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25 December 2017, Volume 16 Issue 06 Previous Issue    Next Issue

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Effects of salt loading and potassium supplement on circadian blood pressure profile in salt-sensitive Chinese subjects GUO Tongshuai, CHU Chao, WANG Yang, REN Keyu, MU Jianjun 2017, 16 (06):  582-586.  DOI: 10.16150/j.1671-2870.2017.06.004 Abstract ( 306 )   PDF (546KB) ( 94 )   Objective: Salt-sensitive subjects showed more frequently a non-dipper blood pressure pattern. This study aimed to investigate whether potassium supplement can improve the blunted nocturnal blood pressure fall in salt-sensitive patients exposed to high-salt diet. Methods: A total of 49 normotensive and mildly hypertensive Chinese patients received a study protocol of a 3 d baseline examination, 7 d low salt diet (51.3 mmol/d NaCl), 7 d high salt diet (307.7 mmol/d NaCl) and 7 d high salt diet with a potassium supplement (307.7 mmol/d NaCl and 60 mmol/d KCl). The blood pressure of the subjects was measured at the end of each period, and blood and urine samples were collected. The 24 h ambulatory blood pressure was also obtained. Results: Of all the 49 subjects, the detection rate of salt-sensitive individuals was 28.6%. The night-to-day blood pressure ratio was significantly higher in salt-sensitive subjects than in non-salt-sensitive ones during the high salt loading period (systolic blood pressure 0.96±0.01 vs 0.89±0.01, P<0.01; diastolic blood pressure 0.96±0.01 vs 0.92±0.01, P<0.05). Compared with the high-salt loading period, night-to-day blood pressure ratio was significantly decreased by potassium supplement in salt-sensitive subjects (systolic blood pressure 0.91±0.01 vs 0.96±0.01, P<0.05; diastolic blood pressure 0.91±0.01 vs 0.96±0.01, P<0.05). Conclusions: Potassium supplement can improve the blunted nocturnal blood pressure fall in salt sensitive patients exposed to high-salt diet. References | Related Articles | Metrics

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Feasibility of screening and diagnosing obstructive sleep apnea-hypopnea syndrome by oxygen desaturation index and its association with nighttime blood pressure CHEN Qi, CHENG Yibang, HUANG Qifang, WANG Jiguang, LI Yan 2017, 16 (06):  587-591.  DOI: 10.16150/j.1671-2870.2017.06.005 Abstract ( 811 )   PDF (538KB) ( 163 )   Objectives: To investigate the correlation of oxygen desaturation index (ODI) with apnea-hypopnea index (AHI) and nighttime blood pressure, and to calculate the sensitivity and specificity of ODI for diagnosing obstructive sleep apnea-hypopnea syndrome(OSAS). Methods: Standard polysomnography examination was conducted in patients who had 24-h ambulatory blood pressure and nighttime pulse oxygen saturation monitoring performed and having ODI>3 times/h and 24-h ambulatory hypertension (≥130/80 mmHg). The correlations of ODI with AHI and ambulatory blood pressure were analyzed by Spearman correlation analysis and covariance analysis; sensitivity and specificity of ODI for diagnosing OSAS were calculated by receiver operator characteristic(ROC) curve. Results: A total of 184 patients with average age of 51.3 years, 52.7% were male, and 50.5% were on antihypertensive treatment were enrolled. It showed that ODI was positively correlated with AHI (r=0.38, P<0.001). When ODI≥8 times/h was taken as cutoff value, the sensitivity and specificity for diagnosing moderate and severe OSAS (AHI≥5 times/h) were 69.4%, 65.0% respectively, and the area under the ROC curve was 0.69. When ODI≥14 times/h was taken as the cutoff value for diagnosing moderate and severe OSAS (AHI≥15 times/h), the corresponding values were 48.3%, 83.2% and 0.68, respectively. Nighttime systolic and diastolic blood pressures and heart rate increased with the increase of ODI (P for trends<0.05). Compared with those who had an ODI of <8 times/h, patients with ODI≥14 times/h suffered an increased nighttime blood pressure of 6.2/4.7 mmHg and a faster heart rate by 3.3 beats/min. Conclusions: ODI derived from a simple and noninvasive nighttime pulse oxygen saturation monitoring is correlated with the AHI obtained from polysomnography. The sensitivity and specificity of ODI for diagnosing OSAS is moderate and acceptable. ODI is correlated with nighttime blood pressure and should be helpful to the etiological analysis of nighttime hypertension. References | Related Articles | Metrics

