Preliminary study of magnetic resonance lymphography to identify the sentinel lymph node of breast cancer / 实用放射学杂志

Objective To evaluate the value of interstitial magnetic resonance lymphography (MRL) to identify the sentinel lymph node (SLN) of breast cancer.Methods Totally 58 patients with invasive breast cancer were consecutive collected.15 mL of Gd-DTPA and 2 mL of mepivacain hydrochloride 2% were mixed and 0.5 mL of them was injected into the outside of the subareolar breast tissue.MRI was performed with Siemens 3.0 T Magnetom Trio MRI instrument using volumetric interpolated breath-hold examination sequence.Axillary lymph flow was tracked on maximum intensity projection (MIP) and sentinel lymph nodes were identified by interstitial MRL as M-SLN.All M-SLN were marked by a method of surface capsule localization.During surgery, methylene blue was used as tracer and SLNs stained by it were detected and excised by following the blue lymphatic vessels,these were designated as D-SLN.The numbers of SLNs detected by interstitial MRL and stained by methylene blue during operation were compared by paired samples rank-sum test and the correlation was analyzed by Spearman rank correlation test.Assessing the sensitivity, specificity and accuracy of interstitial MRL for diagnosing M-SLN.Results A total of 75 M-SLNs (average 1.60 ± 0.52) were identified by interstitial MRL.During operation, all M-SLNs were easily resected under the guidance of skin marker.91 D-SLNs (average 1.94±0.63) were stained by methylene blue, which was significant more than those of the M-SLNs.There was a strong correlation (Spearman's rank correlation coefficient 0.69,P<0.001) between the SLNs identified by these two methods.Interstitial MRL in diagnosing D-SLN metastasis of breast cancer had a sensitivity of 95.8%,specificity of 88.9%,and accuracy of 93.3%.Conclusion Interstitial MRL can accurately identify the axillary sentinel lymph node and guide the biopsy.It may have great clinical value in the future.

Closed reduction and percutaneous double K-wires internal fixation for the treatment of multisegmental fracture of humeral shaft / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical effects of closed reduction and percutaneous double K-wires internal fixation in treating multisegmental fracture of humeral shaft.</p><p><b>METHODS</b>From January 2009 to April 2015, 27 patients with multisegmental fracture of humeral shaft were treated with closed reduction and percutaneous double K-wires internal fixation, including 10 males and 17 females, ranging in age from 26 to 81 years with an average of 52 years;the disease course ranged from 2 hours to 6 days with an average of 1.5 days. Operative time, intraoperative blood loss, hospital stay, fracture healed time, complications were observed and recovery of shoulder joint function was evaluated by Constant-Murley shoulder score.</p><p><b>RESULTS</b>All the patients were followed up from 12 to 24 weeks with an average of 16 weeks. Operative time was 20 to 40 min with an average of 28 min; intraoperative blood loss was 5 to 25 ml with an average of 10 ml;hospital stay was 3 to 5 days with an average of 3.5 days. All fractures got bone healing and healed time was 12 to 22 weeks with average of 14 weeks. Postoperatively 1 case complicated with wire tail bulging and local irritation symptoms, and the symptoms disappeared when the wire was removed out after the fracture healing; 1 case complicated with local infection after wire tail disengaging, and recovered through anti-septic treatment. According to the Constant-Murley standard of shoulder joint function, 10 cases got excellent results, 15 good, 2 fair, with scores of 89.1±2.7.</p><p><b>CONCLUSIONS</b>Closed reduction and percutaneous double K-wires fixation for the treatment of multisegmental fractures of humeral shaft have advantages of simpler manipulating, less bleeding, less invasive, less complications, and shoulder and elbow joint can obtain good recovery. But closed reduction and percutaneous double K-wires internal fixation cannot be effective against rotation and provide axial stability, the immoblization with a sling or other auxiliary methods should be applied.</p>

Effects of negative pressure on osteogenesis in human bone marrow-derived stroma cells cultured in vitro / 中国骨伤

<p><b>OBJECTIVE</b>To investigate effects of intermittent negative pressure on osteogenesis in human bone marrow-derived stroma cells (BMSCs) cultured in vitro.</p><p><b>METHODS</b>The third passage cells were divided into negative pressure treatment group and control group. The cells in the treatment group were induced by negative pressure intermittently (pressure: 17 kPa, 30 min per time, and four times of each day). The cells in the control group were cultured in conventional condition. The osteogenesis of BMSCs was examined by phase-contrast microscopy. The alkaline phosphatase (ALP) activities were determined. The expression of collagen type I was detected by immunohistochemistry method. The mRNA expressions of osteoprotegerin (OPG) and osteoprotegerin ligand (OPGL) in BMSCs were analyzed by real-time polymerase chain reaction (PCR).</p><p><b>RESULTS</b>BMSCs showed a typical appearance of osteoblast after 2 weeks of induction by intermittent negative pressure. The activity of ALP increased significantly, and the expression of collagen type I was positive. In the treatment group, the mRNA expression of OPG increased significantly (P < 0.05) and the mRNA expression of OPGL decreased significantly (P < 0.05) after 2 weeks, compared with the control. However, 3 days after the exposure to 2-week negative pressure, these were no significantly different from that of the control group (P > 0.05).</p><p><b>CONCLUSION</b>Intermittent negative pressure could promote osteogenesis in BMSCs in vitro.</p>

