Complex mechanisms of chronic pain in knee osteoarthritis identified by neuroimaging technology / 生理学报

Chronic pain of knee osteoarthritis (KOA) greatly affects the quality of life and functional activities of patients. It is important to clarify the underlying mechanisms of KOA pain and the analgesic effect of different therapies. Neuroimaging technology has been widely used in the basic and clinical research of pain. In the recent years, neuroimaging technology has played an important role in the basic and clinical research of KOA pain. Increasing evidence demonstrates that chronic pain in KOA includes both nociceptive and neuropathic pain. The neuropathic mechanism involved in KOA pain is complex, which may be caused by peripheral or central sensitization. In this paper, we review the regional changes of brain pathophysiology caused by KOA pain based on magnetic resonance imaging (MRI), electroencephalogram (EEG), magnetoencephalogram (MEG), near-infrared spectroscopy (NIRS) and other neuroimaging techniques. We also discuss the central analgesic mechanism of different KOA therapies, with a focus on the latest achievements in the evaluation and prediction of pain. We hope to provide new thoughts for the treatment of KOA pain, especially in the early and middle stages of KOA.

Lactoferrin improved radioactive lung damage by regulating HMGB1/TLR4 inflammation / 中华放射医学与防护杂志

Objective:To investigate the protective effect of lactoferrin(Lf) on lung injury in mice exposed to irradiation.Methods:C57BL/6 J mice were randomly divided into control group, 15 Gy irradiation group (IR group) and lactoferrin combined 15 Gy irradiation group (Lf+ IR group), with 5 mice in each group. The mice in the Lf+ 15 Gy group drank lactoferrin solution (10 mg/ml) from 3 days before irradiation and contained the whole experiments. Then, single chest 15 Gyirradiation was performed both in the IR and Lf+ IR groups. The body weight and other characteristics were monitored during the experiment. The mice were killed at day 14 after irradiation. The lung histopathology was observed by HE staining. Serum inflammatory cytokine such as HMGB1, TNF-α, IL-1β and IL-6 was determined by ELISA method . The expression of inflammatory related protein in lung tissue including HMGB1, TLR4, MyD88 and NF-κB were performed by immune histochemistry and Western blot method.Results:Compared with the control group, lung weight was significantly increased ( t=3.20, P<0.05), pulmonary hyperemia and inflammatory cell infiltration was observed in the IR group. Exposure also significantly increased serum level of TNF-α[(291.80±5.49) vs.(332.25±22.18)pg/ml]( t=3.07, P<0.05), up-regulated the expression of inflammatory related protein in lung tissue ( t=4.04, 4.78, 3.77, 6.14, P<0.05). Lactoferrin intervention (Lf+ IR group) significantly decreased lung weight ( t=2.18, P<0.05), alleviated histopathologic changes, decrease serum levels of HMGB1, TNF-α and IL-1β ( t=4.67, 2.97, 3.49, P<0.05). On the other hand, lactoferrin intervention decreased the positive cell number of HMGB1 and NF-κB, and down-regulated the protein expression of HMGB1, TLR4, MyD88 and NF-κB in lung tissues, with significant difference with the IR group ( t=8.06, 9.80, 3.07, 5.56, P<0.05). Conclusions:Lactoferrin plays the protective effect of radiation-induced lung injury through the downregulation of inflammatory response, such as HMGB1/TLR4/MyD88/NF-κB signaling pathway.

Progress of cell phenotypes and molecular subtypes as well as p53 gene abnormalities in the prognosis of diffuse large B-cell lymphoma / 肿瘤研究与临床

Diffuse large B-cell lymphoma (DLBCL) is a group of heterogeneous diseases, and further classification is of great value for prognostic stratification. In recent years, some subtypes with poor prognosis have been recognized, such as "double-hit" lymphoma or "double-expressing" lymphoma. In addition, the new molecular classification provides a new perspective for the accurate diagnosis and prognosis stratification of DLBCL. The mutation and deletion of p53 gene are high risk factors in the traditional sense of DLBCL, while with the application of the next generation sequencing and other technologies, the influence of more accurate gene mutation or deletion on prognosis and its prognostic value in new cell molecular subtypes still need to be further confirmed. This paper reviews the progress of cell phenotypes and molecular subtypes as well as p53 gene abnormalities in the prognosis of DLBCL.

