Raw data and processed data of bulk RNA part in the article.RNA-seq data (array) of mouse liver allograft from day7 to day 60 post-allograft.g1:Liver allograft C57BL/6 to C3H(day7)g2:Liver allograft C57BL/6 to C3H(day14)g3:Liver allograft C57BL/6 to C3H(day28) g4:Liver allograft C57BL/6 to C3H(day60) g5:Liver allograft C3H to C3H(day7,control group)
Objecfive To compare the sensitivity of diffusion weighted imaging(DWI)with dynamic contrast enhanced(DeE)MRI for the detection of small breast caJlcers and to evaluate the clinical value of DWI.Methods Forty-eight patients with benign(n=25)and malignant(n=45)small breast lesions(≤2 cm)proved by pathology underwent DWI and DCE MRI.The DCE MRI was performed using FLASH sequence and the time-signal intensity chive was drawn.The DWl was performed using GRAPPAEPI sequence with different b values(800,1000 s/mm2) and the ADC values of lesions were measured.The sensitivity and specificity of DWI for the detection of small breast cancers were compared with DCE MRI. Results Forty of 45 small breast cancers and 19 of 25 small benign breast lesions were corrlectly diagnosed using DCE MRI.The sensitivity and positive predictive value of TIC were 88.9%(40/45)and 87.0%(40/46).With b values of 800 s/mm2 and 1000 s/mm2,the avemge ADC values of small breast cancers were(1.153±0.192)× 10-3 and(1.079±0.186)× 10-3 mm2/s,while those of benign ones were (1.473±0.252)×10-3 and(1.419±0.255)×10-3 mm2/s,respeetively. There was no significant difference for the ADC values with different b values in the same group(P＞0.05),while there was a signiticant difference between the malignant and the benign lesions(P＜0.05)Thirty-nine of 45 small breast cancers and 19 of 25 small benign breast lesions were correctly diagnosed using DWI with b value of 1000see/mm2.Both the sensitivity and positive predictive value of diagnosis were 86.7%(39/45).The abilities of DWI and DCE MRI for the diagnosis of small breast cancers werle the same. The sensitivity(93.3%)and positive predictive value(91.3%)were improved with the combination of DCE MRI and DWI. Conclusion DWI has a high sensitivity for the detection of small breast cancers,the ADC value can provide valuable information in the differential diagnosis.
Key words:
Breast neoplasm; Magnetic resonance imaging; Diffusion; Image enhancement
Objective To compare the clinical efficacy of three minimally invasive methods of anterior column screw, plate and screw rod system in the treatment of anterior pelvic ring fracture. Methods From December 2015 to September 2018, 77 patients with pelvic anterior ring fracture were treated and followed up, including 45 males and 32 females, aged 19 to 73 years. According to AO / OTA classification, there were 26 cases of type B1, 20 cases of type B2, 17 cases of type B3 and 14 cases of type C. According to the different internal fixation methods, they were divided into three groups:anterior column screw group(35 cases), plate group(20 cases), and screw rod system group(22 cases). The operation time, intraoperative fluoroscopy times, blood loss, fracture reduction quality, complications and curative effect of the three groups were compared. Results All 77 patients were followed up for 12 to 33 (16.5±5.7) months. The operation time, intraoperative blood loss and incision length of anterior column screw group were significantly shorter than those of plate group and screw rod system group, and intraoperative fluoroscopy times of plate group were significantly less than those of anterior column screw group and screw rod system group (P 0.05). The incidence of complications was significant different among three group(P Conclusion Minimally invasive internal fixation with anterior column screw, plate and screw rod system can obtain good clinical effect, but anterior column screw fixation has less trauma and lower incidence of surgicalcomplications.
