Objective To improve the cognition of abnormal changes of the medial soft tissue of styloid process (MSTSP) in nasopharyngeal carcinoma after radiotherapy. Methods CT scans of nasopharynx in 39 cases with NPC that had change at the MSTSP in NPC after radiotherapy were performed.CT findings of recurrence and non-recurrence at MSTSP were studied and compared carefully.Results In the recurrence cases, the MSTSP was thickening and compactness in all cases, in the non-recurrence cases ,only 37.04% (10/27) were thickening and compactness at MSTSP. In all the cases which had thickening and compactness of the MSTSP, the borders were slightly protruding in 9 cases and the borders were straight in 3 cases in the recurrence cases, while the borders were straight in 7 cases and the borders were slightly hollow in 3 cases,and there wasn't any case appeared as protruding of borders in the non-recurrence cases. All the cases were dealt with statistic methods and had remarkable difference between them(P

OBJECTIVE To study the clinical usability of virtual endoscopy(VE) in tympanoplasty.METHODS A total of 102 patients (204 ears) were observed by virtual endoscopy. Tympanoplasty was performed in 72 cases (75 ears) including 53 cases (55 ears) with chronic otitis media and 19 cases (20 ears) with congenital microtia and middle ear dysmorphia. Ossicular chain reconstruction was conducteded in 65 ears at the same time. RESULTS The ossicular chain was showed eroded in 19 ears of 23 patients with cholesteatoma otitis media pre-operatively by VE, but was found eroded in all of 23 ears during operation. The ossicular chain was showed eroded in 29 ears of 32 patients with osteitis otitis media pre-operatively by VE, but during operation it was found 23 ears with malleus and incus eroded, 11 ears without head of stapes or up-structure of stapes. VE showed 18 ears with congenital microtia and middle ear malformation and 2 ears with small tympanic cavity and no ossicular chain preoperatively, and operation proved 17 ears with severe ossicular malformation, 2 ears without stapes, 1 ear with vestibular window atresia. There were 2 ears with sudden hearing loss after tympanoplasty, the VE showed ossicular displacement. The coincidence rates between VE and operation view were 92 % in patients with otitis media and 100 % in patients with congenital microtia and middle ear malformation. CONCLUSION VE can supply reliability data for evaluation of the damaged ossicular chain and efficacy of tympanoplasty.

Objective To detect apoptosis of transplanted lung adenocarcinoma cells in nude mice after 125I brachytherapy by 99Tcm-Annexin V combined with diffusion weighted MRI (MR-DWI).Methods Twenty-five BALB/c-nu nude mice models subcutaneously transplanted with A549 cells were divided into experimental group (EG,n=13) and control group (CG,n=12) by random number table method.One 125I seed with apparent activity of (24.8±6.3) MBq was implanted into each mouse in EG,while CG underwent cold seed implantation.Both of 99Tcm-Annexin V imaging and MR-DWI were performed within 7-10 d after brachytherapy,then all mice were sacrificed and tumor cell apoptosis was detected by terminal oxynucleotidyl transferase mediated dUTP biotin nick end labeling (TUNEL) immunofluorescence,Survivin expression was assayed by SP.Two-sample t test,x2 test and Pearson correlation analysis were used for data analysis.Results Positive rate of cell apoptosis by 99Tcm-Annexin V imaging was 69.2％(9/13) and 8.3％(1/12) respectively in EG and CG (x2 =12.73,P＜0.01).The uptake ratio of 99Tcm-Annexin V,apparent diffusion coefficient(ADC) value and apoptosis index(M) of the tumor in EG were 2.91±0.85,(2.03±0.44)×10-3 mm2/s and (49± 18) ％,respectively,which were significantly higher than those of CG (1.26 ± 0.37,(1.29 ± 0.21) ×10-3 mm2/s and (11±4)％ respectively,t=5.930,5.452,7.606,all P＜0.05).Survivin expression in EG and CG was (46± 13) ％ and (15±7) ％ respectively (t =5.158,P＜0.05).The value of ADC was correlated with AI and uptake ratio(r=0.756,0.788,both P＜0.05).Uptake ratio was correlated with AI (r=0.754,P＜0.05),while Survivin expression was negatively correlated with AI (r =-0.772,P＜0.05).Conclusions Down-regulation of Survivin expression may play an important role in apoptosis induced by 125I brachytherapy.99Tcm-Annexin V combined with MR-DWI could effectively evaluate apoptosis of lung adenocarcinoma cells in a non-invasive way,thus it might be helpful in evaluation of early efficacy of 125I brachytherapy.