Influence of menopause status on breast fibrograndular tissue and background parenchymal enhancement / 复旦学报（医学版）

Objective To evaluate the influence of menopause status on breast fibrograndular tissue (FGT),background parenchymal enhancement volume ratio (BPEv) and intensity ratio (BPEI) by breast MR image automatic quantitative analysis.Methods From 14 033 consecutive patients who underwent breast MR in our center from 2009 to 2012,we randomly selected 101 normal cases (47cases of premenopausal and 54 cases of postmenopausal).Premenopausal status was subclassified into four groups (8 cases in the 1st week and 13 cases in the 2nd,3rd and 4th week,respectively) based on the menstrual cycle.We evaluated FGT,BPEv and BPEI at early (2 minutes),medium (4 minutes) and late (6 minutes) enhanced time phases of breast MRI for quantitative assessment.The FGT,BPEv and BPEI in premenopausal and postmenopausal women were compared using the Mann-Whitney U test.Comparison of each menstrual cycle was made using the Kruskal-Wallis test.Results The FGT,BPEv and middle-late BPEI of postmenopausal women were significantly lower than that of premenopausal women (P＜0.05).The maximum BPEI was in the 1st week,the minimum in the 2nd week in premenopausal women (P＜0.05).The FGT and BPEv in the 1st week were the highest among the 4 weeks,but there was no significant difference.Conclusions The FGT,BPEv and BPEI were significantly decreased after menopause.The optimal time of breast MR examination is in the 2nd week of menstrual cycle.

Effects of percutaneous compression plateversus proximal femoral nail anti-rotation internal fixation on the postoperative functional recovery and femoral head rotation and nail slippage in elderly patients with stable intertrochanteric fracture / 中国组织工程研究

BACKGROUND: Senile unstable intertrochanteric fractures are usually treated with intramedullary nail fixation, but for stable intertrochanteric fractures, extramedullary fixation and intramedullary nail both can obtain satisfactory curative efficacy. Therefore, surgical options are still a controversy.OBJECTIVE: To investigate the effect of percutaneous compression plate (PCCP) versus proximal femoral nail anti-rotation (PFNA) on the postoperative functional recovery of the elderly with stable intertrochanteric fractures and to observe the rotational stability and nail slipping.METHODS: Totally 86 elderly patients with stable intertrochanteric fracture were randomly divided into two groups, and then underwent PCCP or PFNA. The operation time, intraoperative blood loss, postoperative hemoglobin level, the time of weigh bearing, and fracture healing time were recorded; Harris hip scores at postoperative 4 weeks were detected to assess the functional recovery; the rotation rate of femoral head and incidence of nail slipping at 4 weeks postoperatively,as well as the complications within 6 months postoperatively were analyzed statistically.RESULTS AND CONCLUSION: (1) The intraoperative and postoperative declined levels of hemoglobin in the PFNA group were significantly higher than those in the PCCP group (P < 0.05). (2) There was no significant difference for in the Harris hip scores between two groups at postoperative 4 weeks (P > 0.05). The weight bearing time and fracture healing time in the PFNA group were significantly shorter than those in the PCCP group (P < 0.05). (3) The rotation rate of femoral head and nail slipping in the PFNA group were significantly lower than those in the PCCP group (P < 0.05). (4) The incidence of complications within 6 months postoperatively did not differ significantly between two groups (P > 0.05).(5) These results suggest that there is no significant difference in the postoperative function recovery and complications between PCCP and PFNA in the treatment of senile femoral intertrochanteric fracture fixation. However, PFNA possesses advantages in the rotation rate of femoral head and nail slipping.

Breviscapine listed on progress of new varieties and dosage form research / 中国中药杂志

Breviscapine, a flavone glucuronide, is a cardiovascular medicine extracted from a Chinese herb Erigeron breviscapinus. Modern pharmacological research shows breviscapine has a therapeutic effect on cardiovascular diseases such as cerebral thrombus,cerebral ischemia hemiparesis and platelet aggregation et al. However, its poor water solubility and low bioavailability in vivo severely restrict the clinical application. In this article, we reviewed the marketing preparations of breviscapine and its research progress on the new dosage forms.

