Objective To study the interobserver variabilities and the differential diagnosis value of Breast Imaging Reporting and Data System-Ultrasound (BI-RADS-US) lexicon for small ( ≤ 2 cm) breast nodules. Methods Between January 2009 and December 2011, 289 patients with small (≤2 cm) breast nodules (n=317) were included. According to sizes, the lesions were divided into two groups, i.e., 0-1 cm (n=160) group and 1-2 cm (n=157)group. Each lesion was described independently by 3 radiologists using BI-RADS-US lexicon. Interobserver variabilities were assessed by Kappa test. Chi-square test was used to compare the frequency difference of the descriptors between malignant and benign lesions. Sensitivity, speciifcity, accuracy, positive predictive value and negtive predictive value were calculated. Results (1)Moderate agreements were obtained for lesion shape, orientation, margin, echo pattern, surrounding tissue and calciifcations (κ=0.44, 0.57, 0.48, 0.43, 0.51 and 0.57) in 0-1 cm group. Substantial agreements were obtained for lesion shape, orientation, margin and echo pattern (κ=0.65, 0.61, 0.64 and 0.63) in 1-2 cm group. (2)Irregular shape, non-parallel orientation, non-circumscribed margin, echogenic halo and microcalciifcations were more frequently found in malignant nodules than in benign nodules in 0-1 cm group [52.3% (34/65) vs 20.0% (19/95), 38.5%(25/65) vs 13.7%(13/95), 75.4%(49/65) vs 32.6%(31/95), 18.6%(12/65) vs 0 (0/95) and 10.8%(7/65) vs 2.1%(2/95);χ2=18.19, 13.08, 28.22, 16.39 and 3.95;P=0.000, 0.000, 0.000, 0.000 and 0.047]. Similarly, irregular shape, non-parallel orientation, non-circumscribed margin, echogenic halo, shadowing, changes of Cooper′s ligament and microcalciifcations were signiifcantly more frequent found in malignant nodules than in benign nodules in 1-2 cm group [74.2%(49/66) vs 12.1%(11/91), 36.3%(24/66) vs 5.5%(5/91), 93.9%(62/66) vs 22.0%(20/91), 37.9%(25/66) vs 3.3%(3/91), 30.3%(20/66) vs 7.7%(7/91), 15.2%(10/66) vs 0 (0/91) and 16.7%(11/66) vs 4.4%(4/91);χ2=62.59, 24.21, 79.40, 31.22, 13.73, 12.30 and 6.67;P=0.000, 0.000, 0.000, 0.000, 0.000, 0.000 and 0.010]. (3)In both groups, a good sensitivity was demonstrated (75.4%&93.9%) when using the non-circumscribed margin as a criterion for malignancy, and high speciifcity was achieved in two groups (80.0%-100%and 87.9%-100%) when other descriptors including irregular shape, non-parallel orientation, echogenic halo, shadowing, changes of Cooper′s ligament and microcalciifcations were used as differentiation criteria. Conclusions Good interobserver agreement can be achieved using the BI-RADS-US lexicon in the diagnosis of small breast nodules. Non-circumscribed margin are proved as the most valuable sign for screening malignant breast lesions ≤ 2 cm. High speciifcity was found for irregular shape, nonparallel orientation, echogenic halo, shadowing, Cooper′s ligament changes and microcalciifcations, which can help biopsy and preoperative diagnosis.

OBJECTIVETo investigate the distributive rule of Chinese medicine syndromes in patients with hyperlipidemia (HLE) in Xinjiang region.

METHODSChinese medicine syndrome of HLE patients were differentiated. The common factors of diagnostic information for dominating HLE were extracted by factor analysis and the syndrome type was determined based on Chinese medicine theory and experiences of experts.

RESULTSThe syndromes in HLE patients of Xinjiang region were mainly the Pi-Shen deficiency with insufficient Jin syndrome (I), the qi-blood deficiency syndrome (II), the Fei-Wei dryness syndrome (III), the phlegm-dampness obstructing Fei syndrome (IV), the dampness-heat accumulation syndrome (V), and the Gan-Shen yin-deficiency with blood-stasis syndrome (VI). Syndrome II was the most commonly encountered one (35.09%), the next were syndrome III (29.82%) and I (13.45%). Scores of the 6 syndromes, which embodied the severity of disease, were different significantly (F = 32.746, P < 0.01), the highest presented in syndrome I and the second in Syndrome VI.