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Prevalence and determinants of asymptomatic intracranial artery stenosis assessed by transcranial Doppler ultrosonography CHEN Hui, GUO Qianhui, XU Jie, CHENG Yibang, ZHANG Dongyan, WANG Ying, HUANG Qifang, SHENG Changsheng, LI Yan 2017, 16 (06):  592-595.  DOI: 10.16150/j.1671-2870.2017.06.006 Abstract ( 314 )   PDF (453KB) ( 37 )   Objectives: To investigate the prevalence and determinants of asymptomatic intracranial artery stenosis in untreated patients from hypertension outpatient clinic. Methods: Outpatients having not treated with antihypertensive medi-cation for Ambulatory Blood Pressure Monitoring at Department of Hypertension, Ruijin Hospital from the year of 2009 to 2013 were recruited. Transcranial Doppler ultrasonography was used to assess the stenosis at the bilateral anterior, middle and posterior cerebral arteries and vertebral arteries. T test and Chi square test were used to compare the difference in clinical features between patients with stenosis and those without. Multiple logistic regression analysis was used to analyze the determinants of intracranial arterial stenosis. Results: A total of 1 130 patients with average age of 51 years were enrolled, including 49% males, 63% hypertensives and 5.3% diabetic patients. The prevalence of intracranial arterial stenosis was 7.4% (84 cases). The stenosis located mainly at anterior (45 cases) and middle (44 cases) cerebral arteries, less frequently at posterior (16 cases) or vertebral (7 cases) arteries. No differences in clinic characteristics were found between patients with and without stenosis, except that 24-h systolic blood pressure was significantly higher in patients with intracranial arterial stenosis (132 vs 126 mmHg, P<0.001). Multivariate logistic regression analyses showed that women had higher risk of intracranial arterial stenosis than men by 72% (95% CI, 6%-179%, P=0.026). For every 10 mmHg increase in 24-h systolic blood pressure, the risk of intracranial artery stenosis increased by 56% (29%-88%, P<0.001). Irrespective of the time of measuring (daytime, nighttime, morning), increase of systolic blood pressure was associated with increased risk of intracranial arterial stenosis, and for every 10 mmHg increase, risk of intracranial artery stenosis increased by 34%-47% (P all <0.001). Conclusions: Asymptomatic intracranial artery stenosis is moderately prevalent in untreated Chinese patients at the hypertension clinic, of which systolic blood pressure is an important determinant. References | Related Articles | Metrics

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Real-time electronic alert system improving the detection of acute kidney injury WANG Yimei, TENG Jie, SHEN Bo, XU Jiarui, JIANG Wuhua, YU Jiawei, HU Jiachang, DING Xiaoqiang 2017, 16 (06):  596-600.  DOI: 10.16150/j.1671-2870.2017.06.007 Abstract ( 214 )   PDF (506KB) ( 66 )   Objective: To investigate the occurrence of acute kidney injury（AKI）in hospitalized patients, and to compare the detection rate by real-time electronic alert system with the results by manual diagnosis. Methods: A total of 2 563 hospitalized patients in Zhongshan Hospital, Fudan University from November 3rd, 2014 to November 9th, 2014 were screened by real-time electronic alert system and the results of manual diagnosis were compared. Results: Detection rates by electronic alert system and manual diagnosis were 10.2% and 3.59%, respectively. The median age of AKI patients was (63±16) years, and among them 176 cases (67.4%) were male and 17 cases（6.5%） received renal replacement therapy; the hospital mortality of AKI patients was 5.7%. Of them 93.5% of patients were not from Department of Nephrology, and only 9.8% received consultation by nephrologists. Only 1.5% had discharge diagnosis of AKI related to acute kidney injury. The Departments with the high incidence of AKI were Cardiac Surgery(39.0%), nephrology(33.0%) and Liver Surgery (19.0%). The incidence of community acquired AKI (CA-AKI) and hospital-acquired AKI (HA-AKI) were 26.1% and 73.9%, respectively. The AKI group had significantly longer hospital stay and higher expenses than the non-AKI group (P<0.05). Of AKI patients, AKI stage(KDIGO criteria) and age were independent risk factors of in-hospital mortality according to the results of multivariate logistic regression. Conclusions: The majority of AKI patients are not from Department of Nephrology and has high missed diagnosis rate and low consultation rate by nephrologists. The establishment of AKI electronic alerting system can significantly increase the recognition rate of AKI patients, raise doctors’ awareness of AKI, and may help to improve the prognosis of AKI patients. References | Related Articles | Metrics