Study on effect of astragali radix polysaccharides in improving learning and memory functions in aged rats and its mechanism / 中国中药杂志

To observe the effect of Astragali Radix polysaccharides (APS) on the learning and memory functions of aged rats, in order to explore its mechanism for improving the learning and memory functions. Natural aging female SD rats were selected in the animal model and randomly divided into the control group, the APS low-dose group (50 mg x kg(-1)), the APS high-dose group (150 mg x kg(-1)) and the piracetam-treated group (560 mg x kg(-1)). They were orally administered with the corresponding drugs for consecutively 60 days. Besides, a young control group was set. The learning and memory functions of the rats were tested by the open-field test and the Morris water maze task. The Western-blot method was used to observe the levels of relevant neural plasticity protein N-methyl-D-aspartate receptor (NMDA receptor) in hippocampus, calcium/calmodulin dependent protein kinase II (CaMK II), protein kinase (PKA), the phosphorylation level of CAMP response element binding protein (CREB) and the protein expression of brain derived neurotrophic factor(BDNF). In this study, the authors found that the learning and memory functions and the hippocampus neural plasticity protein expression of the aged rat group were much lower than that of the young control group (P < 0.01). Compared with the aged rat group, the APS group showed the significant improvement in the impaired learning and memory functions of aged rats and the up-regulation in the hippocampus neural plasticity protein expression. The results showed that APS may improve the learning and memory functions of aged rats by increasing the expressions of relevant neural plasticity proteins.

Progress of the segmentation methods of magnetic resonance image and its application / 国际生物医学工程杂志

Magnetic resonance imaging (MRI) plays a more and more important role in medical image area for its advantages of nonradiative,multiple imaging and high spatial resolution.This review gives a systematic discussion over a couple of MRI segmentation algorithms that are used widely to help people have an entire knowledge of MRI segmentation methods.On the base of classification and summary of MRI segmentation,the MRI segmentation algorithms have been classified into 5 different categories after preliminary investigation and survey.Based on threshold,pattern recognition,active contours,Markov random field (MRF) and graph cut,separately.After further investigation and survey we summarize the characters and field of applications of the 5 different algorithms,then take a few segment experiments among these algorithms on abdomen MRI and present their distinct characteristics.At last,we take a prospect at the future of the MRI segmentation.

Value of diffusion weighted imaging (DWI) in evaluating early response to neoadjuvant chemotherapy in locally advanced breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the role and the performance of diffusion weighted imaging (DWI) for predicting the early response to neoadjuvant chemotherapy (NAC) in local advanced breast cancer (LABC) and to assess the accuracy of DWI in evaluating residual lesion after NAC.</p><p><b>METHODS</b>88 women with LABC (89 lesions) underwent DWI before and after the first and final cycle of NAC. For each patient, the apparent diffusion coefficient (ADC) values were compared between the baseline and follow-up to predict the early response to NAC. The residual tumor volumes were obtained using 3D maximum intensity projections (MIP) of DWI map, and were compared with pathological findings to assess the accuracy of DWI in detecting and measuring residual tumor. All results were proved or analyzed comparing with the data from histopathology.</p><p><b>RESULTS</b>There were 68 lesions responding to NAC, while 21 non-responders. The baseline ADC values of responders and non-responders were (1.049 +/- 0.135) x 10(-3) mm(2)/s and (1.171 +/- 0.134) x 10(-3)mm(2)/s, respectively, with a significant difference (t = -2.731, P = 0.009 < 0.01). The ADC value measured prior to treatment was (1.087 +/- 0.146) x 10(-3)mm(2)/s, and the degree of the changes in tumor volume after NAC was (70.4% +/- 55.1)%. A negative correlation was observed (r = -0.430, P = 0.025 < 0.05). In the response group, there was a significant difference in ADC value between prior to NAC and 1st cycle of NAC, the final cycle of NAC, respectively (P < 0.001). While no significant differences were found in non-responders during NAC (P > 0.05). The tumor volume correlation coefficient between DWI and pathology measurements was very high (r = 0.749, P < 0.01).</p><p><b>CONCLUSION</b>DWI appears to provide functional information regarding changes in ADC value of tumors due to NAC. DWI may be useful in monitoring the early pathological response of tumor after the initiation of treatment and in evaluating the residual tumor after NAC.</p>

