VPS13B gene variation and clinical phenotype of Cohen syndrome in a Chinese Han family / 中华实验眼科杂志

Objective:To analyze the pathogenicity and clinical characteristics of patients with Cohen syndrome caused by a compound heterozygous variation of VPS13B gene. Methods:A pedigree investigation was conducted.A Chinese Han family with Cohen syndrome was recruited from Henan Eye Hospital in September 2021.There were three members of two generations in this family, including one patient.The clinical data of the proband and his parents were collected, and the relevant ophthalmic and general examinations were performed to evaluate the clinical phenotype.The peripheral venous blood samples of the family members were collected to extract whole genomic DNA, and the whole exome sequencing was performed.Sanger sequencing and pedigree co-segregation analysis were performed among the family members.According to the ACMG guidelines, the pathogenicity of the selected variants was evaluated and the online tools were used to predict the pathogenicity of the variants.Relevant literature of Cohen syndrome were retrieved in Online Mendelian Inheritance in Man (OMIM) and PubMed, China National Knowledge Infrastructure and Wanfang databases by taking Cohen syndrome and VPS13B gene as the searching keywords.The clinical manifestations and pathogenic variants of patients in the literature were summarized, and the relationship between genotype and clinical phenotype was analyzed.This study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2019[15]). Both the subject and the patient's guardian were aware of the study purpose and method.Written informed consent was obtained. Results:The family was consistent with autosomal recessive inheritance.The proband, a 5-year-old male, had bilateral night blindness with photophobia, ptosis, lower eyelid entropion, and trichiasis; high myopia in both eyes; osteoblastoid pigmentation in the peripheral retina, atrophy and thinning of the outer layer of the peripheral retina, extinguished flashing electroretinogram; global growth retardation, typical facial features, slender fingers and toes, flatfoot, foot valgus, dystonia, no cardiac abnormalities; excessively cheerful personality.The clinical manifestations of the proband were consistent with Cohen syndrome.No obvious abnormality was found in the clinical phenotype and the auxiliary examination of the proband's parents.Whole exon sequencing revealed that the proband carried two heterozygous variations, a nonsense variation c. 11713C>T(p.Gln3905*) and a splicing variation c. 6940+ 1G>T.Sanger sequencing confirmed that the above variations were co-segregated in this family.c.11713C>T(p.Gln3905*) was a novel variant, which prematurely terminated the protein encoded by it and affected the normal function of the protein.The two variations were pathogenic variants according to the ACMG guidelines.A total of 12 articles on variants and clinical characteristics of Cohen syndrome in China were retrieved.Combined with the results of this study, a total of 24 VPS13B variants were found in Chinese patients, of which the incidence of frameshift variation was 41.7%(10/24), missense variation 20.8%(5/24), splicing variation 20.8%(5/24) and nonsense variation 16.7%(4/24), respectively.The onset age of patients with Cohen syndrome was from 28 days to 12 years old.The symptoms such as nerve system, eye, brain, and bone were sporadic, and the clinical manifestations were highly heterogeneous. Conclusions:A novel pathogenic variation c. 11713C>T is found in the VPS13B gene of the Cohen syndrome pedigree in this study, and expands the pathogenic variation spectrum of the VPS13B gene.The clinical manifestations of Cohen syndrome are highly heterogeneous.

Research on the mechanism of Atractylodes-Pinellia-Poria in the treatment of pancreatic cancer based on network pharmacology and molecular docking / 药学实践杂志

