Objective:To compare the image quality and the diagnostic efficiency for breast malignant lesions using simultaneous multi-slice single shot echo planar imaging (SMS+SS-EPI) and readout segment of long variable echo trains (RESOLVE) for breast diffusion-weighted imaging (DWI).Methods:This study was a cross-sectional study. Clinical and imaging data of 102 patients with breast lesion from March 2021 to February 2023 in the First Hospital Affiliated to Ningbo University were prospectively analyzed. All patients underwent routine breast MRI scans and cross-sectional RESOLVE and SMS+SS EPI sequence DWI, and the image quality of 2 types sequences of DWI was evaluated. The subjective evaluation was based on a 5-point scale, including geometric distortion, artifact blurring, fat suppression, overall image quality, and lesion conspicuity of the breast. The objective evaluation included signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) value of the lesion. Wilcoxon signed rank sum test was used to compare the subjective and objective parameters between the two sequences. Finally, the receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the effectiveness of ADC values for diagnosing breast malignant lesions based on two sequence images.Results:All 102 female patients had single lesions, aged from 25 to 68 years and 60 lesions were malignant and 42 were benign. The acquisition time for SMS+SS-EPI sequence imaging was 1 min 50 s, and the acquisition time for RESOLVE sequence imaging was 3 min 43 s.The subjective scores from both SMS+SS-EPI and RESOLVE sequence were over than 3 points. The geometric distortion, artifact blurring, and overall image quality scores of RESOLVE sequence images were higher than those of SMS+SS-EPI (all P<0.001). The overall lesion conspicuity score, malignant lesion conspicuity score, and benign lesion conspicuity score of DWI and ADC images combined with SMS+SS-EPI sequence were higher than those of the RESOLVE sequence (all P<0.05). There were no statistically difference in SNR, CNR, overall ADC value, malignant ADC value, and benign ADC value between SMS+SS-EPI and RESOLVE sequence DWI images of breast lesions (all P>0.05). The AUC of RESOLVE sequence ADC value in diagnosis of breast cancer was 0.973, the sensitivity was 0.929, and the specificity was 0.915; The AUC of SMS+SSC-EPI sequence ADC value in diagnosis of breast cancer was 0.956, the sensitivity was 0.977, and the specificity was 0.850. Conclusions:In breast DWI, the subjective score of SMS+SS EPI image quality can basically meet the diagnostic requirements and the conspicuity of lesions is better than that of the RESOLVE sequence. Both have good diagnostic efficacy for malignant breast lesions.

Objective To analyze the clinical efficacy of microwave ablation in the colorectal cancer with simultaneously multiple liver metastases that was initially evaluated as potentially resectable.Methods The patients with potentially resectable colorectal cancer with simultaneous multiple liver metastases treated in the De-partment of General Surgery of the First Affiliated Hospital of Hebei North University,the Center of Minimally Invasive Therapy in Oncology of Traditional Chinese and Western Medicine in Dongzhimen Hospital of Beijing U-niversity of Chinese Medicine,and the Second Department of General Surgery in the Fourth Hospital of Hebei Medical University from October 1,2018 to October 1,2020 were selected in this study.The general data,pathological features,treatment methods,and clinical efficacy of the patients were collected.According to the treatment methods,the patients were assigned into a surgical resection group(conversion therapy + laparoscopic primary resection +hepatectomy)and a microwave ablation group(conversion therapy +laparoscopic primary re-section +microwave ablation).The surgical indicators(operation duration,time to first postoperative anal ex-haust,hospital stay,etc.)and postoperative complications(anastomotic stenosis,anastomotic hemorrhage,incision infection,etc.)were compared between the two groups.The survival period was followed up,including the overall survival period and disease-free survival period,and the survival curves were drawn to analyze the clinical efficacy of the two treatment regimens.Results A total of 198 patients with potentially resectable color-ectal cancer with simultaneous multiple liver metastases were included in this study.Sixty-six patients were cured by neoadjuvant chemotherapy(FOLFOX or FOLFIRI),including 30 patients in the surgical resection group and 36 patients in the microwave ablation group(with 57 tumors ablated).After the first ablation,54(94.74%)tumors achieved complete ablation,and all of them reached no evidence of disease status after re-ablation.The microwave ablation group had shorter operation duration,less intraoperative blood loss,shorter time to first post-operative anal exhaust,shorter time of taking a liquid diet,shorter hospital stay,and lower hospitalization cost than the surgical resection group(all P<0.001).In addition,the microwave ablation group had lower visual analogue scale score(P<0.001)than the surgical resection group.The incidences of complications such as inci-sion infection(P =0.740),anastomotic fistula(P =1.000),and anastomotic stenosis(P =1.000),the over-all survival period(P =0.191),and the disease-free survival period(P =0.934)showed no significant differ-ences between the two groups.Conclusions For patients with colorectal cancer with simultaneous multiple liver metastases initially assessed as potentially resectable,laparoscopic primary resection +surgical resection/microwave ablation after conversion therapy was safe,effective,and had similar survival outcomes.Microwave ablation outper-formed surgical resection in postoperative recovery,economy,and tolerability,being worthy of clinical promotion.