Objective To investigate the diagnostic value of ADC for breast lesions with different enhancement shape or mass size. Methods One hundred and thirty-six breast lesions confirmed by histopathology were included in this study. According to enhancement shape and size of the lesion, all lesions were divided into 3 groups: non-masslike enhancement ( G1 ), masslike enhancement with the largest diameter ＜ 2. 0 cm (G2a) and masslike enhancement with the largest diameter ＞ 2. 0 cm (G2b). Echo planar imaging DWI was performed and three b-values (0,500 and 1000 s/mm2) were applied. The t-test was used for testing the difference of ADC between malignant and non-malignant breast lesions in each group. ROC curve was deduced to test the diagnostic efficiency of ADC. The sensitivity, specificity, negative predictive value( NPV), positive predictive value(PPV) and accuracy of ADC for the diagnosis of breast lesions were calculated under the different threshold. Appropriate b value and threshold were determined with the combination of morphologic evaluation. Results There were no significant differences for the mean ADC values between malignant [b =800 mm2/s: ADC value = ( 1.13 ±0. 23) × 10-3 mm2/s,b=1000 mm2/s: ADC value = (1.05 ±0.20) × 10-3 mm2/s] and non-malignant breast lesions [b =800 mm2/s: ADC value = ( 1.28 ±0. 27) × 10-3 mm2/s, t = 1. 636, P =0. 112,b = 1000 mm2/s: ADC value=(1.20 ±0.23) × 10-3 mm2/s, t = 1.720, P =0. 109] in Group 1. The mean ADC values of malignant breast lesion [b =800 mm2/s: ADC value = (1.07 ±0. 15) × 10-3 mm2/s,b = 1000 mm2/s:ADC value = (0. 99 ±0. 14) × 10-3 mm2/s] were significantly lower than that of non-malignant lesion [b =800 mm2/s: ADC value = ( 1.37 ± 0. 37 ) × 10-3 mm2/s, t = 4. 803, P = 0. 000; b = 1000 mm2/s: ADC value= (1.30 ±0.34) × 10-3 mm2/s, t =4.227, P =0.000] in Group 2a. The mean ADC values of malignant breast lesion [b =800 mm2/s: ADC value = (0. 97 ±0. 14) × 10-3 mm2/s; b = 1000 mm2/s:ADC value = (0. 93 ±0. 14) × 10-3 mm2/s] were significantly lower than that of non-malignant lesion [b =800 mm2/s: ADC value = ( 1.40 ± 0. 39) × 10 -3 mm2/s, t = 4. 227, P = 0. 000; b = 1000 mm2/s: ADC value = ( 1.35 ±0. 36) × 10-3 mm2/s, t =4. 329, P =0. 000] in Group 2b. The diagnostic efficiency was equal( x2 =0. 36,P =0. 5460) whenever b value of 800 or 1000 s/mm2 was selected. The highest sensitivity (97.7%) and NPV (97. 1%) were obtained with b value of 1000 s/mm2 and threshold of 1.25 ×10 -3 s/mm2. Conclusion MR DWI is useful for the differential diagnosis of breast lesions with masslike enhancement rather than nonmasslike enhancement.
Key words:
Breast neoplasms; Diffusion magnetic resonance imaging
Objective To report the repair of large area soft tissue defects combined with deep tissue injury in the forearm and hand using second toe composite flap,anterolateral thigh flap,latissimus dorsi flap and thoraco-umbilical flap.Methods Four types of free flaps were transferred to repair large area soft tissue defects combined with deep tissue injury in the forearm and hand in 46 cases.There were 4 cases treated with second toe composite flap,19 with anterolateral thigh flap,15 with latissimus dorsi flap and 8 with thoracoumbilical flap.Results Postoperatively complete flap survival was seen in 44 cases achieving a 95.7％ successful rate.Debulking of the cutaneous flap or myocutaneous flap was done in 29 cases due to flap bulkiness.Postoperative follow-up was achieved in 37 cases ranging from 3 months to 11 years.The texture,elasticity and appearance of the flaps were good.Finger extension function was mostly restored in 11 patients of forearm large soft tissue defects who underwent latissimus dorsi myocutaneous flap for soft tissue coverage and finger extensor reconstruction.Four thumbs that were reconstructed with second toe composite flap recovered good appearance and function.Two-point discrimination in the pulp was 6 to 8 mm.Conclusion Free tissue transplantation is suitable for repairing large area soft tissue defects combined with deep tissue injury in the forearm and hand.Latissimus dorsi myocutaneous flap can be used to reconstruct some finger flexor and extensor function.Second toe composite flap transfer can repair forearm large area soft tissue defects combined with thumb defect.The appearance and function achieved are better than other methods.
Key words:
Surgical flaps; Tissue transplantation; Forearm injuries; Hand injuries
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