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Background and purpose: The technique of dynamic contrast-enhanced MRI (DCE-MRI) is widely applied in differential diagnosis between benign and malignant tumor and therapeutic estimation of neoadjuvant chemotherapy in clinic. However, there is no standard quantitative measurement method. This study aimed to assess the variability of different region of interest (ROI) selections for tumor bed of breast cancer using DCE-MRI, and to ascertain the optimal ROI delineation. Methods: We retrospectively analyzed DCE-MRI of 30 patients diagnosed with breast cancer by pathology. The ROIs were delineated by 2 different observers using iCAD software with 4 methods, including whole tumor (Whole), the slice containing the most enhancing voxels (SliceMax), 3 slices centered in SliceMax (Partial) and the 5％ most enhancing contiguous voxels within SliceMax (5Max), to generate the volume transfer constant (Ktrans), the extracellular volume fraction (Ve) and rate constant (Kep). And the reproducibilities of the measurements were assessed using the Bland-Altman method. Results: In the analysis of ROIs delineation, the Ktrans, Ve and Kep reported by different observers were 1.26±0.54 vs 1.25±0.53, 0.75±0.23 vs 0.73±0.22 and 1.93±1.46 vs 1.95±1.51 (P＞0.05) using the method of Whole, and 1.28±0.43 vs 1.26±0.43, 0.74±0.21 vs 0.80±0.27, 1.95±1.53 vs 1.93±1.43 (P＞0.05) using the method of Partial, and 1.30±0.33 vs 1.32±0.33, 0.77±0.20 vs 0.73±0.24, 1.82±1.53 vs 1.87±1.45 (P＞0.05) using the method of SliceMax, and 1.31±0.35 vs 1.35±0.33, 0.77±0.20 vs 0.98±0.25, 1.97±1.36 vs 1.73±1.55 using the method of 5Max (P＜0.05). Using the methods of ROI delineation except 5Max, there was no significant difference between Ktrans, Ve and Kep reported by different observers. The bias vs limits of agreement were 0.002 vs-0.013 to 0.012,-0.003 vs-0.023 to 0.017, 0.006 vs-0.018 to 0.029,-0.035 vs-0.054 to 0.018 measured with Whole method, SliceMax, Partial and 5Max respectively using the Bland-Altman method. Conclusion: It may be reliable to measure functional parameters of primary tumors in breast cancer using DCE-MRI according to the methods of Whole, Partial and SliceMax.
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Objective To observe the effect of biologics intravenous infusion center on patient satisfaction. Methods A total of 120 patients with rheumatism diagnosed and treated with biologics at Renji Hospital South Campus and West Campus from August 2016 to November 2016 were enrolled. Patients in South Campus were offered an optimized clinical practice in the biologics intravenous infusion center as an intervention group, while patients in West Campus received an ordinary clinical practice in the department of rheumatism as the control. Patient satisfaction of appointment, treatment process, specialist physician, clinical nurse specialist, and overall sense was compared. Results Patient satisfaction score of appointment in the intervention group was 4.397 ± 0.112, and 3.451 ± 0.080 in the control, a statistically significant difference (t=5.762, P<0.01). Patient satisfaction score of treatment process in the intervention group was 4.105 ± 0.138, and 2.612 ± 0.109 in the control, a statistically significant difference (t=8.202, P<0.01). Patient satisfaction score of specialist physician in the intervention group was 4.495 ± 0.091, and 3.371 ± 0.061 in the control, a statistically significant difference (t=9.745, P<0.01). Patient satisfaction score of clinical nurse specialist in the intervention group was 4.589 ± 0.101, and 3.147 ± 0.064 in the control, a statistically significant difference (t=9.739, P<0.01). Patient satisfaction score of overall sense in the intervention group was 4.238±0.121, and 3.147±0.086 in the control, a statistically significant difference (t=10.514, P<0.01). Conclusions Biologics intravenous infusion center can significantly improve patient satisfaction, helps to promote the management of patients and working efficiency, ensures the safety of biologics use, makes more efficient utilization of medical care resources.
