Objective To study the imaging features and the diagnostic value of conventional and enhanced MRI,DWI and magnetic resonance cholangiopancreatography (MRCP)in primary duodenal adenocarcinoma.Methods 12 cases with duodenal adenocarcinoma confirmed by pathological results were analyzed by conventional and enhanced MRI,DWI (3.0T,b＝0 and 800 s/mm2 )and MRCP.Results 11 cases out of twelve cases of duodenal adenocarcinoma demonstrated uneven thickening of intestinal wall,while mass shadow was observed in 1 case.Slight hypointensity of T1 WI and slight hyperintensity of T2 WI were demonstrated in all the twelve cases .DWI demonstrated mild increase in signal in 3 cases,while hyperintensity was observed in 9 cases.On MRCP,ampullary obstructions were observed in 1 1 cases,of which 6 were accompanied with the dilatation of common bile duct (CBD),and 5 with dilatation of CBD and pancreatic duct, while no dilatation of CBD or pancreatic duct was observed in 1 case.The tumors showed moderate enhancement after intravenous administration of contrast material.No normal layered intestinal walls were observed.Conclusion Conventional and enhanced MRI combined with DWI can clearly demonstrate the features of duodenal adenocarcinoma.Additionally,MRCP is instrumental in assessing the lesions involved in the duodenal papilla.

Objective: To discuss the androgen receptor (AR) expresion and its association with clinicopathological features and prognosis in early stage triple-negative breast cancer patients (TNBC). Methods: The present study retrospectively analyzed the clinic data of 1 018 patients with early-stage invasive breast cancer treated at the Breast Disease Center at Peking University First Hospital between January 2014 and December 2016, including 1 011 females and 7 males; the age range was 21 to 92 years, and the median age was 57 years. Patients with TNBC were enrolled, and divided into AR positive group and AR negative group according to the expression of AR.The clinicopathological features were analysed, including menopause status, pathological type, T staging, lymph node involvement, anatomic staging, prognostic staging, Ki-67 index, histological grade, vascular tumor thrombus and neuroinvation, and the correlation between the expression of AR and clinicopathological features, curative effect of neoadjuvant chemotherapy and prognosis were calculated. The Student’s t test was used to compare continuous data, the Pearson χ² test or Fisher exact test was used to compare categorical variables, and the Mann-Whitney U test was used for quantitative data. The Kaplan-Meier method was used to analyze survival status, and comparisons between groups were calculated by the log-rank test. Results: This study included 148 TNBC, accounting for 14.5% of all patients, in which all patients were females, and the median age was 55 years, ranging from 27 years to 75 years. The number of AR-positive TNBC was 59, accounted for 39.9% of all TNBC patients, and the numbers of AR-negative were 89, accounted for 60.1%. Ki-67 index, histological grade and prognostic stage were significantly different in AR-positive and AR-negative TNBC(P<0.05). There was no statistically significant difference between AR-positive TNBC and AR-negative TNBC in OS (98.3% vs 95.4%, P=0.830) or in DFS (91.4% vs 91.0%, P=0.812). Among TNBC who received neoadjuvant chemotherapy, AR-positive patients showed a lower pCR rate than AR-negative patients(χ²=4.381, P=0.046). Conclusions AR expression is associated with lower respond to neoadjuvant chemotherapy in TNBC. However, the association between AR expression and prognosis in TNBCs was still not clear.

Objective: To investigate the clinical relevance of prognostic staging according to the AJCC Breast Cancer Staging System, Eighth Edition for evaluation of the prognosis of triple-negative breast cancer. Methods: The clinical data of 293 patients with triple-negative breast cancer who were treated at the Breast Disease Center, Peking University First Hospital, between January 2008 and December 2014, were retrospectively analyzed. All patients were female, with age of 53(16) years (M(Q_R)). The patients were staged according to the AJCC Breast Cancer Staging System, Eighth Edition. Survival analysis was performed by Kaplan-Meier method and Log-rank test. The role of clinical staging and prognostic staging in prognostic evaluation was investigated. Results: In all, 293 patients with triple-negative invasive breast cancer with complete clinical data and follow-up data were treated over a 7-year period. The follow-up time was 64.5(32.8) months, the 5-year overall survival (OS) rate was 83.9%, and the 5-year disease-free survival (DFS) rate was 84.1%. The results showed that clinical staging and prognostic staging were correlated with the DFS rate and OS rate of patients with triple-negative breast cancer (χ² were 15.395 to 50.084,P=0.00). However, these two staging systems yielded different results. The prognostic stage of 91.8%(269/293) patients was higher than that of the original anatomical stage. There were significant differences in disease-free survival rate (χ²=22.357,P=0.00) and overall survival rate (χ²=50.084, P=0.00) among patients with different clinical stages. There were significant differences in disease-free survival rate (χ²=15.395,P=0.00) and overall survival rate (χ²=29.187,P=0.00)among patients with different prognostic stages. Conclusions The prognostic stage according to the AJCC Breast Cancer Staging System, Eighth Edition complements the clinical stage. It has a good predictive value for the prognosis of triple-negative breast cancer.