Value of dynamic contrast-enhanced MRI in assessment of early response to neoadjuvant chemotherapy in breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To assess the value of dynamic contrast-enhanced MRI (DMRI) in predicting early response to neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer (LABC) and to assess the accuracy of MRI in evaluation of residual disease after NAC.</p><p><b>METHODS</b>Forty-three women with LABC (44 lesions, all were invasive ductal carcinoma) underwent DMRI before, after the first and final cycles of NAC. For each patient, the tumor volume, early enhancement ratio (E1), maximum enhancement ratio (Emax), and maximum enhancement time (Tmax), dynamic signal intensity-time curve were obtained during treatment. The residual tumor volumes obtained by DMRI were compared with pathological findings to assess the accuracy of DMRI.</p><p><b>RESULTS</b>After the first cycle of NAC, the mean volume of responders decreased insignificantly (P = 0.055), but after NAC, mean volume of residual tumor decreased significantly (P = 0.000). Morphological changes: 29 cases showed a concentric shrinkage pattern while 7 cases showed a dendritic shrinkage pattern. Significant differences were found in E1, Emax and Tmax between responders and non-responders (P < 0.05). After the first cycle of NAC, E1, Emax and Tmax of responders changed significantly (P < 0.001), while there was no significant change in non-responders (P > 0.05). After NAC, the dynamic signal intensity-time types were changed in responders, and tended to be significantly flattening, while no significant change was found in non-responders. The residual tumor volume correlation coefficient between MRI and pathology measurements was very high (r = 0.866, P < 0.01).</p><p><b>CONCLUSION</b>DMRI is useful to evaluate the early response to NAC in LABC. The presence and volume of residual tumor in LABC patients treated with NAC can be accurately evaluated by DMRI.</p>

Comparative evaluation of two kinds of micro-implant system with different size / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To offer some reference for micro-implant's development and population by analyzing clinical application of two kinds of micro-implant systems.</p><p><b>METHODS</b>38 patients treated with MIA (micro-implant anchorage) and 28 patients treated with SDIA (self-driven titanium implant for orthodontic anchorage) were included. Analyzing the rate of lost implants, the gum's reactivity and the efficiency of moving teeth summarized the excellences and shortcomings of two systems.</p><p><b>RESULTS</b>1) Six of MIA implants fell off after being inserted. Seven of SDIA implants lost when they had been implanted for a month. But they were stable after being inserted again. 2) The gum around 12 SDIA implants got inflammation symptom, but the gum around MIA implants was normal. 3) Both MIA implants and SDIA implants could move teeth effectively and persistently when they were stable.</p><p><b>CONCLUSION</b>When we apply micro-implant in clinic, we should prevent it from closing roots of teeth and choose the small tip micro-implant. The embedded position should be in area of attachment gum. At the same time, the areas around the tip of micro-implant should be keeping clean.</p>

Comparison between J-hook and micro-implant anchorage in the treatment of patients with bimaxillary protrusion / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare the difference between J-hook and micro-implant anchorage in the treatment of patient with bimaxillary protrusion.</p><p><b>METHODS</b>Thirty patients with bimaxillary protrusion were divided into two groups (J-hook and micro-implant groups) and treated with MBT appliance. Four first premolars were extracted in all patients. Cephalometric analyses were carried out before and after treatment.</p><p><b>RESULTS</b>In J-hook group and micro-implant group,computerized cephalometric analysis revealed that before treatment U6C-PP was (12.4 +/- 0.2) mm and (12.5 +/- 0.1) mm, respectively,and after treatment U6C-PP was (12.6 +/- 0.1) mm and (12.8 +/- 0.1) mm,respectively. The difference between J-hook group and microimplant group was significant (P < 0.01). The other differences of cephalometric analyses between J-hook group and micro-implant group was not significant.</p><p><b>CONCLUSIONS</b>Both J-hook and micro-implant could provide adequate anchorage in the treatment of patients with bimaxillary protrusion.</p>

