Case based learning ( CBL ) teaching method was applied to the experiment group in radiology internship teaching,and conventional teaching in control group.Two mentors would evaluate and score their radiological case analysis.The aim of this research was to explore the application and effect of case-based learning ( CBL ) teaching method in radiology internship teaching.

Objective To compare the prognosis and life quality of patients with early-stage breast cancer(stage I or II)undergoing breast-conserving surgery or modified radical mastectomy.Methods 180 cases with early-stage breast cancer were divided into 2 groups:breast-conserving surgery group(BCS)and modified radical mastcctomy group(MRM),with 90 cases in each group.The 2 groups were all given radiotherapy,chemotherapy and endocrine therapy according to indications.The prognosis and life quality in the 2 groups were compared.Results The 5-year-postoperative follow-up showed there was no significant difference in duration of disease-free survival(DFS)of the 2 groups.However,life quality of BCS patients was significantly better than that of MRM patients in terms of general health,physical function,pain,vitality,social functioning,emotion and mental health.Conclusion Breast-conserving surgery is highly recommended for patients with early-stage breast cancer.

Objective To study the application value of parathyrod in situ exposure and protection in differentiated thyroid cancer thyroid carcinoma (DTC) surgery. Methods 500 cases of DTC admitted from Jan. 2012 to Dec. 2014 were selected for the research. According to whether the parathyroid was anatomically exposed during the surgery, the patients were divided into experimental group (exposed group) and the control group (un-exposed group). Then, depending on tumor extent and risk factors, the experimental group were divided into group E1 (lateral affected glandular lobe, isthmus lobe resection and unilateral VI lymph node dissection )and E2 (total or subtotal thyroidectomy and bilateral VI lymph node dissection), while the control group were divided in-to group C1 (surgical treatment same as E1)and group C2 (surgical treatment same as E2). Patients’ postopera-tive nerve and muscle symptoms were observed, such as clinical manifestations of face, lips, hand and foot numb-ness or convulsions. Both preoperatively and postoperatively, patients’ parathyroid hormone (PTH) and serum calcium level indicators were detected before surgery and at the 1st, 3rd, 5th, 7th, 14th and 28th day after surgery. Results The lymph node metastasis rate and number between experimental group and the control group had statistical insignificance (χ2=1.02, 0.79, P=0.14, 0.96). The recurrence rate of the 2 groups had no significant difference during the follow-up (χ2=0.23, P=0.65). Group E1 was significantly lower than Group C1 in postopera-tive parathyroid function decline rate, incidence of hypocalcemia and parathyroid mistakenly cut rate. Group E2 was also obviously lower than Group C2 in all these aspects. The difference had statistical significance (P<0.05). Conclusion Parathyrod in situ exposure and protection assisted by direct vision of the magnifying glass can re-duce the mistakenly cut rate of parathyroid and the temporary hypoparathyroidism, which can effectively avoid the adverse effects caused by total thyroidectomy.

Objective: Fetal monitoring is extremely important in perinatal care. Analysis of cardiotocogragh(CTG) can suppose if the fetus is lack of oxygen, distressed, acidosis, etc. in order to take measures timely. Methods: We have designed Meticare analysis software package to analyze 867 pieces of CTG data, and researched the relationship between short term variation (STV) and basal heart rate(BHR) by statistics, and short time monitoring analysis based on STV. Results: The amplitude of fetal heart rate curve variation(long term variation) tended to decrease when BHR increasing, with the negative correlation and regression equation STV = 9.866-0.02×BHR. Positive correlation exists between 5 and 10 mimute-STV, with the regression equation STV_(10min)=2.861-0.596×STV_(5min).Conclusion: STV calculated by 5 minutes CTG data can forecast the one by 10 minutes data as a reference demanded by Dawes & Redman criterion. If fetal doppler contains STV analysis function, out-patient fetal heart auscultation will be more significant. After 30 weeks pregnancy, with the STV decreasing, fetal distress, asphyxia, low birth weight, and even mortality increasing. BHR increasing should cause attention that STV might decrease, when monitoring with no analysis functional devices or fetal dopplars.