CONCLUSIONSSyndrome in hyperlipidemia patients of Xinjiang region is dominantly the deficiency syndrome, combined with qi-stagnancy and blood-stasis, showing a complex state involving multiple organs and all the qi, blood and Jin-Ye in body.

Adult ; Aged ; China ; Diagnosis, Differential ; Factor Analysis, Statistical ; Female ; Humans ; Hyperlipidemias ; classification ; diagnosis ; Male ; Medicine, Chinese Traditional ; Middle Aged

OBJECTIVETo investigate the anesthetic management features of laparoscopic adrenalectomy for pheochromocytoma.

METHODSTwelve patients scheduled for laparoscopic adrenalectomy for pheochromocytoma under general anesthesia were allocated into group 1, while another 12 patients who received transabdominal adrenalectomy for pheochromocytoma under general anesthesia were selected as group 2. The hemodynamic changes and the postoperative recovery profiles between the two groups were compared.

RESULTSHemodynamic fluctuation occurred during carbon dioxide insufflation and tumor manipulation in group 1. However, there were no differences between the two groups. Duration of post operative recovery and hospital stay as well as requirement of analgesics in group 1 were significantly lower than those in group 2 (P < 0.05).

CONCLUSIONHemodynamic fluctuation still exists during laparoscopic adrenalectomy for pheochromacytoma. However, patients undergoing such surgical procedure recover faster as compared with open surgery.

Adrenal Gland Neoplasms ; physiopathology ; surgery ; Adrenalectomy ; methods ; Adult ; Anesthesia, General ; Blood Pressure ; Female ; Heart Rate ; Humans ; Intraoperative Complications ; prevention & control ; Laparoscopy ; Male ; Middle Aged ; Monitoring, Intraoperative ; Pheochromocytoma ; physiopathology ; surgery ; Pneumoperitoneum, Artificial ; adverse effects

OBJECTIVETo compare the knee osteoarthritis (OA) models in rabbits by different concentrations of papain and provide data for exploring pathogenesis and treatments of this disease.

METHODSSixty New Zealand white rabbits were randomly divided into four groups of 15 each and given injections into the right knee on days 1, 3 and 5 including intra-articular injections of 2%, 5% or 10% (w/v) papain and 0.03 mol/L L-cysteine at the dose of 0.1 ml/kg (experimental groups). The 0.9% NaCl (w/v) with a dose of 0.1 ml/kg were injected intra-articularly into the right knees of rabbits in the control group. The rabbits were sacrificed at 2, 4, 6 weeks respectively after the initiation of papain injection and these OA models were evaluated through recording the width of knee joint, performing the morphological observation and histological evaluation of articular cartilage and synovium.

RESULTSThe degenerative changes were demonstrated in knee joints of rabbit in all experimental groups, such as thinner articular cartilage, fibrillation and destroyed cartilage matrix, and inflammation, proliferation, and degeneration of the synovial tissue. All these changes were much worse with increased concentration and prolonged observation time.

CONCLUSIONDifferent severity of OA are established through intra-articular injections of 2%, 5% or 10% papain and 0.03 mol/L L-cysteine at the dose of 0.1 ml/kg. These models are of the characters of short period and a good reproducibility.

Animals ; Disease Models, Animal ; Male ; Osteoarthritis, Knee ; chemically induced ; pathology ; Papain ; toxicity ; Rabbits

OBJECTIVETo investigate the frequency of mitochondrial DNA (mtDNA) D-loop hypervariable region II (HVR II) and hypervariable region III (HVR III) mutations in oral squamous cell carcinoma (OSCC) and their correlation to provide the new targets for the prevention and treatment of OSCC.

METHODSThe D-loop HVR II and HVR III regions of mtDNA in seven cases with OSCC tissues, matched with paracancerous tissues and normal mucosa tissues from the same case, were amplified by polymerase chain raction (PCR), then were detected by direct sequencing to find the mutantsites after the comparison of all sequencing results with the mtDNA Cambridge sequence in the GenBank database.