Objective To predict the target of Atractylodes-Panxia-Poria in the treatment of pancreatic cancer, and to explore its potential molecular mechanism by using network pharmacology and molecular docking. Methods Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), PharmMapper, OMIM, GeneCards, STRING, DAVID and Cytoscape software were used to construct a series of network diagrams. The core targets and conduct GO analysis and KEGG pathway enrichment analyses of the target genes were selected. Finally, molecular docking verification of key active ingredients and potential targets were conducted by AutoDock software. Results A total of 35 active ingredients, 190 related targets, 1566 targets of pancreatic cancer and 76 intersection targets were screened for the treatment of pancreatic cancer with Atractylodes-Panxia-Poria. These intersection targets were mainly involved in several biological processes, including positive regulation of gene expression, cytokine-mediated signaling pathway and regulation of apoptotic process, etc, which were also related to pathways in cancer, hepatitis B, colorectal cancer, chemical carcinogenesis-receptor activation, pancreatic cancer, and MAPK signaling pathway, etc. Molecular docking results showed that the main active components of Atractylodes-Panxia-Poria had certain affinity with the potential targets of pancreatic cancer. Conclusion Atractylodes-Panxia-Poria mainly exerts a therapeutic effect on pancreatic cancer through multi-component, multi-target and multi-pathway, which provides a certain theoretical basis for the clinical application of Atractylodes -Panxia-Poria in the treatment of pancreatic cancer.

Analysis on the output of pharmaceutical papers and highly cited papers in Double First-rate universities / 药学实践杂志

Objective To understand the current situation of pharmaceutical research development in China and provide a constructive thinking for universities to serve the national innovation strategy through the statistical analysis of pharmaceutical papers and highly cited papers from Double First-rate universities. Methods CNKI, Wanfang, VIP and Chinese Biomedical Literature Database were searched for Chinese publications, and Scopus database was searched for English publications. Duplicates and non-research literatures were excluded. Excel 2016 software was used for statistical data analysis. Results By comparing the data from 2017 to 2019 with that from 2014 to 2016, it was found that the number of papers in Q1 area from international journals and Q2 area from domestic journals increased significantly. The popularity of publishing papers in international journals by university authors was increasing. The number of publications in domestic journals slightly decreased. From 2014 to 2020, 850 papers were published in domestic journals, among which 223 papers were highly cited, with a total cited times of 2 410 and an average cited times per publication of 10.81. Conclusion In spite of the government’s encouragement to publish the scientific and technological achievements in domestic journals, no such trend was formed from our analysis. Therefore, it is necessary to further build the corresponding academic ecology and enhance the international influence of domestic journals. The science and technology circles and technology publication circles in China should be deeply integrated to promote mutual development.

Bibliometric analysis of pharmaceutical papers from Double First-rate universities in China / 药学实践杂志

Objective To understand the development status in the subject of pharmacy and provide recommendations for the construction of universities and the development of pharmacy by the bibliometric analysis of pharmaceutical papers from Double First-rate universities in China. Methods China National Knowledge Network (CNKI), Wanfang and VIP databases were searched for Chinese literature, and Scopus database was searched for English literature. Duplicates and non-research literatures were deleted. 12 028 literatures were included. Excel 2016 software was used for statistical analysis. Results From 2014 to 2019, the total number of papers published by Double First-rate universities increased year by year, with the highest increase rate of 14%. From 2014 to 2020, 11 178 papers were published in international journals, while only 850 were published in domestic journals. Nearly 93% of pharmaceutical papers flowed to foreign journals. Peking Union Medical College published the most papers in international journals. Sun Yat-sen University published the most SCI papers. Peking University published the most papers in domestic journals, while Fudan University published the highest number of papers in Q1 area. Only a few papers published with international coauthors from colleges or universities. The cooperation works were limited in the same province or municipality directly under the central government. Conclusion Double First-rate universities should focus on strengthening international cooperation and inter-provincial cooperation, improving industry-university collaboration, and accelerating the transformation from scholar research to productions.

Overseas warehouses for prepositioning medicine materials / 药学实践杂志

In order to meet our country strategic needs of “The Belt and Road”, it was proposed to use the existing overseas warehouses from domestic companies as prepositioning locations. The situation and functionality were clarified. A comprehensive evaluation for the existing overseas warehouses in the Indian Ocean was conducted. The authors screened out several countries suitable for prepositioning medicinal supplies. Meanwhile, the potential problems were discussed in order to provide a theoretical basis for the future research on overseas medicinal supplies.