Objective To study the clinical significance for expression of serum matrix metalloproteinase and HER-2 extracellular domain in primary breast cancer.Methods Two hundred and forty two early breast cancer patients were enrolled as research group who met the criteria in Peking University Shenzhen Hospital from May 2015 to October 2017.They were divided into HER-2 positive breast cancer group (n =53) and HER-2 negative breast cancer group (n =189) according to HER-2 status.At the came time,non breast cancer women were recruited in outpatient as control group.The concentrations of serum MMP-2,MMP-9 and HER-2 ECD were detected by ELISA,and the differences of concentration in each grup were compared.Measurement data were expressed by mean and standard deviation,t test was used between two groups of parameters.A single factor analysis of variance was used among the multiple groups of parameters,and LSD test was used in the comparison between every two groups.Results The serum levels of MMP-2,MMP-9 and HER-2 ECD were (12.07 ± 1.23) ng/ml,(25.20 ±3.53) ng/ml and (10.42 ± 6.08) ng/ml in research group,HER-2 positive group were (13.43 ± 4.63) ng/ml,(25.24 ± 2.12) ng/ml and (13.25 ± 3.42) ng/ml,HER-2 negative group were (10.55 ± 3.72) ng/ml,(23.16 ±3.21) ng/ml and (6.33 ±4.11) ng/ml.The serum levels of MMP-2,MMP-9 and HER-2 ECD in the control group were (9.03 ± 1.15) ng/ml,(21.15 ±2.12) ng/ml and (4.71 ± 1.93) ng/ml.There were significant differences in MMP-2,MMP-9 and HER-2 ECD concentration between research group and control group (all P ＜ 0.0001).There was significant difference between HER-2 positive group and HER-2 negative group,HER-2 positive group and control group in the HER-2 ECD (P ＜ 0.0001).There were significant difference between control group and HER-2 positive group,control group and HER-2 negative group in the MMP-2 and MMP-9(P ＜ 0.000 1).In the HER-2 positive group,there was significant difference between HER-2 ECD positive and HER-2 ECD negative subgroup of MMP-2 and MMP-9(P ＜ 0.000 1).Conclusions In early breast cancer,HER-2 positive is an important condition for HER-2 ECD positive,and associated with abnormal activation of MMP.Combined detection of serum HER-2 ECD,MMP-2 and MMP-9 contributes to the determination of HER-2 status in tissues.

Objective To evaluate the incidental irradiation to the axillary levels Ⅰ,Ⅱ and Ⅲduring the whole breast radiotherapy after breast conserving surgery(BCS)without axillary lymph node dissection(ALND)in breast cancer(BC)patients.Methods A retrospective analysis was performed on the consecutive 42 cases of T1-2N0M0stage BC patients with sentinel lymphnode biopsy(SLNB)and BCS but without ALND.The axillary lymph nodes of Ⅰ,Ⅱ and Ⅲ were delineated according to RTOG atlas guideline.Three radiotherapy plans including conventional tangential field(CTF),three-dimensional conformal radiotherapy(3D-CRT)and forward-planned intensity-modulated radiotherapy(IMRT)for whole breast irradiation were devised for each case.The Prescription dose was 50 Gy per 25 fractions.Doses to axillary levels(Ⅰ-Ⅲ)were evaluated.Results The mean doses delivered to axillary by the three techniques(CTF,3D-CRT and IMRT)were(40.1 ±6.8),(35.4 ±8.3),(32.9 ±7.0)Gy for level Ⅰ(F＝10.269,P＜0.05),(33.2 ±7.1),(30.6 ±6.7),(30.4 ±7.0)Gy for level Ⅱ(P＞0.05)and(9.6 ±6.8),(6.4 ±4.5),(5.2 ±3.7)Gy for level Ⅲ(F ＝8.377,P ＜0.05),respectively.V50(volume receiving 50 Gy)for the three techniques were 21.3％,27.6％,9.6％for level Ⅰ(F＝13.161,P＜0.05),12.9％,15.9％,8.3％for level Ⅱ(F＝2.750,P＜0.05)and 0.4％,0.1％and 0％for level Ⅲ(P＞0.05),respectively.Conclusions The doses coverage to axillary levelsⅠ-Ⅲwere all limited in the three techniques.Therefore,it is necessary to assess the risk of axillary lymph node metastasis adequately to develop individualized radiotherapy plans.