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Objective To investigate and compare the effect of orally or intranasally administered borneol on ketamine‐mid‐azolam anesthesia anesthetized rats′regained consciousness and cognitive functions .Methods The rats were trained to escape laten‐cy and divided into 6 groups:control group ,model group ,low dose oral borneol group ,high dose group oral borneol group ,low dose intranasal borneol group and high dose intranasal borneol group ,16 rats in each group .All groups were given general anesthesia ,be‐side the control group .The reflex recovery time ,blood gas analysis ,escape latency and space exploration capability were recorded and compared within groups .Results Compared with the control group ,PaCO2 ,P(A‐a)DO2 and latent escape time increased (P 0 .05) .Compared with low dose oral borneol group ,latent escape time decreased in high dose oral borneol group (P<0 .05) .Compared with borneol oral groups ,the righting reflex test time ,times of platform across and latent escape time decreased (P< 0 .05) ,blood gas analysis improved (P< 0 .05) in intranasal borneol groups .Compared with low dose intranasal borneol group ,the righting reflex test time and latent escape time decreased (P<0 .05) , blood gas analysis improved (P<0 .05) in high dose intranasal borneol group .Conclusion Intranasal borneol could reduce righting reflex test time and improve cognitive function by improving the blood gas analysis .
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Objective To explore the best anticoagulant ratio in SD rats .To analyse the influence of insufficient blood specimens volume on coagulation tests .Methods 60 rats were divided into 2 groups.According to the method of vacuum blood, collect abdominal aortic blood after fasting 12 hours.The first group 20 rats were used only for routine blood test.Fully automatic hematology analyzer detected hematocrit and platelet .The second group 40 rats were used for coagulation test .Every rat was collected 2 blood specimens with different anticoagulant ratio [ the proportion of sodium citrate anticoagulation and the whole blood (vlume∶volume)]1∶9(the control group)and 1∶5( the experimental group),1∶8( the experimental group) and 1∶7( the experimental group).Get plasma without platelet through centrifugation.Fully automatic blood coagulation analyzer detected prothrombin time , activated partial thromboplatin time , thrombin time and Fibrinogen.Results HCT (%) and PLT (x 109/L) in SD rats were respectively 41.7 ±2.9 and 1114 ±173.As anticoagulant ratio was increased ,PT, APTT and TT were extended and FIB was decreased .Compared with the control group ,these PT,APTT,TT,FIB four results of 1∶8 group were not statistically different , of 1∶5 group were statistically different, these PT,APTT,FIB three results of 1∶7 group were not statistically different , TT of 1∶7 group was statistically different.Conclusions The detection of coagulation project coagulation test results were affected by the proportion of anticoagulant and blood .1∶9 was the best anticoagulant ratio in SD rats , 1∶8 can also.Rat had its unique physiological characteristics .The results could provide reference for the evaluation of rats .
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Objective To observe the protective effect of Vdvet-feeling on phlebitis in rabbit ears induced by Fluorouracil.Methods The models of Fluorouracil induced phlebitis in rabbit ears were established.24 rabbits were randomized into three groups:group A used Velvet-feeling for wet dressing,group B was the blank control group C was coated with Hirudoid.The vein was assessed before and after the intervention,and the changes in appearance of vein and the occurrence of phlebitis were observed.The samples of local vein and surrounding tissues were cut off 24 hours after intravenous injection of Fluorouracil and were made pathological sections,HE staining.The pathological damage degree of the vein and surrounding tissues were evaluated by light microscopy.Results The degree of phlebitis in group A and C were lower than group B,there was significant difference.There was significant difference between group A and C at the degree of phlebitis,especially in infiltration of inflammatory cells of vessel wall and perivascular edema.Conclusions Early application of the Velvet-feeling or Hirudoid coating were better in prevention of Fluorouracil induced phlebitis,and wet dressing of Velvet-feeling was better than Hirudoid coating.
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In order to study the constituents and pharmacology of Tripterygium plants (Tripterygium willfordii Hook.f), a variety of chromatography methods were used. Four compounds were isolated from Tripterygium plant and their structures were elucidated by UV, IR, MS, HR-MS, 1H NMR, 13C NMR and 2D-NMR techniques. The isolated compounds were named as triptonide (1), neo-triptetraolide (2), 2alpha-hydroxytriptonide (3), and 15-hydroxytriptonide (4), separately. Compounds 3, 4 belong to new diterpenoids, which can inhibit the growth of K562 cells (leukemia cells) and HL60 cells (acute myeloid leukemia cells).