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Application of texture analysis of MR imagings in grading of pancreatic neuroendocrine neoplasms LI Xudong, LIN Xiaozhu, FANG Weihuan, XIE Huanhuan, CHEN Nan, CHAI Weimin, YAN Fuhua, CHEN Kemin 2017, 16 (06):  601-606.  DOI: 10.16150/j.1671-2870.2017.06.008 Abstract ( 402 )   PDF (755KB) ( 157 )   Objective: To investigate the application of texture analysis derived from MR imaging in grading of pancreatic neuroendocrine neoplasms(PNENs). Methods: MR imagings of 64 patients with pathologically confirmed PNENs admitted to Ruijin Hospital were enrolled. Texture features were extracted from manually drawn ROIs by using MaZda software, and were selected according to the pathological grade by the feature selection methods. Statistical methods including Fisher coefficient(Fisher), classification error probability combined with average correlation coefficients(POE+ACC), mutual information(MI), and combination of above three methods(FPM) were used to classify the pathological grading of PNENs. The results were shown by misclassification rate. Results: For feature selection methods, FPM had the lowest misclassification rate. Among the statistical methods, the misclassification of NDA was lower than those of RDA, PCA, and LDA. Among the MRI sequences, the ADC map obtained the lowest misclassification rate of 9.38%(6/64), but there was no significant difference between sequences. Conclusions: Texture analysis of MR imaging can be used as an assistant tool for preoperative grading of pancreatic neuroendocrine neoplasms, and when it comes to statistical methods, FPM has the lowest misclassification rate. References | Related Articles | Metrics

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A contrast analysis of thyroid ultrasound-guided fine needle aspiration cytology and thyroid ultrasound imaging reporting and data system LI Qinqin, YE Tingjun, MAO Minjing 2017, 16 (06):  607-611.  DOI: 10.16150/j.1671-2870.2017.06.009 Abstract ( 596 )   PDF (504KB) ( 96 )   Objective: To study the value of ultrasound-guided fine-needle aspiration biopsy(US-FNAB) and thyroid ultrasound imaging reporting and data system(TI-RADS) in the diagnosis of thyroid nodules. Methods: Data from 2 901 patients undergone thyroid ultrasound guided fine needle aspiration biopsy at Ruijin Hospital during January 2017 to June 2017 were retrospectively reviewed, and the cytologic findings were contrasted with the results of TI-RADS classification. Results: According to the results of cytological diagnosis, thyroid benign nodules were more commonly seen in TI-RADS 3 and 4A and accounting for 94.00% and 61.62%, respectively; while malignant nodules were commonly seen in TI-RADS 4A, 4B, 4C, and 5 and accounting for 38.38%, 78.34%, 87.02% and 92.87%, respectively. Conclusions: It is recommended that when one or more of the indicators in ultrasound TI-RADS classification suggests a malignant nodule(≥4A), US-FNAB is required to identify the character of the nodule. US-FNAB combined with TI-RADS classification can be used in the differential diagnosis of thyroid nodules and has importantclinical significance for preoperative diagnosis. References | Related Articles | Metrics