A comparative study of diagnostic performance between digital breast tomosynthesis and conventional imaging methods / 中国癌症杂志

Background and purpose:Breast cancer is the most common malignancy in women. The new technology of mammography is helpful in breast cancer diagnosis. This study aimed to compare the efficacy of digital breast tomosynthesis (DBT) with conventional imaging methods in the diagnosis of benign and malignant breast lesions.Methods:During the period from Mar. 2015 to Dec. 2015, 227 patients with suspected lesions (by palpation or sonography) underwent further imaging exam in our hospital. The sonography, full-field digital mammography (FFDM), DBT and breast MRI were performed on all the patients. A double-blind assessment was carried out according to BI-RADS (version 2013) by experienced radiologists. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of all methods, referring to the pathological data as the golden standard; the difference in the efficiency of DBT from the other methods was determined byZ-test.Results:Thirty patients were excluded for the unsatisfactory images, and 205 lesions (132 malignant and 73 benign lesions) were detected in the remaining 197 patients. Area under the curve (AUC) of sonography, FFDM, DBT, DBT+FFDM and MRI based on the BI-RADS were 0.8308, 0.8592, 0.9167, 0.9198, and 0.9354, respectively. The AUC of DBT was significantly higher than those of sonography (Z=7.36,P=0.0067) and FFDM (Z=4.89,P=0.0271), while there was no significantly difference between DBT and MRI (Z=0.02,P=0.9002) or FFDM+DBT (Z=0.69,P=0.4048).Conclusion:DBT could significantly improve the diagnostic performance for breast lesions compared with sonography and FFDM, providing a comparable efficiency to MRI. As a new mammography technology, DBT has good clinical application prospect.

Diagnostic performance of contrast-enhanced spectral mammography / 中华放射学杂志

Objective To assess the value of contrast enhanced mammography (CESM) in the detection of breast cancer. Methods A total of 145 patients who were suspected of breast abnormalities by clinical examination or ultrasound were prospectively collected. All patients underwent bilateral breast CESM and MRI examinations. Breast CESM and MRI examination were completed in the same week. The pathological specimens were analyzed and the maximum diameters of pathological lesions were measured. The lesions were observed on low energy(LE), CESM and MRI images, and then the maximum diameters of lesions on the above images were measured. Using pathology results as the gold standard, the diagnostic efficacy of LE, CESM and MRI were analyzed by ROC curve, and Z test was used to compare the areas under the ROC curves among different imaging methods. Bland-Altman method was used to analyze the consistency of the maximum diameters of the lesions obtained with different imaging methods. Results One hundred and fifty three lesions were found in 145 patients, in which 36 were benign and 117 were malignant. The LE, CESM and MRI showed 140, 151 and 149 lesions respectively, and the qualitative diagnostic errors were 25, 8 and 11, respectively. The areas under ROC curves of LE, CESM and MRI were 0.87, 0.96 and 0.97 respectively. There was significant difference of the area under ROC curve between CESM and LE, so did the MRI and LE (P<0.05), but there was not significant difference between CESM and MRI (P=0.51). The sensitivity, specificity and accuracy in the diagnosis of malignant breast lesions were 88.98%, 65.71% and 83.66% for LE, while they were 95.80%, 91.18% and 94.77% for CESM, 94.17%, 87.88%and 92.81%for MRI. The average difference of diameters between LE, CESM, MRI and pathologic size was-1.7, 1.1 and 0.3 mm, respectively, with 95%consistency interval range of-18.6 to 15.1,-9.8 to 12.1,-10.6 to 11.2 mm, respectively. There was best consistency between the pathological size and the size on MRI. Conclusion CESM can significantly improve the diagnostic efficacy of breast lesions, which is comparable with MRI.

