PurposeRecurrence limits the survival of postoperative hepatocellular carcinoma (HCC) patients. The purpose of this study is to investigate the value of ultrasound (US), CT and MRI follow-up in alpha fetoprotein (AFP) negative HCC patients.Materials and MethodsThe follow-up data of 31 pathology-confirmed, AFP negative HCC patients were analyzed retrospectively. All patients underwent US, CT and MRI. Features including tumor size, morphology, echogenicity and enhancement pattern were analyzed. The recurrent lesion detection rates of all three diagnostic modalities were compared.ResultsThere were 55 recurrent lesions. On CT and MRI, these lesions were round or ovoid in shape with long axis of 0.7-3.4 (1.7±1.1) cm. There were 16 solitary lesions and multifocal lesions in 15 cases. US showed widely distributed blood vessels within the lesions and heterogeneous flow rate. CT and MRI demonstrated significant enhancement in the arterial phase with wash out in portal phase and delayed phase. The detection rate were 60.0% (33/55), 83.6% (46/55), 89.1% (49/55) for US, CT and MRI, respectively (χ2=15.120,P<0.01). Detection rate of MRI (80.0%, 16/20) was signiifcantly higher than that of CT (65.0%, 13/20) and US (40.0%, 8/20) for lesions with long axis diameter of 0.7-1.0 cm (χ2=6.910,P<0.05). For lesions between 1.0-2.0 cm, MRI, CT and US detection rate were 91.7% (22/24), 91.7% (22/24) and 66.7% (16/24), respectively (χ2=6.792,P<0.05). ConclusionImaging follow up can detect AFP negative HCC recurrence. MRI has unique advantage in lesions <2 cm.

Objective To evaluate the role of spiral CT and its reconstruction techniques in orientation and determination of the nature of small bowel neoplasms.Methods CT manifestations,multiple planar reformation(MPR) and slip thin slice maximum intensity projection(STS-MIP) of 54 cases small bowel noplasms confirmed pathologically were analysed.Results 54 cases of small bowel neoplasm mainly included:adenocarcinoma in 15 cases,stromal tumor in 24 cases,lipoma in 4 cases,lymphoma in 4 cases and adenoma in one case.The accurate rate of orientation and determination of the nature of small bowel neoplasm by CT were all 96.3%(52/54).MPR and STS-MIP can demonstrated the blood supply arteries and drainage veins of tumors.Conclusion Spiral CT and its MPR,STS-MIP have an important clinical value in orientation and determination of the nature of intestinal obstruction by neoplasm.

PurposeSmall breast mass (diameter≤1 cm) is prone to misdiagnosis in clinic. This paper aims to evaluate a combined application of breast imaging reporting and data system (BI-RADS) and ultrasound elastography (UE) on small breast mass (diameter≤1 cm).Materials and MethodsA retrospective analysis was carried out on 231 patients with a total of 258 small masses (the maximal diameter ≤1 cm). Ultrasound BI-RADS was used for classiifcation while UE was used to adjust the results. The results were further compared with those of postoperative pathology. The curve of ROC was employed to evaluate the combined use on small breast mass.ResultsAmong the 258 small masses, 178 (69.0%) were benign masses and the rest 80 (31.0%) were malignant. The small masses which were evaluated as BI-RADS grade 3, 4 and 5 before the operation had positive prediction value for malignant masses of 10.3% (17/165), 60.5% (46/76) and 100.0% (17/17), respectively. After adjustment with UE, the values changed to 5.3%(9/169), 75.0% (54/72) and 100.0% (17/17), respectively. After adjustment with the combination method, the area under ROC curve in BI-RADS classification was 0.904, which was signiifcantly higher than that (0.827) before the adjustment (Z=2.83,P<0.05). ConclusionFor small breast mass (diameter≤1 cm), mass of BI-RADS grade 3 has higher positive prediction value. But after adjustment with UE, the positive prediction value of mass of BI-RADS grade 3 tends to be lower, whilst that of mass of BI-RADS grade 4 increases, thus promoting the efficiency of ultrasound BI-RADS classification for small breast mass and contributing to the identiifcation of benign and malignant small breast masses.

