS 4 for excisable lesions (M+HR) was 46.9% and the biopsy was essential. The PPV of BI-RADS 3 and below for follow-up lesions (B+HR) was 90.4%.Conclusion A simple diagnosis algorithm was established, which equally weighted the DCE morphological feature, DCE-TIC and DWI-ADC. The diagnosis protocol was well consistent with BI-RADS categorization and could predict the benign, high risk and malignant lesions in pathology as well as the proper management.

Objective To explore the role of specific AT rich sequence binding protein 1(SATB1) and wnt/β-catenin signaling pathways in the regulation of trophoblast invasion and its effect in the pathogenesis of preeclampsia. Methods From March 2013 to March 2014, 20 cases of human villous tissues (early pregnancy group) from women of 8-10 gestational weeks who received artificial abortion at the First Affiliated Hospital of Chongqing Medical University, 18 cases of placental tissues (mid-pregnancy group) from women of 18-20 gestational weeks who had labor induction by water bag, 20 cases of placental tissues (normal full-term group) from healthy full-term pregnancy women and 20 cases of placental tissues (preeclamptic group) from women with preeclampsia who received elective c-section in were collected. Immunohistochemical SP method was utilized to determine the position of SATB1 and beta-catenin in villous tissues or placental tissues. Western blot was performed to analyze the expression level of SATB1 and beta-catenin in villous tissues or placental tissues. Immunofluorescence assay was used to determine the location of SATB1 andβ-catenin in HTR8/SVneo cells. Western blot was performed to detect the expression level of SATB1 and beta-catenin in HTR8/SVneo cells cultured in normoxia and hypoxia reoxygenation(H/R) condition. Co-Immunoprecipitation detection was used to evaluate the interaction between SATB1 andβ-catenin in placental tissues in preeclamptic group and HTR8/SVneo cells in H/R group. Gelatin zymography analysis was used to measure the activity of matrix metalloproteinases(MMP)-2 and 9 in placental tissues from preeclamptic group and HTR8/SVneo cells in H/R group. Results (1) In the normal full-term group, rare syncytiotrophoblastic nodule, less fibrinoid necrosis and abundant numbers of capillary could be observed in placental tissues. In comparison, there were obvious vacuolation in the cytoblast of syncytiotrophoblast, rich fibrinoid necrosis and poor numbers of villous capillary in placental tissues from preeclamptic group. (2) SATB1 could be found by immunochemical staining in placenta or villous tissues from all the groups. The staining intensity of SATB1 were more weakening in preeclamptic group than in the normal full-term group. (3) β-catenin could be found by immunochemical staining in placenta or villous tissues from all the groups. The staining intensity of β-catenin were more weakening in preeclamptic group than in the normal full-term group. (4) The protein expression levels of SATB1 in early pregnancy group, mid-pregnancy group, normal full-term group and preeclamptic group were 0.300 ± 0.009, 0.271 ± 0.015, 0.238 ± 0.018 and 0.153 ± 0.007, respectively. The protein levels of β-catenin among the above groups were 0.743±0.041, 0.648±0.021, 0.549±0.069 and 0.269±0.047, respectively. Both the expression of SATB1 andβ-catenin protein were significant decreased in placental tissues from preeclamptic group compared with the other three groups. (5) The SATB1 andβ-catenin protein was located in nucleus of trophoblast and a small amount was in the cytoplasm. The fluorescence intensity of both SATB1 and β-catenin in the H/R group were significantly decreasing when compared to the normoxia group. (6) HTR8/SVneo cells in H/R group showed a significant decrease in both SATB1 andβ-catenin protein levels when compared to the normoxia group. The protein level of SATB1 in the normoxia group was 0.213 ± 0.005, while was 0.083 ± 0.021 in the H/R group. The protein level ofβ-catenin in the normoxia group was 0.797±0.081, and was 0.543±0.131 in the H/R group. (7) There was an interaction between SATB1 and β-catenin in placental tissues from the preeclamptic group and HTR8/SVneo cells exposed by H/R. (8) The enzymatic activity of MMP-2 and MMP-9 protein were decreased significantly in placental tissues from the preeclamptic group (2.251±0.310, 1.447 ± 0.102, respectively) when compared to the normal full-term group (7.098 ± 0.451, 5.502 ± 0.197, respectively). MMP-2 and MMP-9 were significantly decreased in the H/R group (0.471 ± 0.104, 0.297 ± 0.103, respectively) when compared to the normoxia group (0.842 ± 0.209, 0.595 ± 0.100, respectively). Conclusion The expression of SATB1 decreased in the placenta of preeclampsia. This may influence the activity of MMP-2 and 9 by regulating Wnt/β-catenin signaling pathways, affect trophoblast invasion and eventually result in preeclampsia.

Objective To investigate proteolipid protein 1 (PLP1) mutations in six pedigrees with Pelizaeus-Merzbacher disease (PMD),and to provide prenatal consulting and prenatal diagnosis.Methods Subjects were six probands with PMD admitted in Department of Pediatrics,Peking University First Hospital from July 2006 to November 2011 and their family members.Genomic DNA sarnples were extracted from peripheral bloods of probands and their family members.Multiplex ligation-dependent probe amplification (MLPA) technique was used to detect PLP1 duplication mutation.Direct DNA sequencing was used to detect point mutation.Genetic diagnosis were based on PLP1 mutation genotype from probands.Prenatal diagnosis of nine fetuses were performed from seven PLP1 mutation female carriers by fetuses' DNA extracted from amniocytes or villus cells.Results PLP1 duplications were found in probands 1-4 (P1-4) whose mothers and the aunt of proband 1 (P1) were PLP1 duplications carriers.The two cases of point mutation,c.96C＞G(p.F32L) and c.623G＞T (p.G208V),were found in proband 5 (P5) and proband 6 (P6).Hcterozygous changes of the same mutations were found in P5' and P6' mothers with normal phenotypes.Seven female PLP1 mutation carriers were pregnant again.Prenatal diagnosis of PLP1 for nine fetuses presented one PLP1 duplication,one point mutation,one PLP1 duplication carrier,and six wildtypes.A segmental crossing over of X chromosome was detected in one male fetus of PLP1 wildtype.Conclusions PLP1 mutation analysis could help to diagnose PMD pedigree and to identify female PLP1 mutation carrier in the family.The following prenatal diagnosis and proper genetic counseling are very important to prevent PMD child from being delivered.