MR imaging features of different renal cell carcinoma subtypes / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare and analyze the MRI features of different renal cell carcinoma (RCC) subtypes.</p><p><b>METHODS</b>The MR images of 81 surgically and pathologically confirmed renal cell carcinomas from 79 patients were reviewed retrospectively. The MR imaging features of lesions in plain scan, the degree and patterns of lesion enhancement (homogeneous, heterogeneous, peripheral), and tumor spreading patterns were analyzed. In order to evaluate the diagnostic validity of differentiating RCC subtypes using signal enhancement, receiver operating characteristic curves (ROC) were generated. The cutoff value of post-contrast signal intensity to noise ratios (SNR) of the tumor parenchyma were also generated in order to differentiate clear cell RCC from other subtypes.</p><p><b>RESULTS</b>Of the 81 lesions, 58 were clear cell carcinomas, 10 chromophobe cell carcinomas, 8 papillary cell carcinomas, and 5 unclassified RCC. All the chromophobe cell subtype tumors showed a homogeneous density (P < 0.05). The clear cell subtype tumors were likely heterogenous, and also showed heterogenous enhancement with mixed signal than other subtypes (P < 0.05). The cutoff value of SNR, which was used to differentiate clear cell subtype from the other subtypes, were 616 (corticomedullary phase), 579 (nephrographic phase) and 278 (excretory phase), retrospectively. The nephrographic phase is the most appropriate for differentiation, with a sensitivity of 62.1%, specificity of 91.3%, positive predictive value of 94.7%, negative predictive value of 48.8% and an accuracy value of 70.3%. No significant difference was found in tumor spreading patterns among all subtypes of RCC.</p><p><b>CONCLUSION</b>MR imaging features, particularly tumor heterogeneity and degree of enhancement are useful in differentiation of the renal cell carcinoma subtypes, and in choosing an individualized therapy.</p>

In vivo 1H magnetic resonance spectroscopy in evaluation of hepatocellular carcinoma and its early response to transcatheter arterial chemoembolization / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the value of in vivo proton magnetic resonance spectroscopy (MRS) in the assessment of hepatocellular carcinoma (HCC) and monitor its metabolic change shortly after transcatheter arterial chemoembolization (TACE).</p><p><b>METHODS</b>In this prospective study, 28 consecutive patients with large HCC (> or = 3 cm in diameter) confirmed by fine needle aspiration biopsy were recruited. The 1H MRS of all hepatic lesions and some uninvolved liver parenchyma were performed with 1. 5T whole body MR scanner. Among them, 15 cases were evaluated again about one week after TACE. The main metabolites such as choline and lipid before and after interventional therapy were measured to assess the early response of the tumor.</p><p><b>RESULTS</b>The technical success rate of 1H MRS in liver was high (33/41, 80%), closely related to breath motion, location of lesion, and size of voxel. In spectra, the choline compound peak of HCC elevated compared with uninvolved liver parenchyma. After TACE, both the amplitude and the area of choline resonance peak significantly descended (choline-to-lipid ratios from 0.352 +/- 0.080 to 0.167 +/- 0.030, P = 0.026; from 0.205 +/- 0.060 to 0.070 +/-0.020, P = 0.042, respectively); yet lipid resonance peak ascended.</p><p><b>CONCLUSIONS</b>In vivo 1H MRS is technically feasible for the evaluation of large focal hepatic lesions, however, the reproducibility and stability are not as good as routine MR scan. 1H MRS can monitor the early stage metabolic changes of HCC after TACE but limitation like quantification still exists.</p>

Comparative study of video-assisted thoracoscopic surgery vs thoracic tube drainage in synthetic therapy for malignant pleural effusion secondary to non-small cell lung cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the value of video-assisted thoracoscopic surgery (VATS) and identify its indications in synthetic therapy for malignant pleural effusion secondary to non-small cell lung cancer.</p><p><b>METHODS</b>A prospective randomized single-blinded controlled clinical trial was conducted. Fifty-three patients with moderate or large amount of ipsilateral malignant pleural effusion (MPE) secondary to non-small cell lung cancer (NSCLC) were randomly divided into VATS group and tube drainage group (TD group). All patients received chemotherapy with the regimen of paclitaxel combined with paraplatin, and the response rate of MPE after therapy, difference of Karnofsky performance status (KPS) grades before and after therapy and the survival rate of the patients were compared.</p><p><b>RESULTS</b>The response rate of MPE after therapy in VATS group and TD group was 92.3% and 59.3%, and the complete remission rate was 88.5% and 44.4% (P<0.05), respectively. The difference of KPS grades before and after therapy in VATS group and TD group were 30 and 20, with a mean of 33.5-/+11.3 and 24.07-/+10.5 (P<0.05), respectively. Till August of 2005 years, all patients were available for followed-up, whose median survival time was 20 months in VATS group and 15 months in TD group. The 1-, 2- and 3-year survival rate were 65.4%, 38.5% and 22.4% in VATS group and 59.3%, 25.9% and 14.8% in TD group (P>0.05), respectively.</p><p><b>CONCLUSION</b>Video-assisted thoracoscopic pleurectomy can effectively control MPE and improve the quality of life for NSCLC patients with MPE, but failed to significantly improve the patients' survival rate in comparison with tube drainage. Except for grade IV, grades I, II and III according to CT findings all can be indications of VATS.</p>

