A preliminary study of MRI background parenchymal enhancement in the early prediction for tumor response during neoadjuvant chemotherapy / 中华放射学杂志

Objective To retrospectively investigate the characteristics of background parenchymal enhancement(BPE)in the contralateral breast following neoadjuvant chemotherapy(NAC)and whether BPE could help predict tumor response in early stage of advanced breast cancer. Methods Data from 161 patients who were diagnosed with unilateral breast cancer and then underwent NAC before surgery were analyzed retrospectively from August 2014 to December 2016.All the patients underwent both bilateral breast MRI scan with contrast enhancement. Two experienced radiologists independently categorized the patients' levels of BPE into four categories (1=minimal, 2=mild, 3=moderate, 4=marked) at baseline and after the 2nd cycle of NAC. All the patients were divided in to pathologic complete response (pCR) group and non-pCR group according to the histopathologic tumour response.The status of estrogen receptor(ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) were recorded before underwent NAC.The t test and Pearson chi-squared test were used to compare the baseline characteristics of the pCR and Non-pCR groups.The kappa test was used to test the inter-observer agreement.The Wilcoxon test was used to test for changes of BPE categories after NAC.The Mann-Whitney U test was used to test the difference of BPE between pre-and post-menopausal status. Associations were evaluated using Binary logistic regression models. Results Fifty nine patients achieved pCR, and 102 patients had residual disease (non-pCR). Age, tumor size, distribution of size, menopausal status and lymph node showed no significance between pCR and non-pCR groups(all P>0.05),while only ER/PR status and HER2 status had a significant difference (P>0.05 in both). Inter-observer agreement regarding BPE categorization was moderate and substantial before and after NAC(Kappa value 0.644 and 0.708).The level of BPE was higher in premenopausal than post-menopausal women both at baseline and after the 2nd cycle of NAC(P<0.01). Decreased BPE was observed in 106 cases(premenopausal 60 cases and postmenopausal 46 cases),and no change in BPE were observed in 55 cases (premenopausal 27 cases and postmenopausal 28 cases). A significant reduction in BPE was observed after the 2nd NAC cycle in the overall cases, pre-and post-menopausal cases (all P<0.01). Logistic model showed that hormonal receptor (HR) negative and HER-2 receptor at baseline and the change of BPE after NAC were the independent factors for predicting pCR. Conclusions Regardless of the menopausal status, BPE showed a reduction after NAC, and it can serve as an additional imaging biomarker of tumour response at an early stage of NAC.

Protective Effect of Tibetan Medicine Compound Duoxuekang Capsules on Acute Lung Injury in Mice In-duced by Lipopolysaccharide / 中国药房

OBJECTIVE:To investigate the protective effect of Tibetan medicine Compound Duoxuekang capsules on the acute lung injury in mice induced by lipopolysaccharide. METHODS:60 KM mice were randomly divided into blank group,model group,dexamethasone group (positive control,1 mg/kg) and Compound Duoxuekang high-dose,medium-dose,low-dose groups (3.6,1.8,0.9 g/kg,calculated by crude drug),10 in each group. Intragastrically administrated,mice in blank group and model group intragastrically administrated equal volume of normal saline,once a day. After 7 d of administration,except for blank group, mice in other groups intraperitoneally injected lipopolysaccharide to induce acute lung injury. After 6 h modeling,pathological changes in the lung tissue was observed,lung tissue water content was measured,superoxide dismutase(SOD),glutathione peroxi-dase(GSH-Px),malondialdehyde(MDA)levels in lung tissue and IL-6,TNF-α levels in serum were detected. RESULTS:Com-pared with blank group,mice in model group showed pathological changes in congestion and edema,inflammatory cell infiltra-tion,obvious widened alveolar septum and alveolar wall;water content in lung tissue and IL-6,TNF-αlevels in serum were signifi-cantly increased (P<0.01);SOD,GSH-Px levels in lung tissue were significantly decreased (P<0.01). Compared with model group,injury degree of lung tissue reduced to varying degrees in each treatment group,except for the water content,MDA level in lung tissue and TNF-α level in serum in Compound Duoxuekang capsules low-dose group;the above-mentioned indexes in other groups were significantly improved (P<0.05 or P<0.01). CONCLUSIONS:Compound Duoxuekang capsules can obviously re-duce mice's oxidative stress and inflammatory response,and has certain protective effect on acute lung injury in mice.

Change of Volume and Mechanical Properties of Femoral Bone in Rabbits at Different Ages with Knee Osteoarthritis under Sand-therapy / 生物医学工程学杂志

The present paper is aimed to study the effect of sand-therapy with Uyghur medicine on biomechanical properties and femoral bone volume of the femur of osteoarthritis (OA) rabbits at two different ages. In the experiments, we injected Papain through the joint space of right knees into the bodies of New Zealand rabbits (16 in the growing group, and 16 in the mature group), and established an OA model. The 16 rabbits in the mature group were divided randomly into 2 sub-groups: 8 in control group (no sand therapy), and 8 sand-therapy group. The 16 rabbits in the growing group were divided randomly into 2 groups as well: 8 in the control group (no sand therapy), and 8 in the sand-therapy group. We carried out CT scanning four times (1 day before, 13th, 27th and 41st days after the establishment of the model, respectively). After importing the CT data to MIMICS, the different volumes of each sclerotin were recorded and change of the percentage of each sclerotins in total femur bone volume were analyzed. Finally the rabbit femurs were given three-point bending test, the elastic load and the elastic deflection were obtained and the inertia of the section, the maximum bending stresses, the bending modulus of elasticity and the structural rigidity were calculated. The experimental results showed that (1) Compared with 1 day before and 13th day after establishment of model at maturity, the cancellous bone volume increased and cortical bone volume decreased (P < 0.05), but compared with those in the control group, the cancellous bone volume of femurs decrease and cortical bone volume increased under sand-therapy (P < 0.05). Compared with those in the control group, there were no significant changes in the deflection and cross-sectional moment of inertia in the sand-therapy group (P > 0.05), but the maximum bending normal stress, maximum load, elastic modulus, and structural stiffness (P < 0.05) in the sand therapy group were larger than those in the control group. The study showed that sand-therapy in Uyghur medicine has benign effect on bone volume of the OA rabbit femur in two ages and the mechanical properties of the OA rabbit femur at the two ages induced by sand-therapy in Uyghur medicine have been improved.