Objective: To explore the relationship among mobile phone addiction, locus of control and anxiety in college students. Methods: Using Mobile Phone Addiction Index (MPAI), Internality, Powerful Others, and Chance Scale (IPC), Self-Rating Anxiety Scale (SAS), 826 college students were surveyed and the data were analyzed by SPSS17.0 and Amos24.0. Results: 73.6% college students had mobile phone dependence. College students being addicted to mobile phone got higher scores on chance(20.17±6.65), powerful others(18.74±7.45) and anxiety(45.95±10.41)than non-cellphone dependent students (chance(17.09±6.67), powerful others(15.03±7.65)and anxiety(40.44±8.29)). There were significant differences(all P<0.01). The scores on mobile phone addiction were positively related to chance, powerful others and anxiety (r=0.289, r=0.261, r=0.267, P<0.01). Anxiety played a partial mediating role between chance and mobile phone addiction and the mediating effect was 26.6%. Conclusion Chance can directly predict mobile phone addiction or indirectly predict cell phone addiction through anxiety.

OBJECTIVETo investigate the association of parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using reference region model with prognostic factors and molecular subtypes of breast cancer.

METHODSMRI and pathological data of 50 patients with pathologically confirmed invasive ductal carcinoma of the breast were retrospectively analyzed. Reference region model was applied to analyze pharmacokinetic quantitative parameters including volume transfer constant (RR K), rate constant (K) and the ratio of Kto extracellular space volume (K/V). The associations of the above parameters with prognostic factors and molecular subtypes of breast cancer were analyzed.

RESULTSRR Kand Kwere significantly higher in patients of histological grade 3 compared with those of histological grade 1 & 2 (all<0.05); and the patients with estrogen receptor (ER)-negative and/or progesterone receptor (PR)-negative also had higher RR Kand Kthan those with ER-positive or PR-positive (all<0.05). For immunohistochemistry, RR Kand Kwere significantly higher in triple negative breast cancer compared with luminal type breast cancer (all<0.05).

CONCLUSIONSHigh RR Kand Kare associated with poor prognosis of breast cancer, and which can also be used to distinguish molecular subtypes of breast cancer.

Objective To investigate the clinical efficacy ofYinxing-Tongzhi dripping pills combined with clopidogrel in the secondary prevention of non cardiac acute cerebral infarction (ACI).Methods A total of 117 patients met the inclusion criteria in our hospital were divided into the control group (58 cases) and observation group (59 cases). The control group was orally clopidogrel 75 mg/d in prevention of ACI recurrence, and the observation group addedYinxing-Tongzhi dripping pills based on the treatment of control group, each time 50 mg tid. Both groups were fellowed-up 1 year. The color Doppler ultrasound was used for determination of carotid artery interior and medial thickness (IMT), maximum thickness of the common carotid artery, internal carotid artery, external carotid artery plaques for evaluation. The carotid plaque score was introduced into evaluation of crouse plaque; blood rheometer was used for testing of whole blood viscosity (BV) and plasma viscosity (PV); automatic biochemical analyzer was used for testinghigh sensitive protein (hs-CRP), D-dimer and homocysteine (HCY). The patient's infertility response was recorded during the medication,and adverse drug reactions of the two groups were compared.Results The reductions on IMT (0.18 ± 0.07vs. 0.12 ± 0.04,t=5.679)mm and carotid plaque score (1.25 ± 0.31vs. 1.04 ± 0.26,t=5.009) of the observation group after follow-up were significantly higher than the control group (P<0.05). The reductions on low shear BV (0.73 ± 0.19vs. 0.51 ± 0.16,t=6.769) mPa?s and PV (0.37 ± 0.09vs. 0.22 ± 0.05,t=11.117) mPa?s of the observation group after follow-up were significantly higher than the control group (P<0.05). The reductons on hs-CRP (3.67 ± 0.88vs. 2.65 ± 0.75,t=6.742) mg/L, D-dimer (107.6 ± 23.8vs. 89.3 ± 18.7,t=4.629) g/L、Hcy (15.1 ± 2.9vs. 11.7 ± 2.6,t=6.679) mol/L of the observation group were significantly higher than the control group (P<0.05). The observation group with incidences of transient ischemic attack (8.5%vs. 19.0%), ACI recurrence (0vs. 8.6%), cerebrovascular death (0vs. 1.7%) were significantly lowerer than the control group. The ACI recurrences of the two groups with statistically significant difference (P=0.027).Conclusions Based on orally clopidogrel in secondary prevention of ACI,Yinxing-Tongzhi dripping pills combined can reduce blood viscosity, inhibit atherosclerotic plaque growth, reduce ACI recurrence, and with no increase of adverse reactions.