The inactivating effect of chito-oligosaccharides on TMV particles in vitro / 病毒学报

To confirm the inactivating effect of chito-oligosaccharides on Tobacco mosaic virus (TMV) par ticles in vitro, the difference of TMV pathogenicity was evaluated according to the decrease of local lesion numbers after inoculating with TMV mixed with chito-oligosaccharides (DP3-10) in Nicotiana glutinosa, and the virion structural change was studied by transmission electron microscopy after mixed with chito-oligosaccharides. In the range of tested concentrations of chito-oligosaccharides (100-1000 microg /mL), the numbers of local lesions were strongly reduced with over 30% decrement, and the 88.4% reduction gained at the concentration of 600g /mL. It revealed that treatment with chito-oligosaccharide solution of 300-500 microg /mL directly broke TMV particles into tiny pieces of 50-150nm long, and that treatment with solutions of 600-1000 microg/mL caused virus particle agglomerated. The data presented here suggested that chito-oligosaccharides exerted strong inactivating effect on plant virus in vitro.

Value of 3D-DCE MRA in diagnosis of cavernous transformation of portal vein / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate three dimensional dynamic contrast-enhanced magnetic resonance angiography (3D-DCE MRA) in diagnosis of cavernous transformation of portal vein (CTPV).</p><p><b>METHODS</b>Twenty-four patients with CTPV underwent 3D-DCE MRA examinations and the reconstructed images were retrospectively analyzed. A series of clinical, laboratory and imaging studies were performed on all these cases. Among all cases 14 underwent operations and 2 with hepatocellular carcinoma complicated portal thrombosis received transhepatic artery chemoembolization.</p><p><b>RESULT</b>The CTPA was located in the main trunk in 10 cases, in both the main trunk and left/right branches in 8, and in left or right branches of the portal vein in 4. In the remaining 2 cases CTPA was located at the level of superior mesenteric vein. MRA revealed multiple circuitous collateral veins striding over obstruction to extend into the liver in 9 cases,and in 7 it simultaneously showed streaky or dot-like low signal intensities representing thrombi in the extensively dilated network of portal system. MRA did not clearly demonstrate the structure of the portal vein but only showed multiple sinuous network of venous collaterals strangling together in 6 cases. In 15 cases it also showed the route and distribution of multiple hepatofugal venous collaterals.</p><p><b>CONCLUSION</b>3D-DCE MRA can provide adequate information about the site and severity of CTPA.</p>

Clinical value of three-dimensional dynamic contrast-enhanced MR angiography in diagnosis of angiostenosis after liver transplantation / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the clinical application of three-dimensional dynamic contrast-enhanced MR angiography (3D DCE MRA) in diagnosis of angiostenosis after liver transplantation.</p><p><b>METHODS</b>Twenty recipients of liver transplantation underwent 3D DCE MRA examination. The blood vessel rating grades were accessed and the relative diameter of vascular anastomosis was measured; and the results were compared with those of US or DSA examination.</p><p><b>RESULTS</b>Satisfactory angiography images were obtained in all cases by 3D DCE MRA, including 11 cases with normal and mild stenosis, 5 with moderate and 4 with severe stenosis in hepatic artery. Except one case in which 3D DCE MRA showed severe stenosis but DSA showed moderate stenosis, the results of MRA were all consistent with those of US or/and DSA in the stenosis degree of the portal vein, hepatic vein and the postcava.</p><p><b>CONCLUSION</b>3D DCE MRA is an effective technique to evaluate the degree of angiostenosis after liver transplantation.</p>

Cortical language activation in aphasia: a functional MRI study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Functional neuroimaging has been used in neurolinguistic research on normal subjects and on patients with brain damage. This study was designed to investigate the differences of the neural basis underlying language processing between normal subjects and aphasics.</p><p><b>METHODS</b>Functional magnetic resonance imaging (fMRI) was used to map the language network in 6 normal subjects and 3 patients with aphasia who were in the stage of recovery from acute stroke. The participants performed a word generation task during multi-slice functional scanning for the measurement of signal change associated with regional neural activity induced by the task.</p><p><b>RESULTS</b>In normal subjects, a distributed language network was activated. Activations were present in the frontal, temporal, parietal and occipital regions. In the patient group, however, no activation was detected in the left inferior frontal gyrus whether the patient had a lesion in the left frontal lobe or not. Two patients showed activations in some right hemisphere regions where no activation appeared in normal subjects.</p><p><b>CONCLUSIONS</b>fMRI with word generation task is feasible for evaluating language function in aphasic patients. Remote effect of focal lesion and functional redistribution or reorganisation can be found in aphasic patients.</p>