Comparison Study on Zhenbu Disease of Tibetan Medicine and Bi Syndrome in Traditional Chinese Medicine / 世界科学技术-中医药现代化

Chinese medicine and Tibetan medicine both belong to the traditional medicine, and have their unique background and theoretical systems. There are similar features and differences in diagnosis of disease, syndrome and treatment between Chinese medicine and Tibetan medicine. Tibetan Zhenbu disease is common and frequently-occurring in plateau area with high morbidity, which is corresponding to rheumatoid arthritis in modern medicine and the category of Bi syndrome in Chinese medicine. During a long period of clinical efficacy verification, Tibetan treatment of Zhenbu disease presents to be little side effects, good curative effect, safe and economic etc. In the review, according to the introduction of Tibetan medicine and Chinese medicine, Zhenbu disease of Tibetan medicine and Chinese Bi syndrome will be compared in their pathogeneses and treatments to understand advantages and peculiarities of Tibetan medicine. The development of Tibentan medicine in the future will also be pointed out.

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.

The feasibility of breast cancer sentinel lymph node mapping at CT lymphography / 中华放射学杂志

Objective To evaluate the feasibility of sentinel lymph node(SLN) mapping with CT lymphography (CT-LG). Methods Twenty-five patients with confirmed breast cancer and no palpably axillary lymph node underwent CT-LG examination. The first one or more lymph nodes along the lymph duct draining from the injection sites to axilla were defined as SLNs, and then the LG results were compared with sentinel lymph node biopsy (SLNB). The over- and underestimation of LG were evaluated. The quality of LG imaging was classified Grade Ⅰ and Ⅱ according to lymph duct appearance on volume rendering (VR). The body mass index (BMI) ＞ 25 was considered obesity. Fisher exact test was used for the statistics. Results (1)Of 25 patients, 5 had local mastectomy history. BMI ＜ 25 was found in 20 cases, and ≥25 was in 5 cases. (2) All SLNs were showed by CT-LG, and Grade Ⅰ and Ⅱ imaging quality were achieved in 21 cases ( 84. 0% ) and 4 cases ( 16. 0% ), respectively. The obese patient tended to have a poor imaging quality ( P ＜ 0. 05 ). (3) Fifty-six SLNs and 45 lymph ducts in all 25 patients were identified on CT-LG. Compared with the results of SLNB, 7 cases ( 28. 0% ) and 9 cases ( 36. 0% ) were over- and underestimated respectively by CT-LG due to obesity and local mastectomy ( P ＜ 0. 05 ). (4) Fifty-two negative SLNs in 18 patients and 15 positive SLNs in 7 patients were confirmed by pathology through SLNB, while 56 SLNs were delineated on CT-LG with 43 negative and 13 positive. The shape in 32. 6% of the negative SLNs (14/43) and 76. 9% of the positive SLNs (10/13) was round,the difference was significant (P＜0. 05). The filling defect on the center in 9.3% of negative SLNs (4/43) and 23. 1% of positive SLNs (3/13) was demonstrated, and irregular filling defect on the margin was found only in 30.8% of positive SLNs (4/13). 3 SLNs in 2 patients combined with small satellite lymph nodes on CT-LG were also confirmed to have tumor infiltration. Conclusion CT-LG can clearly demonstrate the breast lymphatic pathway and may potentially be used for breast SLN mapping, while the imaging quality can be influenced by the obesity and local mastectomy.

Diagnosis of extreme lateral lumbar disc herniation with spiral CT multiplanar reformation / 中华放射学杂志

Objective To investigate the characteristics of extreme lateral lumbar disc herniation (ELLDH) with spiral CT multiplanar reformation (MPR), and to determine the effectiveness of MPR in the diagnosis of ELLDH. Method Twenty-five cases with ELLDH underwent conventional CT scans, thin slice spiral scan, and MPR on coronal and sagittal plane. Results Operative findings basically matched the MPR results in 25 ELLDH patients concerning the disc herniation position and compression of the nerve roots. The herniation involved the intervertebral foramina in 15 cases, external intervertebral foramina in 4, both intervertebral and external intervertebral foramina in 3, and intervertebral foramina and vertebral tubes of parity plane in 3. They were demonstrated on MPR as shapes of hillock, circular or trigonal soft-tissue density mass in intervertebral foramen, or outside and tread on the nerve root of parity plane. Among these 25 ELLDH cases, ELLDH was not found by conventional CT scans in 7 cases, but was found by MPR. ELLDH was suspected by conventional CT in 8, and was confirmed to be ELLDH by MPR. ELLDH was revealed by conventional CT scans in 10, but without indications of nerve root compression status, while MPR clearly indicated nerve root compression status. Conclusion MPR has important value in the diagnosis of ELLDH. It can properly identify the ELLDH site, shape, size, and its relation to nerve roots. It is very helpful for the surgeons in the selection of operation method.