Role of the dynamic contrast-enhanced MRI in assessing the response to neoadjuvant chemotherapy of breast cancer / 中国癌症杂志

Background and purpose:Neoadjuvant chemotherapy to breast cancer has become a mature treat-ment method. The purpose of this study was to evaluate the dynamic contrast-enhanced MRI in assessing the response to neoadjuvant chemotherapy (NAC).Methods:Twenty-four female patients with breast carcinoma (24 were all inva-sive ductal carcinoma) underwent dynamic contrast-enhanced MRI (DCE-MRI) before, after the second and ifnal cycle of NAC. For each patient and each MRI examination, the maximum diameter of tumor, volume transfer constant (Ktrans), exchange rate constant (Kep), and extravascular extracellular volume fraction (Ve) were compared. According to the method of response evaluation criteria in solid tumor (RECIST), the results of neoadjuvant chemotherapy were divided into responder and non-responder.Results:All 24 patients were unilateral and single breast cancer; there were 17 cases of responders and 7 cases of non-responders according to RECIST criteria. For 17 cases of responders, both the average values ofKtrans andKepwere signiifcantly descended after neoadjuvant chemotherapy (allP<0.05).Conclusion:The quantitative parameters ofKtrans andKep can evaluate objectively and veridically the response to neoadjuvant chemother-apy for breast cancer in dynamic contrast-enhanced MRI.

The construction of medical supplies support practice training platform under in-formatization / 药学实践杂志

Objective To introduce the process and experience of construction of medical supplies support practice train-ing platform under informatization.Methods To review and comment the structure composition,functions implemented,ap-plications and experience of medical supplies support practice training platform.Results The medical supplies support practice training platform achieved four functions which are indoor deduction,simulation training,drill outdoor,participate in military health service exercise.Conclusion The medical supplies support practice training platform has achieved good effects in teach-ing and training,which has effectively promoted the teaching and training mode reform aimed at combat requirements.

Anti-tumor immune therapy with programmed death-1 and its ligand inhibitors:research advances / 国际药学研究杂志

Programmed death-1(PD-1)and its ligand(PD-L1)inhibitors are a novel kind of immune checkpoint blockers, which are the highlights of anti-tumor immune therapy. PD-1 inhibitors,such as nivolumab and pembrolizumab have been granted by the market authorization to treat melanoma and non-small cell lung cancer. Clinical trials of their efficacy and safety on renal cell carci?noma,bladder carcinoma and Hodgkin′s lymphoma are still in process. PD-L1 inhibitors atezolizumab,durvalumab and avelumab have been approved by FDA for treatment of urothelial carcinoma. Several other drugs are in phaseⅠclinical trials. This paper gives a brief summary of recent advances in the studies on PD-1/PD-L1 inhibitors.

Epidemiological and etiological characteristics of dengue fever in Shenzhen in 2014 / 中华微生物学和免疫学杂志

Objective To investigate the epidemiological characteristics of dengue fever in Shenz-hen city in 2014 and to analyze the evolutional characteristics of the epidemic dengue virus(DENV)strains in order to provide scientific guidelines for the prevention and control of dengue fever. Methods Descrip-tive epidemiological analysis was used to analyze the prevalence of dengue fever in Shenzhen city in 2014. Immunochromatography and real-time PCR were performed to detect the specific antibodies(IgM and IgG) and DENV nucleic acids in serum samples collected from suspected cases of dengue fever. Serum samples collected from the patients at early stage of dengue fever were used to infect the C6 / 36 cell line for further isolation of DENV strains. The types of isolated DENV strains were determined by using real-time PCR. E genes of the isolated DENV strains were amplified by RT-PCR and then sequenced. DNAStar and Clustslx (1. 83)softwares were used to analyze the homology between DENV strains isolated in Shenzhen and other areas. A phylogenetic tree based on the sequences of E genes of Shenzhen strains and other sequences of DENV reference strains downloaded from GenBank was constructed for further analysis. Results A total of 454 cases of dengue fever were reported in Shenzhen in 2014 with a male to female ratio of 1. 43 ∶ 1. Local patients accounted for 76. 21% and the rest 23. 79% were imported cases mainly from Southeast Asian and surrounding cities. There were 441 cases reported from September to November,accounting for 97. 14% of all reported cases. Most of the infected subjects were aged 20 to 50,accounting for 76. 73% . Of the 270 samples positive for DENV nucleic acids,strains of DENV-1,DENV-2,DENV-3 and DENV-4 accounted for 87. 41% ,8. 89% ,0. 37% and 2. 22% ,respectively. The phylogenetic tree analysis revealed that the DENV-1 strains belonged to two genotypes,which were genotypeⅠ and genotype Ⅴ. The DENV strains of genotypeⅠ were highly similar to the epidemic strain isolated in Shenzhen in 2010 and the genotype Ⅴstrains were first reported in Shenzhen. The homology analysis of the nucleotides of E genes showed that mi-nor differences in the nucleotide sequences were found between DENV-2 strains. All of the DENV-2 strains belonged to the genotype Ⅳ as indicated by the phylogenic tree. Conclusion There were 454 cases of den-gue fever(including both local and imported cases)reported in Shenzhen city in 2014,reaching an all-time high. DENV-1 was the predominant pathogen in combination with an increased infection of DENV-2. This study indicated that the prevalent DENV strains might be imported from Southeast countries and neighboring cities. Further researches should be conducted to analyze whether dengue fever is endemic in Shenzhen City.