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Objective To investigate the protective effects of isoflurane preconditioning plus mild hypothermia on isolated rat hearts against ischemia-reperfusion (I/R) injury. Methods Fifty male SD rats weighing 250-300 g were randomly divided into 5 groups ( n = 10 each): group Ⅰ control (group C); group Ⅱ I/R; group Ⅲ isoflurane preconditioning (group P); group Ⅳ mild hypothermia (group M) and group Ⅴ isoflurane preconditioning + mild hypothermia (group PM). The animals were anesthetized with intraperitoneal pentobarbital 40 mg/kg. The hearts were immediately removed and perfused with Krebs-Hensleit (K-H) solution aerated with 95% O2 and 5% CO2 at 10 kPa via aorta at 37℃ in a Langendorff apparatus. The hearts were made globally ischemic for 30 min followed by 60 min reperfusion in group Ⅱ-Ⅴ. In group P and PM the hearts were perfused with K-H solution saturated with 1.0% isoflurane for 15 min followed by 15 min washout before ischemia.In group M and PM the hearts were made ischemic at 31 ℃ and perfused at 37℃. LVEDP, LVSP, dp/dtmax,dp/dtmm and HR were measured after equilibration (baseline), immediately before ischemia, and at 30 and 60 min reperfusion. The infarct size and cytochrome C level in cytoplasm and mitochondria of myocytes were measured.Motochondrial ultrastructure was examined using electron microscope. Results Cardiac function was significantly better, the infarct size significantly smaller, the cytochrome C level in cytoplasm significantly lower, while the cytochrome C level in mitochondria of myocytes significantly higher in group Ⅲ-Ⅴ than in group Ⅱ and in group Ⅴ than in group Ⅲ. The cytochrome C level in cytoplasm was significantly lower, while the cytochrome C level in mitochondria of myocytes significantly higher in group Ⅴ than in group Ⅳ. Less damage to mitochondria was observed in group PM than in group I/R, P and M. Conclusion Isoflurane preconditioning combined with mild hypothermia provides better protection against myocardial I/R injury by attenuating the release of cytochrome C from mitochrondria.
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Now there are many difficulties in pediatric clinical teaching. As one important part of medical education, how to improve the teaching quality is worth discussion. Based on the current situation of pediatric clinical teaching in our Soochow University, the suggestions of how to improve the quality of pediatric clinical teaching are given.
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Objective To investigate the role of microsatellite instability(MSI) in the carcinogenesis and development of gastric cancer (GC). Methods MSI was examined in 36 gastric cancer specimens obtained endoscopically and during surgery and in 30 intestinal metaplasia specimens using PCR SSCP methods. Results MSI was detected in 15 of 36 GC and 9 of 30 intestinal metaplasia specimens at one or more loci. MSI was positive in all three cases of early GC. The incidence of MSI in well differenciated GC was significantly higher than that in poorly differentiated GC (66.7% vs 26.3%, P
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Objective To evaluate the diagnostic value, patients' tolerance and complications of double-balloon enteroscopy (DBE) in the diagnosis of small intestinal diseases. Methods During May 2003 to July 2005, a total of 68 patients (36 men, 32 women; mean age of 52. 6 years, range 15-78 years) with suspected small intestinal diseases were performed double-balloon enteroscopy (36 via mouth, 25 via anus and 7 via both mouth and anus according to suspected lesion location). Among them, obscure recurrent gastrointestinal bleeding was found in 39 cases, incomplete small intestinal obstruction in 7 cases, chronic abdominal pain in 14 cases, and chronic diarrhea in 8 cases. Results Approximately one half to three-fourth of the entire small intestine was observed by each approach in all cases except for 3 cases of severe intestinal stricture. The observation of the whole small intestine was finished by the combination of both oral and anal approaches in 7 cases. The appropriate use of X-ray made the enteroscopy easier and more helpful to determine the extent and location of the lesions. The lesions were found in 41 of the 68 patients, with a total positive rate of 60. 3%. The diagnostics yields was 26/39(62. 6%) in obscure recurrent gastrointestinal bleeding, 5 in incomplete intestinal obstruction, 6/14(43%) in chronic abdominal pain and 4 in chronic diarrhea, respectively. Fifty-seven cases (83. 8%) tolerated well without anesthesia while 11 cases received propofol anesthesia. No procedure-related severe adverse events or severe complications such as hemorrhage or perforation occurred in all cases. Conclusion Double-balloon enteroscopy is a well-tolerated and safe diagnostic approach with a high diagnostic yield in small intestinal diseases.