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

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.

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.

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.

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.

Objective To study curative effect of edaravone on acute severe brain injury through the observation of neuron-specific enolase( that is:NSE) changes.Methods 60 severe brain injury patients were randomly assigned into the treatment group (n=30 ) and the control group (n=30).Besides the routine treatment,edaravone was used in the treatment group for 7 days.The control group received the same treatment except edaravone.NSE were measured in the two groups before the treatment and at 1st,3rd,5th,7th day after the treatment.GCS was evaluated at 21 days.Results Compared the NSE before treatment and after three days,they had significant difference(P＜0.05,also between the two groups and the GCS after 21 days.they had no significant adverse drug reactions during the two groups of patients with medication.Conclusion Edaravone for patients with severe brain injury has a better treatment effect,medication safety,fewer adverse reactions from the mechanism of NSE at acute phase.

Objecfive To study the influence of edaravone therapy on semm levels of neuronspecific enolase (NSE)in the patients of severe brain trauma and assess the therapic effect of edaravone.Method Sixty patients of severe brain trauma were randomly assigned into the treatment group(n=30)and the control group(n=30).Besides the routine treatment in both groups.edaravone Was only used in the treatment group.NSE levels were measured in the two groups before treatment and at 1st,3rd,5th,7th day after treatment.Results NSE levels before treatment in treatment group and control group were(48.73±30.46)μg/L and (40.86±22.05)μg/L,respectively,there Was no statistical significance between two groups.NSE levels after treatment at 3rd,5th,7th day in the two groups were(34.16±15.08),(29.86±12.61),(29.93±14.77)μg/L and (27.42±10.07),(22.33±8.93),(21.17±9.67)μg/L,respectively,there were statistical significances between two groups and in the same group (P＜ 0.05 or ＜ 0.01 ). With the time of therapy extended,NSE levels declined progressively. There were no significant adverse drug reactions during the treatment period. Conclusions The influence of edaravone therapy on serum levels of NSE in the patients of severe brain trauma is significant,edaravone for patients with severe brain trauma has a better curative effect ,medication safety,and fewer adverse drug reactions during acute phase.

Objective To investigate the clinical characteristics and chronological change of ulcerative colitis(UC) in the Chinese PLA General Hospital in near 16 years. Methods Patients diagnosed with UC during the period from 1994 to 2009 in the Chinese PLA General Hospital were registered and their clinical profiles were analyzed. Results From 1994 to 2009, of 525 patients diagnosed with UC, with a median onset age of 42 years. The predominant form of UC was extensive colitis, which affected almost 33.3% (175/525), left-sided colitis was present in 21.3% (112/525) and rectum was present in 12.4%(65/525). The chronic relapsing type of UC was the most common (69.0%, 362/525 ), followed by the initial onset type (18. 1%, 95/525 ), chronic continuous type with intermittent exacerbations (9.7%,51/525), and acute fulminant type (3. 2%, 17/525 ). Two hundred and twenty-one patients (42. 1%,221/525) were graded as mild, 162 (30.9% , 162/525) as moderate, and 142(27.0%, 142/525) as severe UC. The proportion of mild colitis and rectum was significantly higher in patients with an onset age of over 60 years, compared with those with an onset age of less than 30 years( P ＜0. 05 ). The proportion of UC patients with old age onset ( P ＜ 0. 05 ), male sex ( P ＜ 0. 01 ), mild colitis ( P ＜ 0. 01 ), rectum ( P ＜0. 01 ) , relapse-free type ( P ＜ 0. 01 ) demonstrated a chronological increase from 1994 to 2009.Conclusions The distinctive clinical features and chronological change were seen in UC patients in recent years. Compare to those with an onset at less than 30 years, the proportion of mild colitis and rectum was significantly larger in patients with an onset at over 60 years of age, and the proportion of UC patients with old age onset, male sex, mild colitis, rectum, relapse type were less.