Objective To analyze the sensitivity of ARHGAP8 in predicting the efficacy of neoadjuvant chemotherapy in the patients with locally advanced mid-low colorectal cancer and provide accurate evidence for the treatment of advanced colorectal cancer.Methods The differentially expressed gene ARHGAP8 was screened out by bioinformatics analysis.Cancer tissue and rectal tissue of 68 patients with primary rectal cancer were select-ed.The rectal cancer tissue samples and the rectal tissue samples were collected for clinical validation of ARH-GAP8 expression by quantitative real-time PCR,Western blotting,and immunohistochemistry.The clinical and pathological features such as gender,age,tumor stage,differentiation degree,and pathological type of the pa-tients were collected for functional validation.Forty-four patients with locally advanced mid-low rectal cancer who received neoadjuvant chemotherapy were selected for immunohistochemical examination of ARHGAP8 expres-sion.The expression level of ARHGAP8 was compared between before and after chemotherapy and among different efficacy groups.Results The bioinformatics analysis revealed differences in the expression level of ARHGAP8 between the cancer tissue and rectal tissue(P＜0.001).The expression level of ARHGAP8 was correlated with tumor stage(P=0.024),lymph node metastasis(P=0.007),and age(P=0.005).Quantitative real-time PCR results showed that the mRNA level of ARHGAP8 in the cancer tissue was higher than that in the rectal tis-sue(P＜0.001).Western blotting and immunohistochemistry results demonstrated that the protein level of ARH-GAP8 in the cancer tissue was higher than that in the rectal tissue(P=0.011).The expression of ARHGAP8 was correlated with tumor size(P=0.010)and pathological stage(P=0.005),while it showed no significant association with tumor differentiation degree,lymph node metastasis,liver metastasis,Ki-67,or microsatellite instability expression level.The 44 patients receiving neoadjuvant chemotherapy included 13,8,8,and 15 pa-tients of tumor regression grades 0,1,2,and 3,respectively.Among them,65.91％(29/44)patients showed responses to the treatment.After neoadjuvant chemotherapy,the expression of ARHGAP8 in the cancer tissue was down-regulated in the patients who responded to the chemotherapy(P＜0.001).The response rate in the patients with low protein level of ARHGAP8 was 92.86％,which was higher than that(53.33％)in the patients with high pro-tein level of ARHGAP8(P=0.033).Conclusions ARHGAP8 is highly expressed in the rectal cancer tissue.The pa-tients with locally advanced mid-low rectal cancer and low ARHGAP8 expression are more sensitive to neoadjuvant chemotherapy with the XELOX protocol.ARHGAP8 can serve as a potential biomarker for the occurrence and develop-ment of rectal cancer and an important index for evaluating the efficacy of neoadjuvant chemotherapy with the XELOX protocol in the patients with locally advanced mid-low rectal cancer.

With the development of patient-centered medical model,patient values and preferences have become a hot research topic.This paper starts from the concept of patients'values and preferences,analyzes the important importance of patients'values and preferences;Based on the published literature,the importance of patients'values and preferences in the development of acupuncture clinical guidelines,the positive role in doctor-patient co-decision,the value of patients'cognition and value promotion in acupuncture"Deqi"were sorted out,and the influencing factors of patients'values and preferences and acupuncture compliance were summarized.According to the influencing factors,the corresponding solutions were proposed to help patients establish correct values,and thus improve patients'acupuncture compliance.