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Study on correlation between serum vitamin D and severity of community-acquired pneumonia in elderly people ZHOU Yan, GU Yi 2017, 16 (06):  612-616.  DOI: 10.16150/j.1671-2870.2017.06.010 Abstract ( 227 )   PDF (537KB) ( 111 )   Objectives: To analyze the correlation between serum vitamin D and severity of community-acquired pneumonia (CAP) in elderly people. Methods: A total of 235 cases of elderly people with CAP were enrolled and were divided into severe CAP group(39 cases) and common CAP group (196 cases). And 219 healthy elderly people were served as controls.Levels of serum 25-(OH)D3, procalcitonin( PCT), hsCRP, serum C-reactive protein (CRP) and electrolytes were determined, and blood routine and arterial blood gas were detected. The diagnostic value of serum 25-(OH)D3 level for CAP was evaluated by ROC curve. Results: The levels of serum 25-(OH)D3, PCT, hsCRP, CRP, WBC count, PMN%, PaO2, calcium between the three groups were statistically different (F=117.66, 21.79, 53.21, 113.86, 91.83, 179.83, 30.46, 22.34, P<0.05). Pearson correlation analysis showed that serum 25-(OH)D3 level was negatively correlated with hsCRP, CRP, WBC (r=-0.81, -0.23, -0.18, P<0.05), and positively correlated with PaO2, calcium (r=0.22, 0.27, P<0.05). The multi-variable logistic regression analysis showed that serum low level of 25-(OH)D3 was highly correlated with the severity of CAP. The ROC curve analysis showed that serum 25-(OH)D3 had good diagnostic value for severe CAP (area under the curve was 0.864, 95% CI was 0.83~0.90, P<0.05). Conclusions: Serum vitamin D deficiency is closely correlated with severity of CAP in elderly people and is a high risk factor for severe CAP. Early detection of serum vitamin D level has clinical significance in evaluating the severity of CAP to some extent. References | Related Articles | Metrics

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Dynamic monitoring of levels of procalcitonin and C-reactive protein in acute brucellosis HE Jingjing, ZHANG Yan, ZHOU Yuzhen, LIU Jingyao, ZHAO Dongmei, ZHENG Zunrong 2017, 16 (06):  617-621.  DOI: 10.16150/j.1671-2870.2017.06.011 Abstract ( 372 )   PDF (603KB) ( 69 )   Objective: To investigate the value of dynamic monitoring of procalcitonin(PCT), C-reaction protein (CRP) and WBC in acute brucellosis patients. Methods: A total of 151 patients with acute brucellosis, 120 patients with chronic brucellosis and 72 healthy controls were recruited in this study. The levels of PCT, CRP and WBC were detected and the results before and after therapy were compared. Results: Of the 151 acute brucellosis patients the level of PCT was(3.29±0.49) ng/mL with positive rate of 65.56%, the level of CRP was(24.84±2.95) mg/L with positive rate of 56.29% , and the WBC count was (7.53±3.42)×109/L with positive rate of 7.28%. The levels of PCT, CRP and WBC in 120 cases of chronic brucellosis patients were (0.27±0.03) ng/mL, (3.32±0.35) mg/L and (6.27±2.56)×109/L, respectively, and the positive rates were 7.50%, 8.33% and 6.67% , respectively. The levels of PCT, CRP and WBC in 72 healthy controls were(0.21±0.01) ng/mL, (2.93±0.35) mg/L and (5.91±2.31)×109/L, respectively. The differences in levels of PCT, CRP were statistically significant between acute brucellosis group, chronic brucellosis group and healthy control group(P<0.01), but there was no significant difference in WBC count between the three groups. The sensitivity, specificity, Youden index, positive predictive value and negative predictive value of PCT for diagnosing acute brucellosiswere higher than those of CRP, and the combined detection of PCT and CRP showed the highest sensitivity and negative predictive value. In acute brucellosis group the levels of PCT and CRP after treatment were lower than those before treatment, and the differences were statistically significant(P<0.05). Conclusions: Combined detection of levels of procalcitonin and C-reactive protein could increase the sensitivity for diagnosing acute brucellosis, and monitoring of levels of procalcitonin and C-reactive protein in treatment of acute brucellosis has value in predicting the outcome. References | Related Articles | Metrics