Objective:To evaluate the effect of epigallocatechin-3-gallate (EGCG) and epigallocatechin-3-O-(3-O-methyl)-gallate (EGCG-3Me) on the anti-bacterial effect and the stability of intraradicular dentin-adhesive interface.Methods:EGCG and EGCG3Me with the concentration of 400 μg/ml were incorporated into Single Bond 2 (SB2) respectively to obtain 2 modified adhesives E-SB2 and E3-SB2.Confocal laser scanning microscopy(CLSM) and ultraviolet spectrophotometry were used to evaluate the anti-bacterial effect of the modified adhesives.Micro-Raman spectrum was used to test the degree of conversion (DC) of the adhesives.Push-out bond strength test was conducted to examine the immediate bond strength and the bond strength after themocycling.Results:E-SB2 and E3-SB2 both showed inhibiting effect on the proliferation of E.faecalis,while E3-SB2 performed stronger inhibiting effect.DC and the immediate push-out bond strength of SB2 were not decreased with the incorporation of EGCG or EGCG-3Me(P ＞ 0.05).E-SB2 and E3-SB2 showed significantly higher push-out bond strengths than that of SB2 (P ＜ 0.05) after themocycling.Conclusion:EGCG and EGCG-3Me modified adhesives have anti-bacterial effect and can enhance the stability of bonding between intraradicular dentin and adhesive,EGCG-3Me may have stronger anti-bacterial effect.

Objective To evaluate the diagnostic value of MSCT in the differentiation of thymic epithelial tumours (TET)with the maximum diameter equal or less than 3 cm.Methods A retrospective analysis of pathological and imaging data of 56 patients with pathologically confirmed TET with the maximum diameter equal or less than 3 cm was performed.According to the 2004 WHO classification,56 TETs were classified as low-risk thymomas(types A/AB/B1),high-risk thymomas (types B2/B3)and thymic carcinomas (type C).The CT manifestations of TET in each group,including shape of tumor,tumor edge (smooth or spiculate protuberance), presence of small nodule around tumor,enhancement degree,pleura invasion and fat space around tumor,were analyzed retrospectively.The differences in the CT manifestations among three types were compared using chi-square test.If the sample number was too small, Fisher 's exact test was used.Results Compared with high-risk thymomas (23 cases)and thymic carcinomas (6 cases),regular round shape was more often observed in low-risk thymomas (27 cases)(χ2 =73,P <0.001;χ2 =116,P <0.001)and the mediastinum-lung interface was more likely to bulge (χ2 = 3.41,P =0.046;χ2 =7.39,P =0.01).Blurred edge,spiculate protuberance and pleural invasion and so on were significantly more common in high-risk thymomas and thymic carcinomas (P <0.001)and they were the most common in thymic carcinomas (χ2 =11.5,P =0.009).There was a significant difference between type B2 thymomas and thymic carcinomas (χ2 =31.52, P <0.001),however there was no significant difference between type B3 thymomas and thymic carcinomas (χ2 =6.96,P =0.07). Conclusion MSCT can accurately show the shape of tumor,tumor edge,presence of small nodule around tumor,enhancement degree,pleura invasion,which can predict the histologic type of thymomas and also can provide information for preoperative diagnosis and prognosis evaluation.