ObjectiveTo investigate the value of perfusion CT imaging in thyroid nodule. Methods Of the 40 cases of post-surgical thyroid nodule identified by pathology, nodular goiter was verified in 22 cases, thyroid adenoma in 6 cases,and thyroid carcinoma in 12 cases. All cases underwent CT perfusion scan at preoperative. The perfusion parameters including the blood flow ( BF), blood volume ( BV ), mean transit time ( MTT), and permeability of surface (PS) of region of interest (ROI) were calculated. The Mann-whitney test was used to comparing the differences of the different perfusion parameters. The ones with statistical significance would be introduced into the discriminatory analysis to distinguish the benign and malignant thyroid nodule. ResultsThe median MTT in 28 cases with benign thyroid nodule were 4. 33 s (Min 1.42 s,Max 10. 93 s), and that in 12 cases with malignant nodules were 2. 18 s( Min 1. 95 s, Max 2. 87 s). The difference had statistical significance ( P ＝ 0. 00 ) . The median BF in cases with thyroid carcinoma was 560. 23( Min 330. 66, Max 1000.00) ml ·100 g-1 ·min-1, and that in cases with the benign nodular were 374.79(Min 117.47,Max 1000.00) ml · 100 g-1 · min-1. There was a significant statistical difference ( P ＝0. 01 ). Through the discriminatory analysis, the difference of MTT between benign and malignant nodules were statistically significant (P ＝ 0. 00 ).After establing the Bayes discriminatory function, the overall diagnostic accuracy was 87.5％ (35/40).Conclusions MTT and BF are useful parameters in CT perfusion imaging to distinguish the benign and malignant thyroid nodules and the MTT is more accuracy.

OBJECTIVETo observe treatment response, survival, safety and the improvement of ECOG in patients with refractory multiple myeloma (MM) with serious heart failure after the administration of continuous low-dose of cyclophosphamide combined with prednisone (CP).

METHODSFrom January 2005 to September 2013, a total of 75 patients were treated by metronomic chemotherapy with continuous low-dose cyclophosphamide (50 mg/d) and prednisone (15 mg/d).

RESULTSAmong the 75 patients, 2 were lost for follow-up. In the 73 available patients, the overall response was 64.4%, including 2 patients (2.7%) with complete remission (CR), 4 cases (5.5%) very good partial remission (VGPR), and 24 patients (32.9%) partial remission (PR). The median survival was 12 months (1-70 months) with a median onset time of 90 days (16-120) and a median progressive freedom survival of 12 months (1-60). The level of B-type natriuretic peptide in responders declined significantly, as compared to no responders [(336.6 ± 30.3) ng/L vs (906.4 ± 104.8) ng/L, P<0.01]. Common adverse events were as follows: 32 (43.8%) cases of bone marrow suppression, 26 (35.6%) cases of infection, 8 cases of dizzy as well as sleepiness (11.0%), 7(9.6%) cases of Cushing syndrome, 4 (5.5%) cases of secondary diabetes mellitus, and 3 (4.1%) cases of edema respectively.

CONCLUSIONThe metronomic chemotherapy of cyclophosphamide combined with prednisone had satisfactory impact on the treatment outcome, including the improvement of cardiac functions and physical capacities, better survival and safety in refractory MM with serious heart failure. It provides a novel regimen for such patients.