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Intracranial solitary fibrous tumor/hemangiopericytoma: a clinicopathologic study of 20 cases with review of literature ZHU Peipei, ZOU Jue, CHEN Jun, XU Rongrong, YAN Hongzhu 2017, 16 (06):  622-626.  DOI: 10.16150/j.1671-2870.2017.06.012 Abstract ( 513 )   PDF (1020KB) ( 123 )   Objective: To study the clinicopathologic features, diagnosis, differential diagnosis and prognosis of intracranial solitary fibrous tumor/hemangiopericytoma(SFT/HPC). Methods: A total of 20 cases of intracranial SFT/HPC were enrolled in this study. The clinical data, pathologic characteristics and immunophenotype were studied and relevant literatures were reviewed. Results: Of these patients, 12 cases were male and 8 were female, with an average age of 48.45 years. Seven cases received meningioma resection 6-19 years before. According to the latest 2016 WHO classification, there were 1 case of grade Ⅰ, 13 cases of grade Ⅱ and 6 cases of grade Ⅲ. Immunohisochemically, tumor cells of all specimen were positive for vimentin, bcl-2, CD34 and STAT6, and were negative for EMA, AE1/AE3, S-100, CD31 and factor Ⅷ. The cells of grade Ⅰ case were strong and diffusely positive for CD34, while the cells of grade Ⅱ and grade Ⅲ cases had weak expression and patchy distribution of CD34. Ki-67 proliferation index ranged from 3% to 30%. Fifteen of the 20 patients were followed-up for 5 months to 19 years. During this period, 5 cases had disease recurrence, and 13 received postoperative radiotherapy, while 2 case did not receive any therapy. Up to March 2017, all cases were survived. Conclusions: According to the latest releas from WHO, SFT and HPC are classified as the same type of tumor, and immunohistochemistry staining of CD34 and ki-67 may be useful to grading and differential diagnosis of SFT/HPC. References | Related Articles | Metrics

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Analysis of MRI findings of spinal angiolipoma ZHAO Huali, XI Yuling, HAN Chun, LIANG Zonghui 2017, 16 (06):  627-632.  DOI: 10.16150/j.1671-2870.2017.06.013 Abstract ( 417 )   PDF (847KB) ( 88 )   Objective: To investigate the MRI features of spinal angiolioma. Methods: The MRI features of 8 surgically proved cases of spinal angiolipoma were analyzed retrospectively. Results: Six of the 8 cases of spinal angiolipoma were spinal epidural angiolipoma, 1 case was intramedullary angiolipoma, and 1 case was intradural extra-medullary angio-lipoma. The accuracy of MRI for diagnosing the location of angiolipoma was 100%. Five cases were diagnosed as angio-lipoma and 3 cases were diagnosed as benign tumor. Spinal epidural angiolipoma was presented as shuttle in shape, some cases locating at intervertebral foramens were dumb-bell in shape and adjacent intervertebral foramens were enlarged. The compressed dura mater appeared as linear structures with low signal intensity on MR images obtained with all sequences.The cavitas subarachnoidealis was narrow on affected level. The intramedullary angiolipoma was presented as oval structure and both ends of the spinal cord were cup mouth in shape. The intradural extra-medullary angiolipoma shaped like a crescent, the dura mater was not compressed but the cavitas subarachnoidealis was narrow. The MRI signals: isointense or hyperintense signals on T1WI and T2WI, 7 caseshad signals increased and one decreased on STIR; while 4 cases showed mild contrast enhancement, 3 cases had moderate enhancement, 1 case had intense enhancement on enhanced MRI; the intense was even in 6 cases and uneven in 2 cases. Conclusions: Spinal angiolipoma is mostly extradural, intramedullary and intradural extra-medullary are rare. The size, morphology, MRI signal of angiolipoma and the association with adjacent structure can be clearly displayed on MRI. MRI has good diagnostic value for the location and identification of angiolipoma. References | Related Articles | Metrics