RESULTS82 (56 species) nucleotide changes, with 51(26 species) nucleotide polymorphism, were found after the comparison of all sequencing results with the mtDNA Cambridge sequence in the GenBank database. 31(30 species) mutations, with 21 located within the HVR II and HVR III regions, were found in 3 tumor tissue samples, their paracancerous and normal mucosa tissue were found more polymorphic changes but no mutation. The mtDNA D-loop HVR II and HVR III regions mutation rate was 42.9% (3/7) in OSCC.

CONCLUSIONThe mtDNA D-loop HVR II and HVR III regions were highly polymorphic and mutable regions in OSCC. It suggested that the D-loop HVR II and HVR III regions of mtDNA might play a significant role in the tumorigenesis of OSCC. It may become new targets for the gene therapy of OSCC by regulating the above indexes.

Carcinoma, Squamous Cell ; DNA, Mitochondrial ; Female ; Humans ; Mouth Neoplasms ; Mutation ; Polymorphism, Genetic

OBJECTIVETo investigate the impact of hCG on the epidermal growth factor (EGF) in the phallic tissues of hypospadiac mice.

METHODSThe Kunming mouse model of congenital hypospadias was established. As controls, 10 three-week-old normal male mice and 10 3-week-old congenital hypospadiac mice were injected with isometric sodium chloride intraperitoneally. Another 40 mice with hypospadias were divided into 4 groups and injected intraperitoneally with 50 IU, 100 IU, 150 IU and 200 IU of hCG respectively per day for 7 days. Then the concentration of ECG in the phallus and in the serum were assayed by ELISA.

RESULTSThe EGF level in the phallus of the hypospadiac mice was much lower than that of the controls statistically (P < 0. 05). After the injection of exogenous hCG, the concentration of ECG increased with the dose of hCG, 50 IU (59.57 +/- 22.16) pg/ml, 100 IU (57.97 +/- 9.59) pg/ml, 150 IU (73.02 +/- 31.35) pg/ml and 200 IU (92.45 +/- 35.74) pg/ml. The concentration of ECG showed no significant difference between the control group and the 150 IU and 2000 IU groups (P > 0.05).

CONCLUSIONDecreased concentration of EGF in the mouse phallus may be associated with the pathogeny of hypospadias. A proper dose of exogenous hCG may increase the concentration of EGF in the mouse phallus.

Animals ; Chorionic Gonadotropin ; administration & dosage ; pharmacology ; Dose-Response Relationship, Drug ; Enzyme-Linked Immunosorbent Assay ; Epidermal Growth Factor ; biosynthesis ; blood ; Hypospadias ; blood ; metabolism ; Injections, Intraperitoneal ; Male ; Mice ; Penis ; drug effects ; metabolism ; pathology

OBJECTIVETo identify radiographic predictors of residual low back pain (LBP) after laminectomy for lumbar canal stenosis (LCS).

METHODSClinical results and radiographic findings in 69 patients who underwent single level laminectomy for LCS were retrospectively reviewed. Patients who had an improvement in LBP scores evaluated by Japanese Orthopaedic Association (JOA) scoring system during the follow-up periods were classified as the recovery group, and others were classified as the non-recovery group. Patients'clinical data and radiographic parameters like lordosis angle, range of motion and intervertebral rotational angle were analyzed using binary logistic regression analysis to detect factors significantly related with the occurrence of residual LBP.

RESULTSThe average preoperative JOA score of 14.8+/-5.05 improved to 21.59+/-5.51 at the final follow-up. Binary logistic regression analysis revealed that significant predictors of residual LBP were preoperative lumbar lordosis angle and range of motion.

CONCLUSIONSOur results suggest that patients with flat back and limited lumbar mobility before surgery tend to have poor results in terms of LBP. Therefore, these sagittal radiographic parameters should be taken into account when choosing laminectomy as the surgical option for LCS.