Experience of organization and implementation of practical training drill for medical supplies support / 药学实践杂志

Objective To investigate the practices and experience in the organization and implementation process of prac-tical training drill for medical supply support .Methods To review and comment on the overall design ideas ,specific steps , practical effect and experience of medical supply support in practical training drill .Results Through six years of exploration and practice , we established a training method of implementation of practical training drill for medical supply support . Conclusion It is right and effective in the organization and implementation of practical training drill for medical supply support . It is necessary to continue improving the mode of organization and implementation with combination of practical teaching and re-search .

The Diagnostic Value of Combined Detection of Peripheral Blood CK19 and SCCAg mRNA Expression in The Early Cervical Cancer Micrometastasis / 昆明医科大学学报

Objective Detect the change of relative expression level and positive rate of peripheral blood CK19 and SCCAg mRNA in early cervical cancer patients before receiving radical hysterectomy by qRT-PCR technique, then study the value of combined detection of peripheral blood CK19 and SCCAg mRNA expression in diagnosis of early cervical cancer micrometastasis. Methods Thirty patients with early (ⅠA2 ~ⅡA) cervical cancer from the department of gynecological tumors in the third affiliated hospital of Kunming Medical University were selected as experimental group, 15 patients with uterine myoma and 15 healthy volunteers as negative control group, and 15 advanced (ⅡB~ⅢB) cervical cancer patients as positive control group. Peripheral blood samples before receiving radical resection of experimental group and the same samples before treatment of control groups were collected. The changes of relative expression level and positive rate of peripheral blood CK19 and SCCAg mRNA were analyzed using qRT-PCR technique. Results There was significant difference in relative expression level of CK19 and SCCAg mRNA in the peripheral blood between experimental group and control groups ( <0.01) . And the positive rate of CK19 and SCCAg mRNA in the peripheral blood from 30 patients with early cervical cancer before operation in the experimental group was 30%(9/30) and 20% (6/30), respectively. Furthermore, combined detection of the expression of the two markers can improve the positive rate to 43.3%, much higher than single marker. There was also significant difference in the positive rate by combined detection of the two markers between the experimental group and control groups ( <0.05) . Conclusion CK19 and SCCAg mRNA could be used as the specific and suitable molecular markers for the detection of early cervical cancer micrometastasis. The combined detection of relative expression level and positive rate of peripheral blood CK19 and SCCAg mRNA by qRT-PCR array could significantly enhance the sensitivity and specificity for cancer cell detection.