Value of magnetic resonance imaging in diagnosing breast lesions which need biopsy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate MRI in diagnosing breast lesions which need biopsy.</p><p><b>METHODS</b>One hundred and eight patients were admitted to hospital for biopsies due to one hundred and sixteen suspicious lesions detected in their breasts. These lesions were detected by physical examination, mammography or ultrasonography. They were also administrated MRI examination before biopsy. The sensitivity and specificity of each diagnostic method were obtained and the radiologic-pathologic correlation was meanwhile calculated.</p><p><b>RESULTS</b>Seventy (60.3%) breast lesions were diagnosed malignancy. The sensitivity, specificity, accuracy, positive prognostic value and negative prognostic value of ultrasonography were 83.3%, 62.0%, 74.1%, 74.3% and 73.8%. Such data of mammography were 86.8%, 68.1%, 78.0%, 75.4% and 82.1%. And those of MRI were 97.1%, 73.9%, 87.9%, 85.0% and 94.4%.</p><p><b>CONCLUSION</b>MRI is superior to ultrasonography and mammography in diagnosing breast lesions, especially for the nonpalpable lesions.</p>

Comparison of mini-probe endoscopic ultrasonography with computed tomography in preoperative staging of esophageal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare mini-probe endoscopic ultrasonography (MCUS) with computed tomography (CT) in preoperative T and N staging of esophageal cancer, and to find out the MCUS parameters to judge lymph node metastasis for esophageal cancer.</p><p><b>METHODS</b>Thirty-five patients received both MCUS and CT preoperatively, on both of which the T and N stages were determined. The accuracy, sensitivity, specificity, positive predicting value and negative predicting value were compared with the postoperative pathological results.</p><p><b>RESULTS</b>The accuracy of MCUS was 85.7% in T staging and 85.7% and 80.0% in N staging by the two different methods, which were 45.7% and 74.3%, respectively, by CT.</p><p><b>CONCLUSION</b>MCUS is better than CT in preoperative staging for esophageal cancer. The ratio of short to long axis (S/L) combined with short axis is a useful way to determine lymph node metastasis.</p>

Treatment of non-small-cell lung cancer with paraplatin given by two different dosage calculation methods / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the reasonable dosage for paraplatin according to different dosage calculations.</p><p><b>METHODS</b>A prospective, randomized, single-blinded study on 54 patients with advanced non-small-cell lung cancer (NSCLC) treated with paraplatin was conducted. Patients were divided to 2 groups. In group A, paraplatin dosage was calculated according to patients' body surface, and in group B, it was calculated according to the area under the curve (AUS). Hematological toxicity, response rate and survival rate in the two groups of patients were compared.</p><p><b>RESULTS</b>Neutropenia in group A and group B was seen in 77.8% and 37.0% (P < 0.05), and thrombocytopenia in 18.5% and 3.7% (P > 0.05) of patients, respectively. Hemoglobin decrease was seen in 48.2% of patients in both groups. The average quantity of paraplatin given in one cycle of treatment was 535.93 +/- 106.71 mg and 398.52 +/- 71.72 mg (P < 0.01) respectively. The average time interval between treatment cycles was 27.04 +/- 5.30 d and 22.85 +/- 2.80 d (P < 0.05). The response rate and survival rate of patients in group A and B were 22.2% versus 48.2% (P < 0.05), and 40.7% versus 44.4% (P > 0.05) respectively, but the median survival time was identical (12 months) in the two groups.</p><p><b>CONCLUSION</b>NSCLC patients given paraplatin with dosages calculated on the basis of AUC have higher response rate and less severe hematological toxicity than those given paraplatin with dosages on the basis of body surface. However, the median survival time and survival rate have no statistical differences between the two groups of patients.</p>

Evaluation of breast cancer extension with diffusion-weighted MR imaging / 中华放射学杂志

