Objective:To analyze the assessment effect and reliable indicators of multimodal magnetic resonance imaging(MRI)for axillary lymph node metastasis(ALNM)of breast cancer.Methods:A total of 152 female patients with breast cancer who were diagnosed and received surgical treatment in Handan First Hospital from January 2020 to November 2021 were selected.According to the pathological results of postoperative axillary lymph node,45 cases with ALNM were selected as ALNM group,and 107 cases without ALNM were selected as non-ALNM group.Dynamic contrast enhanced-magnetic resonance imaging(DCE-MRI),T2weighted image(T2WI)and diffusion-weighted imaging(DWI)were used to determine breast cancer ALNM.Results:The diagnostic sensitivity,specificity,positive predictive value and negative predictive value and diagnostic consistent rate of multimodal MRI were respectively 82.22%,96.26%,90.24%,92.79%and 92.11%.Logistic regression analysis showed that the maximum tumor size and ADC value were closely correlated with lymph node metastasis.The receiver operating characteristic(ROC)curve analysis showed that the area under curve(AUC)of the maximum tumor diameter was 0.797(95%CI=0.694～0.842,P<0.01),and the diagnostic sensitivity and specificity were respectively 77.4%and 60.7%when the optimal cut-off value was 1.96cm.The AUC of ADC value was 0.844(95%CI=0.808-0.915,P<0.01),and the diagnostic sensitivity and specificity were respectively 82.1%and 71.2%when the optimal cutoff value was 1.122×10-3mm2/s.The AUC value of the combined diagnosis of maximum tumor diameter and AUC value was 0.952(95%CI:0.904-0.991,P<0.01),and the sensitivity and specificity were respectively 88.6%and 81.4%under the optimal cutoff value.The AUC value of the combined indicators was higher than that of the maximum tumor diameter(Z=3.982,P<0.05)and ADC value(Z=3.014,P<0.05),respectively.Conclusion:Multimodal MRI has a good diagnostic effect on breast cancer ALNM,in which the maximum tumor diameter and AUC value are important reference indicators,and the combination of them can improve the diagnostic efficiency.

Objective To discuss the clinical application of percutaneous transhepatic removal of gall-stone technique in treating common bile duct (CBD) stones.Methods Between January 2013 and January 2015,a total of 25 patients with CBD stones underwent lithotomy procedure via percutaneous transhepatic route.First,under ultrasound or fluoroscopy guidance percutaneous transhepatic cholangiography (PTC) was performed with subsequent placement of an 8 F rsheath;then,a balloon of 8-12 mm diameter was employed to dilate the papilla;mechanical lithotripsy was adopted when the stone size exceeded 12 mm;finally,through guide-wire exchange technique the stone-retrieval balloon was used to push the stones into the intestinal tract through the sphincter of duodenal papilla.Results The reasons to receive percutaneous transhepatic removal of gall-stone technique in the 25 patients included previous gastrointestinal surgery (n=18),endoscopic treatment failure (n=3),unwilling to receive endoscopic treatment (n=3),and other reasons (n=1).Successful removal of stones was accomplished in all 25 patients.After the treatment,complications occurred in 3 patients (12％),including fever (n=2) and liver abscess formation (n=1).The patients were followed up for 0.5-3 years;two patients died of tumor recurrence and metastasis,and one patient developed recurrence of common bile duct stones.No reflux cholangitis occurred.Conclusion For the treatment of CBD stones,percutaneous transhepatic removal of gall-stone technique carries higher technical success rate with lower incidence of complications,therefore,this technique can be used for the patients who are not suitable for endoscopic treatment or in whom endoscopic treatment failed.

Objective To screen strains of minipigs sensitive to highly pathogenic porcine reproductive and respiratory syndrome virus (HP-PRRSV) for evaluation of HP-PRRS live vaccine.Methods Lantang pigs, Juema, Bama and Wuzhishan ( white) minipigs were inoculated with virulent strain NVDC-JXA1 of PRRSV, and local binary hybrid pigs were used as control.The animals were continuously observed for 5 weeks on mental status, appetite, survival, etc.after inoculation of virus.The dead pigs were autopsied and the lung tissue samples were collected for detecting virus by RT-PCR.By the end of the experiment, serum of survival animals were collected for detecting PRRSV antibody by ELISA assay.Result The animals showed depression, anorexia, and other clinical signs and death in each group after inoculation.Meanwhile, the testing results were all positive in the RT-PCR and ELISA detection.Bama and Wuzhishan ( white) minipigs were the most sensitive to virulent strain NVDC-JXA1 of PRRSV regarding mortality rate.Conclusions Bama and Wuzhishan ( white) minipigs are sensitive to HP-PRRSV, and can be used for the inspection of HP-PRRS live vaccine.