Aged ; Female ; Humans ; Laminectomy ; Low Back Pain ; diagnostic imaging ; Lumbosacral Region ; Male ; Prognosis ; Radiography ; Retrospective Studies ; Spinal Stenosis ; surgery ; Spine ; diagnostic imaging ; Treatment Outcome

OBJECTIVETo observe whether adenosine Al receptor (Al R) mediated neuroprotection of Shenmai Injection (SI) on rat cerebral ischemia/reperfusion (I/R) injury.

METHODSThe focal cerebral I/R model was established by middle cerebral artery occlusion (MCAO). Totally 60 successfully modeled rats was divided into 5 groups according to randomized block principle, i.e., the model group, the SI group, the SI + AlR antagonist (1,3-dipropyl-8-cyclopentylxanthine, DPCPX) group, the AlR antagonist control group, and the dimethyl sulfoxide (DMSO) control group, 12 in each group. Besides, a sham-operation group was set up (n =12). SI at 15 mL/kg was peritoneally injected to mice in the SI group immediately after cerebral I/R. Equal volume of normal saline was injected to mice in the model group and the sham-operation group. DPCPX at 1 mg/mL was peritoneally injected to mice in the Al R antagonist control group 30 min before peritoneal injecting SI. DPCPX at 1 mg/kg and DMSO at 1 mL/kg were peritoneally injected to mice in the AlR antagonist control group and the DMSO control group 30 min immediately before cerebral I/R. Rats' neurobehavioral scores were assessed after 24 h reperfusion. The volume of cerebral infarction and Bcl-2 protein expression of cerebral infarction penumbra were also detected. Results Compared with the sham-operation group, neurobehavioral scores, the volume of cerebral infarction, and Bcl-2 protein expression increased (all P <0. 05). Compared with the model group, neurobehavioral scores and the volume of cerebral infarction obviously decreased, but Bcl-2 protein expression increased in the SI group (all P <0. 05). Compared with the SI group, neurobehavioral scores increased, the volume of cerebral infarction was obviously enlarged, and Bcl-2 protein expression was obviously reduced in the A1R antagonist control group (all P <0. 05).

CONCLUSIONSSI's neurobehavioral scores could be partially reversed in the Al R antagonist control group, the volume of cerebral infarction and Bcl-2 protein expression improved. AlR might possibly meditate neuroprotection of SI on MACO mire

Adenosine ; Animals ; Brain Ischemia ; drug therapy ; Drug Combinations ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Infarction, Middle Cerebral Artery ; Mice ; Neuroprotection ; physiology ; Neuroprotective Agents ; pharmacology ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Receptor, Adenosine A1 ; metabolism ; Reperfusion Injury ; drug therapy ; Xanthines

OBJECTIVETo investigate the effect of early intervention by pravastatin with two different dosage on inflammatory factors and endothelial vasodilator function in patients with unstable angina (UA).

METHODS108 patients with UA were investigated consecutively and divided randomly into three groups (group 20 mg, n = 37; group 10 mg, n = 37; group control, n = 34). Blood samples were examined at admission and 4, 8 weeks after the therapy of pravastatin. Fourty patients of UA were chosen from those three groups (15, 15 and 10 cases respectively). The endothelium-dependent vasodilation and the function of vascular endothelium of them were measured. In the dosage of 20 mg pravastatin group non-endothelium-dependent vasodilation in brachial artery was also tested by ultrasound before and 8 weeks after the therapy. Cardiac events were followed up for 2 months.

RESULTS(1) The use of pravastatin in early admission period of UA could significantly reduce inflammatory factors and improve vascular endothelium function, which was more obviously in the group of 20 mg/d than in group of 10 mg/d. These benefits occurred in 4th week and more obviously in 8th week after the therapy. (2) The lipid lowering therapy in the early stage of admission (24 - 48 h) resulted in the reduction of cardiac events in the hospital.

CONCLUSIONThe use of pravastatin 20 mg/d seems better than that of 10 mg/d in all the fields as above in early admission period of UA patients.

Adult ; Aged ; Angina, Unstable ; drug therapy ; Anticholesteremic Agents ; administration & dosage ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Inpatients ; Male ; Middle Aged ; Pravastatin ; administration & dosage ; therapeutic use ; Prospective Studies