Cholangitis, Sclerosing ; etiology ; Genetic Predisposition to Disease ; Hepatitis, Autoimmune ; etiology ; Humans ; Liver Cirrhosis, Biliary ; etiology

Objective: To observe the promoting blood circulation by removing blood stasis of Lubai Capsule(LBC)(Rhizoma Phragmitis, Radix Paeoniae Alba, Radix Saposhnikoviae, Flos Schizonepetae, etc.). Methods: Acute blood stasis rat models were established with swimming in iced water and sc adrenalin in order to observe the effect of LBC on blood rheology. Mesenteric microcirculatory disturbance rat models were also established with adrenalin in order to observe the effect of LBC. Clotting time was measured in vitro with prothrombin time(PT) and kaolin partial thromboplastin time(KPTT) kit in order to observe its effects. Results: LBC could decrease the whole blood and plasma viscosity, fibrinogen, erythrocyte sedimentation and aggregation ratio of blood platelets of rats, ease the sticky condition of blood stasis rat models and prevent from forming thrombus. It could also inhibit the constraction and slowing of blood flow of thin artery, the reducing of open capillaries and change of fluid condition caused by adrenalin and improve these phenomena. PT and KPTT could be increased obviously. Conclusion: LBC can significantly promote blood circulation by removing blood stasis, because of improving blood rheology and mesenteric microcirculatory disturbance and inhibit endogenous and exogenous coagulation system.

L3 skeletal muscle index (L3 SMI) is an emerging nutritional assessment tool. It has been well documented that L3 SMI can correctly reflect body skeletal muscle mass, and can be used to evaluate the prognosis of sarcopenia, chronic liver disease and many malignant tumors. Moreover, it can also be used to predict some surgical complications. This review sums up the recent advances of L3 SMI in evaluating prognosis of diseases.

Objective To discuss the clinical efficacy of early surgical intervention of acute incomplete cervical spinal cord injury and the selection of operative modes. Methods The clinical data of 462 patients incomplete cervical spinal cord injury, who were treated in our hospital from January 2003 to May 2014 were analyzed retrospectively. There were 387 cases in the operation group (283 received anterior cervical decompression and bone graft fusion and internal fixation, 26 received anterior and posterior decompression, and 78 received simple posterior decompression) and 75 cases in non-operative group. The neurological function recovery of cervical spinal cord injury was evaluated by Frankel classification and ASIA scoring criteria. Results The patients were followed up for 12-27 months. The results showed that the Frankel classification was improved to different degrees in 432 cases, with an improvement rate of 93.51%. The improvement rate of operative treatment group was 98.45%, which was higher than that of the non-operative group (68.00%). The ASIA scores of both groups were increased after treatment (P<0.05), and the increase in the operation group was greater than the non-operation group (P<0.05). In addition, the ASIA improvement of the anterior and anterior plus posterior approach surgery was greater than that of the simple posterior approach surgery (P<0.05). Conclusion Early surgical intervention should be given to acute incomplete cervical spinal cord injury so as to promote the neuronal function recovery.

Objective To evaluate the clinical values of complement C3 and C4 and C-reactive protein (CRP) in the differential diagnosis of disease relapse and infection in systemic lupus erythematosus (SLE). Methods Sixty-three hospitalized SLE patients during 2011-2014 were retrospectively analyzed in this study. Patients were grouped according to the presence of infection and SLE disease activity index (SLEDAI). The laboratory findings, including CRP, erythrocyte sedimentation rate(ESR), complement and immunoglobulin were compared between the infected group (n=20) and non-infected group (n=43) and the flare group (n=44) and inactive group (n=19). Correlation analysis was also made between SLEDAI and serum markers. Results The levels of CRP, ESR, IgA, and SLEDAI in the infection group were significantly higher than those of the non-infection group (P<0.05). The levels of ESR and IgG in the flare group were significantly higher and C3 was significantly lower than those in the inactive group (P<0.05). Correlation analysis found that C3 was negatively correlated with SLEDAI (r=-0.666, P<0.01), but CRP was not correlated with C4(r=0.073, r=0.143; P>0.05). Conclusion CRP is elevated when SLE patients have infection, but C3 and C4 have no decrease or only with slight decrease. During flare of SLE patients, C3 is decreased and C4 has no obvious decrease, with CRP not elevated or slightly elevated. It is indicated that C3 and CRP are valuable in the differential diagnosis of disease relapse and infection in SLE.