PurposeTo study the MRI and pathological features of ovarian endometrioid adenocarcinoma (OEC) in order to evaluate the value of MRI in diagnosing OEC. Materials and Methods The MRI imaging features of 8 patients confirmed by surgery and pathology were analyzed retrospectively and were compared with the results of surgery and pathology. The MRI outcome and the related histological findings were further analyzed.Results Six out of the eight patients had unilateral tumor, 3 tumors in the left and the other 3 in the right; 2 patients had masses in the both ovaries. The total number of masses was ten.The diameters of the tumors ranged from 3.5 to 16.5 cm, with the average size of (10.5±4.1) cm. The border of 2 tumors was partially fuzzy and that of the other 6 was clear. The MRI scans showed that 8 tumors were cystic-solid and the other 2 were solid with heterogeneous signals. The solid components mainly presented slightly short T1 signals and long T2 signals; the cystic ones revealed long T1 and T2 signals. The enhanced scanning showed that the solid components of 8 tumors were patchy and obviously enhanced and the other 2 had mild or moderate enhancement. The cystic components were not hyper-intense. The enhanced MRI scans of two cases of primary endometrial carcinoma with metastases to the ovaries showed thickened endometrium and mild hyper-intense.Conclusion MRI can reveal the pathological features of OEC and clearly presents the forms, components and the relationship with its surroundings of tumors. Therefore, MRI is of great importance to the clinical diagnosis of OEC.

This study examined the radiation-induced ERBB2 nuclear transport in the BT474 breast cancer cell line and the relationship between caveolin-1 and radiation-induced ERBB2 nuclear transport. The BT474 cells were treated with herceptin (200 nmol/L), PP2 (a caveolin-1 inhibitor, 100 nmol/L) and irradiation combined or alone. Confocal microscopy was used to observe the nuclear import of ERBB2 and caveolin-1 after irradiation. Western blotting was employed to detect the expression of ERBB2, caveolin-1 and DNA-PKcs after irradiation, and immunoprecipitation to identify the ERBB2 and caveolin-1 complex before perinuclear ERBB2 localization. Confocal microscopy showed the transport of ERBB2 and caveolin-1 from the cell membrane to the nucleus 15 min after irradiation and the proteins accumulated at the perinuclear region within 45 min. Western blotting revealed that the expression levels of ERBB2, caveolin-1 and DNA-PKcs were increased after irradiation and reached a peak 45 min later. Both herceptin and PP2 treatments were found to decrease ERBB2 expression. An immune complex composed of ERBB2 and caveolin-1 was found in the herceptin group after irradiation. It was concluded that after irradiation, ERBB2 may be transported from the cell membrane to the nucleus and activate DNA-PKcs to trigger DNA double-strand break (DSB) repair; caveolin-1 may participate in this process. Treatments involving the downregulation of caveolin-1 may increase the radiosensitization of breast cancer cells.

Objective To observe the influence of trastuzumab on DNA break repair and Her-2 nuclear import after radiation in breast cancer cell line SKBR3,and discuss the radiosensitivity mechanism of trastuzumab.Methods Clone formation assay was used to analyze the difference of survival fractions between radiation group and radiation plus trastuzumab group.Confocal microscopy was applied to observe the influence of trastuzumab in the nuclear import process of Her-2 and the expression of γH2AX after radiation,which is considered as the marker of DNA double strand break.Western blotting was used to detect the expression of Her-2 and DNA-PKcs in nuclei after radiation.Results The result of clone formation assayshowed that the SF2 in radiation group was 0.547±0.046 and 0.321±0.022 in the radiation plus trastuzumab group were significantly decreased,the results of confocal microscopy showed that trastuzumab postponed the nuclear import process of Her-2 (52.80±19.74 in radiation group,21.41±10.55 in the radiation group),and increased expression of γH2AX after radiation (85.40±25.63 in radiation group,18.53±44.32 in the radiation group),and western blotting revealed trastuzumab reduced the expression of Her-2,DNA-PKcs in nuclei.Conclusion Trastuzumab can inhibit the radiation induced nuclear import of Her-2,and decrease Her-2,DNA-PKcs in nuclei to increase the DSB on early stage after radiation.