Detection of Early Cervical Cancer Patient’s Peripheral Blood CK19 mRNA before Surgery and its Clinical Significance / 昆明医科大学学报

Objective To investigate the detection of early cervical cancer patient's peripheral blood CK19 mRNA and its clinical significance. Methods 30 early (ⅠA2~ⅡA) cervical cancer patients from the department of gynecological tumors in the third affiliated hospital of Kunming Medical University were selected as experimental group, 15 patients with uterine myoma and 15 healthy volunteers as negative control group,15 advanced (ⅡB~ⅢB) cervical cancer patients as positive control group. Peripheral blood samples before receiving radical resection of experimental group,and the same samples before treatment of control groups were collected. The change of relative expression level and positive rate of peripheral blood CK19 was analyzed using qRT-PCR technique, and its correlation with clinicopathological parameters and prognosis was further analyzed. Results There was significant difference in relative expression level of CK19 mRNA in the peripheral blood between experimental group and control groups ( 0.05) . Conclusions CK-19 mRNA is a specific and suitable molecular marker for the detection of circulating tumor cells in early cervical cancer. Detection of peripheral blood CK19 mRNA expression before receiving radical hysterectomy in patients with early cervical cancer can also make up for the disadvantage of other methods such as the imaging, tumor marker detection. Most important of all, it can provide the basis for choosing a proper adjuvant therapy post-operation and estimating the relapse and prognosis.

Radiological features of mastitis / 中华放射学杂志

Objective To describe the radiological features of mastitis.Methods Imaging findings were retrospectively reviewed in 58 women with mastitis,which was confirmed by pathological results.The imaging features were described according to the BI-RADS (breast imaging reporting and data system).All 58 patients had preoperative MRI,while 49 of them were examined with sonograms and 30 with mammograms preoperatively.Results Overall,no remarkable findings were reported on 6 mammography and 2 sonography examinations,but all 58 lesions were identified on MRI in our study.Asymmetrical density (n =16,53.3％) on mammograms and solitary or multiple separated/contiguous hypoechoic mass-like lesions (n =34,69.4％) on ultrasound were the most common signs of mastitis.On enhanced MR images,82.8 ％ (48/58) patients showed non-mass-like enhanced lesions.Multiple,regional enhancement (66.7％,32/48) and separated or contiguous,clumped,rim-like enhancement (63.1％,31/48) were the most common manifestations in non-mass-like enhanced lesions.Of the 58 patients,type Ⅰ and type Ⅱ timesignal intensity curve were detected in 48.3％ and 50.0％ of the patients,respectively.BI-RADS 0 had the highest frequency in reports on mammography (33.3％,10/30),while category 4a was most frequent on sonography (36.7％,18/49) and also on MRI (56.9％,33/58).Conclusion The imaging findings from mammography and US are non-specific for mastitis,therefore,MR can be helpful in the diagnosis,especially in the presence of non-mass-like enhancement that are multiple,regional,separated,or contiguous,clumped,and tim-like.

Determination of Atractylodin in Essential Oil of Jingfukang Preparations and Stability in Different Solutions / 中国中医药信息杂志

Objective To establish a method for determination of atractylodin in essential oil of Jingfukang preparations by GC and analyze its stability in different solutions. Methods Using HP-5 quartz capillary column (30 m×0.32 mm), programmed temperature was conducted with the FID as detector. The content of atractylodin was determined both at room temperature and 4 ℃ in 20 days. Results The linear range of atractylodin was 4.172-41.72 μg/mL (r=0.999 7). The stability of atractylodin in essential oil of atractylodes was better than in anhydrous alcohol solution or in essential oil of Jingfukang preparation. Conclusion This method is suitable for the quality control of atractylodin in essential oil of Jingfukang preparations. Low temperature is helpful to the stability of atractylodin. The storage period of essential oil of Jingfukang preparations should not be too long.