Objective:To investigate the degenerative characteristics and biomechanical effects of paravertebral muscles in patients with degenerative lumbar scoliosis.Methods:The clinical data of 236 patients with degenerative lumbar scoliosis from January 2016 to January 2020 in Yuncheng Central Hospital of Shanxi Province were retrospectively analyzed. All patients underwent lumbar X-ray and MRI measurement, and the indexes included coronal scoliosis Cobb angle, rotation classification of apical vertebra, cross-sectional area (CSA) of the apical vertebra upper and lower intercalated disc plane, fatty infiltration rate (FIR) of psoas major and back extensor muscle group (including erector spinae and multifidus muscle), cross-sectional area difference index (CDI) and fatty infiltration difference (FID). The correlation between paravertebral muscle degeneration and coronal scoliosis Cobb angle was evaluated.Results:The coronal scoliosis Cobb angle of 236 patients was 10.4° to 57.8° (18.72 ± 6.44)°; there were no statistical differences in coronal scoliosis Cobb angle and rotation classification of apical vertebra between different sex, scoliosis direction and apical vertebra position ( P>0.05). In the apical vertebra upper intercalated disc plane, the concave side CSA of psoas major muscle was significantly higher than convex side: (3.82 ± 1.06) cm 2 vs. (3.68 ± 1.01) cm 2, the concave side CSA of multifidus muscle, back extensor muscle group and paraspinal muscle group (including psoas major muscle, quadratus lumborum, erector spinae and multifidus muscle) was significantly lower than convex side: (9.80 ± 2.14) cm 2 vs. (10.46 ± 2.60) cm 2, (18.18 ± 3.03) cm 2 vs. (19.79 ± 3.22) cm 2 and (25.25 ± 5.06) cm 2 vs. (27.86 ± 6.90) cm 2, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in CSA of quadratus lumborum and erector spinae between concave side and convex side ( P>0.05). In the apical vertebra lower intercalated disc plane, the concave side CSA of psoas major muscle and quadratus lumborum was significantly higher than convex side: (6.62 ± 3.09) cm 2 vs. (6.40 ± 3.23) cm 2 and (4.58 ± 0.57) cm 2 vs. (4.45 ± 0.64) cm 2, the concave side CSA of multifidus muscle and back extensor muscle group was significantly lower than concave side: (9.49 ± 3.10) cm 2 vs. (10.32 ± 4.06) cm 2 and (19.31 ± 4.36) cm 2 vs. (20.54 ± 5.60) cm 2, and there were statistical differences ( P<0.01 or <0.05); there was no statistical difference in CSA of erector spinae and paraspinal muscle group between concave side and convex side ( P>0.05). In apical vertebra upper and lower intercalated disc plane, the concave side FIR of back extensor muscle group was significantly higher than convex side: (31.83 ± 11.04)% vs. (24.37 ± 12.76)% and (38.62 ± 10.09)% vs. (31.80 ± 8.23)%, and there was statistical difference ( P<0.01); there was no statistical difference in FIR of psoas major muscle between concave side and convex side ( P>0.05). Pearson linear correlation analysis result showed that CDI of multifidus muscle, back extensor muscle group, paraspinal muscle group and FID of back extensor muscle group were positively correlated with coronal scoliosis Cobb angle (apical vertebra upper intercalated disc plane: r = 0.94, 0.70, 0.86 and 0.90, P<0.01; apical vertebra lower intercalated disc plane: r = 0.92, 0.94, 0.81 and 0.66, P<0.01); the CDI of psoas major muscle in apical vertebra lower intercalated disc plane was positively correlated with coronal scoliosis Cobb angle ( r = 0.73, P<0.01); there was no correlation between CDI of psoas major muscle in apical vertebra upper intercalated disc plane and coronal scoliosis Cobb angle ( r = 0.17, P>0.05). In patients with apical vertebra located in L 2 and L 3, the CSA of psoas major muscle and quadratus lumborum in apical vertebra lower intercalated disc plane was significantly higher than that in apical vertebra upper intercalated disc plane, and there was statistical difference ( P<0.01); in patients with apical vertebra located in L 2, the concave side CSA of erector spinae in apical vertebra lower intercalated disc plane was significantly higher than that in apical vertebra upper intercalated disc plane, and there was statistical difference ( P<0.01). Conclusions:The biomechanical effects of lumbar flexion/ back extensor muscle group should be different in the process of disease progression in patients with degenerative lumbar scoliosis, in which the back extensor muscle group can effectively inhibit the degenerative disease. The protection of paravertebral muscle group function should be placed in an important role in degenerative lumbar scoliosis treatment.

Methods:A total of 1 152 amniotic fluid samples were collected from pregnant women who underwent prenatal diagnosis in the Nanjing Maternity and Child Health Care Hospital, Women′s Hospital School of Medicine Zhejiang University, West China Second University Hospital, Sichuan University/West China Women′s and Children′s Hospital, and Xiamen Maternal and Child Health Hospital from September 2014 to August 2016. These samples were examined with SD-HRM and karyotyping simultaneously. Clinical sensitivity and specificity of SD-HRM were calculated, and Kappa values were measured to evaluate the consistency of detection results of the two methods.Results:A total of 161 cases of trisomy 21, 60 cases of trisomy 18, and 5 cases of trisomy 13 were detected by SD-HRM in 1 152 prenatal samples, sensitivity and specificity were both up to 100%, and Kappa values is equal to 1 which were consistent with the results of karyotype analysis.Conclusion:SD-HRM is validated to be highly accurate for the prenatal diagnosis of common trisomies, which is promising in the clinical practice.