Objective To investigate the feasibility of determining the breast cancer extension with diffusion-weighted imaging(DWI)and the apparent diffusion coefficient(ADC).Methods Fifty-nine lesions(57 patients)were studied by using DWI and ADC measurement before surgical excision.The cancer extension was investigated on ADC maps with different b values(b=500 and 1000 s?mm~(-2))according to the threshold values discussed before.The lesion extension on dynamic enhanced images and on DWI was used for comparison.The tumor extension was determined by calculating two lines.Line one:the maximum diameter of lesion.Line two:perpendicular line crossing the midpoint of line one.All measurement was compared with the pathologic specimen.Results(1)There were 48 invasive ductal carcinomas,6 ductal carcinomas in situ with small invasive foci,3 mucinous carcinomas,and 2 medullary carcinomas.(2)The low ADC value on ADC maps at b=500 and 1000 s?mm~(-2)was described as cancer extension.The measurement results were compared to pathologic figures and the pattern of correlation was categorized into 3 groups:Group 1,the area of low ADC values was almost the same as the pathological tumor extension; Group 2(overdiagnosis),the area of low ADC values was wider and more than 20% larger than the area of tumor extension;Group 3(false negative),no area of low ADC value was observed.There were no significant difference between DWI with b of 500 and b of 1000 s?mm~(-2)(X~2=0.160,P=0.689;X~2= 0.172,P=0.679)in Groups 1 and Group 3.There were 2 lesions in Group 2,which were consistent in DWI with b of 500 and b of 1000 s?mm~(-2).There were 14 misdiagnosed lesions,including overdiagnosis in 2 lesions and false negative in 12 lesions.Eight lesions measured at DWI with b of 500 and b of 1000 s? mm~(-2)were not consistent.Five lesions were diagnosed correctly at DWI with b of 500 s?mm~(-2),three of them were duetal carcinomas in situ with small invasive foci.(3)The extension of lesion on dynamic enhanced imaging was measured at 4 minutes after enhancement,and was compared with the extension measured at the same slice on DWI map.Pathologic figures were regarded as the gold standard.The extension of 47 lesions(80%)on enhanced images accorded with DWI.The abnormal area on DWI,which was consistent with pathologic figures,was wider than the area on enhanced images in 8 lesions.Of them,3 lesions were mucinous carcinomas and 5 lesions were grade 3 invasive ductal carcinomas.Conclusion DWI and ADC value have the potential in evaluating the cancer extension.The accuracy of extension measured on DWI map was better than that on dynamic enhanced images for some kinds of breast cancers.

Diffusion-weighted MRI of the breast:lesion characterization and parameter selection / 中华放射学杂志

Objective To evaluate the b value of diffusion-weighted(DW)MRI in distinguishing between benign and malignant breast lesions.Methods Three diffusion-weighted sequences were implemented with 500,1000 and 2000 s/mm~2 b values respectively on 95 breast lesions in 83 patients.All lesions were confirmed by pathology.The apparent diffusion coefficient(ADC)values and signal intensity (SI)were recorded and compared in different lesions(breast cancer,benign lesion,cyst and normal beast tissue)with the same b value and the same lesions with the different b values.Results(1)The mean ADC value and SI of breast cancer were 1.375?0.378 and 839.713?360.493 respectively with b= 500 s/mm~2,1.176?0.311 and 459.314?229.609 with b=1000 s/mm~2,0.824?0.198 and 243.825? 110.616 with b=2000 s/mm~2.The differences in the mean ADC value were significant between two type lesions(cancer and benign lesion,cancer and cyst,cancer and normal breast tissue)with b values of 500 s/mm~2 and 1000 s/mm~2.But the significant differenee was only seen between cancer and benign lesions when b value was 2000 s/mm~2.(2)The one-side upper limits of 95% confidence interval of mean ADCs were adopted as the point to separate the malignant from the benign lesions,the sensitivity was 70.92%, 70.73% and 69.77%,the specificity was 77.19%,75.70% and 54.76%,the accuracy was 77.12%, 74.32% and 62.35% respectively with b values of 500 s/mm~2,1000 s/mm~2 and 2000 s/mm~2.The areas under ROC eurves were Az_(500)=0.775?0.046(P0.05).Conclusion DWI MRI is useful for the differential diagnosis of breast lesions with b values of 500 s/mm~2 and 1000 s/mm~2.