Effects of 3-megapixel and 5-megapixel monitors on detecting micro-calcification in high- and low-resolution breast images / 生物医学工程学杂志

To evaluate the influence of 3- and 5-megapixel medical professional monitors in detecting the micro-calcifications on high- and low-resolution breast images, we performed a retrospective study in low- (n = 100) and high-resolution (n = 100) data, including 40 micro-calcification patients in a group and 60 normal ones in control group respectively. Two doctors, one junior, and the other senior, reviewed all the images without knowing the clinical data and histology, and their observations of each image with different monitors were calculated. The areas under the ROC curves (Az) were compared. Finally, the interpretation consistency of the two doctors was assessed using Kappa analysis. In the low resolution data group, the two doctors' detection performance of breast micro-calcifications were very similar in the 3M and 5M medical professional monitors (P = 0.451 and 0.559). In the high resolution group, however, the senior doctor's recognition rate on the 5M monitor was significantly higher than that on the 3M (P = 0.022), while the junior's recognition rate had no significant difference (P = 0.141) between the two readings. The two doctors' interpretation consistency on 5M monitor was better than that on 3M monitor. For the high-resolution images on the 5M monitor, the interpretation of the two doctors had extremely great consistency (K = 0.862). Therefore, different breast images of different resolutions should match corresponding resolution monitor. Interpretation of high-resolution images with 5M monitor has more advantages in the micro-calcification detection for senior doctors.

MRI characteristics of ductal carcinoma in situ of the breast / 中华放射学杂志

Objective To evaluate and recognize the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast and provide imaging information for the early detection and treatment planning Methods All MRI data in 71 patients with histollogically proved DCIS were analyzed retrospectively. The 71 patients were divided into two groups, NI ( pure DCIS, 44 patients) and N2 ( DCIS with microinvasion, 27 patients). According to the BI-RADS descriptors, all lesions were defined as a focus (smaller than 5 mm in diameter), mass and no-mass-like three enhancement types. The morphological features (M1 = focus, M2 = linear or linear-branched, M3 = branching-ductal, M4 = segmental, M5 = focal,M6 = regional, M7 = diffuse, M8 = mass) and the time-intensity curve (TIC) pattern [type l ( persistent enhancement curves), type Ⅱ( plateau), type Ⅲ(washout) and type Ⅳ (the same enhancement as glandular tissue)] were described. Chi-square test was used for the morphological characteristics of lesions.Results The 73 DCIS lesions were found in 71 patients, and 5.5% (n =4) were stippled lesions, 87.7%( n =64) were no-mass-like lesions, 6.8%(n=5) were mass-like lesions. In no-mass-like lesions (n=64), M3 was found in 15 cases, M4 in 34 cases, M5 in 9 cases and M6 in 6 cases, respectively, M3 and M4 were the most common distribution patterns. In N1 group(n =45) and N2 group (n =28), M3, M4,M5, M6 were found in 7 and 8, 21 and 13, 7 and 2, 3 and 3 cases, respectively. There were no statistic differences between two groups (P＞0.05). In 31 showed heterogeneous enhancement, both M3 and M4 were observed in 35.5% (11/31). In 26 clustered ring enhancement lesions, M4 was observed in 88.5% (23/26). Four lesions showed reticular enhancement,2 lesions showed a clumped enhancement and 1 lesion showed homogeneous enhancement. In 5 mass-like lesions, N1 group had 3 cases, N2 group had 2 cases.Four lesions showed lobulated margin, 4 lesions showed speculated margin, 1 mass showed smooth margin.Five mass showed heterogeneous enhancement. Type Ⅰ , type Ⅱ , type Ⅲ and type Ⅳ TIC ( n = 25) were demonstrated in 8, 11, 3 and 3 lesions, respectively. Conclusions M3, M4, especially segmental clustered ring enhancement, are the most common morphological characteristics of DCIS. Type Ⅰ and type Ⅱ TIC are the most common types.