Objective: To investigate the influence of low viscosity and high viscosity bone cement in PVP on active function, anatomical index and leakage rate of patients with severe osteoporotic vertebral compression fractures (OVCF). Methods: From October 2015 to June 2017, 136 patients with severe OVCF were chosen in the Central Hospital of Yuncheng and randomly divided into two groups according to the digital table, with 68 patients in each group.The control group was given low viscosity bone cement by PVP scheme, and the observation group was given high viscosity bone cement by PVP.The VAS score, ODI score, SF-36 score and kyphosis Cobb angle before and after operation, the recovery rate of injured vertebrae, bone cement injection volume and postoperative cement leakage rate of the two groups were compared. Results: There were no statistically significant differences in the VAS score, ODI score and SF-36 score before operation between the two groups(all P>0.05). The VAS score, ODI score and SF-36 score after operation of the control group were (1.90±0.32)points, (30.38±3.52)points, (76.07±9.38)points, respectively, which of the observation group were (1.94±0.34)points, (29.72±3.34)points, (77.10±9.60)points, respectively, which were significantly better than those before operation(control group: t=4.27, 5.01, 4.02; observation group: t=4.21, 4.89, 3.87, all P<0.05). There were no statistically significant differences in the VAS score, ODI score and SF-36 score after operation between the two groups(all P>0.05). The kyphosis Cobb angle after operation of the observation group was (14.02±2.59)°, which was significantly lower than (16.83±3.31)° of the control group and (27.78±4.09)° before operation (t=4.99, 2.64, all P<0.05). The recovery rate of injured vertebrae of the observation group was (28.34±5.70)%, which was statistically significantly higher than (22.72±4.16)% of the control group (t=3.42, P<0.05). There was no statistically significant difference in the bone cement injection volume between the two groups(P>0.05). The incidence rate of bone cement leakage in the observation group was 10.29%(7/68), which was significantly lower than that in the control group [30.88%(21/68)](χ²=12.15, P<0.05). Conclusion Low viscosity and high viscosity bone cement in PVP in the treatment of patients with severe OVCF possess the same clinical effects on relieve pain and improve activity and quality of life; but high viscosity bone cement application can efficiently improve the anatomical index of injured vertebrae and avoid postoperative cement leakage.

ObjectiveTo investigate the value of endoscopic ultrasound (EUS) versus magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of obstructive jaundice. MethodsA total of 31 patients with obstructive jaundice who visited Beijing Tiantan Hospital, Capital Medical University, from January 2015 to March 2016 were enrolled, and all the patients underwent EUS and MRCP. The sensitivity, specificity, accuracy, and Youden index of EUS and MRCP in the diagnosis of obstructive jaundice were compared. ResultsOf all patients, 16 (51.61%) were diagnosed with common bile duct stones, 1 (3.23%) was diagnosed with ampullary tumor, 6 (19.35%) were diagnosed with duodenal papillary tumor, 3 (9.68%) were diagnosed with tumor of the head of the pancreas, 2 (6.45%) were diagnosed with bile duct tumor, 2 (6.45%) were diagnosed with bile duct inflammation, and 1 had no stones or space-occupying lesions observed by endoscopic retrograde cholangiopancreatography, EUS, or MRCP. The coincidence rate of EUS in the diagnosis of ampullary tumor, duodenal papillary tumor, and tumor of the head of the pancreas was 100%, and MRCP had a lower coincidence rate in the diagnosis of common bile duct stones and a lower overall coincidence rate of diagnosis than EUS (81.25%/76.67% vs 93.75%/90.00%). In the diagnosis of obstructive jaundice, EUS and MRCP had sensitivities of 90.00% and 76.70%, specificities of 100%, accuracy rates of 90.30% and 7740%, and Youden indices of 0.90 and 0.77. ConclusionEUS has a higher value in the diagnosis of obstructive jaundice than MRCP.

Enterovirus 71 (EV71) is a major agent of hand, foot and mouth disease that can cause a severe burden of disease to children. To identify an effective method for the control and prevention of EV71, we studied the effect of exposure to heat and ultraviolet (UV) light upon EV71 inactivation. We found that exposure to 50 degrees C could not inactivate the infectivity of EV71. However, exposure to 60 degrees C and 70 degrees C could inactivate EV71 effectively. EV71 could be inactivated after exposure to UV light at a distance between the sample and a lamp of 30 cm for 30 min or 60 min because viral genomic RNA was destroyed. However, fetal bovine serum (FBS) could attenuate the inactivation proffered by heat and UV light. Attenuation effects of FBS were correlated positively with FBS concentration. Hence, EV71 can be inactivated by exposure to heat and UV light, and our results could provide guidance on prevention of the spread of EV71.
Disinfection ; instrumentation ; methods ; Enterovirus A, Human ; genetics ; physiology ; radiation effects ; Enterovirus Infections ; virology ; Hot Temperature ; Humans ; Ultraviolet Rays ; Virus Inactivation ; radiation effects