Objective To investigate the characteristic and the value of renal solid lesions' boundary at contrast-enhanced ultrasonography(CEUS). Methods The study included 225 patients (124 males, 101 females) with renal 239 solid lesions [133 renal cell carcinoma(RCC) and 106 benign lesions]. The enhanced mode of lesion boundary at CEUS was observed. The histopathologic pseudocapsule of RCCs was analysed.Results Enhanced modes of all lesions' boundary at CEUS were classified as: type Ⅰ , iso-enhanced boundry in whole phase, 82.85 % (198 of 239) ;type Ⅱ , a perilesional annular highly-enhanced signal at early phase,4.18% (10 of 239);type Ⅲ ,perilesional annular highly-enhanced signal in whole phase,9.62% (23 of 239) ;type Ⅳ, perilesional annular highly-enhanced signal in midium and late phase, 1.25 % (3 of 239) ;type Ⅴ ,iso-enhanced boundry in the mdium and late phase with no enhancment at early phase, 2. 09% (5 of 239). The distribution of types Ⅰ , Ⅱ , Ⅲ between groups were significant different( P=0.000, 0.046,0. 000), the type Ⅳ and Ⅴ was not ( P = 0.256,0.068). The distribution of perilesional annular highlyenhanced signal between benign and RCC groups was statistically different (x2=29. 681, P=0.000).Regared it as a diagnostic criteria of RCC,the sensitivity was 26.32% (35/133) ,the specificity was 99.06%(105/106) ,the positive predictive value was 97.22% (35/36),the negative predictive value was 51.72%(105/203) ,and the accuracy was 58.58% (140/239). The perilesional annular highly-enhanced signal was not correlated with the pseudocapsule in pathology ( P = 1. 000). Conclusions The boundary enhancement mode of renal solid lesions at CEUS was divided into five types. The perilesional annular highly-enhanced signal was important in diagnosis of RCC,which was not correlated with the pseudocapsule in pathology.

Objective To study prognostic factors after surgical resection for distal bile duct cancer. Methods A retrospective muhicenter clinical analysis,including Beijing Shijitan Hospital,Peking University People's Hospital and Peking University First Hospital,was made for 103 patients of distal bile duct cancer receiving surgical resection from 1995 to 2009.Potential clinicopathological prognostic factors were examined bv univariate and multivariate survival analysis. Results The 1.3 and 5 years overall survival rate was 72%,41%and 25% respectively (median survival time,24.13 months).Univariate analysis revealed operative modality,lymph node status,surgical margin and TNM stage as significant factors influencing postoperative survival.Positive surgical margin,lymph node metastasis and TNM stage were significant independent predictors of poor prognosis by a Cox proportional hazards regression model. Condusions Surgical margin margin,lymph node metastasis and TNM stage were the most important prognostic factors for bile duct carcinoma after resection.Radical pancreaticoduodenectomy was the choice of therapy for distal bile duct carcinoma.

OBJECTIVE: To investigate the surgical treatment for cervical dumbbell tumors. METHODS: Clinical manifestation, surgical type and stage, and surgical method of 36 consecutive patients with cervical dumbbell tumor were retrospectively studied. RESULTS: The tumors in 35 patients were completely resected once, and the other one patient underwent subtotal resection. Signs and symptoms of all patients were recovered to different degrees, without significant complications and tumor recurrence. CONCLUSION According to the type and stage of dumbbell tumors, we could adopt surgical methods through posterior or posterior combined with anterior approach, together with instruments and fusion, which could completely resect tumors and prevent complications.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cervical Vertebrae ; pathology ; surgery ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemmoma ; surgery ; Neurofibroma ; surgery ; Neurosurgical Procedures ; methods ; Retrospective Studies ; Spinal Canal ; pathology ; surgery ; Spinal Neoplasms ; classification ; surgery ; Young Adult

Objective To evaluate the efficacy and safety of lenalidomide in a real-world clinical practice in Chinese patients with multiple myeloma (MM).Methods It was a prospective,multi-center,observational study.A total of 165 consecutive patients with MM treated with lenalidomide-based regimens were enrolled in 12 hospitals from June 2013 to November 2015.Relevant information was recorded,such as baseline clinical data,cytogenetic abnormalities,treatment regimens,and duration of treatment,safety,and survival.Results (1)There were 126 relapsed and refractory MM (RRMM) patients,25 newly diagnosed patients and 19 maintenance patients.The evaluable RRMM patients accounted for 120 cases,among which 74 cases(61.7％) reached the partial response (PR) or above,and a very good partial response (VGPR) in 16 patients (13.3％),a complete response (CR) in 14 cases (11.7％),a strictly complete response (sCR) in 4 cases (3.3％).Thus,a VGPR or above in 34 patients accounted for 28.3％.(2)The median follow-up was 13 months,the median time to progression 12 months.The median survival after receiving lenalidomide was 19 months,and the median overall survival (OS) was 62 months.(3) The univariate analysis in 120 RRMM patients suggested that prognostic factors for significant improvement in PFS included normal karyotype,international staging system (ISS) Ⅰ-Ⅱ,t(4;14) negative (detected by fluorescence in situ hybridization),non-bortezomib resistance and response to previous regimens.As to OS,nonbortezomib resistance,response to previous regimens and non-primary refractoriness were positive factors.Multivariate analysis showed that the response to previous regimens (PR or better) was an independent good prognostic factor for progress-free survival (PFS),non-bortezomib resistance and non-primary refractoriness for OS.(4) Grade 3 or 4 adverse events that occurred in more than 10％ of all enrolled patients were neutropenia (12.7％),leukocytosis (11.5％) and thrombocytopenia (12.7％).Owing to intolerance of toxic side effects,7 cases withdrew lenalidomide.Conclusions No matter what combination,regimens containing lenalidomide are effective to RRMM patients with overall response rate 61.7％,a time to progression 12 months and an overall survival 62 months.The toxicity is quite tolerable and manageable.In addition,the response to previous treatment (reached PR or above) is the independent good prognostic factor for PFS,non-bortezomib resistance and non-primary refractoriness for OS.Clinical trail registration Clinicaltrials.gov,NCT01947309