The X-ray computed tomography (CT) appearance of 4 cases with pulmonary cryptococcosis (PC) diagnosed by pathological examination in our hospital was retrospectively analyzed. The appearances of PC on CT were various: solitary lesion in 1 case, multiple lesions in single lobe in 2, and multiple lesions in multiple lobes in 1. There were total 52 lesions in 4 cases; the diameter of nodules or masses was 3 - 75 mm. Cavitations were found in 1 case; lesions appeared obviously enhanced and one lesion showed central necrosis. Two cases underwent pulmonary lobectomy; and 2 cases received core cutting needle biopsies, after antifungal therapy for 3 months to 1 year the lesions showed being absorbed. In summary, the CT appearance of PC is non-specific with various modes and forms. PC should be considered when multiple nodules or masses scattered in subpleural zone, accompanied with ground-glass opacity and obviously enhanced. The examination of pathogen and pathology at the beginning is crucial for improving diagnostic accuracy.

[ ABSTRACT] AIM:To investigate whether the increase in PTEN expression is related to apoptosis, and whether it is regulated by reactive oxygen species( ROS) .METHODS: The rat islet cells were divided into constant low glucose group ( group L) , constant high glucose group ( group H) , glucose fluctuation group ( group F) , low glucose after high glucose group (group HL) and low glucose after fluctuation group (group FL).The ROS level, apoptotic rate, intracellu-lar calcium, insulin release and PTEN protein expression were analyzed.RESULTS:Compared with groups H and L, the insulin secretion decreased, and intracellular calcium, ROS level, PTEN protein expression and apoptotic rate increased in group F ( P<0.05) .Compared with group H, the intracellular calcium, ROS level, PTEN protein expression and apoptot-ic rate in group HL decreased, but were still higher than those in group L (P<0.05).Compared with group F, the intra-cellular calcium, ROS level, PTEN protein expression and apoptotic rate in group FL decreased, but were still higher than those in group L (P<0.05).CONCLUSION:Glucose fluctuation can cause the apoptosis of islet cells more easily than constant high glucose.This may be related to the change of intracellular calcium and increase in oxidative stress which pro-motes PTEN expression.The recovery of glucose level to some extent relieves oxidative stress, decrease PTEN expression and reduce cell damage.

Objective To summarize the diagnosis and treatment of localized malignant peritoneal mesothelioma(LMPM). Methods A total of 68 cases of LMPM were analyzed retrospectively,including 65 patients in the literature concerning LMPM published in Chinese medical journals be-fore October 2014 plus 3 cases of LMPM admitted in The First Hospital of China Medical University in the same period. Results Among the 68 cas-es,30 cases were male,38 cases were female,with a male to female ratio of 1:1.27. Mean age was 57.6 years. Major clinical manifestations includ-ed abdominal pain or discomfort(76.9%)and palpable abdominal masses(58.5%). Patients(41.7%)had the history of exposure to asbestos. Among the 48 cases(92.3%)that underwent CT examination,ascites was found in 16 cases,and hepatic metastasis was found in 11 cases. Most of the tumors were epithelial type(76.7%),with a mean diameter of 12.2 cm. The main therapeutic strategy was combination therapy of cytoreductive surgery with intraperitoneal hyperthemic chemotherapy. Conclusion LMPM is a rare malignant tumor that occurs predominantly in old people. Symptoms and imaging examinations are untypical. The diagnosis is dependent on pathological examination. Combining several laboratory tests could help the diagnosis. Combination therapy of cytoreductive surgery with intraperitoneal hyperthemic chemotherapy provides an adequate and efficient treatment for LMPM.