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 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

OBJECTIVETo screen the differently expressed proteins related to regulating the depolymerization of microtubules in the spinal cord of hens exposed to tri-o-cresyl phosphate (TOCP) and to provide target protein evidence for exploring the mechanisms of the delayed neurotoxicology (OPIDN) induced by organophosphorus compounds (OPs).

METHODSForty two Roman hens were randomly divided into three groups, i.e. TOCP group treated with 1000 mg/kg TOCP; intervention group treated with 40 mg/kg phenylmethanesulfonyl fluoride (PMSF) before 1000 mg/kg TOCP treatment and control group treated with tap water. Four hens in each group were sacrificed on the 5th and 20th days after exposure, respectively. Spinal cords were separated and homogenates at low temperature, and the total proteins were extracted. The OPIDN symptoms observed and recorded in the remaining 6 hens in each group. The differently expressed proteins related to regulating the depolymerization of microtubules were screen by two-dimensional electrophoresis and mass spectroscopy (MS).

RESULTSThe OPIDN symptoms appeared on the 5th day after exposure in TOCP group, which were gradually serious with time. The results by two-dimensional electrophoresis and MS showed that the Stathmin expression was downregulated 3.4 times and 2.8 times in TOCP group, respectively, as compared with the control and PMSF intervention groups. However, there was no significant difference of the Stathmin expression between control group and PMSF intervention group.

CONCLUSIONThe Stathmin expression in the spinal cord tissues of hens exposed to TOCP significantly downregulated. Moreover, the downregulated Stathmin expression may be related to excess polymerization of microtubules and the mechanism of OPIDN.

Animals ; Chickens ; Environmental Exposure ; Female ; Spinal Cord ; metabolism ; Stathmin ; metabolism ; Tritolyl Phosphates ; toxicity

OBJECTIVETo investigate the effects of phytoestrogens (daidzein and genistein) on the testosterone production of rat Leydig cells and the possible mechanisms.

METHODSPrimary Leydig cells were obtained from 3-month old male SD rats using discontinuous Percoll density gradient centrifugation. The effects of phytoestrogens at various concentrations were evaluated by ELISA, with hCG as the positive control. The mRNA expression of P450 side-chain cleavage enzyme (P450scc) was analyzed by semi-quantitative RT-PCR.

RESULTSGenistein at 0.1 micromol/L obviously promoted the secretion of testosterone and upregulated the mRNA level of P450scc. At a higher concentration of 5 micromol/L, however, both daidzein and genistein significantly inhibited the testosterone production of Leydig cells (P > 0.05).

CONCLUSIONGenistein can promote the testosterone production of Leydig cells at a low concentration (0.1 micromol/L), but both daidzein and genistein can inhibit it at a higher concentration ( >5 micromol/L).

Animals ; Cells, Cultured ; Genistein ; pharmacology ; Isoflavones ; pharmacology ; Leydig Cells ; drug effects ; secretion ; Male ; Phytoestrogens ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Testosterone ; biosynthesis

OBJECTIVETo analyze the incidence and survival rates of primary liver cancer (PLC) among residents in Yangpu district of Shanghai.

METHODSA total of 9 730 736 permanent residents (male 4 996 390 and female 4 734 346) of Yangpu district in Shanghai were recruited in the study between year 2002 and 2010; among whom 2726 PLC cases were diagnosed and 2427 death cases were certified. The incidence and mortality of PLC were calculated under the analysis of the new PLC cases and death cases between year 2002 and 2010. The rates were standardized by the demographic composition developed in the Fifth Nationwide Census in year 2000, in order to analyze the survival condition of PLC patients and explore the prognosis of surgical excision treatment.

RESULTSAmong the new PLC cases between year 2002 and 2010, 1966 cases were male, whose average age of onset was 59.81; while 760 cases were female, whose average age of onset was 68.93. The crude incidence rate was 39.35/100 000 in male, which was higher than it in female, as 16.05/100 000. The difference showed statistical significance (U = 7.32, P < 0.01). The standardized incidence rates were 21.98/100 000 and 6.96/100 000 in male and female, respectively. The difference showed statistical significance (U = 221.76, P < 0.01). There were 2427 PLC death cases in total, including 1734 male death cases and 693 female death cases. The crude mortality rate was 34.71/100 000 in male and 14.64/100 000 in female, whose difference were statistically significant (U = 6.68, P < 0.01). The standardized mortality rate was 19.16/100 000 in male and 6.06/100 000 in female, whose difference were statistically significant (U = 207.18, P < 0.01). The incidence and mortality rates both increased apparently since males aging over 35 and females over 45. The 1 - 5 year survival rates of PLC patients were 33.95%, 23.11%, 17.04%, 14.42% and 12.29%, respectively. In the surgical excision treatment group (321 cases), the 1 - 5 year survival rates were separately 66.78%, 52.87%, 41.88%, 33.57% and 32.64%; while in the non-surgical treatment group (2405 cases), the 1 - 5 year survival rates were separately 29.04%, 18.58%, 13.30%, 11.16% and 9.01%. The differences in 1 - 5 year survival rates between surgical and non-surgical groups all showed statistical significance (U = 12.78, 10.52, 8.28, 5.56 and 5.12, respectively, P < 0.01).

CONCLUSIONThe incidence of PLC was close to its mortality in Yangpu district of Shanghai. The male incidence and mortality rates were significantly higher than female corresponding rates. The surgical excision treatment could improve the prognosis of PLC.

Aged ; China ; epidemiology ; Female ; Humans ; Incidence ; Liver Neoplasms ; epidemiology ; mortality ; surgery ; Male ; Middle Aged ; Prognosis ; Survival Rate