Objective To characterize the baseline status of Chinese diabetic patients based on data derived from Chinese cohort from SOLVETM study.Methods Patients with type 2 diabetes initiating basal insulin detemir at the decision of the physician were eligible for the study.Data on demographics,medical history,glycemic profile and treatment regimen at baseline were collected by physicians.Results A total of 3272 patients [female 42％,male 58％,mean age (56.2 ± 10.8) years] were included in the study.Their BMI was (25.3 ± 3.3) kg/m2.The duration of diabetes was 4.0 (0.1-27.0) years,and the duration of treatment with oral antidiabetic drugs (OADs) was 3.0(0.0-20.2) years.The proportions of subjects with diabetic macro-and micro-vascular complications were 15.8％ (515 cases) and 27.1％ (866 cases),respectively.The hemoglobin Al c (HbAl c) at baseline was (8.33 ± 1.70) ％,and the fasting blood glucose (FPG) was (9.5 ± 2.6) mmol/L.Conclusions A large proportion of patients with type 2 diabetes remain in poor glycemic control,and the prevalence of diabetic complications is high,which requires optimal therapeutic strategy for the patients with suboptimal glycemic control.

Objective To investigate clinical features and antibiotic resistance of pseudomonas aeruginosa (PA) strains isolated from patients with diabetic foot infections (DFI) in Tianjin Metabolic Diseases Hospital.Methods Eighty-five PA strains were isolated from 428 patients with diabetic foot in the hospital from Jan 2008 to Dec 2010.The clinical features of patients were summarized.Relationships between the isolates and depth of ulcer or severity of infection were analyzed.The disk-diffusion method was performed to examine antimicrobial susceptibility.Results Gram positive (G+) and Gram negative (Gˉ) isolates were 50.47％ and 41.12％,respectively.Multidrug-resistant PA composed 32.9％ of the total PA isolates.The size of ulcers with PA infections was bigger than those with non-PA bacterial infections (P＜0.05).Compared to G+ strains,patients with PA strains were older,had lower hemoglobin,but higher serum sensitive C-reactive protein; and more frequently,they had ischemic ulcer and osteomyelitis.Compared to G+ strains,the PA strains were more frequently isolated from deeper ulcers and with more serious infections(P＜0.05).The resistant rates of PA to cephalosporins,fluoroquinolones,and aminoglycosides were between 32.9％-61.2％,37.6％-42.4％,and 37.6％-62.4％,respectively.Only one out of 85 PA strains was imipenem-resistant.However,sensitiveness of all PA isolates to cefoperazone and sulbactam reached 100％.Conclusion PA strains are mainly found in patients with deeper ulcers and more serious infections.Multidrug-resistant PA is common in DFI.It is important to isolate pathogens and determine their antibiotic resistance correctly in diabetic foot patients in order to provide appropriate drug administration and to reduce the production and dissemination of drug resistant strains.

0 05). Conclusion Femal, splenomegaly and increase of the MPV width and PVP were the risk factors inducing PVT in liver cirrhosis patients, while liver function, BPC, PT, ect, may not be related to the formation of PVT.

Objective To clarify the relationship between ABO blood group and the development of duodenal ulcer(DU)in aspects of gastric acia and Hp infection.Methods The blood group of ABO was determined in 80 patients who were diagnosed as DU and received 24-hour gastric pH monitoring between 1995 and 2003.These results were compared with the expected frequency in the 1061 healthy controls in Beijing.The prevalence Helicobacter pylori (Hp) infection rate was determined by rapid urinase test,biopsy and 13C breath test.Results Blood type O was present in 56.3% of the patients with DU,which was significantly higher than the expected rate (28.7%) in healthy population (? 2=26.69,P0.05).Conclusion Blood group O doesn’t cause the disease by affecting Hp infection rate or stronger gastric acid secretion,it maybe another independent risk factor for DU.The onset age in blood group O is not different from that in other types.The mechanism needs to be explored.

Objective To investigate the effect of the formation of portal vein thrombosis(PVT) on the nature course of liver cirrhosis(LC). Methods Patients with LC during 1995 2002 in our hospital were reviewed and forty eight cases of LC with PVT were included in the study. The PVT was diagnosed by color Doppler and/or CT. Fifty two cases of LC patients without PVT were chosen as controls. The liver function, coagulation function and the aspects of portal hypertension etc. were compared between these two groups. The average diameter of main portal vein(MPV) and spleen vein (SPV) were measured by color ultrasound. Results In 75.0% of patients, thrombosis happened gradually without symptoms, and 85.4% happened in the MPV trunks. The splenomegaly and width of MPV were the risk factors for the formation of PVT ( P = 0.003 and 0.010). In PVT group, the average width of MPV and SPV was 1.48 cm ?0.26 cm and 1.23 cm ?0.38 cm , respectively, significantly wider than 1.37 cm?0.22 cm and 1.05 cm ?0.30 cm in controls( P =0.037 and 0.031). In addition, larger size of spleen,more severe esophageal varices, higher rate of severe variceal haemorrhage and larger volume of ascites after portal vein thrombosis were shown in the study group( P