AIM To determine the antagonistic activities of new endothelin receptor antagonist CPU0214 on the left ventricle membranes and the aorta ring contraction in normal rat and its reduction effect on the mean arterial pressure in conscious DOCA salt hypertensive rats. METHODS Left ventricle membranes of normal rat hearts achieved for competition binding assay was used to investigate the antagonistic effects of CPU0214. Aorta ring contraction induced by ET 1 in normal rat was used to investigate the antagonistic activity of CPU0214. DOCA salt hypertensive rats were induced by injection of deoxycorticosterone acetate (DOCA, sc) following with 1% NaCl as drinking for 4 wk. A multiple physiological recorder was used to record the mean arterial pressure of femoral artery. The endothelin receptor change in the left ventricle membranes of DOCA salt hypertensive rat was measured by binding assays. Intraperitoneal injection of CPU0214 was used to investigate its effect on reduction of mean arterial pressure. RESULTS In the left ventricle the IC 50 of endothelin receptor antagonist CPU0214 is 16 nmol?L -1 and CPU0214 (10 ?mol?L -1 ) inhibited the ET 1 induced isolated aorta rings contraction in normal rats. Mean arterial pressure as well as B max and K d of left ventricle were increased significantly in DOCA salt hypertensive rat. CPU0214 (60 mg?kg -1 ip) significantly reduced the mean arterial pressure of conscious DOCA salt hypertensive rats especially during 60～90 min after administration. CONCLUSIONS CPU0214 has significantly antagonistic effects on the left ventricle membrane and the isolated aorta ring contraction in normal rat, which is verified by CPU0214 as a strong endothelin receptor antagonist. Furthermore its effect on the mean blood pressure reduction in conscious DOCA salt hypertensive rats, which is manifested as an abnormal endothelin system, shows its prosperity of drug development value as a new endothelin receptor antagonist.

Objective To assess the clinical value of transcatheter arterial chemoembolization (TACE) together with radiofrequency ablation (RFA) and sorafenib in treating recurrent hepatocellular carcinoma (HCC) after surgery.Methods A total of 40 patients with recurrent HCC after surgery, who were encountered at authors' hospital during the period from December 2009 to May 2014, were collected. The patients were divided into the study group (n=20) receiving TACE combined with RFA and sorafenib and the control group (n=20) receiving TACE plus RFA. Within 7-10 days after TACE, RFA was carried out. In the study group, oral sorafenib therapy (400 mg, two times everyday) started at 4 days after TACE. Withdrawal of sorafenib would be ordered if drug resistance occurred. Each patient underwent TACE combined with RFA not less than two times. Results The median survival time of the study group and the control group was 31.0 months and 24.8 months respectively, and statistically significant difference existed between the two groups (P<0.05). The one-year, 2-year and 3-year survival rates of the study group were 85%, 70% and 50%respectively, while the one-year, 2-year and 3-year survival rates of the control group were 80%, 55% and 30% respectively; the differences between the two groups were not statistically significant (P>0.05). The progression free survival (PFS) time of the study group and the control group was 6.8 months and 5.7 months respectively, the difference between the two groups was statistically significant (P<0.05). Conclusion TACE combined with RFA and sorafenib can prolong the overall survival time and the progression free survival time of patients with recurrent HCC after surgery.

Objective To investigate the method of endovascular puncture to establish rabbit models of cerebral vasospasm. Methods New Zealand white rabbits were divided into 5 groups (12 h,1 d,2 d,3 d and 7 d) randomly, and each group was separated into subarachinoid hemorrhage (SAH) subgroup (n = 5) and control subgroup (n = 2). cerebral vascular spasm (CVS) models were established atfer SAH with endovascular puncture. CT scans before and after operation were performed. The internal diameters and the wall thicknesses of posterior communicans artery (PcoA) and basilar artery (BA) were measured with HE stain after the animals were executed. Results CVS model was successfully eastblished in 35 rabbits (SAH subgroup 25,control subgroup 10), resulting a successful rate of 48.61% . Compared with control subgroup, PcoA and BA showed shrinkage of internal diameters of 43.60% and 51.82% 12 h after SAH, respectively, and the shrinkage appeared as biphasic patterns until the 7th study day with another peaks of 29.32% and 45.19%, respectively. Conclusions Endovascular puncture is an effective method to establish rabbit of CVS. The death rate of animals can be decreased with the asage of new interventional material and perfection for the details of operation.

Objective To evaluate argon-helium cryoablation combined with transcatheter arterial chemoembolization (TACE) in treating advanced hepatocellular carcinoma (HCC). Methods The clinical data of 66 patients with pathologically-proved HCC were retrospectively analyzed. Based on the therapeutic scheme the patients were divided into TACE group (n=31) and combination group (TACE+argon-helium cryoablation, n=35). All the patients were followed up for 5-35 months. The complete remission rate, total effective rate and survival time were evaluated. The short-term and the long-term effectiveness were compared between the two groups. Results Both the complete remission rate and total effective rate of the combination group were significantly higher than those of TACE group (P<0.05). The median survival time of the combination group was significantly longer than that of TACE group (P=0.038). The half-year, one-year and 2-year overall survival rates of the combination group were higher than those of TACE group, although the differences were not statistically significant (P>0.05). Conclusion For the treatment of advanced hepatocellular carcinoma, argon-helium cryoablation combined with TACE can improve the short-term effect and prolong the progression-free survival time, although its exact effectiveness still needs to be confirmed by large sample, multi-central and randomized controlled studies.