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Correlation between bone metabolism and atherosclerotic disease in elderly WANG Cuixia, ZHANG Xiaoyan, GONG Yunxia, WU Fang 2017, 16 (06):  633-638.  DOI: 10.16150/j.1671-2870.2017.06.014 Abstract ( 285 )   PDF (641KB) ( 53 )   Objective: To investigate the correlation of indicators of bone metabolism including hydroxyvitamin D (25-OH-D), osteoprotegerin (OPG), parathyroid（PTH）, procollagen type 1 N-terminal propeptide（P1NP）, β cross-linked C-telopeptide of type 1 collagen（β-CTX）with atherosclerotic disease in elderly. Methods: A total of 163 elderly patients at Department of Geriatrics, Ruijin Hospital from January 2015 to October 2016（mean age 75.8 years）were recruited. Blood pressure, BMI, plasma glucose, renal function, blood lipids, CRP, 25-OH-D, OPG, PTH, P1NP, β-CTX were measured. Both carotid and lower extremity atherosclerosis were assessed by Doppler ultrasound,and patients were divided into 2 groups: atherosclerosis group and control group. Results: ①The mean serum level of 25-OH-D in all subjects was (47.11±17.29) nmol/L and the percentage of vitamin D deficiency was 58.1%. ②Compared with the control group, serum 25-OH-D in atherosclerosis group was significantly lower (P<0.05), while OPG and PTH were significantly higher (P<0.05). ③Atherosclerotic disease was negatively correlated with 25-OH-D （r=-0.559, P<0.05）and positively correlated with OPG（r=0.459, P<0.05）by correlation analysis. ④Logistic regression analysis showed that serum 25-OH-D and OPG were independent risk factors of atherosclerotic disease. Conclusions: Patients with atherosclerotic disease have lower serum 25-OH-D level. Early vitamin D supplementation may slow down the progression of atherosclerosis. The significantly higher serum OPG in patients with atherosclerotic disease may be due to the compensatory protective effect of body. This study reveales that status of bone turnover has no relationship with atherosclerosis, yet needs to be further investigated. References | Related Articles | Metrics

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Clinical characteristics and pathological features of Kimura disease: report of 13 case and review of literature LU Xiaoxue, DA Qian 2017, 16 (06):  639-644.  DOI: 10.16150/j.1671-2870.2017.06.015 Abstract ( 534 )   PDF (965KB) ( 117 )   Objective: To investigate the clinical and pathological features of Kimura's disease (KD) for improving its diagnosis and treatment experiences. Methods: The clinical data and histological morphology of 13 cases of Kimura disease were retrospectively analyzed, with review of literature.Clinicopathological features, diagnosis and treatment of Kimura disease were summarized. Results: All the patients were male, with mean age of (41±4) years and average duration of (35±11) months. The clinical manifestations of KD were progressive and painless tumors in different sites, including 3 cases with trunk and/or limbs scattered with papules with itching, 4 cases with single tumor nodule, 9 cases with multiple tumors. The largest tumor had a diameter reaching 10.0 cm. Blood examination showed increased peripheral blood eosinophils in all the cases. Four cases had immunoglobulin IgE test performed, and it showed increased level of serum IgE. And 2 cases had bone marrow puncture performed, which revealed active proliferation of bone marrow and evident infiltration of eosinophils. Histopathologically, they mainly composed of hyperplastic lymphoid tissue, expansion of germinal center, obvious mantle zone, lymphoid follicle formation and fibrous tissue hyperplasia;small vascular hyperplasia can be seen between lymph follicles. Marked infiltration and accumulation of mature eosinophils were seen in interstitial tissue, and eosinophilic tiny abscesses were formed.Seven cases received surgical resection only, and the other 6 cases received treatment such as hormones or radiation in addition. Seven patients were followed up for 4-96 months and 5 had relapse. Conclusions: Kimura disease is a kind of benign lymphoproliferative lesion, and it is important to master its clinical features and histological morphology for improving its diagnosis. References | Related Articles | Metrics