Evaluation of quantitative dynamic contrast enhanced MRI in differential diagnosis of breast lesions / 中华放射学杂志

Objective To evaluate the value of quantitative 3T dynamic contrast enhanced MRI in the diagnosis of breast lesions. Methods One-hundred and eighteen patients suspected of breast lesions underwent MRI examination. A 3.0 T MR scanner was used to obtain the quantitative MR pharmacokinetic parameters: Ktrans( volume transfer constant), Kep (exchange rate constant) and Ve (extravascular extracellular volume fraction). The mean Ktrans, Kep and Ve of malignant, benign and normal glandular tissues were calculated and compared each other using LSD method. Independent sample t test was used between invasive ductal carcinoma and ductal carcinoma in situ (microinvasion included). Finally, the areas under the ROC curve (AUC) of Ktrans, Kep and Ve between malignant and benign lesions were compared. Results The mean Ktrans, Kep and Ve of malignant lesions (n=87) were (1.010±0.580) min-1, (1.634 ± 1.481) min-1 and (0.735 ±0.273); the mean Ktrans, Kep and Ve of benign lesions (n=23) were (0.331±0.192) min - 1, (0.417±0.324) min - 1 and (0.847±0.291); and the mean Ktrans, Kep and Ve of normal glandular tissues (n =83) were (0.051 ±0.028) min-1, (0.133±0.125) min-1 and (0.597±0.354), respectively. There were significant differences between normal glandular tissues and benign lesions, normal glandular tissues and malignant lesions, benign and malignant lesions in Ktrans (t=9.681, 11.189, 5. 590, respectively, P ＜ 0. 01 ), normal glandular tissues and malignant lesions, benign and malignant lesions in Kep(t =5. 287, 3. 874, P＜0. 05). There were a statistic differences between normal glandular tissues and benign lesions, normal glandular tissues and malignant lesions in Ve(t =2. 932, 2. 562 ,P ＜0. 05). There were no significant differences between normal glandular tissues and benign lesions in Kep, benign and malignant lesions in Ve ( t = 0. 760, 0. 832, P ＞ 0.05 ),invasive ductal carcinoma and ductal carcinoma in situ (microinvasion included) in Ktrans, Kep and Ve(t =0.834,0.075,0.454,P＞0.05). The areas under the ROC curve (AUC) of Ktrans, Kep and Ve between malignant and benign lesions were 0. 934, 0. 941 and 0. 659. The sensitivity of Ktrans, Kep and Ve were 77.01% ,91.95% ,56. 32% and the specificity of Ktrans, Kep and Ve were 95. 65%, 86. 96%, 78.26% for the differential diagnosis of breast lesions if taken the maximum Youden's index as cut-off. Conclusion The differential diagnosis of benign and malignant breast lesions by Ktrans, Kep is applicable.

MRI findings and correlation with pathological features in breast phyllodes tumor / 中华放射学杂志

ObjectiveTo study the MR Imaging features of breast phyllodes tumor (PT),and to correlate it with pathological results.MethodClinical and MRI findings were retrospectively reviewed in twenty-seven women with 28 PTs lesions confirmed by surgical pathology.Statistical analyses were one-way ANOVA for size analysis,Fisher exact test for analysis of MR appearances and Spearman correlation to study the relationship between MRI findings and BI-RADS categories.Results( 1 ) The histologic findings were benign,borderline and malignant PTs in 14.3％ (4/28),53.6％ (15/28) and 32.1％ (9/28) of lesions,respectively.(2) The mean maximum-diameter were (6.4 ± 3.9) cm,(5.7 ± 2.2) cm in borderline type and (4.8 ± 1.8)cm in benign type respectively.The results showed differences in lesion's size among the three type (F = 287.541,P =0.000),especially between malignant and benign type (P = 0.033 ).(3)Internal non-enhanced septations and silt-like changes on enhanced images,as well as time-signal curve on MRI correlated significantly with the histological grade ( P ＜ 0.05 ).( 4 ) If the category BI-RADS ≥ 4a was considered to be a suspicious sign for malignant lesion,the diagnostic accuracy of MRI would be 96.4％ (27/28),and the BI-RADS category of the MRI could reflect the PT's histological grade with a low correlation coefficient ( r = 0.382,P = 0.045 ).Conclusion The findings of PT on MRI have some characteristics,with tumor size and several MRI features correlating with the histological grade of breast PT.