Thyroid nodules are common clinical disease, and most of the nodules are benign. After radiofrequency ablation (RFA) treatment, the volume of benign thyroid nodules will significantly shrink or the nodules will even disappear, thus, the related clinical symptoms induced by the thyroid nodules will be improved. For recent years, radiofrequency ablation has become the treatment of first choice for benign thyroid nodules. This paper aims to make a comprehensive review about the research situation concerning the radiofrequency ablation in the treatment of the benign thyroid nodules so as to provide scientific guidance and basis for the relevant clinical research and treatment.

OBJECTIVE: To study the expression of DNA-dependent protein kinase (DNA-PK) in human laryngeal squamous cell carcinoma (LSCC) and normal laryngeal mucosa (NLM), and to analysize the relationship between the expression and the clinicopathologic parameters of LSCC. METHOD: Immunohistochemical technique (Envision) was used to detect the expression of DNA-PK in 64 cases of LSCC and 15 cases of NLM. To investigate an investigation was conducted on the relationship between the expression and clinico-pathological features of LSCC. RESULT: DNA-PK was lowly expressed in NLM and highly expressed in LSCC,the positive rate of DNA-PK expression was 26.67% (4/15), 78.13% (50/64), respectively, and there was significant different difference between the two groups (P < 0.05). Its expression was correlated with the level of histodifferentiation (P < 0.05), but not with TNM stages and neck lymph node metastasis (P > 0.05). CONCLUSION DNA-PK may be involved in disease development of LSCC.
Aged ; Carcinoma, Squamous Cell ; enzymology ; pathology ; DNA-Activated Protein Kinase ; metabolism ; Female ; Head and Neck Neoplasms ; enzymology ; pathology ; Humans ; Laryngeal Mucosa ; enzymology ; Laryngeal Neoplasms ; enzymology ; pathology ; Larynx ; enzymology ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Squamous Cell Carcinoma of Head and Neck

Objective To investigate the eftect of radiation dose of dual-source computed tomography (CT) dual energy single-phase enhanced scan in patients with esophageal cancer.Methods The prospective study was conducted.The clinicopathological data of 56 patients with esophageal cancer who were admitted to the Lishui Hospital of Zhejiang University between January 2015 and December 2016 were collected.All the patients were divided into the experimental group (undergoing dual-source CT dual energy single-phase enhanced scan) and control group (undergoing dual-phase CT enhanced scan) bv randomised block method.TNM classification of esophageal cancer (Seventh Edition) published by American Joint Committee on Cancer (AJCC) was used as a standard TNM staging.Two observers independently read films.All the patients underwent radical resection of esophageal cancer or palliative surgery,and then received adjuvant radiochemotherapy.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients up to March 2017.Observation indicators:(1) consistencies of T staging,N staging and M staging;(2) accuracies of T staging,N staging and M staging (pathological results as a gold standard);(3) radiation dose of CT scan;(4) treatment and follow-up situations.The Kappa test was used for evaluating the consistency,κ≥0.75 as a good consistency,0.40≤κ＜0.75 as a normal consistency and κ＜0.40 as a poor consistency.Comparisons of count data and ratio were done by the chi-square test.Comparisons of measurement data were analyzed by the t test.Results A total of 50 patients were enrolled in the study,including 25 in the experimental group and 25 in the control group.(1) Consistencies of T staging,N staging and M staging:all the 50 patients finished successfully CT scans.Two observers considered that consistencies of T staging,N staging and M staging in the 2 groups were normal (κ =0.452,0.618,0.729,P＜0.05).Consistencies of N staging and M staging were superior to T staging.(2) The pathological results were used as a gold standard.Accuracies of T staging,N staging and M staging in the experimental and control groups were 72％,76％ and 88％,84％ and 92％,88％,respectively,with no statistically significant difference between the 2 groups (x2 =0.10,0.37,0.50,P＞0.05).(3) Radiation dose of CT scan:volume CT dose index (CTDIvol),dose length production (DLP) and effective radiation dose (E) were (10.35±2.01) mGy,(400.63± 34.13) mGy · cm,(5.61 ± 0.47) mSv in the experimental group and (3.55 ± 0.60)mGy,(140.66± 10.89) mGy · cm,(1.98±0.17) mSv in the control group,respectively.There were statistically significant differences in CTDIvol and E between the 2 groups (t =16.23,36.30,P＜0.05).(4) Treatment and follow-up situations:of 50 patients,43 patients received treatments,including 32 undergoing radical resection (11 receiving postoperative adjuvant chemotherapy),6 undergoing palliative surgery,3 receiving single radiotherapy and 2 receiving single chemotherapy.Thirty-six of 43 patients were followed up for 3-18 months,with a median time of 6 months.During follow-up,1-year survival rate was 61.1％.Conclusion Dual-source CT dual energy single-phase enhanced scan in patients with esophageal cancer cannot reduce accuracy of TNM staging,but decreased effectively radiation dose.