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Comparison of performance between three types of automatic immunohistochemical stainer in pathological diagnosis of breast cancer XU Haimin, ZHANG Peipei 2017, 16 (06):  645-649.  DOI: 10.16150/j.1671-2870.2017.06.016 Abstract ( 649 )   PDF (777KB) ( 114 )   Objective: To investigate the performance of 3 types of automatic immunohistochemical stainer(Leica Bond-Max, Dako Omnis and BenchMark Ultra automatic immunohistochemical stainer) in pathological diagnosis of invasive ductal carcinoma of breast. Methods: Paraffin-embedded tissue blocks from 30 patients with infiltrating ductal carcinoma were collected,and 12 sections with a thickness of 3 μm were excised from each paraffin-embedded tissue block. After being stained with these three types of automatic immunohistochemical stainer, the specimens were examined to determine the expressions of estrogen receptor(ER）, progesterone receptor (PR）, human epidermal growth factor receptor 2（HER-2） and Ki67. Positive rates of above mentioned parameters between specimens prepared with these three different stainers were compared. Results: For Leica Bond-Max, the cases with positive ER(10%-99%, +~+++）, PR(1%-99%, +~+++）, HER-2（+~+++） and Ki-67（5%-90%, +）were 18, 14, 29 and 30 cases, respectively, by Dako Omnis were 18, 12, 28 and 30 cases, respectively, and by BenchMark Ultra were 18, 12, 28 and, 30 cases, respectively. There were no significant differences in positive expressions of these parameters in specimens prepared with these 3 types of automatic immunohistochemical stainer(P>0.05). Conclusions: Pathologic results of ER, PR, HER-2 and Ki-67 expression in breast carcinoma tissue were similar when specimens were prepared with these three types of automatic immunohistochemical stainer, indicating that specimens could be prepared with any type of above mentioned automatic immunohistochemical stainer. References | Related Articles | Metrics

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Features of magnetic resonance imaging and its value in clinicaldiagnosis of ectopic pregnancy YE Lan, ZHANG Huan, QIAN Zhaoxia 2017, 16 (06):  650-655.  DOI: 10.16150/j.1671-2870.2017.06.017 Abstract ( 661 )   PDF (813KB) ( 151 )   Objective: To investigate the manifestation and value of magnetic resonance imaging(MRI) in clinical diag-nosis of ectopic pregnancy(EP). Methods: Ultrasonic and clinical data in 58 cases of ectopic pregnancy confirmed by clini-cal or pathology in our hospital from July 2013 to April 2017 were collected and features of MR imaging were retrospectively analyzed. The diagnostic accuracy of ultrasound and MRI were calculated and compared. Results: Of all the 58 patients, the accuracy rate of MRI in diagnosis of ectopic pregnancy was 91.38%(53 cases), and was higher than that of ultrasound (77.59%, 45 cases)（P<0.05）. MRI could show complete gestational sac and cystic, solid-cystic or heterogeneous mass imaging in 56 cases. The mass of pregnancy sac was round or oval and the boundary with surrounding tissue was clear on MR imaging. The high signal in T1W imaging was related to the hemorrhage of gestational sac. Two cases of ruptured pregnancy sac showed imaging with irregular mass, heterogeneous SI in T1WI and T2WI, and signal of scattered or patchy bleeding was found in the mass, with high SI in T1WI and slightly higher SI in T2WI; imaging of hemorrhage in gestational sac and pelvic hemorrhage were the characteristic features. Conclusions: MRI can clearly reveal the anatomic relationship between embryo sac and its surrounding structures, identifying the location and showing the implantation of gestational sac clearly. For cases of ectopic pregnancy which are difficult to diagnose by ultrasound, MRI examination could be performed, which is of important reference value for evaluation of the disease and selection of treatment options. References | Related Articles | Metrics