This study examined the role of PI3K/Akt pathway in radiosensitization of DNA damage of cervical carcinoma cells. The 50% inhibition concentration (IC(50)) of cisplatin and docetaxel in HeLa cells was detected by Mono-nuclear cell direct cytotoxicity assay (MTT) in vitro. HeLa cells were treated by cisplatin/docetaxel of 10 percent of IC(20) alone or combined with LY294002 for 24 h, and then radiated by different doses of X-ray. The cell survival ratio was obtained by means of clone formation. One-hit multi-target model was fitted to the cell survival curve to calculate dose quasithreshold (Dq), mean lethal dose (D(0)), 2Gy survival fraction (SF(2)) and sensitization enhancement ratio (SER). The pAkt and total Akt expression was detected by Western blotting and DNA damage by neutro-comet electrophoresis. The HeLa cells were randomly divided into 7 groups in terms of different treatments: Control; radiation treatment (RT) group; LY294002+RT group; cisplatin+RT group; docetaxel+RT group; LY294002+cisplatin+RT group; LY294002+docetaxel+RT group. The apoptosis ratio of each group was measured by flow cytometry. The results showed that docetaxel and cisplatin significantly enhanced the phosphorylation of Akt in radiation-treated HeLa cells. The Dq, D(0) and SF2 in LY294002-contained groups were lower than those in docetaxel or cisplatin+RT group. The SER in the LY294002+docetaxel+RT group was 1.35 times that of the docetaxel+RT group, and that in the LY294002+cisplatin+RT group 1.26 times that of the cisplatin+RT group. The Comet electrophoresis showed that tail distance in the LY294002+cisplatin+RT group or LY294002+docetaxel+ RT group was longer than in the cisplatin+RT group or docetaxel+RT group. The apoptosis ratio in the LY294002+cisplatin+RT group or LY294002+docetaxel +RT group was higher than in the cisplatin+RT group or docetaxel+RT group. It was concluded that inhibiting PI3K/Akt pathway can increase the effect of docetaxel and cisplatin on the radiosensitivity of HeLa cells and DNA damage resulted from radiation.

Objective To explore the efficacy of mycophenolate mofetil (MMF), which is a kind of immuno-suppressant drugs, on the treatment of Connective tissue diseases-pulmonary arterial hypertension (CTD-PAH). Methods Medical charts of eleven cases of hospitalized patients who were diagnosed as CTD-PAH and treated by MMF in Beijing Chaoyang Hospital affiliated to the Capital Medical University, from January 2014 to June 2016 were collected and analyzed. Results In the 11 cases of CTD-PAH, the systemic lupus erythematosus (SLE) related pulmonary hypertension (SLE-PAH) were 7, while the systemic sclero-derma associated pulmonary hypertension (SSc-PAH) were 2, and rheumatoid arthritis related pulmonary hy-pertension (RA-PAH) was 1, and the mixed connective tissue disease related pulmonary hypertension (MCTD-PAH) was 1. All patients were women, and the average age was (40 ±14) years, and the average duration of PAH was (34 ±35) months. The combination therapy of corticosteriods and MMF was applied to 7 cases, meanwhile the therapy of corticosteriods, MMF and bosentan was used in 1 case, corticosteriods, MMF and sildenafil was prescribed for 3 cases, and symptoms of the patients alleviated. Except for one case having been followed up for 7 months and one for 6 months, 9 patients completed the 1-year follow-up, and the survival rate was 100%(9/9). Notably, one patient, who had been alleviated for 111 months with therapy of corticosteriods and MMF, adopted the combination therapy of corticosteriods, MMF and bosentan for aggravated chest distress, and became stable eventually. Conclusion MMF may have therapeutic effects on inducing and even maintaining the stabilization of CTD-PAH.

Objective To investigate CT and MRI features of dermatofibrosarcoma protuberans (DFSP).Methods Totally 16 patients with DFSP confirmed by pathology were enrolled.Tumor morphology,CT and MRI imaging appearance (11 cases underwent plain and enhanced CT,5 cases underwent plain and enhanced MRI) were analyzed retrospectively.Results DFSP usually occurred in the skin of truck,head and neck,protruding from the skin surface in different extent.Some lesions even suspended out of the skin.The lesions were divided into nodular type (n=12) and diffuse type (n=4) according to their morphological appearance.The tumors usually demonstrated as iso-density or slightly low density solid mass compared to muscle on CT.On MRI,it usually demonstrated as low signal on T1WI and high signal on T2WI.Tumor blood supply was rich,and it usually showed progressively moderate to strong enhancement.The signs within DFSP include hanging sign (n=2),skin tail sign (n＝6),fascia tail sign (n=l),fat tail sign (n=4).Conclusion DFSP can be characterized by nodular or diffuse lesions,the manifestations of different form are slightly different,but still have a certain characteristic.